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Lumbar-puncture headache

Abstract

Mild or severe headache follows diagnostic lumbar puncture (LP) in about 30% of patients, but the incidence varies considerably depending on the circumstances of the patient and the technique.1 The headache is characteristically worse when the patient stands, and improves when he lies flat. It is usually frontal or occipital radiating into the neck and is often associated with nausea or postural vertigo.1 The headache typically starts within 12 hours of LP or when the patient sits or stands up, but it may be delayed for several days. The headache usually continues for about 4 days, but occasionally lasts for up to 9 days or longer if there are any complicating factors. Simple analgesics such as aspirin can be used and the patient should be assured that the headache can be explained physiologically and does not mean further disease.

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