INTRODUCTION: Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain. METHODS: We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III). RESULTS: Our consensus guidelines address contraindications, as well as patient-related and procedure-related risk factors that can influence the development of post-LP complications. DISCUSSION: When an LP is performed correctly, the procedure is well tolerated and accepted with a low complication rate.

Alzheimer center and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands

Alzheimer Centre Limburg School for Mental Health and Neuroscience Department of Psychiatry and Neuropsychology Maastricht University Maastricht The Netherlands

Alzheimer's disease and other cognitive disorders unit Neurology Service Hospital Clinic i Universitari IDIBAPS Barcelona Spain

Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas CIBERNED Madrid Spain

Clinic of Neurology Clinical Centre of Serbia Department of Neurology Faculty of Medicine University of Belgrade School of Medicine Belgrade Serbia

Clinical Memory Research Unit Department of Clinical Sciences Lund University Lund Sweden

Clinical Neurochemistry Laboratory Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Mölndal Sweden

CSF Laboratory and Multiple Sclerosis Outpatient Unit Department of Neurology University of Ulm Ulm Germany

Department of Clinical Neuroscience Karolinska Institute Karolinska University Hospital Stockholm Sweden

Department of Geriatric Psychiatry Central Institute of Mental Health Medical Faculty Mannheim Heidelberg University Mannheim Germany

Department of Geriatrics Kalmar County Hospital Kalmar Sweden

Department of Neurology and Memory Clinic Hospital Network Antwerp Middelheim and Hoge Beuken Antwerp Belgium

Department of Neurology Atrium Medisch Centrum Parkstad Heerlen The Netherlands

Department of Neurology Erasmus Medical Center Rotterdam The Netherlands

Department of Neurology Medical University Graz Graz Austria

Department of Neurology St Elisabeth Ziekenhuis Tilburg The Netherlands

Department of Neurology Technische Universität München Munich Germany

Department of Neurology Universitair Ziekenhuis Brussel Brussels Belgium

Department of Neurology University Hospital Basel Basel Switzerland

Department of Neuroscience and Trauma Blizard Institute Queen Mary University of London London United Kingdom

Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden

Departments of Neurology and Neurosurgery and Psychiatry McGill Centre for Studies in Aging Douglas Hospital Research Center McGill University Montreal Canada

Departments of Psychiatry McGill Centre for Studies in Aging Douglas Hospital Research Center McGill University Montreal Canada

Faculté de Psychologie et des sciences de l'éducation UMons Mons Belgium

International Clinical Research Center St Anne's University Hospital Brno Brno Czech Republic

Karolinska Institutet Department of Neurobiology Care Sciences and Society Center for Alzheimer Research Division for Neurogeriatrics Huddinge Sweden

Laboratory of Neurosciences Department of Molecular Medicine and Faculty of Medicine University of Lisbon Lisbon Portugal

Memory Clinic Department of Neuropsychiatry Sahlgrenska University Hospital Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Mölndal Sweden

Memory Disorders Clinic Department of Neurology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

Memory Unit Department of Neurology Hospital de la Santa Creu i Sant Pau Barcelona Spain

Munich Cluster for Systems Neurology Munich Germany

National MS Center Melsbroek Brussels Belgium

Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands

Neurology Unit Department of Pathophysiology and Transplantation University of Milan Fondazione Ca' Granda IRCCS Ospedale Policlinico Milan Italy

Reference Center for Biological Markers of Dementia Department of Biomedical Sciences Institute Born Bunge University of Antwerp Antwerp Belgium

Research Memory Center Lariboisière Hospital University Paris Diderot INSERMU942 Paris France

Section of Neurology Centre for Memory Disturbances Department of Medicine University of Perugia Perugia Italy

Servei de Neurologia Neuroimmunologia Centre d'Esclerosi Múltiple de Catalunya Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Barcelona Spain

UCL Institute of Neurology Department of Molecular Neuroscience London United Kingdom

Zobrazit více v PubMed

Niemantsverdriet E., Struyfs H., Duits F., Teunissen C., Engelborghs S. Techniques, contraindications and complications of CSF collection procedures. In: Deisenhammer F., Sellebjerg F., Teunissen C.E., Tumani H., editors. Cerebrospinal Fluid in Clinical Neurology. Springer; New York: 2015. pp. 37–57.

