Pain location and associated symptoms in post-lumbar puncture headache

In this prospective study of 239 patients, 88 (37%) suffered from post-lumb ar puncture headache (PPH). The pain was located within the region innervat ed by the trigeminal nerve in 49% of the drawings, within the occipital and /or suboccipital region in 11% and within the combined trigeminal/occipital region in 39%. The headache was unilateral at least once in 34% of the pat ients. Changes in pain location from one region to the other and/or between bilateral and unilateral headache were observed in 54% of the patients thr oughout the PPH period. Associated symptoms were experienced by 85%, nausea (73%) and dizziness (60%) being the most frequently reported. In the uprig ht position, nausea, dizziness, and tinnitus tended to be present during a fairly large part of the PPH period (57-63% of the days), vomiting occurrin g only occasionally (28%). The intensity of associated symptoms was positiv ely correlated to PPH severity. rain in the combined trigeminal/occipital r egion was most severe and related to more associated symptoms than pain in other regions, and unilateral pain was milder than bilateral pain, rain in the occipital and/or suboccipital region was mildest. The severity of nause a decreased significantly on the last 2 days of the PPH period, and the int ensity of dizziness decreased when PPH was about to subside. Tinnitus is pr obably due to a cochlear dysfunction, and presents special characteristics. Its incidence was not clearly related to PPH severity and it increased wit h increasing duration of PPH; its intensity did not decline when PPH was ab out to wane.