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.

中文翻译：

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低脑脊液量和腰椎穿刺后头痛的风险

背景脑脊液（CSF）对于神经系统疾病患者的医学检查和疾病缓解临床试验是必不可少的。腰椎穿刺后 (LP) 头痛受操作者和患者相关因素的影响，包括针头类型和规格、年龄和性别。目的 我们旨在评估基于术前脑部 MRI 测量的 CSF 体积是否与发生 LP 后头痛的风险相关。方法 总共有 n = 117 名参与者（n = 58 名帕金森病患者，n = 59 名健康对照者）接受了 LP 和 CSF 采集。其中，n = 89 在 LP 程序之前接受了 MRI 扫描，使用 3 T MR 扫描仪获取高分辨率 3D 磁化准备快速梯度回波 (MP-RAGE) T1 加权图像。对所有参与者进行临床和行为评估，并评估脑脊液的内容。T1 加权图像被分割产生灰质、白质和脑脊液概率图。结果 13 名参与者 (11.1%) 经历了腰椎穿刺后头痛。与未出现腰椎穿刺后头痛的参与者相比，他们更年轻 (p = .033) 且脑脊液体积较低 (p = .040)。结论 这项试点研究的结果表明，低 CSF 容量可能会增加发生 LP 后不良事件的风险，在计划 LP 时应予以考虑。033) 并且与没有发生腰椎穿刺后头痛的参与者相比，脑脊液体积较低 (p = .040)。结论 这项试点研究的结果表明，低 CSF 容量可能会增加发生 LP 后不良事件的风险，在计划 LP 时应予以考虑。033) 并且与没有发生腰椎穿刺后头痛的参与者相比，脑脊液体积较低 (p = .040)。结论 这项试点研究的结果表明，低 CSF 容量可能会增加发生 LP 后不良事件的风险，在计划 LP 时应予以考虑。