McKhann G.M., Knopman D.S., Chertkow H., Hyman B.T., Jack C.R., Jr., Kawas C.H. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:263–269. PubMed PMC

Albert M.S., DeKosky S.T., Dickson D., Dubois B., Feldman H.H., Fox N.C. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:270–279. PubMed PMC

Dubois B., Feldman H.H., Jacova C., Hampel H., Molinuevo J.L., Blennow K. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol. 2014;13:614–629. PubMed

Duits F.H., Martinez-Lage P., Paquet C., Engelborghs S., Lleo A., Hausner L. Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study. Alzheimers Dement. 2016;12:154–163. PubMed

Headache Classification Subcommittee of the International Headache Society The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9–160. PubMed

Leibold R.A., Yealy D.M., Coppola M., Cantees K.K. Post-dural-puncture headache: characteristics, management, and prevention. Ann Emerg Med. 1993;22:1863–1870. PubMed

Safa-Tisseront V., Thormann F., Malassine P., Henry M., Riou B., Coriat P. Effectiveness of epidural blood patch in the management of post-dural puncture headache. Anesthesiology. 2001;95:334–339. PubMed

US. Preventive Services Task Force . DIANE Publishing; Darby, PA: 1989. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force; p. 24.

PRISMA. Transparent reporting of systematic reviews and meta-anayses. Available at: http://www.prisma-statement.org/. Accessed October 19, 2016.

Linker G., Mirza N., Manetti G., Meyer M., Putnam K., Sunderland T. Fine-needle, negative-pressure lumbar puncture: a safe technique for collecting CSF. Neurology. 2002;59:2008–2009. PubMed

Engelhardt A., Oheim S., Neundorfer B. Post-lumbar puncture headache: experiences with Sprotte's atraumatic needle. Cephalalgia. 1992;12:259. PubMed

Dakka Y., Warra N., Albadareen R.J., Jankowski M., Silver B. Headache rate and cost of care following lumbar puncture at a single tertiary care hospital. Neurology. 2011;77:71–74. PubMed

Turnbull D., McKevitt F. Headache after diagnostic lumbar puncture. Authors should have used smaller gauge needles. BMJ. 2001;322:994. PubMed

Davies J.R. Headache after diagnostic lumbar puncture. Smaller is better where needles are concerned. BMJ. 2001;322:993–994. PubMed

Reynolds F., O'Sullivan G. Lumbar puncture and headache. “Atraumatic needle” is a better term than “blunt needle”. BMJ. 1998;316:1018. PubMed

Chow T.K. Education research: changing practice: residents' adoption of the atraumatic lumbar puncture needle. Neurology. 2014;82:734–735. PubMed

Toyka K.V., Muller B., Reichmann H. “Atraumatic” Sprotte needle reduces the incidence of post-lumbar puncture headaches. Neurology. 2002;59:1120. author reply 1120–1. PubMed

Kuczkowski K.M. Pneumocephalus following an uneventful lumbar puncture: does the gauge of a spinal needle matter? Anesth Analg. 2004;99:303. author reply 303–4. PubMed

Smeltzer J.S. Headache after diagnostic lumbar puncture. Using 20 gauge needle is blunderbuss technique. BMJ. 2001;322:993. author reply 994. PubMed PMC

Leone M.A., Brainin M., Boon P., Pugliatti M., Keindl M., Bassetti C.L. Guidance for the preparation of neurological management guidelines by EFNS scientific task forces - revised recommendations 2012. Eur J Neurol. 2013;20:410–419. PubMed

Hasbun R., Abrahams J., Jekel J., Quagliarello V.J. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001;345:1727–1733. PubMed

Korein J., Cravioto H., Leicach M. Reevaluation of lumbar puncture; a study of 129 patients with papilledema or intracranial hypertension. Neurology. 1959;9:290–297. PubMed

Archer B.D. Computed tomography before lumbar puncture in acute meningitis: a review of the risks and benefits. CMAJ. 1993;148:961–965. PubMed PMC

Practice parameters: lumbar puncture (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1993;43:625–627. PubMed

Gower D.J., Baker A.L., Bell W.O., Ball M.R. Contraindications to lumbar puncture as defined by computed cranial tomography. J Neurol Neurosurg Psychiatry. 1987;50:1071–1074. PubMed PMC

