Low cerebrospinal fluid volume and the risk for post-lumbar puncture headaches

Amgad Droby, Nurit Omer, Tanya Gurevich, Meir Kestenbaum, Yair Mina, Jesse M. Cedarbaum, Orna Aizenstein, Nir Giladi, Anat Mirelman, Avner Thaler

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Cerebrospinal fluid (CSF) is essential for the medical workup of patients with neurological conditions and for disease-modifying clinical trials. Post- lumbar puncture (LP) headache is influenced by both operator and patient-related factors, including needle type and gauge, age, and gender. Objectives: We aimed to assess whether CSF volume measured based on pre-procedural brain MRI is associated with the risk of developing a post-LP headache. Methods: In total, n = 117 participants (n = 58 Parkinson's disease patients, and n = 59 healthy controls) underwent an LP and CSF collection. Of those, n = 89 underwent MRI scans prior to the LP procedure acquiring high-resolution 3D magnetization-prepared rapid gradient echo (MP-RAGE) T1-weighted images using a 3 T MR scanner. Clinical and behavioral assessments were performed for all participants, and CSF was assessed for content. The T1-weighted images were segmented producing gray matter, white matter, and CSF probability maps. Results: Thirteen participants (11.1%) experienced post-LP headache. They were younger (p =.033) and had lower CSF volumes (p =.040) compared to participants that did not develop a post LP headache. Conclusions: The results of this pilot study suggest that low CSF volumes might increase the risk for the occurrence of post-LP adverse events and should be taken into consideration when planning LP's.

Original languageEnglish
Article number117059
JournalJournal of the Neurological Sciences
StatePublished - 15 Oct 2020
Externally publishedYes


  • CSF volume
  • MRI
  • Post LP headaches

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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