What Helps Prevent Post LP Headaches:

• 20 – 22G needles seems to be the optimal size for diagnostic/therapeutic LPs in adults
• Needle bevel parallel to dural fibers
• Replacement of stylet before withdrawal of spinal needle
• Early ambulation, NOT laying flat post procedure
• Number of LP attempts (Never studied, but pathophysiologically makes sense)

What DOES NOT Help Prevent Post LP Headaches:

• Volume of CSF removed
• Patient Position
• IVF prior to LP, but may decrease duration of headache being > 24 hours

Treatment for post LP headache:

• Oral hydration after lumbar puncture does not improve treatment
• The evidence is weak, but IV or oral caffeine does improve post LP headache, but with a high recurrence rate
• Blood patch is an effective treatment for post LP headache

Reference: http://rebelem.com/post-lumbar-puncture-headaches/