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Techniques, Contraindications, and Complications of CSF Collection Procedures

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Cerebrospinal Fluid in Clinical Neurology

Abstract

Lumbar puncture (LP), also known as spinal tap, is the most frequently used technique through which the restricted compartment of the subarachnoid space is accessed to sample cerebrospinal fluid. An LP can have both diagnostic and therapeutic indications. To perform an LP, the optimal length, size, and type of needle should be used, depending on the medical indication. Needles used for LP can differ in length, diameter, and design. Head-to-head studies are in favor of atraumatic-type and small-diameter needles given the lower incidence of post-lumbar puncture headache (PLPH), and consensus-based guidelines recommend to use 25G atraumatic needles.

The most important contraindication to perform an LP is a posterior fossa mass and intracranial hypertension, given the risk of central nervous system or tonsillar herniation. Other contraindications are local infections at the puncture site, congenital abnormalities, and uncorrected bleeding diathesis. The LP procedure is easy to perform by an experienced physician with proper understanding of the anatomical implications and results in low risks of complications. The most common complaint after an LP is PLPH; other infrequent complications include infections, local hematomas, pain, and local discomfort.

In conclusion, an LP is a viable therapeutic technique and a common diagnostic procedure, which, if performed correctly, has a low complication rate and a high diagnostic yield and is usually more tolerable than patients expect.

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Notes

  1. 1.

    The recommendations described are based on a systematic review conducted in April 2014. All relevant studies published between January 1970 and March 2014 were identified and included in the systematic analysis. Searches were conducted in PubMed and Google Scholar, with a filter for English and search terms in title and/or abstract: needle and lumbar puncture.

Abbreviations

AD:

Alzheimer’s disease

BMI:

Body mass index

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

CT:

Computed tomography

G:

Gauge

ICP:

Intracranial pressure

JPND:

The EU Joint Programme – Neurodegenerative Disease Research

LP:

Lumbar puncture

MRI:

Magnetic resonance imaging

PD:

Parkinson’s disease

PLPH:

Post-lumbar puncture headache

References

  • Aamodt A, Vedeler C (2001) Complications after LP related to needle type: pencil-point versus Quincke. Acta Neurol Scand 103(6):396–398

    CAS  PubMed  Google Scholar 

  • Abrahams PH, Webb P (1975) Clinical anatomy of practical procedures. Pitman Medical, London, pp 13–15

    Google Scholar 

  • Adams RD, Maurice V, Ropper AH (1997) Principles of neurology, 6th edn. McGraw-Hill, New York, pp 13–14

    Google Scholar 

  • Alcolea D, Martinez-Lage P, Izagirre A, Clerigue M, Carmona-Iragui M, Alvarez RM et al (2014) Feasibility of lumbar puncture in the study of cerebrospinal fluid biomarkers for Alzheimer’s disease: a multicenter study in Spain. J Alzheimers Dis 39(4):719–726

    PubMed  Google Scholar 

  • American Association of Clinical Anatomists EAC (1999) The clinical anatomy of several invasive procedures. Clin Anat 12:43–54

    Google Scholar 

  • Andreasen N, Minthon L, Davidsson P, Vanmechelen E, Vanderstichele H, Winblad B et al (2001) Evaluation of CSF-tau and CSF-Abeta42 as diagnostic markers for Alzheimer disease in clinical practice. Arch Neurol 58(3):373–379

    CAS  PubMed  Google Scholar 

  • Arendt K, Demaerschalk BM, Wingerchuk DM, Camann W (2009) Atraumatic lumbar puncture needles: after all these years, are we still missing the point? Neurologist 15(1):17–20

    PubMed  Google Scholar 

  • Arevalo-Rodriguez I, Pedraza OL, Rodriguez A, Sanchez E, Gich I, Sola I et al (2013) Alzheimer’s disease dementia guidelines for diagnostic testing: a systematic review. Am J Alzheimers Dis Other Demen 28(2):111–119

    PubMed  Google Scholar 

  • Armon C, Evans RW, Therapeutics, Technology Assessment Subcommittee of the American Academy of N (2005) Addendum to assessment: prevention of post-lumbar puncture headaches: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 65(4):510–512

