Post-dural puncture headache-a single-centre analysis in paediatric patients with and without SMA

Abstract

Aim: To gather epidemiologic data on post-dural puncture headache (PDPH) after diagnostic or therapeutic lumbar puncture (LP) in children and adolescents with SMA as well as in a cohort of paediatric patients without SMA.

Methods: We performed a retrospective, single-centre analysis via chart review and questionnaire. Patients were identified using the German procedure classification. Respective charts and SMArtCARE documentation forms (SMA patients) were reviewed concerning documentation of headaches fulfilling criteria of the IHS-classification for PDPH of 2004. Non-SMA patients received additional questionnaires.

Results: We identified a total of 218 LPs in 95 patients. Of those 141 were performed in 22 patients with known SMA (mean age SMA patients 9.2 years; non-SMA patients 11.4 years). Following chart review, IHS criteria for PDPH were fulfilled in 6.9% of all procedures (3.5% in SMA patients; 13.0% in non-SMA patients; p = 0.008). Data from questionnaires of non-SMA patients confirmed this result (position dependent headache within 72 h after intervention in 13.0% of procedures).

Conclusion: The prevalence of PDPH after therapeutic LPs in our cohort of SMA patients was significantly lower than after LPs in the general paediatric cohort. Data of this retrospective analysis show a similar overall prevalence of PDPH in paediatric patients as reported in bigger adult cohorts.

Keywords: headache; lumbar puncture; post-dural puncture headache; spinal muscular atrophy.