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Post-lumbar puncture headache

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https://www.readbyqxmd.com/read/30121441/where-there-is-no-brain-imaging-safety-and-diagnostic-value-of-lumbar-puncture-in-patients-with-neurological-disorders-in-a-rural-hospital-of-central-africa
#1
Deby Mukendi, Jean-Roger Lilo Kalo, Tharcisse Kayembe, Pascal Lutumba, Barbara Barbé, Philippe Gillet, Jan Jacobs, Cedric P Yansouni, François Chappuis, Kristien Verdonck, Marleen Boelaert, Andrea S Winkler, Emmanuel Bottieau
Analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) is an essential step for the diagnostic approach of neurological disorders, in particular neuro-infections. In low-resource settings, it is even often the only available diagnostic method. Despite its key contribution, little is known on the risks and benefits of LP in the large tropical areas where hospital-based neuroimaging is not available. The objectives of this study were to assess the safety and diagnostic yield of LP in a rural hospital of central Africa and to identify predictors of CSF pleocytosis (white blood cell count >5/μL) as surrogate marker of neuro-infections...
October 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/30008228/nusinersen-a-treatment-for-spinal-muscular-atrophy
#2
Melanie K Claborn, Debra L Stevens, Cheri K Walker, Brooke L Gildon
OBJECTIVE: To review the efficacy and safety of nusinersen (Spinraza) in the treatment of spinal muscular atrophy (SMA). DATA SOURCES: An English-language literature search of PubMed and MEDLINE (1946 to June 2018) was performed using the terms nusinersen, ISIS-SMN (Rx), and spinal muscular atrophy. Manufacturer prescribing information, abstracts, article bibliographies, and clinicaltrials.gov data were incorporated for additional materials. STUDY SELECTION/DATA EXTRACTION: All clinical trials of nusinersen were identified and analyzed in the review...
July 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29945400/-precise-application-of-traditional-chinese-medicine-in-minimally-invasive-techniques
#3
Fu-Hui Dong
The miminally-invasive techniques of traditional Chinese medicine(TCM) uses different types of acupuncture needles to treat diseased locations with special techniques. These techniques include different methods of insertion and closed incision (press cutting, sliding cutting, scrape cutting, etc.). This needling technique is based on the traditional Chinese medicine theories of Pi Bu (cutaneous), Jing Jin (sinew), Jing Luo (meridian), Wu Ti (five body structure components) and Zang Fu (organ system). Commonly used needles include: needle Dao , needle with edge, Pi needle, Shui needle, Ren needle, Gou needle, Chang Yuan needle, Bo needle and so on...
June 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29944052/diagnosing-causes-of-headache-within-the-postpartum-period
#4
Emma Stanhope, Lynsey Foulds, Gamal Sayed, Ute Goldmann
BACKGROUND: Headache is one of the most common symptoms following delivery and the underlying cause may be benign or life threatening. Identification of the cause of headache in the postpartum period can be challenging and relies on a comprehensive history and thorough examination, with particular focus on the presence or absence of neurological signs, which may suggest a more serious diagnosis (Nelson-Piercy 2010 ). However, through clinical experience and research, we have noted that post-partum headache is significantly under-recognised and treated (Goldszmidt et al...
July 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29913693/treatment-of-post-dural-puncture-headache-using-epidural-injection-of-fibrin-sealant-as-an-alternative-to-autologous-epidural-blood-patch-case-report
#5
Joseph Atallah, Emmanuel Gage, Jonathan Koning, Joan Duggan, Vicki Ramsey-Williams, Samuel Scott, Daniel Gaudin, Mazin Sarhan
Background Post dural puncture headache (PDPH) is an iatrogenic cause of patient morbidity in pain management after spinal or epidural anaesthesia, as well as after diagnostic lumbar puncture. Most patients respond to conservative treatment or to epidural blood patch, yet limited options for effective treatment are available for patients who fail these treatments or present with theoretical contraindication. Case report We present a case of a patient with previously diagnosed human immunodeficiency virus and hepatitis C, who presented with signs of PDPH, which placed him at a theoretical risk of meningeal seeding of the virus during the blood patching procedure...
July 1, 2014: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913017/safety-and-tolerability-of-multiple-ascending-doses-of-prx002-rg7935-an-anti-%C3%AE-synuclein-monoclonal-antibody-in-patients-with-parkinson-disease-a-randomized-clinical-trial
#6
Joseph Jankovic, Ira Goodman, Beth Safirstein, Tonya K Marmon, Dale B Schenk, Martin Koller, Wagner Zago, Daniel K Ness, Sue G Griffith, Michael Grundman, Jay Soto, Susanne Ostrowitzki, Frank G Boess, Meret Martin-Facklam, Joseph F Quinn, Stuart H Isaacson, Omid Omidvar, Aaron Ellenbogen, Gene G Kinney
Importance: Aggregated α-synuclein is believed to be central to the pathogenesis of Parkinson disease (PD). PRX002/RG7935 (PRX002) is a humanized monoclonal antibody designed to target aggregated forms of α-synuclein, thereby inhibiting neuron-to-neuron transfer of presumed pathogenic forms of α-synuclein, potentially resulting in neuronal protection and slowing disease progression. Objective: To evaluate the safety and tolerability of multiple intravenous infusions of PRX002 in patients with idiopathic PD...