    PubMed  Google Scholar 

  • Baer ET (2006) Post-dural puncture bacterial meningitis. Anesthesiology 105(2):381–393

    PubMed  Google Scholar 

  • Beresford HR (1980) Informed consent before lumbar puncture. N Engl J Med 303(26):1534

    CAS  PubMed  Google Scholar 

  • Birnbach DJ, Kuroda MM, Sternman D, Thys DM (2001) Use of atraumatic spinal needles among neurologists in the United States. Headache 41(4):385–390

    CAS  PubMed  Google Scholar 

  • Blennow K, Wallin A, Hager O (1993) Low frequency of post-lumbar puncture headache in demented patients. Acta Neurol Scand 88(3):221–223

    CAS  PubMed  Google Scholar 

  • Bolder PM (1986) Postlumbar puncture headache in pediatric oncology patients. Anesthesiology 65(6):696–698

    CAS  PubMed  Google Scholar 

  • Boon JM, Abrahams PH, Meiring JH, Welch T (2004) Lumbar puncture: anatomical review of a clinical skill. Clin Anat 17(7):544–553

    CAS  PubMed  Google Scholar 

  • Boonmak P, Boonmak S (2010) Epidural blood patching for preventing and treating post-dural puncture headache. Cochrane Database Syst Rev (1):CD001791

    Google Scholar 

  • Braune HJ, Huffmann GA (1992) 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 86(1):50–54

    CAS  PubMed  Google Scholar 

  • Carson D, Serpell M (1996) Choosing the best needle for diagnostic lumbar puncture. Neurology 47(1):33–37

    CAS  PubMed  Google Scholar 

  • Crock C, Orsini F, Lee KJ, Phillips RJ (2014) Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles. Arch Dis Child 99(3):203–207

    PubMed  Google Scholar 

  • Cruickshank R, Hopkinson J (1989) Fluid flow through dural puncture sites. Anaesthesia 44(5):415–418

    CAS  PubMed  Google Scholar 

  • Dakka Y, Warra N, Albadareen RJ, Jankowski M, Silver B (2011) Headache rate and cost of care following lumbar puncture at a single tertiary care hospital. Neurology 77(1):71–74

    CAS  PubMed  Google Scholar 

  • Davis A, Dobson R, Kaninia S, Espasandin M, Berg A, Giovannoni G et al (2014) Change practice now! Using atraumatic needles to prevent post lumbar puncture headache. Eur J Neurol 21(2):305–311

    CAS  PubMed  Google Scholar 

  • de Almeida SM, Shumaker SD, LeBlanc SK, Delaney P, Marquie-Beck J, Ueland S et al (2011) Incidence of post-dural puncture headache in research volunteers. Headache 51(10):1503–1510

    PubMed Central  PubMed  Google Scholar 

  • del Campo M, Mollenhauer B, Bertolotto A, Engelborghs S, Hampel H, Simonsen AH et al (2012) Recommendations to standardize preanalytical confounding factors in Alzheimer’s and Parkinson’s disease cerebrospinal fluid biomarkers: an update. Biomark Med 6(4):419–430

    PubMed  Google Scholar 

  • Dieterich M, Brandt T (1985) Is obligatory bed rest after lumbar puncture obsolete? Eur Arch Psychiatry Neurol Sci 235(2):71–75

    CAS  PubMed  Google Scholar 

  • Duffy GP (1969) Lumbar puncture in the presence of raised intracranial pressure. Br Med J 1(5641):407–409

    CAS  PubMed Central  PubMed  Google Scholar 

  • Duits FH, Martinez-Lage P, Paquet C, Engelborghs S, Lleo A, Hausner L et al (submitted) Performance and complications of lumbar puncture in memory clinics: results of a multicenter study. JAMA Neurol

    Google Scholar 

  • Ellis H, Feldman S (1997) Anatomy for anesthetists, 7th edn. Blackwell Science, Oxford, pp 108–112

    Google Scholar 

  • Ellis RW 3rd, Strauss LC, Wiley JM, Killmond TM, Ellis RW Jr (1992) A simple method of estimating cerebrospinal fluid pressure during lumbar puncture. Pediatrics 89(5 Pt 1):895–897

