{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:00:39Z","timestamp":1787504439071,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T00:00:00Z","timestamp":1563926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>(1) To perform a systematic literature review to evaluate associations between post\u2010dural puncture headache (PDPH) and opening pressure (OP), closing pressure (CP), and volume of cerebrospinal fluid (V) removed. (2) To perform a case\u2010control study to evaluate pressure\u2010volume index (PVI) as a novel risk factor for PDPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>According to the International Classification of Headache Diagnoses, 3rd Edition (ICHD\u20103), the diagnosis of PDPH requires documentation of intracranial hypotension. However, this remains an unproven concept.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature review was conducted, searching Cochrane Database of Systematic Reviews, Ovid EMBASE, OVID MEDLINE, Scopus, and Web of Science. Study inclusion required a comparison of headache incidence following a LP as a function of OP, CP, and\/or V.<\/jats:p>\n                    <jats:p>A retrospective, case\u2010control study with 1:1 matching was conducted utilizing ICHD\u20103 criteria. Patients with factors that could influence CSF pressure were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In our case\u2010control study, we did not identify a paired difference in either median (95% CI) elastance (0.05 [\u22120.09, 0.11],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.503) or PVI (4.53 [\u22127.98, 19.97],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.678). We identified 22 references, evaluating V (n\u00a0=\u00a014), OP (n\u00a0=\u00a011), and\/or CP (n\u00a0=\u00a04). There was no convincing evidence for an association of PDPH with either OP or CP. A minority of studies documenting an association with V included patients with high\u2010volume CSF removal, and\/or stratified patients by the timing of the headache onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The overall risk of PDPH does not appear to be influenced by OP, CP, V or PVI. PDPH may be related to V in instances of high\u2010volume removal, and depend on the timing of outcome assessment. Future revision of criteria should consider the existence of immediate and delayed PDPH subtypes, and not presume intracranial hypotension as a mandatory feature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13602","type":"journal-article","created":{"date-parts":[[2019,7,25]],"date-time":"2019-07-25T02:23:03Z","timestamp":1564021383000},"page":"1324-1338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["CSF Pressure, Volume, and Post\u2010Dural Puncture Headache: A Case\u2010Control Study and Systematic Review"],"prefix":"10.1111","volume":"59","author":[{"given":"Jonathan H.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic Scottsdale AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Mac Grory","sequence":"additional","affiliation":[{"name":"Department of Neurology Brown University Providence RI 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