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Dural Trauma During Lumbar Puncture

Dural Trauma During Lumbar Puncture Abstract To the Editor.—In the July 1988 issue of the Archives,1 Kotagal and Fischer recommend that, when performing lumbar puncture, one should keep the needle bevel parallel to the long axis of the spine. On pure theoretical grounds, the resulting puncture hole in the dura will be smaller this way. It has, however, never been shown that adhering to this rule will actually result in diminishing the percentage of patients with post–lumbar puncture headache. A study like that would be very worthwhile, but, until now, has not been undertaken. Because this theoretical concept is not backed up with clinical research, it is perhaps too early to suggest that this advice should be printed in the internal medicine and pediatrics textbooks. In a similar case it was recently shown that oblique or tangential insertion of the needle does not prevent post–lumbar puncture headache.2 In theory this technique was also References 1. Kotagal S, Fischer VW. Dural trauma during lumbar puncture . Arch Intern Med . 1988;148:1663.Crossref 2. Morrow JI, McAuley A, Patterson VH. Failure of oblique needle insertion to prevent post lumbar puncture headache . Arch Neurol . 1987;44:795.Crossref 3. Hatfalvi BI. The dynamics of post spinal headache . Headache . 1977;17:64-66.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Dural Trauma During Lumbar Puncture

Archives of Internal Medicine , Volume 149 (9) – Sep 1, 1989

Dural Trauma During Lumbar Puncture

Abstract

Abstract To the Editor.—In the July 1988 issue of the Archives,1 Kotagal and Fischer recommend that, when performing lumbar puncture, one should keep the needle bevel parallel to the long axis of the spine. On pure theoretical grounds, the resulting puncture hole in the dura will be smaller this way. It has, however, never been shown that adhering to this rule will actually result in diminishing the percentage of patients with post–lumbar puncture headache. A study like that would...
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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1989.00390090151034
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.—In the July 1988 issue of the Archives,1 Kotagal and Fischer recommend that, when performing lumbar puncture, one should keep the needle bevel parallel to the long axis of the spine. On pure theoretical grounds, the resulting puncture hole in the dura will be smaller this way. It has, however, never been shown that adhering to this rule will actually result in diminishing the percentage of patients with post–lumbar puncture headache. A study like that would be very worthwhile, but, until now, has not been undertaken. Because this theoretical concept is not backed up with clinical research, it is perhaps too early to suggest that this advice should be printed in the internal medicine and pediatrics textbooks. In a similar case it was recently shown that oblique or tangential insertion of the needle does not prevent post–lumbar puncture headache.2 In theory this technique was also References 1. Kotagal S, Fischer VW. Dural trauma during lumbar puncture . Arch Intern Med . 1988;148:1663.Crossref 2. Morrow JI, McAuley A, Patterson VH. Failure of oblique needle insertion to prevent post lumbar puncture headache . Arch Neurol . 1987;44:795.Crossref 3. Hatfalvi BI. The dynamics of post spinal headache . Headache . 1977;17:64-66.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1989

References