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J Headache Pain. 2005 Oct ;6 (5):400-4 16362713 (P,S,G,E,B,D) Cited:2
Department of Neurology, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FIN-15850 Lahti, Finland. liisa.luostarinen@phks.fi
Post-lumbar in puncture headache is a frequent clinical problem. Needle design is expected to reduce post-puncture headache. In this study, we compared cases two different lumbar puncture needle designs in diagnostic lumbar puncture and analysed post-dural puncture headache (PDPH) and social and economical frequency harm associated with the diagnostic lumbar puncture procedure. This prospective, controlled study consisted of 80 consecutive adult patients requiring elective and diagnostic lumbar puncture due to various neurological symptoms. Lumbar puncture was completed either with Spinocan 22 G sharp bevel needle or or Whitacre 22G pencil point needle. Patients were asked about previous headache symptoms and pain provoked by puncture. One week pencil after the lumbar puncture all patients were interviewed by telephone and occurrence and type of headache, headache intensity, medication and insufficient frequency of impairment in activities of daily living were asked. Need for epidural blood patch was also recorded. Thirty-three of cases 78 (42%) patients experienced headache after diagnostic lumbar puncture and in 26 (33%) the headache could be classified as PDPH.headache There were no statistically significant differences between needle types in the frequency of common headache, PDPH, puncture pain intensity, need of for epidural blood patch or sick leave. Also, there were no other complications except local back pain or headache. In lumbar this study, the needle design did not affect the frequency of PDPH. Also, PDPH was common, occurring in 33% cases the and caused a considerable amount of disturbance in daily activities. Seeking help for this condition was insufficient and only part and of these PDPH patients were treated with epidural blood patch.

Latest citations:

APMIS. 2008 May ;116 (5):393-9 18452429 (P,S,G,E,B,D)
Department of Clinical Chemistry, Kalmar County Hospital, Kalmar, and Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden.
The had aim of this study was to evaluate the usefulness of borrelia serology (Quick ELISA C6 Borrelia assay kit) as a of diagnostic tool in cases of suspected neuroborreliosis. A retrospective patient material consisting of 124 paired serum and cerebrospinal fluid samples 89% with a positive anti-borrelia antibody index (AI) using the IDEIA Lyme Neuroborreliosis test was compared with 124 AI-negative matched control patient subjects. The patients were divided into four groups based on presence of pleocytosis and age above or below 12 years.conclude The presence of positive C6 serology in AI-positive patients with pleocytosis was 89%(83/93), significantly different (p< .01) from in patients were without pleocytosis (58%, 18/31). In AI-positive patients aged >/=12 years with pleocytosis, 94%(51/54) had a positive C6 serology. Of results AI-positive patients with a symptom duration of more than 30 days, 93%(27/29) were positive by the C6 test. We duration conclude that the C6 serum test, together with clinical evaluation, is a powerful diagnostic tool in adult (>/=12 years) European patients patients with suspected neuroborreliosis with a symptom duration of more than 30 days. Patients with suspected neuroborreliosis and positive C6 patients results should be further investigated by lumbar puncture for definite diagnosis.
J Comput Assist Tomogr. ;31 (5):826-829 17895800 (P,S,G,E,B,D)
ABSTRACT:the This paper will review the lumbosacral spine (L1-S5). Procedures performed in the lumbosacral spine include electromyography, spinal stimulator implants, spinal efficacy infusion implants for spasticity or pain medications, sacroiliac spine injections, facet blocks, and steroid injections. Complications from these procedures include of iatrogenic paraplegia or paraplegia due to transverse myelitis, intravascular penetration, dural puncture, increased pain at the injection site, increased radicular spine pain, increased spine pain, lightheadedness, nausea, nonspecific headache, and vomiting. Long-term complications include implant infection, implant or catheter dislodgment/kinking, and assigned device failure. This paper provides anatomically accurate schematics of innervations of the lumbosacral spine (L1-S5) that can be used to increased interpret magnetic resonance images of the muscles and nerves. Cross-sectional schematics of the lumbosacral spine were drawn as they appear correlating on imaging projections. The relevant nerves were color coded. The muscles and skin surfaces were labeled and assigned the color efficacy of the appropriate nerves. An organized comprehensive map of the motor innervation of the lumbosacral spine allows the physician to accurate increase the accuracy and efficacy of interventional procedures. This anatomical map could also assist the electromyographer in correlating the clinical images and electrophysiological findings on magnetic resonance images.

