Amorim JA. Post-dural puncture headache: clinical characteristics and diagnostic criteria (abstract). Headache Medicine. 2012;3(3):10

Amorim, Jane Auxiliadora

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Headache Medicine

100                                                                                                                    Headache Medicine, v.3, n.3, p.100, Jul./Aug./Sep. 2012Post-dural puncture headache: clinical characteristicsand diagnostic criteria (abstract)Cefaleia pós-punção dural: características clínicas e critérios diagnósticos (resumo)Background and objectives: The diagnostic criteriafor post-dural puncture headache (PDPH) of the InternationalClassification of Headache Disorders (ICHD-II, 2004) statethat postural headache appears not later than the fifth dayafter the puncture and disappears spontaneously within aweek, or within 48 hours after treatment with an epiduralblood patch. The criteria also necessarily include at leastone of the following symptoms: neck stiffness, tinnitus, hearingloss, photophobia, and nausea. In this study, we evaluatedthe clinical features of PDPH and the validity of diagnosticcriteria (ICHD-II, 2004).Methods: Over one year, 640 patients (332 women and308 men) aged between 8 and 65 years underwent spinalanesthesia, with Quincke needles, 25G (n = 239) and 27G(n = 401). The onset of postural headache, i.e., when thepain worsens or appears after sitting or standing, wasinvestigated through daily visits to patients and/or phonecontact for seven days after anesthesia. Among the patientswho had PDPH the following characteristics were evaluated:(1) the latency period between the dural puncture and theonset of headache, (2) the location and intensity of pain, 3)accompanying symptoms, and (4) the duration. Theprocedures for descriptive statistics were used measures ofcentral tendency: mean, dispersion (standard deviation andvariation amplitude) and frequency distribution. The chi-squaretest was applied and considered statistically significant whenp <0.05. This study was approved by the Ethics Committee inResearch and informed consent was obtained from patientsor their legal guardians.Results: 48 patients (7.5%) had postural headache. Thelatency period ranged from 6 to 72 hours (24.0 ± 16.8 hours)and the duration from 3 to 15 days (4±2 days). Pain wasreported in the following regions: occipital, 26 (54%); frontal,19 (40%); and holocranial, 3 (6%). In 85% of patients theJane Auxiliadora AmorimUniversidade Federal de Pernambuco – UFPE. Pós-graduação de Neuropsiquiatria eCiências do Comportamento (área de concentração: Neurociências). PhD Thesis. 2012.Orientador: Marcelo Moraes ValençaAmorim JA. Post-dural puncture headache: clinical characteristics and diagnostic criteria (abstract).Headache Medicine. 2012;3(3):100CorrespondenceJane Auxiliadora Amorimjanemarcos22@superig.com.brTHESESintensity of the headache was moderate or severe. 14 of the48 patients (29.2%) had no accompanynig symptoms.Conclusions: Our results are not in consistent with theICHD-II diagnostic criteria; we thus suggest a number ofchanges in the diagnostic criteria.

Cefaleia pós-punção dural: características clínicas e critérios diagnósticos (resumo)

https://headachemedicine.com.br/index.php/hm/article/download/331/698/869

Cefaleia pós-punção dural: características clínicas e critérios diagnósticos (resumo)

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