What is lumbar puncture and what to do with lumbar puncture headache

The lumbar puncture site takes the 3rd and 4th lumbar intervertebral space as the puncture point (the intersection of the two sides of the Ming dragon line and the vertebral spine line is the 3rd lumbar intervertebral space) for puncture. The cerebrospinal fluid needs to be taken for routine, biochemical, immunological, cytological and bacteriological examinations, the pressure of the cerebrospinal fluid is measured, and sometimes drugs are injected into it for treatment. After lumbar puncture, lie down for 4-.6 hours with absolutely no pillow, and those with severe intracranial pressure need to stay in bed for 1-2 days to prevent low-pressure headache or other complications caused by cerebrospinal fluid leakage. If you have symptoms such as headache, fever, etc., you should notify your doctor in time for treatment. What to do if a lumbar puncture causes a headache? The case patient, a 37-year-old female, suffered from headache, nausea, vomiting, and lethargy for 1 day, and was further diagnosed and treated with "the cause of the headache to be investigated". Lumbar puncture was performed in routine operation, intraoperative brain pressure was measured at 190 mm H20, cerebrospinal fluid was clear, and 5 ml of cerebrospinal fluid was released for biochemical examination. Three days later, the patient's symptoms of headache, nausea and vomiting were relieved, but the headache was severe when standing, and "orthostatic headache" was considered in the comprehensive analysis. Case study 1. Lumbar push puncture is a diagnosis and treatment technique in which a lumbar puncture needle is used to pierce the subarachnoid space of the spinal cord through the lumbar intervertebral space to draw out cerebrospinal fluid or inject drugs. It is mainly used for measuring brain pressure, extracting cerebrospinal fluid for examination or performing brain and myelography examinations to assist in the etiological diagnosis of central nervous system diseases; intrathecal drug injection through lumbar puncture to treat central nervous system infections, malignant tumors and other diseases; release cerebrospinal fluid , reduce intracranial pressure, relieve symptoms of intracranial hypertension; for spinal subarachnoid block anesthesia. The normal lateral decubitus position is 80-180 mm H2o2. After lumbar puncture, sleep on the pillow for 4-6 hours to prevent headaches caused by decreased intracranial pressure. However, through the observation of a large number of clinical cases, it was found that the head and neck of the awake patients were suspended in the supine position for 4-6 hours, and the comfort was reduced. A comatose patient is prone to pressure sores when the skin is pressed for too long. The latest research found that taking a low pillow for 2 hours and then alternately lying on the side for 2 hours can not only reduce or prevent the occurrence of orthostatic headache, but also prevent pressure ulcers. Some people have done statistics, 38.2% of patients undergoing lumbar puncture have intracranial hypertension. If the pillow is removed after surgery, the head position will be too low, and the blood flow of the brain will be accelerated, which will further increase the intracranial pressure and aggravate it. illness. And fixed in the same supine position for a long time, the muscles and ligaments of the whole body are too tense, which can easily lead to fatigue and discomfort of the patient. Especially in comatose patients, most of them are in a state of negative nitrogen balance, malnutrition, and the skin is pressed for too long, which hinders blood circulation and is more likely to lead to the occurrence of pressure ulcers.

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