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Stefka Mantarova, Spaska Georgieva- Zhostova, Boyko Todorov, Anastasia Trenova, Georgi Slavov, Maria Manova.


Background: 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.

Key words: headache, anxiety, depression, lumbar puncture

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