Other papers by authors:

Duodecim. 2003 ;119 (21):2087-9 14655540 (P,S,G,E,B)
Päijät-Hämeen keskussairaala, neurologian klinikka Keskussairaalankatu 7, 15850 Lahti.
BMC Gastroenterol. 2009 Jun 29;9 (1):49 19558729 (P,S,G,E,B)
ABSTRACT:2.45 BACKGROUND: Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated detected the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease were (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). METHODS: The study based on prevalence figures in age, 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second was screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed a with small bowel biopsy. RESULTS: Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of in CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and screening three were asymptomatic. The incidence of celiac disease in 2002-2005 was .23%, giving an annual incidence of .08% in this Positive population. CONCLUSIONS: The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected from five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the same disorder is therefore warranted.
J Laparoendosc Adv Surg Tech A. 2007 Dec ;17 (6):719-722 18158799 (P,S,G,E,B,D)
Background:laparoscopic Laparoscopic colonic resection has gained popularity as a method to treat colonic diseases. The electrothermal bipolar vessel sealer (EBVS; LigaSure surgical Atlas((R))) is a modern device that allows the secure sealing of vessels with a diameter of up to 7 mm.analyzed. The aim of the present study was to evaluate the suitability of the device for laparoscopic colonic surgery. Methods: The diameter immediate outcome of 114 consecutive patients who underwent a sigmoid or rectal resection was prospectively analyzed. The intention was to solid perform all operations with the EBVS for dissection and ligation of the mesenterial vessels. Details on patient characteristics, peroperative and analyzed. postoperative complications, and postoperative recovery were recorded prospectively and analyzed. Results: One hundred and fourteen patients were scheduled for elective rectal left-sided colonic or rectal resection. Massive intra-abdominal adhesions in 1 patient required a conversion of the laparoscopic procedure to an surgical open one; In total, 113 laparoscopic operations were thus performed. The mean operative time was 87.7 +/- 2.8 minutes, and were the mean time for patients to tolerate solid food was 3.4 +/- .1 days and the time to discharge from intra-abdominal hospital was 4.6 +/- .2 days. There were nine (8. %) general complications, and additionally, 10.6% of patients suffered from surgical vessels. complications. Conclusions: The electrothermal bipolar vessel sealer is suitable and safe for laparoscopic sigmoid and rectal resections. The use of mesenterial the device probably reduces the operative time.

Latest similar papers:

