Summary
The clinical practice of advising patients to increase their daily fluid intake after lumbar puncture in order to increase CSF production by re-hydration and thus try to prevent post-lumbar puncture headache (PLPH) has not yet been shown to be effective. In 100 patients the different effects of re-hydration on the incidence of PLPH (1.51 compared with 3.01 oral fluid per day over a period of 5 days) were tested prospectively. The incidence of PLPH was independent of the amount of fluid intake in both groups (18, 36%), as was the duration of PLPH. The physiology of CSF production and resorption suggests that PLPH is not a problem of CSF dynamics but a simple mechanical problem of how to close the dural rent and thereby stop the continuous leakage. It is no longer justifiable to advise patients to drink more than usual since there is no physiological or empirical basis for this and it does not seem to have even a placebo effect.
Similar content being viewed by others
References
Aboulish E, dela Vega S, Blendinger I, Tio T (1975) Long-term follow up of epidural blood patch. Anesth Analg 54:459–463
Bering EA, Sato JRO (1963) Hydrocephalus changes of formation and absorption of cerebrospinal fluid within the cerebral ventricles. J Neurosurg 20:1050–1063
Cutler RWP, Page L, Galicich J, Watters GV (1968) Formation and absorption of cerebrospinal fluid in man. Brain 91:707–720
Dieterich M, Brandt Th (1985) Is obligatory bed rest after lumbar puncture obsolete? Eur Arch Psychiatr Neurol Sci 235:71–75
Hilton-Jones D (1984) What is postlumbar puncture headache and is it avoidable? In: Warlow Ch, Garfield J (eds) Dilemmas in the management of the neurological patient. Churchill Livingstone, Edinburgh London, pp 144–157
Hilton-Jones D, Harrad RA, Gill MW, Warlow CP (1982) Failure of postural manoeuvres to prevent lumbar puncture headache. J Neurol Neurosurg Psychiatry 45:743–746
Kadrie H, Driedger AA, McInnis W (1976) Persistent dural cerebrospinal fluid leak shown by retrograde radionuclide myelography. J Nucl Med 17:797–799
Kunkle EC, Ray BS, Wolff HG (1943) Experimental studies on headache. Arch Neurol Psychiatry 49:323–358
Page LK, Bresnan MJ, Lorenzo AV (1973) Cerebrospinal fluid perfusion studies in childhood hydrocephalus. Surg Neurol 1:317–320
Pappenheimer JR, Heisey SR, Jordan EF, Downer JC (1962) Perfusion of the cerebral ventricular system in unanesthetized goats. Am J Physiol 203:763–774
Pickering GW (1948) Lumbar-puncture headache. Brain 71:271–280
Rubin RC, Henderson ES, Ommaya AK, Walker MD, Rall DP (1966) The production of cerebrospinal fluid in man and its modification by acetazolamide. J Neurosurg 25:430–436
Wolff HG (1972) Headache and other head pain. 3rd edn. Oxford University Press, New York
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dieterich, M., Brandt, T. Incidence of post-lumbar puncture headache is independent of daily fluid intake. Eur Arch Psychiatr Neurol Sci 237, 194–196 (1988). https://doi.org/10.1007/BF00449906
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00449906