Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA.
Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA.
Curr Pain Headache Rep. 2024 Aug;28(8):803-813. doi: 10.1007/s11916-024-01262-2. Epub 2024 May 22.
This paper reviews the complications of lumbar puncture with a focus on post-dural puncture headache including pathophysiology, risk factors, prevention, and treatment.
Recent research has focused on understanding the multifactorial mechanisms of post-dural puncture headache and improving prevention and treatment strategies. Small caliber, pencil-point type needles are encouraged to minimize the risk of post-dural puncture headaches, especially in populations that are at higher risk for complication. While new medications and procedures show promise in small cohorts, conservative medical management and epidural blood patch are still the first and second-line treatments for PDPH. Post-dural puncture headache is the most frequent complication of lumbar puncture. There are both modifiable and nonmodifiable risk factors to consider when performing this procedure. Conservative medical management and procedure-based therapies exist for when complications of lumbar puncture arise.
本文综述了腰椎穿刺的并发症,重点是硬脊膜后头痛,包括其病理生理学、危险因素、预防和治疗。
最近的研究集中在理解硬脊膜后头痛的多因素机制,并改进预防和治疗策略。鼓励使用小口径、笔尖式针头,以最大限度地降低硬脊膜后头痛的风险,尤其是在易发生并发症的人群中。虽然新的药物和程序在小队列中显示出前景,但保守的药物治疗和硬膜外血贴仍然是 PDPH 的一线和二线治疗方法。硬脊膜后头痛是腰椎穿刺最常见的并发症。在进行该操作时,需要考虑到可改变和不可改变的危险因素。当腰椎穿刺出现并发症时,存在保守的药物治疗和基于操作的治疗方法。