How To Prevent Hypotension Headache After Lumbar Puncture?
May 24, 2018
After lumbar puncture, if the cerebrospinal fluid continuously leaks from the puncture site to the outside of the meningeal cavity, the pain-sensitive tissue at the base of the skull may be pulled due to the reduced pressure in the spinal canal, causing headaches. The preventive measures are as follows.
(1) A lumbar puncture needle with a small diameter should be used, preferably a 7-gauge puncture needle. It is necessary to strive for one needle to see fluid, minimize the number of punctures, and avoid multiple punctures at the same site in a short period of time.
(2) After the lumbar puncture, the patient can be put on the prone position for 20 minutes to allow the initial healing of the puncture site, and then lie down on the pillow for more than 6 hours.
(3) Drink more water after puncture to increase the amount of fluid and supplement the leaking part of cerebrospinal fluid, usually no less than 1000ml of water within the first 6 hours.
(4) Once hypotensive headache occurs, the patient should be instructed to rest in bed for 3 to 5 days, or to take 2000 to 3000 ml of saline per day. If the headache is still not relieved, 1000-1500ml of 5% glucose water and 5-10 units of vasopressin can be given intravenously, once a day, 2 to 3 times in a row. For severe headaches, a fine puncture needle can be used to pierce the subarachnoid space and inject normal saline into the subarachnoid space, 5ml each time, and inject 15-20ml to relieve the headache immediately.
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