Heidbuchel H., Verhamme P., Alings M., Antz M., Hacke W., Oldgren J. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J. 2013;34:2094–2106. PubMed

Keeling D., Baglin T., Tait C., Watson H., Perry D., Baglin C. Guidelines on oral anticoagulation with warfarin - fourth edition. Br J Haematol. 2011;154:311–324. PubMed

Horlocker T.T., Wedel D.J., Schroeder D.R., Rose S.H., Elliott B.A., McGregor D.G. Preoperative antiplatelet therapy does not increase the risk of spinal hematoma associated with regional anesthesia. Anesth Analg. 1995;80:303–309. PubMed

Brook A.D., Burns J., Dauer E., Schoendfeld A.H., Miller T.S. Comparison of CT and fluoroscopic guidance for lumbar puncture in an obese population with prior failed unguided attempt. J Neurointerv Surg. 2014;6:324–328. PubMed

Boddu S.R., Corey A., Peterson R., Saindane A.M., Hudgins P.A., Chen Z. Fluoroscopic-guided lumbar puncture: fluoroscopic time and implications of body mass index–a baseline study. AJNR Am J Neuroradiol. 2014;35:1475–1480. PubMed PMC

Kim S., Adler D.K. Ultrasound-assisted lumbar puncture in pediatric emergency medicine. J Emerg Med. 2014;47:59–64. PubMed

Peterson M.A., Pisupati D., Heyming T.W., Abele J.A., Lewis R.J. Ultrasound for routine lumbar puncture. Acad Emerg Med. 2014;21:130–136. PubMed

Armon C., Evans R.W., Therapeutics, Technology Assessment Subcommittee of the American Academy of Neurology Addendum to assessment: Prevention of post-lumbar puncture headaches: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65:510–512. PubMed

Amorim J.A., Gomes de Barros M.V., Valenca M.M. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia. 2012;32:916–923. PubMed

Monserrate A.E., Ryman D.C., Ma S., Xiong C., Noble J.M., Ringman J.M. Factors associated with the onset and persistence of post-lumbar puncture headache. JAMA Neurol. 2015;72:325–332. PubMed PMC

Vilming S.T., Schrader H., Monstad I. The significance of age, sex, and cerebrospinal fluid pressure in post-lumbar-puncture headache. Cephalalgia. 1989;9:99–106. PubMed

Tourtellotte W.W., Henderson W.G., Tucker R.P., Gilland O., Walker J.E., Kokman E. A randomized, double-blind clinical trial comparing the 22 versus 26 gauge needle in the production of the post-lumbar puncture syndrome in normal individuals. Headache. 1972;12:73–78. PubMed

Evans R.W., Armon C., Frohman E.M., Goodin D.S. Assessment: prevention of post-lumbar puncture headaches: report of the therapeutics and technology assessment subcommittee of the american academy of neurology. Neurology. 2000;55:909–914. PubMed

Kaplan G. The psychogenic etiology of headache post lumbar puncture. Psychosom Med. 1967;29:376–379. PubMed

Straus S.E., Thorpe K.E., Holroyd-Leduc J. How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis? JAMA. 2006;296:2012–2022. PubMed

Boon J.M., Abrahams P.H., Meiring J.H., Welch T. Lumbar puncture: anatomical review of a clinical skill. Clin Anat. 2004;17:544–553. PubMed

Doherty C.M., Forbes R.B. Diagnostic lumbar puncture. Ulster Med J. 2014;83:93–102. PubMed PMC

Evans R.W. Complications of lumbar puncture. Neurol Clin. 1998;16:83–105. PubMed

Sahebkar-Moghaddam F., Adornato B.T. The failed lumbar puncture. Neurology. 2005;64:E24. PubMed

Wright B.L., Lai J.T., Sinclair A.J. Cerebrospinal fluid and lumbar puncture: a practical review. J Neurol. 2012;259:1530–1545. PubMed

Ellis R.W., 3rd, Strauss L.C., Wiley J.M., Killmond T.M., Ellis R.W., Jr. A simple method of estimating cerebrospinal fluid pressure during lumbar puncture. Pediatrics. 1992;89:895–897. PubMed

