Université de Paris, UMRS 1144, INSERM, Paris, France; Centre de Neurologie Cognitive, Assistance Publique Hôpitaux de Paris, APHP.Nord, Site Lariboisière Fernand-Widal, Paris France.
Sickle Cell Disease Center, Assistance Publique Hôpitaux de Paris, APHP.Nord, Site Robert Debré, Paris, France.
Ann Emerg Med. 2021 Sep;78(3):443-450. doi: 10.1016/j.annemergmed.2021.02.019. Epub 2021 May 7.
Post-lumbar puncture headache is the main adverse event from lumbar puncture and occurs in 3.5% to 33% of patients, causing functional and socio-professional disability. We searched the post-lumbar puncture headache literature and, based on this review and personal expertise, identified and addressed 19 frequently asked questions regarding post-lumbar puncture headache risk factors and prevention. Among the nonmodifiable factors, older age is associated with a lower incidence of post-lumbar puncture headache, while female sex, lower body mass index, and history of headache might be associated with increased risk. The use of atraumatic, noncutting needles is the most effective intervention for post-lumbar puncture headache prevention. These needles are not more difficult to use than cutting needles. Other commonly recommended measures (eg, fluid supplementation, caffeine) appear unhelpful, and some (eg, bed rest) may worsen post-lumbar puncture headache.
腰椎穿刺后头痛是腰椎穿刺的主要不良反应，发生率为 3.5%至 33%，可导致功能和社会职业障碍。我们检索了腰椎穿刺后头痛的文献，并在此基础上进行了综述，结合个人专业知识，确定并解答了 19 个关于腰椎穿刺后头痛风险因素和预防的常见问题。不可变因素中，年龄较大与腰椎穿刺后头痛发生率较低相关，而女性、较低的体重指数和头痛史可能与风险增加相关。使用无创伤、非切割的针是预防腰椎穿刺后头痛最有效的干预措施。这些针并不比切割针更难使用。其他常用的推荐措施（如补液、咖啡因）似乎没有帮助，而一些措施（如卧床休息）可能会使腰椎穿刺后头痛恶化。
