The principal complication of LP is headache occurring in 10–30% of patients.
Younger age and female gender are associated with an increased risk of a post-LP headache. The headache usually begins within 48 h but may be delayed for up to 12 days.
Head pain is dramatically positional; it begins when the patient sits or stands upright; there is relief upon reclining or with abdominal compression.
The pain is usually a dull ache and it is occipitofrontal
Effective Strategies to prevent post LP headache:
- Use of a small-diameter needle (22-gauge or smaller)
- Use of atraumatic needle (Sprotte and others)
- Replacement of stylet before removal of the needle
- Insertion of a needle with bevel oriented in a cephalad to caudad direction
- Bed rest (up to 4 h) following LP
- Supplemental fluids
- Minimizing the volume of spinal fluid removed
- Immediate mobilization following LP