Alcolea D., Martinez-Lage P., Izagirre A., Clerigue M., Carmona-Iragui M., Alvarez R.M. Feasibility of lumbar puncture in the study of cerebrospinal fluid biomarkers for Alzheimer's disease: a multicenter study in Spain. J Alzheimers Dis. 2014;39:719–726. PubMed

Hammond E.R., Wang Z., Bhulani N., McArthur J.C., Levy M. Needle type and the risk of post-lumbar puncture headache in the outpatient neurology clinic. J Neurol Sci. 2011;306:24–28. PubMed

Rodriguez D., Branstetter B.F., Agarwal V., Palfey S., Ching K.C., Bump G.M. JOURNAL CLUB: Incidence of Complications Following Fluoroscopically Guided Lumbar Punctures and Myelograms. AJR Am J Roentgenol. 2016;206:20–25. PubMed

Crock C., Orsini F., Lee K.J., Phillips R.J. Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles. Arch Dis Child. 2014;99:203–207. PubMed

Kim M., Yoon H. Comparison of post-dural puncture headache and low back pain between 23 and 25 gauge Quincke spinal needles in patients over 60 years: randomized, double-blind controlled trial. Int J Nurs Stud. 2011;48:1315–1322. PubMed

Carson D., Serpell M. Choosing the best needle for diagnostic lumbar puncture. Neurology. 1996;47:33–37. PubMed

Vidoni E.D., Morris J.K., Raider K., Burns J.M., Alzheimer's Disease Neuroimaging Initiative Reducing post-lumbar puncture headaches with small bore atraumatic needles. J Clin Neurosci. 2014;21:536–537. PubMed PMC

Ginosar Y., Smith Y., Ben-Hur T., Lovett J.M., Clements T., Ginosar Y.D. Novel pulsatile cerebrospinal fluid model to assess pressure manometry and fluid sampling through spinal needles of different gauge: support for the use of a 22 G spinal needle with a tapered 27 G pencil-point tip. Br J Anaesth. 2012;108:308–315. PubMed

Flaatten H., Krakenes J., Vedeler C. Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia. Acta Neurol Scand. 1998;98:445–451. PubMed

Muller B., Adelt K., Reichmann H., Toyka K. Atraumatic needle reduces the incidence of post-lumbar puncture syndrome. J Neurol. 1994;241:376–380. PubMed

Aamodt A., Vedeler C. Complications after LP related to needle type: pencil-point versus Quincke. Acta Neurol Scand. 2001;103:396–398. PubMed

Vilming S.T., Kloster R., Sandvik L. The importance of sex, age, needle size, height and body mass index in post-lumbar puncture headache. Cephalalgia. 2001;21:738–743. PubMed

Hatfield M.K., Handrich S.J., Willis J.A., Beres R.A., Zaleski G.X. Blood patch rates after lumbar puncture with Whitacre versus Quincke 22- and 20-gauge spinal needles. AJR Am J Roentgenol. 2008;190:1686–1689. PubMed

Kleyweg R.P., Hertzberger L.I., Carbaat P.A. Significant reduction in post-lumbar puncture headache using an atraumatic needle. A double-blind, controlled clinical trial. Cephalalgia. 1998;18:635–637. PubMed

Kovanen J., Sulkava R. Duration of postural headache after lumbar puncture: effect of needle size. Headache. 1986;26:224–226. PubMed

Bertolotto A., Malentacchi M., Capobianco M., di Sapio A., Malucchi S., Motuzova Y. The use of the 25 Sprotte needle markedly reduces post-dural puncture headache in routine neurological practice. Cephalalgia. 2016;36:131–138. PubMed

Palmers Y., Kuhn F.P., Petersen D., De Greef D. Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial. Eur Radiol. 2002;12:686–691. PubMed

Ready L.B., Cuplin S., Haschke R.H., Nessly M. Spinal needle determinants of rate of transdural fluid leak. Anesth Analg. 1989;69:457–460. PubMed

Lowery S., Oliver A. Incidence of postdural puncture headache and backache following diagnostic/therapeutic lumbar puncture using a 22G cutting spinal needle, and after introduction of a 25G pencil point spinal needle. Paediatr Anaesth. 2008;18:230–234. PubMed

Engedal T.S., Ording H., Vilholm O.J. Changing the needle for lumbar punctures: results from a prospective study. Clin Neurol Neurosurg. 2015;130:74–79. PubMed