October 1, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29911422/therapeutic-lumbar-puncture-for-headache-in-idiopathic-intracranial-hypertension-minimal-gain-is-it-worth-the-pain
#7
Andreas Yiangou, James Mitchell, Keira Annie Markey, William Scotton, Peter Nightingale, Hannah Botfield, Ryan Ottridge, Susan P Mollan, Alexandra J Sinclair
Background Headache is disabling and prevalent in idiopathic intracranial hypertension. Therapeutic lumbar punctures may be considered to manage headache. This study evaluated the acute effect of lumbar punctures on headache severity. Additionally, the effect of lumbar puncture pressure on post-lumbar puncture headache was evaluated. Methods Active idiopathic intracranial hypertension patients were prospectively recruited to a cohort study, lumbar puncture pressure and papilloedema grade were noted. Headache severity was recorded using a numeric rating scale (NRS) 0-10, pre-lumbar puncture and following lumbar puncture at 1, 4 and 6 hours and daily for 7 days...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29568548/safety-of-lumbar-puncture-procedure-in-an-international-research-setting-during-acute-hiv-infection
#8
EDITORIAL
Phillip Chan, Joanna Hellmuth, Donn Colby, Eugene Kroon, Carlo Sacdalan, James Fletcher, Payal Patel, Suteera Pinyakorn, Victor Valcour, Jintanat Ananworanich, Serena Spudich
Background:  Cerebrospinal fluid (CSF) sampling at the time of acute HIV infection (AHI) is crucial in understanding NeuroAIDS pathogenesis. Here, we report on the safety of performing a lumbar puncture (LP) during untreated AHI and follow-up after initiation of combination antiretroviral therapy (cART). Methods:  We reviewed clinical records of participants who took part in an AHI protocol in Bangkok, Thailand, including untreated AHI subjects (baseline), and longitudinal visits following immediate initiation of cART to assess rates and risk of post-lumbar puncture headaches (PLPH)...
January 1, 2018: Journal of Virus Eradication
https://www.readbyqxmd.com/read/29567652/transforaminal-lumbar-puncture-an-alternative-technique-in-patients-with-challenging-access
#9
D R Nascene, C Ozutemiz, H Estby, A M McKinney, J B Rykken
Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1...
May 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29460559/-how-the-bed-rest-period-and-the-posture-assumed-by-the-patient-post-lumbar-puncture-caninfluence-the-onset-of-complications-a-rapid-evidence-assessment
#10
REVIEW
Mery Zaina, Valentina Bressan, Loretta Caporale
AIM: To identify how the bed rest period and the posture assumed by the patient after lumbar puncture can influence the onset of complications, and which nursing interventions to adopt in order to reduce the complications. METHOD: A rapid assessment review was performed and the electronic databases PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials were searched between 2001 and 2015. RESULTS: Initially, 407 studies were retrieved, and 5 of these publications were considered to be eligible for the purpose of the study,4 comparing different periods of bed rest and 1 comparing patients position...
October 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/29429479/-chronic-post-dural-headache-secondary-to-meningitis
#11
Andreas Ravn, Louise Feldborg Lyckhage, Rigmor Høland Jensen
In this case report a young man was admitted with fever and headache, and a lumbar puncture revealed viral meningitis. After discharge, the patient experienced persistent headache, which worsened, when he was in upright position. The condition was considered secondary to the meningitis. After 14 months, the patient was diagnosed with post-dural puncture headache and treated with an epidural blood patch (EBP). The patient experienced no headache for three months, whereafter it returned. Subsequent EBP's were unsuccessful...
February 5, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29378345/ectopic-prolactinoma-presenting-as-bacterial-meningitis-a-diagnostic-conundrum
#12
Oluwaseun O Akinduro, Olutomi T Akinduro, Vivek Gupta, Ronald Reimer, Osarenoma Olomu
BACKGROUND: Prolactinomas may rarely present with meningitis and cerebrospinal fluid (CSF) rhinorrhea secondary to erosion of the wall of the sella turcica. It is even more uncommon for this abnormal communication to be caused by an ectopic prolactinoma arising from the sphenoid sinus and eroding into the sella. This atypical growth pattern makes diagnosis very difficult because there may be no displacement of the normal pituitary gland. The first reported case of a patient with an ectopic prolactinoma originating within the sphenoid sinus presenting primarily with meningitis is presented, and the management strategy and surgical and nonsurgical treatment options are discussed...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29230542/secondary-intracranial-hypertension-pseudotumor-cerebri-presenting-as-post-traumatic-headache-in-mild-traumatic-brain-injury-a-case-series
#13
Tonia Sabo, Charlene Supnet, Sushmita Purkayastha
BACKGROUND: Cerebral edema peaks 36-72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48-72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype...
