Trial reportCephalalgia : an international journal of headache2019
Therapeutic lumbar puncture for headache in idiopathic intracranial hypertension: Minimal gain, is it worth the pain?
Trial report in Cephalalgia : an international journal of headache, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- European headache federation guideline on idiopathic intracranial hypertension.The journal of headache and pain · 2018Guideline
- Intracranial pressure directly predicts headache morbidity in idiopathic intracranial hypertension.The journal of headache and pain · 2021Trial
- The effect of CSF drain on the optic nerve in idiopathic intracranial hypertension.The journal of headache and pain · 2019Trial
- [Idiopathic intracranial hypertension at the Niamey General Reference Hospital (Niger): a series of eight cases].Medecine tropicale et sante internationale · 2026Article
- Idiopathic CSF dynamic disturbances causing headache: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Acute headache treatment in idiopathic intracranial hypertension: treating to the phenotype?The journal of headache and pain · 2025Article
- Migraine-like headache attributed to a causative disorder: primary migraine or secondary headache with a migraine-like phenotype?The journal of headache and pain · 2025Article
- Clinical outcomes of bariatric surgery in patients with obesity and idiopathic intracranial hypertension.Surgical endoscopy · 2025Article
- Metabolic Dysfunction in Idiopathic Intracranial Hypertension: Current Theories and Updates.Aging and disease · 2024Review
- Therapeutic effect of a single lumbar puncture in idiopathic intracranial hypertension.The journal of headache and pain · 2024Observational
- Management of neurotoxicity syndrome complicated by autologous hematopoietic stem cell transplantation bridge to chimeric antigen receptor T-Cell therapy: A case report.Asia-Pacific journal of oncology nursing · 2024Article
- Idiopathic intracranial hypertension: a step change in understanding the disease mechanisms.Nature reviews. Neurology · 2023Review
- Longitudinal prospective cohort study evaluating prognosis in idiopathic intracranial hypertension patients with and without comorbid polycystic ovarian syndrome.Eye (London, England) · 2023Article
- Clinical Course and Ophthalmologic Findings in Idiopathic Intracranial Hypertension and Pregnancy.Brain sciences · 2023Article
- A Neuro-Ophthalmologist's Guide to Advances in Intracranial Pressure Measurements.Eye and brain · 2023Review
- Multiple lumbar punctures aiming to relieve headache results in iatrogenic spinal hematoma: a case report.Journal of medical case reports · 2022Article
- Discordance Between Perceptions and Experience of Lumbar Puncture: A Prospective Study.Neurology. Clinical practice · 2022Article
- Management of idiopathic intracranial hypertension in pregnancy.Obstetric medicine · 2022Review
- Managing idiopathic intracranial hypertension in pregnancy: practical advice.Practical neurology · 2022Article
- Chronic musculoskeletal pain, catastrophizing, and physical function in adult women were improved after 3-month aerobic-resistance circuit training.Scientific reports · 2021Article
Corrections and comments
- Commented on by
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHeadache is disabling and prevalent in idiopathic intracranial hypertension. Therapeutic lumbar punctures may be considered to manage headache. This study evaluated the acute effect of lumbar punctures on headache severity. Additionally, the effect of lumbar puncture pressure on post-lumbar puncture headache was evaluated.
methodsActive idiopathic intracranial hypertension patients were prospectively recruited to a cohort study, lumbar puncture pressure and papilloedema grade were noted. Headache severity was recorded using a numeric rating scale (NRS) 0-10, pre-lumbar puncture and following lumbar puncture at 1, 4 and 6 hours and daily for 7 days.
resultsFifty two patients were recruited (mean lumbar puncture opening pressure 32 (28-37 cmCSF). At any point in the week post-lumbar puncture, headache severity improved in 71% (but a small reduction of -1.1 ± 2.6 numeric rating scale) and exacerbated in 64%, with 30% experiencing a severe exacerbation ≥ 4 numeric rating scale. Therapeutic lumbar punctures are typically considered in idiopathic intracranial hypertension patients with severe headaches (numeric rating scale ≥ 7). In this cohort, the likelihood of improvement was 92% (a modest reduction of headache pain by -3.0 ± 2.8 numeric rating scale, p = 0.012, day 7), while 33% deteriorated. Idiopathic intracranial hypertension patients with mild (numeric rating scale 1-3) or no headache (on the day of lumbar puncture, prior to lumbar puncture) had a high risk of post- lumbar puncture headache exacerbation (81% and 67% respectively). Importantly, there was no relationship between lumbar puncture opening pressure and headache response after lumbar puncture.
conclusionFollowing lumbar puncture, the majority of idiopathic intracranial hypertension patients experience some improvement, but the benefit is small and post-lumbar puncture headache exacerbation is common, and in some prolonged and severe. Lumbar puncture pressure does not influence the post-lumbar puncture headache.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.