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March 8, 1952, Vol 148, No. 10 >
ARTICLE | March 8, 1952

LUMBAR PUNCTURE HEADACHE FREE

Daniel Sciarra, M.D.; Sidney Carter, M.D.
JAMA. 1952;148(10):841-842. doi:10.1001/jama.1952.02930100059013
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References

The occurrence of undesirable reactions following lumbar puncture is not uncommon. The incidence has been variously reported as ranging between 5 and 75%.1 A prominent feature of the postlumbar puncture reaction, and often its only manifestation, is headache. This symptom usually appears 12 to 24 hours after the puncture, though it may occur in a few hours or may be delayed for several days. Characteristically, the headache is relieved when the patient lies down and becomes accentuated when the patient either sits or stands. In most cases the headache persists for several days, but occasionally it may last for as long as eight weeks.

Various explanations have been given for the appearance of the headache, and various factors have been noted that will modify or prevent it. Some observers have felt that postlumbar puncture headache is psychogenic2 and that its incidence is greater in persons known to be neurotic.3 Other investigators, dealing primarily with psychiatric patients, have stated that the incidence of

REFERENCES

1 +
Redlich, F. C.; Moore, B. E., and Kimbell, I., Jr.:  Lumbar Puncture Reactions: Relative Importance of Physiological and Psychological Factors , Psychosom. Med. 8:386-398, 1946;.
2 +
Levin, M. J.: Lumbar Puncture Headaches , Bulletin United States Army Medical Department, No. 82, pp. 107-110, 1944;.
3 +
McCarty, A. C., and Raney, B. B.:  Preventing Post Lumbar Puncture Headache , Kentucky M. J. 43: 165-166, 1945;.
4 +
Adler, H.:  Study of Headaches Following Diagnostic Spinal Taps , New York J. Med. 43: 1328-1330, 1943;.
5 +
Dattner, B.: Moderne Therapie der Neurosyphilis: Mit Einschluss der Punktionstechnick und Liquor-Untersuchung , Vienna, Wilhelm Maudrich, 1938;.
6 +
Emory, M. L.:  Certain Reactions Following Spinal Puncture: Comparison of Technics , Am. Pract. 2:451-456, 1948;.
7 +
Blau, A.:  Reactions Following Spinal Puncture , Urol. & Cutan. Rev. 45: 239-242, 1941;.
8 +
Underwood, L. J.:  Lumbar Puncture Headache: Statistical Analysis of 500 Punctures , Am. J. Syph., Gonor. & Ven. Dis. 30: 264-271, 1946;.
9 +
Reid, W. L.:  Lumbar, Ventricular and Cisternal Puncture: Their Indications and Their Dangers , M. J. Australia 1: 311-317, 1943;.
10 +
Cook, M. J.:  Should Patients Be Ambulatory After Lumbar Puncture? Observations on Frequency, Cause and Prevention of Postlumbar Puncture Reactions , J. Michigan M. Soc. 46: 930-933, 1947;.
11 +
MacRobert, R. G.:  The Cause of Lumbar Puncture Headache , J. A. M. A. 70:1350-1353 ( (May 11) ) 1918;.
12 +
Mixter, W. J., in discussion on Fremont-Smith, F.: Merritt, H., and Lennox, W. G.:  Relationship Between Water Balance, Spinal Fluid Pressure and Epileptic Convulsions , Arch. Neurol. & Psychiat. 28:959 ( (Oct.) ) 1932;.
13 +
Nelson, M. O.:  Postpuncture Headaches: Clinical and Experimental Study of Cause and Prevention , Arch. Dermat. & Syph. 21:615-627 ( (April) ) 1930;.
14 +
Merritt, H. H., and Fremont-Smith, F.: Cerebrospinal Fluid , Phliadelphia, W. B. Saunders Company, 1938;.
15 +
Marshall, J.:  Lumbar-Puncture Headache , J. Neurol., Neurosurg. & Psychiat. 13: 71-74, 1950;.
16 +
Pickering, G. W.:  Lumbar Puncture Headache , Brain 71:274-280, 1948;.
17 +
Alpers, B. J.:  Lumbar Puncture Headache , Arch. Neurol. & Psychiat. 14:806-812 ( (Dec.) ) 1925;.
18 +
Jacobæus, H. C., and Frumerie, K.:  About Leakage of Spinal Fluid After Lumbar Puncture and Its Treatment , Acta med. scandinav. 58:102-108, 1923;.
19 +
Gardner, W. J.:  Mechanism of Postpuncture Headache , Cleveland Clin. Quart. 10: 85-87, 1943;.
20 +
Footnote 11b, d, and f.
21 +
Footnotes la, 4, 5, 11d, and 11f.

