Stefka Mantarova1, Spaska Georgieva- Zhostova2, Boyko Todorov3, Anastasia Trenova4, Georgi Slavov4, Maria Manova4
1) Department of Neurology, Medical University – Plovdiv, Bulgaria; Military Medical Academy - Multiprofile Hospital for Active Treatment Plovdiv, Bulgaria;
2) Multiprofile Hospital for Active Treatment - Blagoevgrad, Bulgaria;
3) Military Medical Academy - Multiprofile Hospital for Active Treatment Plovdiv, Bulgaria; Department of Surgery, Medical University – Plovdiv, Bulgaria;
4) Department of Neurology, Medical University – Plovdiv, Bulgaria; University Hospital St. George, Plovdiv, Bulgaria
Disclosure: The author has declared no conflicts of interest.
Received: 23.07.15 Accepted: 06.09.15
The post-dural puncture headache (PDPH) is the most common complication of lumbar puncture in neurological practice. Although the comorbidity of headache and psychiatric symptoms is well-recognized, the data about the relationship between PDPH and symptoms of anxiety and depression are limited. The aim of the present study was to determine the influence of anxiety symptoms on the risk for PDPH.
Methods: Diagnostic lumbar puncture was performed to thirty-nine neurological patients, presented by 26 women and 13 men. All subjects completed the Hospital Anxiety and Depression Scale (HADS) before the procedure. Information about the clinical characteristic of the headache - quality, location, severity, postural nature, duration and associated symptoms (nausea, vomiting, and tinnitus) was collected.
Results: Fifteen of the patients (38,5%) developed PDPH. According to the presence of PDPH the patients were divided into two groups – with (group 1) and without headache (group 2). Women with headache were significantly younger (mean age 34,00±11,22 years) compared to females in group 2 (mean age 45,07±12,36 years) (p=0,028). Patients in group 1 had significantly higher levels of reported anxiety symptoms compared to group 2 (p= 0,045). A significant positive correlation was observed between anxiety and PDPH (Spearman’s rho = 0,412, p=0,009).
Conclusion: Younger female patients with anxiety had a considerably increased rate of PDPH. This could be of practical benefit in devising an additional treatment strategy for patients with PDPH.
Keywords: headache, anxiety, depression, lumbar puncture
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