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Postdural puncture headache in paediatric oncology patients

  • Napoleon Burt
  • B. Hugh Dorman
  • Scott T. Reeves
  • Philip F. Rust
  • Mark L. Pinosky
  • Miguel R. Abboud
  • Julio C. Barredo
  • Joseph H. Laver
Reports of Investigation

Abstract

Purpose

Previous studies have not determined the correlation between durai puncture and postural headache in paediatric patients. Furthermore, no studies have evaluated the correlation between atypical headache and durai puncture in the paediatric population. Therefore, we prospectively analyzed the incidence of typical postdural puncture headache (PDPHA) and atypical headache in paediatric oncology patients following durai puncture.

Methods

The study population consisted of 66 paediatric patients undergoing 128 consecutive procedures, including 99 lumbar punctures and 29 bone marrow aspirations without concomitant lumbar puncture. Patients were prospectively randomized into four groups: Group I, preteens (< 13 yr) undergoing lumbar puncture, Group II, adolescents (13–21 yr) undergoing lumbar puncture, Group III, preteens undergoing bone marrow aspiration, and Group IV adolescents undergoing bone marrow aspiration. The presence and description of headache was documented immediately after durai puncture or bone marrow aspiration, and on post-procedure days #1,3 and 5 by personnel blinded to the type of procedure.

Results

There was an increase in the incidence of headache (9.1%) after lumbar puncture in patients < 21 yr relative to patients undergoing bone marrow aspiration (P < 0.05). No difference was found between the incidence of typical PDPHA after dural puncture in preteens and adolescents. There was also no difference in the incidence of atypical headache after durai puncture or after bone marrow aspiration among preteens and adolescents.

Conclusions

Paediatric patients experience an increased incidence of typical postdural puncture headache after durai puncture compared with age-matched patients undergoing bone marrow aspiration only. Atypical headache is relatively common in the paediatric population after dural puncture or bone marrow aspiration.

Keywords

Lumbar Puncture Bone Marrow Aspiration Spinal Needle CPPD Dural Puncture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Les études antérieures n’ont pas établi de corrélation entre la ponction durale et la céphalée posturale chez les patients pédiatriques. En outre, aucune étude de cette population n’a évalué le lien entre la céphalée atypique et la ponction durale. Par conséquent, à la suite d’une ponction durale, nous avons analysé de façon prospective l’incidence d’une céphalée de ponction postdurale (CPPD) typique et atypique chez des patients d’oncologie pédiatrique.

Méthode

La population de l’étude était constituée de 66 patients de pédiatrie subissant 128 examens consécutifs, comprenant 99 ponctions lombaires et 29 ponctions médullaires sans ponction lombaire concomitante. Les patients ont été répartis au hasard en quatre groupes de façon prospective: Groupe I de pré-adolescents (< 13 ans) subissant une ponction lombaire; Groupe II d’adolescents (13–21 ans) subissant une ponction lombaire; Groupe III de pré-adolescents inscrits pour une ponction médullaire et Groupe IV d’adolescents pour une ponction médullaire. La présence de céphalée a été vérifiée et décrite immédiatement après la ponction durale ou la ponction médullaire et 1, 3 et 5 jours suivant les interventions par du personnel qui ignorait le type de technique employé.

Résultats

Il y a eu une incidence accrue de céphalée (9,1 %) à la suite de la ponction lombaire chez les patients < 21 ans par rapport aux patients qui ont subi une ponction médullaire (P < 0,05). Aucune différence n’est apparue dans l’incidence de CPPD typique après une ponction lombaire chez les pré-adolescents et chez les adolescents. Il n’y avait pas non plus de différence dans l’incidence de céphalée atypique après une ponction durale ou une ponction médullaire parmi les pré-adolescents et les adolescents.

Conclusion

Les patients de pédiatrie ont connu une incidence accrue de céphalée de ponction postdurale à la suite d’une ponction durale quand on les compare aux patients du même âge qui ont subi une ponction médullaire seulement. La céphalée atypique est relativement fréquente dans la population pédiatrique après une ponction durale ou une ponction médullaire.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Napoleon Burt
    • 1
  • B. Hugh Dorman
    • 1
  • Scott T. Reeves
    • 1
  • Philip F. Rust
    • 2
  • Mark L. Pinosky
    • 1
  • Miguel R. Abboud
    • 3
  • Julio C. Barredo
    • 3
  • Joseph H. Laver
    • 3
  1. 1.Department of AnesthesiologyMedical University of South CarolinaCharlestonUSA
  2. 2.Department of Biostatistics and EpidemiologyMedical University of South CarolinaCharlestonUSA
  3. 3.Department of PediatricsMedical University of South CarolinaCharlestonUSA

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