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1 +
Redlich, F. C.; Moore, B. E., and Kimbell, I., Jr.:  Lumbar Puncture Reactions: Relative Importance of Physiological and Psychological Factors , Psychosom. Med. 8:386-398, 1946;.
2 +
Levin, M. J.: Lumbar Puncture Headaches , Bulletin United States Army Medical Department, No. 82, pp. 107-110, 1944;.
3 +
McCarty, A. C., and Raney, B. B.:  Preventing Post Lumbar Puncture Headache , Kentucky M. J. 43: 165-166, 1945;.
4 +
Adler, H.:  Study of Headaches Following Diagnostic Spinal Taps , New York J. Med. 43: 1328-1330, 1943;.
5 +
Dattner, B.: Moderne Therapie der Neurosyphilis: Mit Einschluss der Punktionstechnick und Liquor-Untersuchung , Vienna, Wilhelm Maudrich, 1938;.
6 +
Emory, M. L.:  Certain Reactions Following Spinal Puncture: Comparison of Technics , Am. Pract. 2:451-456, 1948;.
7 +
Blau, A.:  Reactions Following Spinal Puncture , Urol. & Cutan. Rev. 45: 239-242, 1941;.
8 +
Underwood, L. J.:  Lumbar Puncture Headache: Statistical Analysis of 500 Punctures , Am. J. Syph., Gonor. & Ven. Dis. 30: 264-271, 1946;.
9 +
Reid, W. L.:  Lumbar, Ventricular and Cisternal Puncture: Their Indications and Their Dangers , M. J. Australia 1: 311-317, 1943;.
10 +
Cook, M. J.:  Should Patients Be Ambulatory After Lumbar Puncture? Observations on Frequency, Cause and Prevention of Postlumbar Puncture Reactions , J. Michigan M. Soc. 46: 930-933, 1947;.
11 +
MacRobert, R. G.:  The Cause of Lumbar Puncture Headache , J. A. M. A. 70:1350-1353 ( (May 11) ) 1918;.
12 +
Mixter, W. J., in discussion on Fremont-Smith, F.: Merritt, H., and Lennox, W. G.:  Relationship Between Water Balance, Spinal Fluid Pressure and Epileptic Convulsions , Arch. Neurol. & Psychiat. 28:959 ( (Oct.) ) 1932;.
13 +
Nelson, M. O.:  Postpuncture Headaches: Clinical and Experimental Study of Cause and Prevention , Arch. Dermat. & Syph. 21:615-627 ( (April) ) 1930;.
14 +
Merritt, H. H., and Fremont-Smith, F.: Cerebrospinal Fluid , Phliadelphia, W. B. Saunders Company, 1938;.
15 +
Marshall, J.:  Lumbar-Puncture Headache , J. Neurol., Neurosurg. & Psychiat. 13: 71-74, 1950;.
16 +
Pickering, G. W.:  Lumbar Puncture Headache , Brain 71:274-280, 1948;.
17 +
Alpers, B. J.:  Lumbar Puncture Headache , Arch. Neurol. & Psychiat. 14:806-812 ( (Dec.) ) 1925;.
18 +
Jacobæus, H. C., and Frumerie, K.:  About Leakage of Spinal Fluid After Lumbar Puncture and Its Treatment , Acta med. scandinav. 58:102-108, 1923;.
19 +
Gardner, W. J.:  Mechanism of Postpuncture Headache , Cleveland Clin. Quart. 10: 85-87, 1943;.
20 +
Footnote 11b, d, and f.
21 +
Footnotes la, 4, 5, 11d, and 11f.

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