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Abstract Details

Are Post-lumbar Puncture Headaches More Common in Patients with Idiopathic Intracranial Hypertension: A Small Tertiary Health Care Retrospective Review
P9 - Poster Session 9 (8:00 AM-9:00 AM)

PLPH are a common complication of diagnostic lumbar puncture, usually believed to stem from cerebrospinal fluid(CSF) leakage causing intracranial hypotension. 

Given the frequency of post lumbar puncture headaches(PLPH) observed in our neuro-ophthalmology clinic, we studied the incidence of PLPH in all the patients that underwent lumbar punctures between 2019-2022 in our tertiary health care center. We hypothesized that higher opening pressure(OP) was associated with higher chances of developing PLPH.

A retrospective review of adult patients who underwent lumbar punctures between 2019-2022 was conducted. Data included patient history and demographics, procedure details, incidence of PLPH, opening and closing pressures, and diagnoses. Interventions like blood patches were recorded. Statistical analysis used t tests and chi-square tests.

We recorded a total of 256 lumbar punctures in 220 patients: 31% males, 70% females; predominantly White (66.4%). Average age was 51.73 years (range: 20-93). The percentage of idiopathic intracranial hypertension (IIH) cases was 27.3%(70/256), with 45.7%(32/70) having PLPH.

PLPH incidence was 29% and significantly associated with higher OP (p<0.001), but not closing pressure (p=0.580) or volume removed (p=0.630). The incidence of PLPH in patients with IIH versus those without IIH (p<0.001) was significantly different. A history of headaches was significantly more prevalent in the PLPH group [53% vs. 15%(p<0.001)]. PLPH were not significantly associated with pressure difference (p=0.19) or needle gauge (p=0.490).

This retrospective study highlights OP as a key factor in the occurrence of PLPH, indicating it as a crucial factor, while closing pressure, CSF volume, and needle gauge were not deemed significant. Elevated OP is characteristically more prevalent in IIH, providing a probable explanation for the observed increased incidence of PLPH in IIH patients relative to other diagnoses. There is likely a notable correlation between IIH and PLPH, which advocates for more extensive research on PLPH within IIH patients to enhance patient care.

Ricky Paramo
Mr. Paramo has nothing to disclose.
No disclosure on file
Lakshmi Leishangthem, MD, MBBS (UConn Health) Dr. Leishangthem has nothing to disclose.