Factors associated with the onset and persistence of post-lumbar puncture headache

Andrés E. Monserrate, Davis C. Ryman, Shengmei Ma, Chengjie Xiong, James M. Noble, John M. Ringman, John C. Morris, Adrian Danek, Felix Müller-Sarnowski, David B. Clifford, Eric M. McDade, William S. Brooks, David G. Darby, Colin L. Masters, Philip S J Weston, Martin Farlow, Neill R. Graff-Radford, Stephen P. Salloway, Anne M. Fagan, Angela OliverRandall J. Bateman, Inherited Alzheimer Network Dominantly Inherited Alzheimer Network

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

IMPORTANCE: This study assesses factors associated with the most common adverse event following lumbar puncture. OBJECTIVE: To identify factors associated with the risk, onset, and persistence of post-dural puncture headache (PDPH). DESIGN, SETTING, AND PARTICIPANTS: We performed univariate and multivariable analyses of 338 lumbar punctures in the Dominantly Inherited Alzheimer Network observational study using linear mixed models, adjusting for participant-level and family-level random effects. MAIN OUTCOMES AND MEASURES: We directly evaluated associations of 3 post-lumbar puncture outcomes (immediate postprocedural headache, PDPH at 24-hour follow-up, and PDPH receiving a therapeutic blood patch) with participant age and sex, positioning, collection method, needle size, needle insertion site, and cerebrospinal fluid (CSF) volume collected. RESULTS: The incidence of adverse events included 73 immediate postprocedural headaches (21.6%), 59 PDPHs at 24-hour follow-up (17.5%), and 15 PDPHs receiving a therapeutic blood patch (4.4%). Greater volume of CSF collected was associated with increased risk of immediate postprocedural headache, largely owing to a nonlinear increase in risk on collection of volumes above 30 mL (odds ratio, 3.73 for >30 mL and 0.98 for

Original languageEnglish (US)
Pages (from-to)325-332
Number of pages8
JournalJAMA Neurology
Volume72
Issue number3
DOIs
StatePublished - Mar 1 2015

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Post-Dural Puncture Headache
Spinal Puncture
Headache
Needles
Cerebrospinal Fluid
Observational Studies
Linear Models
Odds Ratio
Incidence
Therapeutics
Persistence
Onset
Blood

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Monserrate, A. E., Ryman, D. C., Ma, S., Xiong, C., Noble, J. M., Ringman, J. M., ... Dominantly Inherited Alzheimer Network, I. A. N. (2015). Factors associated with the onset and persistence of post-lumbar puncture headache. JAMA Neurology, 72(3), 325-332. https://doi.org/10.1001/jamaneurol.2014.3974

Factors associated with the onset and persistence of post-lumbar puncture headache. / Monserrate, Andrés E.; Ryman, Davis C.; Ma, Shengmei; Xiong, Chengjie; Noble, James M.; Ringman, John M.; Morris, John C.; Danek, Adrian; Müller-Sarnowski, Felix; Clifford, David B.; McDade, Eric M.; Brooks, William S.; Darby, David G.; Masters, Colin L.; Weston, Philip S J; Farlow, Martin; Graff-Radford, Neill R.; Salloway, Stephen P.; Fagan, Anne M.; Oliver, Angela; Bateman, Randall J.; Dominantly Inherited Alzheimer Network, Inherited Alzheimer Network.

In: JAMA Neurology, Vol. 72, No. 3, 01.03.2015, p. 325-332.

Research output: Contribution to journalArticle

Monserrate, AE, Ryman, DC, Ma, S, Xiong, C, Noble, JM, Ringman, JM, Morris, JC, Danek, A, Müller-Sarnowski, F, Clifford, DB, McDade, EM, Brooks, WS, Darby, DG, Masters, CL, Weston, PSJ, Farlow, M, Graff-Radford, NR, Salloway, SP, Fagan, AM, Oliver, A, Bateman, RJ & Dominantly Inherited Alzheimer Network, IAN 2015, 'Factors associated with the onset and persistence of post-lumbar puncture headache', JAMA Neurology, vol. 72, no. 3, pp. 325-332. https://doi.org/10.1001/jamaneurol.2014.3974
Monserrate AE, Ryman DC, Ma S, Xiong C, Noble JM, Ringman JM et al. Factors associated with the onset and persistence of post-lumbar puncture headache. JAMA Neurology. 2015 Mar 1;72(3):325-332. https://doi.org/10.1001/jamaneurol.2014.3974
Monserrate, Andrés E. ; Ryman, Davis C. ; Ma, Shengmei ; Xiong, Chengjie ; Noble, James M. ; Ringman, John M. ; Morris, John C. ; Danek, Adrian ; Müller-Sarnowski, Felix ; Clifford, David B. ; McDade, Eric M. ; Brooks, William S. ; Darby, David G. ; Masters, Colin L. ; Weston, Philip S J ; Farlow, Martin ; Graff-Radford, Neill R. ; Salloway, Stephen P. ; Fagan, Anne M. ; Oliver, Angela ; Bateman, Randall J. ; Dominantly Inherited Alzheimer Network, Inherited Alzheimer Network. / Factors associated with the onset and persistence of post-lumbar puncture headache. In: JAMA Neurology. 2015 ; Vol. 72, No. 3. pp. 325-332.
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AU - Monserrate, Andrés E.

AU - Ryman, Davis C.

AU - Ma, Shengmei

AU - Xiong, Chengjie

AU - Noble, James M.

AU - Ringman, John M.

AU - Morris, John C.

AU - Danek, Adrian

AU - Müller-Sarnowski, Felix

AU - Clifford, David B.

AU - McDade, Eric M.

AU - Brooks, William S.

AU - Darby, David G.

AU - Masters, Colin L.

AU - Weston, Philip S J

AU - Farlow, Martin

AU - Graff-Radford, Neill R.

AU - Salloway, Stephen P.

AU - Fagan, Anne M.

AU - Oliver, Angela

AU - Bateman, Randall J.

AU - Dominantly Inherited Alzheimer Network, Inherited Alzheimer Network

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N2 - IMPORTANCE: This study assesses factors associated with the most common adverse event following lumbar puncture. OBJECTIVE: To identify factors associated with the risk, onset, and persistence of post-dural puncture headache (PDPH). DESIGN, SETTING, AND PARTICIPANTS: We performed univariate and multivariable analyses of 338 lumbar punctures in the Dominantly Inherited Alzheimer Network observational study using linear mixed models, adjusting for participant-level and family-level random effects. MAIN OUTCOMES AND MEASURES: We directly evaluated associations of 3 post-lumbar puncture outcomes (immediate postprocedural headache, PDPH at 24-hour follow-up, and PDPH receiving a therapeutic blood patch) with participant age and sex, positioning, collection method, needle size, needle insertion site, and cerebrospinal fluid (CSF) volume collected. RESULTS: The incidence of adverse events included 73 immediate postprocedural headaches (21.6%), 59 PDPHs at 24-hour follow-up (17.5%), and 15 PDPHs receiving a therapeutic blood patch (4.4%). Greater volume of CSF collected was associated with increased risk of immediate postprocedural headache, largely owing to a nonlinear increase in risk on collection of volumes above 30 mL (odds ratio, 3.73 for >30 mL and 0.98 for

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