Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: Is it a clinically significant finding?

Keita Sakurai, Noriyuki Matsukawa, Kenji Okita, Minoru Nishio, Masashi Shimohira, Yoshiyuki Ozawa, Susumu Kobayashi, Takemori Yamawaki, Yuta Shibamoto

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background: Post-dural puncture headache (PDPH) due to excessive cerebrospinal fluid (CSF) leakage is a well-known complication of lumbar puncture. Although various factors, especially the type of spinal needle, have been demonstrated to be associated with PDPH, the clinical implications of CSF leakage detected on magnetic resonance myelography (MRM) images remain unclear. The objective of this case-control study was to evaluate the association between radiologically visualized CSF leakage and PDPH.Methods: Clinical data including patients' age and gender, types of spinal needle, duration of bed rest, interval between lumbar puncture procedures and MRM studies, and incidence of PDPH were compared between patients who were radiologically-positive and -negative for CSF leakage.Results: Of the 22 patients with definite CSF leakage on MRM images, most were asymptomatic (86%, 19/22). The remaining three patients, who were suffering from PDPH, only complained of headaches and were treated conservatively. In a review of patients' clinical data, there were no significant differences in any parameter including the incidence of PDPH between the 22 patients who were radiologically-positive for CSF leakage and the 31 radiologically-negative patients.Conclusion: The significance of radiologically visualized CSF leakage should not be overestimated, as most such incidents are not associated with PDPH and do not require any treatment.

Original languageEnglish
Article number35
JournalBMC Anesthesiology
Volume13
DOIs
Publication statusPublished - 27-10-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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