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BRIEF RESEARCH REPORT article

Front. Neurol.
Sec. Headache and Neurogenic Pain
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1493303

Chronic post-dural puncture headache (cPDPH)-a serious and underrated complication following lumbar puncture: a cohort study

Provisionally accepted
Luisa M. Kraus Luisa M. Kraus 1,2*Levin Häni Levin Häni 3*Amir El Rahal Amir El Rahal 2Dr. Ioannis Vasilikos Dr. Ioannis Vasilikos 2Mateo Tomas Farina Nunez Mateo Tomas Farina Nunez 4Florian Volz Florian Volz 2Horst Urbach Horst Urbach 5Niklas Lützen Niklas Lützen 5*Christian Ulrich Christian Ulrich 6*Jürgen Beck Jürgen Beck 2*Christian Fung Christian Fung 2,6*
  • 1 University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
  • 2 Department Neurozentrum, University of Freiburg Medical Center, Freiburg, Germany
  • 3 University Hospital of Bern, Bern, Bern, Switzerland
  • 4 Spine Center, Schulthess Klinik, Zurich, Switzerland
  • 5 Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany
  • 6 Department of Neurosurgery, Lindenhofspital, Bern, Bern, Switzerland

The final, formatted version of the article will be published soon.

    Post-dural puncture headache (PDPH) is still mostly regarded a minor complication after lumbar puncture. In the International Classification of Headache Disorders (ICHD)-3 headaches lasting longer than 14 days or persisting after epidural blood patch (EBP) are not even considered. We illustrate that there may be many patients with persisting headaches and a large disease burden.In a retrospective, single center analysis from 04/2018 to 03/2022 we assessed patients with a dural puncture and orthostatic headache of >14 days duration, resistant to one or more EBPs. Socioeconomic factors and individual patient history were assessed by a specifically designed questionnaire.We included 30 patients with a mean age of 36.4 (±10.6) years. The median duration of acute inpatient care was 31 (Interquartile ratio (IQR) = 32) days and of sick leave 381 (IQR = 666.3) days. Patients consulted a median of 5 (IQR = 6.5) different physicians/ institutions due to chronic post-dural puncture headache (cPDPH). All patients reported major negative impact of cPDPH on their social and work life.Despite long hospitalizations and a profound impairment of social and work lives cPDPH was neglected and underrated in all patients. We conclude that cPDPH needs to be considered and might be an underreported, severe condition which requires further prospective studies.

    Keywords: postdural puncture headache (PDPH), Chronic headache, Lumbar puncture (LP), Peridural anaesthesia, Socioeconomial impact

    Received: 16 Sep 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Kraus, Häni, El Rahal, Ioannis Vasilikos, Farina Nunez, Volz, Urbach, Lützen, Ulrich, Beck and Fung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Luisa M. Kraus, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
    Levin Häni, University Hospital of Bern, Bern, 3010, Bern, Switzerland
    Niklas Lützen, Department of Neuroradiology, University Hospital Freiburg, Freiburg, 79106, Germany
    Christian Ulrich, Department of Neurosurgery, Lindenhofspital, Bern, Bern, Switzerland
    Jürgen Beck, Department Neurozentrum, University of Freiburg Medical Center, Freiburg, Germany
    Christian Fung, Department Neurozentrum, University of Freiburg Medical Center, Freiburg, Germany

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