In the section on dermatology and syphilology at the Mayo Clinic, approximately fifty spinal punctures are done weekly. The headaches that follow the procedure have been complained of by so many patients that it seemed wise to investigate the cause and search for some means of preventing them.
Based on explanations of the cause of the headaches, various procedures have been recommended for prevention or cure. With the idea of increasing either the pressure or the actual secretion of spinal fluid, subcutaneous injections of solutions of pituitary and the intravenous injection of hypotonic solution of sodium chloride have been used. The use of a needle of small caliber has been advised to reduce to a minimum the size of the hole left in the meninges. Sicard1 and others have suggested confining the patient to bed with the head lowered for from twenty-four to forty-eight hours after puncture. Replacing the
NELSON MO. POSTPUNCTURE HEADACHESA CLINICAL AND EXPERIMENTAL STUDY OF THE CAUSE AND PREVENTION. Arch Derm Syphilol. 1930;21(4):615–627. doi:10.1001/archderm.1930.01440100101010
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