Risk factors and effects of prior headache on post-lumbar puncture headache

Introduction: The most common complication associated with lumbar puncture is postdural puncture headache(PDPH). The incidence of PDPH varies depending on multifactorial nature of the risk factors. The pathophysiology is unclear. Patientrelated and LP procedure-related risk factors are still contoversial. In this prospective study, we aimed to evaluate risk factors for PDPH risk factors, the features of previous headaches and their effect on the development of PDPH, as well as risk factors for the development of PDPH within the first 24-hours(immediate) or after 24-hours(delayed). Method: In our study, 116 patients who underwent LP for diagnostic or treatment purposes were prospectively analyzed. All clinical and laboratory findings of the patients and information related to the LP procedure were evaluated. The history of prior headache was detailed with questionnaire forms. All clinical and laboratory characteristics of patients diagnosed with PDPH were examined for risk factors. Results: It has been shown that the presence of long duration and frequent attacks, independent of the type of prior headache, and a history of migraine accompanied by osmophobia are independent risk factors for the development of PDPH. In immediate and delayed-onset PDPH evaluation; lesser volume of CSF collected, increased frequency of headache attacks, diagnosis of IIHT and acetazolamide use were risk factors for the development of immediate-onset PDPH. Conclusion: This is the first study to detail the history of prior headache in the development of PDPH and to examine the risk factors for immediate and delayed PDPH. As a result; it was shown for the first time that patient-related factors may be more important in terms of the development of PDPH, and procedure-related factors in terms of the time of occurrence of PDPH. These results may help to elucidate the pathophysiology of PDPH development. Determination of the risk factors for PDPH, may help to provide a more diagnosis and treatment, to reduce the anxiety levels of patients by providing detailed information and to optimize the clinical practice. Keyword: Postdural puncture headache(PDPH), headache, osmophobia, onset time of PDPH, idiopathic intracranial hypertension (IIHT).