What is the role of caffeine in the treatment of post-lumbar puncture headache?

Updated: Jun 14, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Answer

The characteristics of headaches associated with low cerebrospinal fluid pressure are very distinct, with typically orthostatic symptoms, but the exact pathophysiology remains poorly understood. Caffeine may lead to vasoconstriction by blocking the adenosine receptors.

There is no standardized protocol for administering caffeine sodium benzoate (CSB), but in previously reported cases, 500 mg of CSB is mixed in 1 L of normal saline or lactated Ringer solution and infused intravenously over 1-2 hours. There is controversy, however, regarding the efficacy of caffeine in this clinical scenario. [11] Most experts recommend an epidural patch or saline infusion if the headaches persist after administration of 1 g of CSB.


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