Kaukinen S., Kaukinen L., Kannisto K., Kataja M. The prevention of headache following spinal anaesthesia. Ann Chir Gynaecol. 1981;70:107–111. PubMed

Wilkinson A.G., Sellar R.J. The influence of needle size and other factors on the incidence of adverse effects caused by myelography. Clin Radiol. 1991;44:338–341. PubMed

McConaha C., Bastiani A.M., Kaye W.H. Significant reduction of post-lumbar puncture headaches by the use of a 29-gauge spinal needle. Biol Psychiatry. 1996;39:1058–1060. PubMed

Lambert D.H., Hurley R.J., Hertwig L., Datta S. Role of needle gauge and tip configuration in the production of lumbar puncture headache. Reg Anesth. 1997;22:66–72. PubMed

Flaatten H., Rodt S.A., Vamnes J., Rosland J., Wisborg T., Koller M.E. Postdural puncture headache. A comparison between 26- and 29-gauge needles in young patients. Anaesthesia. 1989;44:147–149. PubMed

Birnbach D.J., Kuroda M.M., Sternman D., Thys D.M. Use of atraumatic spinal needles among neurologists in the United States. Headache. 2001;41:385–390. PubMed

Stendell L., Fomsgaard J.S., Olsen K.S. There is room for improvement in the prevention and treatment of headache after lumbar puncture. Dan Med J. 2012;59:A4483. PubMed

Tung C.E. Education research: changing practice. Residents' adoption of the atraumatic lumbar puncture needle. Neurology. 2013;80:e180–e182. PubMed

Quincke H. Die lumbarpunktion des hydrocephalus. Klin Wochenschr. 1891;28:929–933. 65–68.

Moller A., Afshari A., Bjerrum O.W. Diagnostic and therapeutic lumbar puncture performed safely and efficiently with a thin blunt needle. Dan Med J. 2013;60:A4684. PubMed

Sharma S., Gambling D., Joshi G., Sidawi J., Herrera E. Comparison of 26-gauge Atraucan® and 25-gauge Whitacre needles: insertion characteristics and complications. Can J Anaesth. 1995;42:706–710. PubMed

Braune H.J., Huffmann G.A. A prospective double-blind clinical trial, comparing the sharp Quincke needle (22G) with an “atraumatic” needle (22G) in the induction of post-lumbar puncture headache. Acta Neurol Scand. 1992;86:50–54. PubMed

Ohman S., Ernerudh J., Forsberg P., Roberg M., Vrethem M. Lower values for immunoglobulin M in cerebrospinal fluid when sampled with an atraumatic Sprotte needle compared with conventional lumbar puncture. Ann Clin Biochem. 1995;32:210–212. PubMed

Strupp M., Schueler O., Straube A., Von Stuckrad–Barre S., Brandt T. “Atraumatic” Sprotte needle reduces the incidence of post-lumbar puncture headaches. Neurology. 2001;57:2310–2312. PubMed

Tung C.E., So Y.T., Lansberg M.G. Cost comparison between the atraumatic and cutting lumbar puncture needles. Neurology. 2012;78:109–113. PubMed PMC

Vakharia V.N., Lote H. Introduction of Sprotte needles to a single-centre acute neurology service: before and after study. JRSM Short Rep. 2012;3:82. PubMed PMC

Davis A., Dobson R., Kaninia S., Espasandin M., Berg A., Giovannoni G. Change practice now! Using atraumatic needles to prevent post lumbar puncture headache. Eur J Neurol. 2014;21:305–311. PubMed

Castrillo A., Tabernero C., Garcia-Olmos L.M., Gil C., Gutierrez R., Zamora M.I. Postdural puncture headache: impact of needle type, a randomized trial. Spine J. 2015;15:1571–1576. PubMed

Thomas S.R., Jamieson D.R., Muir K.W. Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture. BMJ. 2000;321:986–990. PubMed PMC

Puolakka R., Andersson L.C., Rosenberg P.H. Microscopic analysis of three different spinal needle tips after experimental subarachnoid puncture. Reg Anesth Pain Med. 2000;25:163–169. PubMed

Quinn C., Macklin E.A., Atassi N., Bowser R., Boylan K., Cudkowicz M. Post-lumbar puncture headache is reduced with use of atraumatic needles in ALS. Amyotroph Lateral Scler Frontotemporal Degener. 2013;14:632–634. PubMed

