[Lowered incidence of post-lumbar puncture headache following the application of the second edition of the International Headache Society classification]. / Disminución en la incidencia de la cefalea pospunción lumbar tras la aplicación de la segunda edición de la Sociedad Internacional de Cefaleas.

INTRODUCTION: In 1988 the International Headache Society (IHS) published the 1st edition of its headache classification and the 2nd edition was completed in 2003. AIM. To determine whether there exist changes in the incidence of post-lumbar puncture headache depending on the edition of the IHS classification. PATIENTS AND METHODS: Between 2002 and 2003 data was gathered prospectively for 78 patients who were submitted to a diagnostic lumbar puncture, 40 obstetric spinal anaesthesias and 516 non-obstetric spinal anaesthesias. The 1st edition was used and, after the appearance of the 2nd edition, the cases were recoded. RESULTS: With the 1st edition, there were 31 out of 78 cases (39.7%) of post-puncture headache in diagnostic punctures, and when the 2nd edition was used, the number dropped to 10 cases (12.8%). The incidence of headache among patients who had undergone obstetric spinal anaesthesia was six cases out of a total of 40 (15%) using the 1st edition, and four cases with the 2nd edition (10%). The incidence of headache among patients after non-obstetric spinal anaesthesia was 80 cases out of a total of 516 (15.5%) when the 1st edition was utilised and 25 cases with the 2nd edition (4.85%). CONCLUSIONS: To compare the incidences of post-lumbar puncture headaches obtained by diverse observers we need to know which edition was used, since there are considerable differences between the results obtained using one edition or the other. The main reason accounting for the discrepancy between the two editions is the compulsory association of some accompanying sign, since this was not a necessary criterion in the 1st edition but it is included in the 2nd.

Disminución en la incidencia de la cefalea pospunción lumbar tras la aplicación de la segunda edición de la Sociedad Internacional de Cefaleas / Lowered incidence of post-lumbar puncture headache following the application of the second edition of the international headache society

Introducción. La Sociedad Internacional de Cefaleas (IHS, International Headache Society) publicó en 1988 la 1.ª edición de la clasificación de las cefaleas. La 2.ª edición se completa en el 2003. Objetivo. Determinar si existen cambios en la incidencia de la cefalea pospunción lumbar según la edición de la IHS. Pacientes y métodos. Prospectivamente se recogieron, entre el 2002 y 2003, 78 pacientes a los que se realizó una punción lumbar diagnóstica, 40 raquianestesias obstétricas y 516 raquianestesias no obstétricas. Se utilizó la 1.ª edición, y tras la aparición de la 2.ª se recodificaron los casos. Resultados. Con la 1.ª edición, la cefalea pospunción en las punciones diagnósticas fueron 31 de 78 casos (39,7%), y cuando se utilizó la 2.ª fueron 10 casos (12,8%). En las pacientes de raquianestesia obstétrica, con la utilización de la 1.ª edición, la incidencia de cefalea fue de seis casos de 40 (15%) y cuatro casos con la 2.ª (10%). De los pacientes con raquianestesia no obstétrica la incidencia de cefalea fue de 80 (15,5%) de 516 casos con la 1.ª edición de la IHS, y 25 casos (4,85%) con la 2.ª. Conclusiones. Se necesita conocer la edición si se quieren comparar incidencias de cefalea pospunción entre observadores, ya que las diferencias son ostensibles entre utilizar una u otra edición. El principal motivo de discrepancia entre las dos ediciones es la asociación obligada de algún signo acompañante, ya que éste no era criterio necesario en la 1.ª edición y sí en la 2.ª

Introduction. In 1988 the International Headache Society (IHS) published the 1st edition of its headache classification and the 2nd edition was completed in 2003. Aim. To determine whether there exist changes in the incidence of post-lumbar puncture headache depending on the edition of the IHS classification. Patients and methods. Between 2002 and 2003 data was gathered prospectively for 78 patients who were submitted to a diagnostic lumbar puncture, 40 obstetric spinal anaesthesias and 516 non-obstetric spinal anaesthesias. The 1st edition was used and, after the appearance of the 2nd edition, the cases were recoded. Results. With the 1st edition, there were 31 out of 78 cases (39.7%) of post-puncture headache in diagnostic punctures, and when the 2nd edition was used, the number dropped to 10 cases (12.8%). The incidence of headache among patients who had undergone obstetric spinal anaesthesia was six cases out of a total of 40 (15%) using the 1st edition, and four cases with the 2nd edition (10%). The incidence of headache among patients after non-obstetric spinal anaesthesia was 80 cases out of a total of 516 (15.5%) when the 1st edition was utilised and 25 cases with the 2nd edition (4.85%). Conclusions. To compare the incidences of post-lumbar puncture headaches obtained by diverse observers we need to know which edition was used, since there are considerable differences between the results obtained using one edition or the other. The main reason accounting for the discrepancy between the two editions is the compulsory association of some accompanying sign, since this was not a necessary criterion in the 1st edition but it is included in the 2nd