April 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28891819/factors-influencing-successful-lumbar-puncture-in-alzheimer-research
#14
Krista L Moulder, Lilah M Besser, Duane Beekly, Kaj Blennow, Walter Kukull, John C Morris
OBJECTIVE: Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States. METHODS: A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). In all, 64 LP Requestor, 579 Patient/Initial, and 404 Patient/Follow-up surveys were collected...
October 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/28836071/a-dedicated-lumbar-puncture-clinic-performance-and-short-term-patient-outcomes
#15
Paula Barreras, David R Benavides, Jorge F Barreras, Carlos A Pardo, Ami Jani, Roland Faigle, Mona N Bahouth
The purpose of the study was to evaluate patient outcomes, including success rates, factors associated with unsuccessful procedures and frequency of post-lumbar puncture headaches (PLPH), at a dedicated academic outpatient lumbar puncture (LP) clinic. All patients referred to our LP clinic between June 1, 2014 and May 31, 2015 were included in this consecutive observational series. We collected information about patient characteristics, operational parameters of the procedure, and complications. We also recorded rates of participation in biomedical research involving use of cerebrospinal fluid...
October 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28778448/normal-intrathecal-leukocyte-cell-number-and-composition-do-not-decrease-the-incidence-of-post-lumbar-puncture-headache
#16
Olaf Stüve, Fabio Cataldi, Vivek Pradhan, Kenneth J Gorelick
The pathogenesis of post-lumbar puncture headache (PLPH) has remained unclear. A beneficial role of CSF cells in the repair of a post-traumatic dural CSF leak has been suggested. The primary purpose of this study was to investigate the effects of 8weeks of induction therapy with high-dose PF-00547659 on the cellular elements of CNS immune surveillance in patients with active Crohn's Disease and a history of immunosuppressive therapy (Clinicaltrials.govNCT01387594). PF-00547659 is a human monoclonal antibody that binds to mucosal addressin-cell adhesion molecule 1 (MAdCAM-1) on endothelial cells and blocks its interaction with beta7-integrin expressing lymphocytes...
September 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28643170/predictors-and-incidence-of-orthostatic-headache-associated-with-lumbar-drain-placement-following-endoscopic-endonasal-skull-base-surgery
#17
Buqing Liang, Sathwik R Shetty, Sacit Bulent Omay, Joao Paulo Almeida, Shilei Ni, Yu-Ning Chen, Armando S Ruiz-Treviño, Vijay K Anand, Theodore H Schwartz
BACKGROUND: Orthostatic headache (OH) is a potential complication of lumbar drainage (LD) usage. The incidence and risk factors for OH with the use of lumbar drainage during endoscopic endonasal procedures have not been documented. OBJECTIVE: To investigate the incidence of post-procedure OHs associated with placement of LD in patients undergoing endoscopic endonasal procedures. METHODS: We prospectively noted the placement of LDs in a consecutive series of endoscopic endonasal skull base surgeries...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28603768/consensus-guidelines-for-lumbar-puncture-in-patients-with-neurological-diseases
#18
Sebastiaan Engelborghs, Ellis Niemantsverdriet, Hanne Struyfs, Kaj Blennow, Raf Brouns, Manuel Comabella, Irena Dujmovic, Wiesje van der Flier, Lutz Frölich, Daniela Galimberti, Sharmilee Gnanapavan, Bernhard Hemmer, Erik Hoff, Jakub Hort, Ellen Iacobaeus, Martin Ingelsson, Frank Jan de Jong, Michael Jonsson, Michael Khalil, Jens Kuhle, Alberto Lleó, Alexandre de Mendonça, José Luis Molinuevo, Guy Nagels, Claire Paquet, Lucilla Parnetti, Gerwin Roks, Pedro Rosa-Neto, Philip Scheltens, Constance Skårsgard, Erik Stomrud, Hayrettin Tumani, Pieter Jelle Visser, Anders Wallin, Bengt Winblad, Henrik Zetterberg, Flora Duits, Charlotte E Teunissen
INTRODUCTION: Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain. METHODS: We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III)...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28535561/effectiveness-of-lateral-decubitus-position-for-preventing-post-dural-puncture-headache-a-meta-analysis
#19
Andres Zorrilla-Vaca, Jeetinder Kaur Makkar
BACKGROUND: Post-dural puncture headache (PDPH) is a relatively common complication of lumbar punctures for spinal anesthesia or neurologic diagnosis. For many years, a high number of drugs has been evaluated to treat PDPH, yet there is a minority to prevent this complication. The lateral decubitus position instead of sitting position during lumbar puncture has become an interesting approach because of its feasibility and patient satisfaction. OBJECTIVES: In this meta-analysis we hypothesized that lateral decubitus position is an effective manner to prophylactically reduce the incidence of PDPH...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28388808/needle-gauge-and-tip-designs-for-preventing-post-dural-puncture-headache-pdph
#20
REVIEW
Ingrid Arevalo-Rodriguez, Luis Muñoz, Natalia Godoy-Casasbuenas, Agustín Ciapponi, Jimmy J Arevalo, Sabine Boogaard, Marta Roqué I Figuls
BACKGROUND: Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH...
April 7, 2017: Cochrane Database of Systematic Reviews
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