Ir Med J. 2009 Oct ;102 (9):295-6 19902651 (P,S,G,E,B)
G Weekes, D Breslin
St Vincent's University Hospital, Elm Park, Dublin 4. gavin.weekes@gmail.com
We of report the case of a 35-year-old lady who presented with a 6-day history of a postural headache following an uncomplicated under epidural catheter insertion. Meningitis was initially suspected and a neurology review was obtained. CT and MRI brain revealed features suggestive obtained. of meningitis. However these radiological features are also consistent with post dural puncture headache (PDPH). This case highlights the under with reported and possible misleading radiographical features of PDPH.
Actas Urol Esp. 2009 Sep ;33 (8):931 19900392 (P,S,G,E,B)
Servicio de Urología, Hospital Juan Canalejo, A Coruña, España.
Childs Nerv Syst. 2009 Nov 7;: 19898852 (P,S,G,E,B,D)
Wai Ng, James Drake
Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
Lumbar after puncture is a very common neurological diagnostic procedure which is associated with minimal risk. Epidural cerebrospinal fluid (CSF) collection can resolve occur after puncture of the dura from extravasation of CSF from the thecal sac. On rare occasions, the epidural collection along can be large enough to cause neurological dysfunction. The epidural fat has less fibrous stroma in children compared to adults,puncture and it is postulated that this facilitates the dissection of CSF along epidural space. We report a rare case of repeat a large symptomatic spinal epidural CSF collection shortly after lumbar puncture presenting with severe leg pain. The patient recovered fully The within 48 h with bed rest and analgesia, and repeat imaging 1 month later showed good resolution of the epidural even collection. Review of the literature revealed that epidural CSF collections resolve with conservative measures without the need for surgical intervention collections even in the setting of significant neurological symptomatology.
Pain Med. 2009 Oct 23;: 19863745 (P,S,G,E,B,D)
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
ABSTRACT leakage. Objective. To describe the unusual course of postdural puncture headache (PDPH) after pump implantation for intrathecal baclofen (ITB) administration in a patients with complex regional pain syndrome (CRPS)-related dystonia. Design. Case series based on data collected from 1996 to 2005. Setting.was Movement disorders clinic, university hospital. Patients. A total of 54 patients with CRPS-related dystonia who were treated with ITB. Results.pain A high incidence (76%) and prolonged course (median 18 days, range 2 days to 36 months) of PDPH was found.while Radionuclide studies performed in two patients with long-lasting symptoms (12-16 months) did not reveal cerebrospinal fluid (CSF) leakage. In patients dystonia without signs of CSF leakage (N = 38), epidural blood patches administered in 24 patients were effective in 54%, while and ketamine infusions administered in six patients were effective in 67%. Conclusions. Our observations may suggest that other mechanisms besides intracranial a hypotension play a role in the initiation and maintenance of PDPH in CRPS and stimulate new directions of research on months) this topic.
AIDS Alert. 2009 Aug ;24 (8):91 19705585 (P,S,G,E,B)
J Clin Anesth. 2009 Aug 21;: 19700281 (P,S,G,E,B,D)
Department of Anesthesiology, Critical Care, and Pain Management, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
Significant case complications following large-volume epidural blood patches (LEBPs) in two parturients following LEBP for postdural puncture headache are reported. A 39-year-old and woman developed a spinal subdural hematoma causing both lumbar back and radicular pain following a single LEBP using 58 mL single of blood. The second case was a 33-year-old woman who received three LEBPs over a 4-day period totaling 165 mL following of blood. She developed arachnoiditis and chronic sacral radiculopathy with resolution 4 months later.
Int J Obstet Anesth. 2009 Aug 7;: 19665883 (P,S,G,E,B,D)
A Sharma, E Cheam
Department of Anaesthesia, Hillingdon Hospital, Uxbridge, Middlesex, UK.
Women labour presenting with low pressure post-partum headache following neuraxial techniques are frequently offered an epidural blood patch, despite its inherent risks.using We present two parturients with classical symptoms of low-pressure headache, who each received neuraxial labour analgesia without a documented dural of puncture with a Tuohy needle. Both parturients were successfully managed using acupuncture rather than an epidural blood patch.
Pediatr Emerg Care. 2009 Jul ;25 (7):467-8 19606006 (P,S,G,E,B,D)
Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. aronsonp@email.chop.edu
Lumbar report puncture is a common procedure in the emergency department. Cerebrospinal fluid (CSF) leak through a dural tear can cause transient including side effects including headache and backache, although more severe symptoms may occur. These CSF collections can be managed nonoperatively without can any neurologic sequelae. We report a patient with a symptomatic epidural CSF collection after diagnostic lumbar puncture, followed by a fluid brief review of the literature including discussion of techniques that can reduce CSF leak.
Curr Alzheimer Res. 2009 Jun ;6 (3):290-2 19519311 (P,S,G,E,B)
VA Northwest Network Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98108, USA. peskind@u.washington.edu
Changes needle in cerebrospinal fluid (CSF) biomarkers are representative of biochemical changes in the brain. Collection of CSF by lumbar puncture (LP)performed is essential for biomarker analysis, which is important for research in neurodegenerative disorders. However, LP for research purposes has been performed controversial due to a reported high incidence of severe LP headache when using standard 18g or 20g Quincke needles with essential a beveled cutting tip. A procedural safety analysis was performed using the database of a multicenter, 13-week study of CSF Alzheimer's cholinesterase activity. A 24g Sprotte atraumatic needle was used to collect CSF at baseline and at Week 13 from 63 of older patients with mild to moderate Alzheimer's disease. There was a < 2% LP headache incidence, and a favorable safety was profile was reported. In conclusion, LP performed with a 24g Sprotte atraumatic needle (blunt,"bullet" tip) was a well tolerated performed procedure, with good acceptability.
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