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  • Are patients with IIH at lower risk of developing low-pressure syndrome after lumbar puncture?

    Neuro-Ophthalmology/Orbit

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    Investigators explored the incidence of and risk factors for developing persistent low-pressure syndrome after lumbar puncture (LP) in patients with idiopathic intracranial hypertension (IIH).

    Study design 

    The authors performed a retrospective chart review of 104 patients with IIH and a control group of 149 patients with multiple sclerosis (MS). The main outcome was the rate of post-LP blood patches.

    Outcomes

    Twelve patients with IIH (11.5%) underwent an epidural blood patch after LP compared with 8 (5.4%) of the MS control patients (P=0.086). Within the IIH population, none of the clinical or LP parameters were significantly correlated with increased risk of needing a blood patch.

    Limitations

    The main limitation is the retrospective nature of the study and its relatively small sample size.

    Clinical significance

    The incidence of low-pressure syndrome is similar between IIH patients and MS controls. These findings, which are contrary to common assumptions, suggest that patients who have an elevated intracranial pressure are not protected against developing post-LP low-pressure syndrome.