Abstract
The author performed a randomized prospective study of the effects of needle size and of age, sex, myelogram type and operators on the incidence of headache following myelography. In 113 patients randomized to 22 G and 25 G needle groups, data were obtained by questionnaire on the frequency of headache up to five days following the procedure. The influence of needle size was statistically insignificant (63%, 48%,p>0.05). Age (p=0.0002), sex (p=0.01), myelogram type (p=0.002) and myelographer (p=0.03)significantly affected the frequency of headache. The size of the dural perforation appears to be less important than factors relating to age, sex, myelogram type and individual myelographers in the development of headache after myelography.
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Merlo A, Morant R, Ketz E, Gerig HJ, Senn HJ (1989) Does post-puncture syndrome following lumbar puncture depend on needle diameter? J Suisse Méd 119:1781–1786
Vezina JL, Fontaine S, Laperriere J (1989) Outpatient myelography with fine needle technique: an appraisal. AJNR 10:615–617
Rolfe EB, Maguire PD (1980) The incidence of headache following various techniques of metrizamide myelography. Br J Radiol 53:840–844
Villming S, Schrader H, Monstad I (1989) The significance of age, sex, and cerebral spinal fluid pressure in post-lumbar puncture headache. Cephalalgia 9:99–106
Shaw DD, Bach-Gansmo T, Dahlstrom K (1985) Iohexol: summary of North American and European clinical trials in adult lumbar, thoracic and cervical myelography with a new non-ionic contrast medium. Invest Radiol [Suppl] 20:1
Raskin NH (1990) Lumbar puncture headache: a review. Headache 30:197–204
Youl BD (1990) Headaches after lumbar puncture and their treatment. Rev Prat 40:414–425
Skalpe IO (1979) Early adverse effects of myelography. In: Grainger RG, Lamb JT (eds) Myelographic techiques with metrizamide. Nyegaard. Birmingham, pp 157–160
Sand T, Myhr G, Stovner L, Dale LG, Tangerud A (1989) Side effects after ambulatory lumbar iohexol myelography. Neuroradiology 31:49–54
Skalpe IO, Nakstad P (1988) Myelography with iohexol (Omnipaque); a clinical report with special reference to the adverse effects. Neuroradiology 30:169–174
Sand T (1989) Which factors affect reported headache incidence after lumbar myelography? A statistical analysis of publications in the literature. Neuroradiology 31:55–59
Tourtelotte W, Henderson W, Tucker R, Gilland O, Walker J, Kokman E (1972) A randomized double blind clinical trial comparing the 22 versus 26 gauge needle in the production of postlumbar puncture syndrome in normal individuals. Headache 12: 73–79
Pool JL (1942) Myeloscopy: intraspinal endoscopy. Surgery 11: 169–182
Dietrich M, Brandt T (1988) Incidence of post-lumbar puncture headache is independent of daily fluid intake. Eur Arch Psychiatry Neurol Sci 237:194–196
Fernández E (1990) Headaches associated with low spinal fluid pressure. Headache 30:122–128
Gobel H, Klostermann H, Lindner V, Schenkl S (1990) Changes in cerebral hemodynamics in cases of post-lumbar puncture headache: a prospective cranial doppler ultrasound study. Cephalalgia 10:117–122
Thie A, Fuhlendorf A, Spitzer K, Kunze K (1990) Transcranial doppler evaluation of common and classic migraine. Part 1. Ultrasonic features during the headache-free period. Headache 30:201–208
Camann W, Murray R, Mushlin P, Lambert D (1990) Effects of oral caffeine on postdural puncture headache. A double blind placebo-controlled trial. Anesth Analg 70:181–184
Ford C, Ford D, Koenigsberg M (1989) A simple treatment of post-lumbar puncture headache. J Emerg Med 7:29–31
Sand T, Stovner LJ, Myhr G, Sjaastad O (1990) Lumbar iohexol myelography and diagnostic puncture. Headache and associated side effects in relation to neurological signs and diagnosis, previous mental symptoms and pain history. Cephalalgia 10:9–16
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Harrison, P.B. The contribution of needle size and other factors to headache following myelography. Neuroradiology 35, 487–489 (1993). https://doi.org/10.1007/BF00588701
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DOI: https://doi.org/10.1007/BF00588701