J Korean Neurol Assoc.  1997 Oct;15(5):1117-1124.

Post-Lumbar puncture headache: Does bed rest prevent the post-lumbar puncture headache?

• Kwon JC
• Choi NC
• Park KJ
• Kim NG
• Yun HJ
• Kwon OY
• Lim BH

Abstract

BACKGROUND & OBJECTIVES: It is widely believed that the post-lumbar puncture headache(PLPH) is related to CSF leakage through the dural hole made by needle tract. So it is accepted that PLPH is prevented by at least 4 hour bed rest after lumbar puncture (LP). If bed rest was unneccessary, the administrative and nursing advantages would be obvious,, especially in neurologic units, whereLP has been done frequently. Therefore, we evaluate the incidence of PLPH in the ambulant and bed-rest patients prospectively and compared the incidence difference between two group.
METHODS
Eighty-eight patients without preceding headache who were done lumbar puncture for diagnostic purpose were selected prospectively. We compared the incidence of PLPH between the ambulant (50 patients) and bed-rest group (38 patient,) at 6 hour and 24 hours. We also evaluated the effect of the CSF profile (count of RBC and WBC, protein level and opening pressure) on PLPH.
RESULTS
The PLPH was found in 11 cases(12.5%) among bed-rest and ambulant groups. The frequency of each group was 8% (3/38) in bed-rest group and 16%(8/50) in ambulant group, but there is no significant difference between two groups (p-vaIue = 0.26). The frequency of PLPH is also not correlated to the CSF profiles; count of RBC and WBC, protein level, and opening pressure.
CONCLUSIONS
There is no significant difference between the ambulant and bed rest group in the frequency of the PLPH. We conclude that the bed rest after LP is unnecessary for the prevention of the PLPH.

MeSH Terms

Bed Rest*
Headache
Humans
Incidence
Needles
Nursing
Post-Dural Puncture Headache*
Prospective Studies
Punctures
Spinal Puncture