Pedersen O.N. Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles. Eur Radiol. 1996;6:184–187. PubMed

Lavi R., Rowe J.M., Avivi I. Traumatic vs. atraumatic 22 G needle for therapeutic and diagnostic lumbar puncture in the hematologic patient: a prospective clinical trial. Haematologica. 2007;92:1007–1008. PubMed

Lavi R., Yarnitsky D., Rowe J.M., Weissman A., Segal D., Avivi I. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial. Neurology. 2006;67:1492–1494. PubMed

Zhang Y.C., Chandler A.J., Kagetsu N.J. Technical compliance to standard guidelines for lumbar puncture and myelography: survey of academic neuroradiology attendings and fellows. Acad Radiol. 2014;21:612–616. PubMed

Kokki H., Salonvaara M., Herrgard E., Onen P. Postdural puncture headache is not an age-related symptom in children: a prospective, open-randomized, parallel group study comparing a22-gauge Quincke with a 22-gauge Whitacre needle. Paediatr Anaesth. 1999;9:429–434. PubMed

Luostarinen L., Heinonen T., Luostarinen M., Salmivaara A. Diagnostic lumbar puncture. Comparative study between 22-gauge pencil point and sharp bevel needle. J Headache Pain. 2005;6:400–404. PubMed PMC

Knowles P.R., Randall N.P., Lockhart A.S. Vascular trauma associated with routine spinal anaesthesia. Anaesthesia. 1999;54:647–650. PubMed

Kokki H., Heikkinen M., Turunen M., Vanamo K., Hendolin H. Needle design does not affect the success rate of spinal anaesthesia or the incidence of postpuncture complications in children. Acta Anaesthesiol Scand. 2000;44:210–213. PubMed

Lenaerts M., Pepin J.L., Tombu S., Schoenen J. No significant effect of an “atraumatic” needle on incidence of post-lumbar puncture headache or traumatic tap. Cephalalgia. 1993;13:296–297. PubMed

Pelzer N., Vandersteene J., Bekooij T.J., Schoonman G.G., Wirtz P.W., Vanopdenbosch L.J. Are atraumatic spinal needles as efficient as traumatic needles for lumbar puncture? Neurol Sci. 2014;35:1997–1999. PubMed

Peskind E.R., Riekse R., Quinn J.F., Kaye J., Clark C.M., Farlow M.R. Safety and acceptability of the research lumbar puncture. Alzheimer Dis Assoc Disord. 2005;19:220–225. PubMed

Arendt K., Demaerschalk B.M., Wingerchuk D.M., Camann W. Atraumatic lumbar puncture needles: after all these years, are we still missing the point? Neurologist. 2009;15:17–20. PubMed

Van Dellen J.R., Bill P.L. Lumbar puncture–an innocuous diagnostic procedure? S Afr Med J. 1978;53:666–668. PubMed

Adams R.D., Maurice V., Ropper A.H. 6th Ed. McGraw-Hill; New York: 1997. Principles of Neurology; pp. 13–14.

Strupp M., Brandt T., Muller A. Incidence of post-lumbar puncture syndrome reduced by reinserting the stylet: a randomized prospective study of 600 patients. J Neurol. 1998;245:589–592. PubMed

Turnbull D.K., Shepherd D. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003;91:718–729. PubMed

Boonmak P., Boonmak S. Epidural blood patching for preventing and treating post-dural puncture headache. Cochrane Database Syst Rev. 2010:CD001791. PubMed

Basurto Ona X., Osorio D., Bonfill Cosp X. Drug therapy for treating post-dural puncture headache. Cochrane Database Syst Rev. 2015:CD007887. PubMed PMC

Feder G., Eccles M., Grol R., Griffiths C., Grimshaw J. Clinical guidelines: using clinical guidelines. BMJ. 1999;318:728–730. PubMed PMC

Impact of gender on the willingness to participate in clinical trials and undergo related procedures in individuals from an Alzheimer's prevention research cohort

European Academy of Neurology/European Alzheimer's Disease Consortium position statement on diagnostic disclosure, biomarker counseling, and management of patients with mild cognitive impairment

Evaluation of a novel immunoassay to detect p-tau Thr217 in the CSF to distinguish Alzheimer disease from other dementias