Editorials

Lumbar puncture needn't be a headache

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7119.1324 (Published 22 November 1997) Cite this as: BMJ 1997;315:1324

Use blunt needles and no bed rest

  1. Simon A Broadley, Registrara,
  2. Geraint N Fuller, Consultant neurologista
  1. a Department of Neurology, Gloucester Royal Hospital, Gloucester GL1 3NN

    Lumbar puncture is an investigation that patients often fear. Headache afterwards is the commonest complication, occurring in over 30% of patients when a 20 G bevelled needle is used.1 The headache is typically occipital and related to posture. It can be severe in up to a third of patients, rendering the individual immobile. Characteristically, the headache starts 24–48 hours after lumbar puncture and usually lasts one to two days but may be more prolonged. The headache is related to low cerebrospinal fluid pressure resulting from spinal fluid leaking through the hole cut in the dura by bevelled spinal needles.2 3 Traditionally, manoeuvres such as bed rest and posture have been used to prevent headache. Despite the popularity of bed rest, …

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