    PubMed  Google Scholar 

  • Engelborghs S (2013) Clinical indications for analysis of Alzheimer’s disease CSF biomarkers. Rev Neurol (Paris) 169(10):709–714

    CAS  Google Scholar 

  • Engelborghs S, Niemantsverdriet E, Struyfs H, Duits F, Teunissen C (submitted) Consensus guidelines to perform lumbar puncture for CSF sampling in neurological patients. Lancet Neurol

    Google Scholar 

  • Eskey CJ, Ogilvy CS (2001) Fluoroscopy-guided lumbar puncture: decreased frequency of traumatic tap and implications for the assessment of CT-negative acute subarachnoid hemorrhage. AJNR Am J Neuroradiol 22(3):571–576

    CAS  PubMed  Google Scholar 

  • Evans RW, Armon C, Frohman EM, Goodin DS (2000) Assessment: prevention of post-lumbar puncture headaches: report of the therapeutics and technology assessment subcommittee of the american academy of neurology. Neurology 55(7):909–914

    CAS  PubMed  Google Scholar 

  • Flaatten H, Rodt SA, Vamnes J, Rosland J, Wisborg T, Koller ME (1989) Postdural puncture headache. A comparison between 26- and 29-gauge needles in young patients. Anaesthesia 44(2):147–149

    CAS  PubMed  Google Scholar 

  • Flaatten H, Krakenes J, Vedeler C (1998) Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia. Acta Neurol Scand 98(6):445–451

    CAS  PubMed  Google Scholar 

  • Ginosar Y, Smith Y, Ben-Hur T, Lovett JM, Clements T, Ginosar YD et al (2012) Novel pulsatile cerebrospinal fluid model to assess pressure manometry and fluid sampling through spinal needles of different gauge: support for the use of a 22G spinal needle with a tapered 27G pencil-point tip. Br J Anaesth 108(2):308–315

    CAS  PubMed  Google Scholar 

  • Gleason CA, Martin RJ, Anderson JV, Carlo WA, Sanniti KJ, Fanaroff AA (1983) Optimal position for a spinal tap in preterm infants. Pediatrics 71(1):31–35

    CAS  PubMed  Google Scholar 

  • Gopal AK, Whitehouse JD, Simel DL, Corey GR (1999) Cranial computed tomography before lumbar puncture: a prospective clinical evaluation. Arch Intern Med 159(22):2681–2685

    CAS  PubMed  Google Scholar 

  • Gower DJ, Baker AL, Bell WO, Ball MR (1987) Contraindications to lumbar puncture as defined by computed cranial tomography. J Neurol Neurosurg Psychiatry 50(8):1071–1074

    CAS  PubMed Central  PubMed  Google Scholar 

  • Grant R, Condon B, Hart I, Teasdale GM (1991) Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psychiatry 54(5):440–442

    CAS  PubMed Central  PubMed  Google Scholar 

  • Hammond ER, Wang Z, Bhulani N, McArthur JC, Levy M (2011) Needle type and the risk of post-lumbar puncture headache in the outpatient neurology clinic. J Neurol Sci 306(1–2):24–28

    PubMed  Google Scholar 

  • Handler CE, Smith FR, Perkin GD, Rose FC (1982) Posture and lumbar puncture headache: a controlled trial in 50 patients. J R Soc Med 75(6):404–407

    CAS  PubMed Central  PubMed  Google Scholar 

  • Hasbun R, Abrahams J, Jekel J, Quagliarello VJ (2001) Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 345(24):1727–1733

    CAS  PubMed  Google Scholar 

  • Hatfield MK, Handrich SJ, Willis JA, Beres RA, Zaleski GX (2008) Blood patch rates after lumbar puncture with Whitacre versus Quincke 22- and 20-gauge spinal needles. AJR Am J Roentgenol 190(6):1686–1689

    PubMed  Google Scholar 

  • Ievins FA (1991) Accuracy of placement of extradural needles in the L3-4 interspace: comparison of two methods of identifying L4. Br J Anaesth 66(3):381–382

    CAS  PubMed  Google Scholar 

  • Janssens E, Aerssens P, Alliet P, Gillis P, Raes M (2003) Post-dural puncture headaches in children. A literature review. Eur J Pediatr 162(3):117–121

    PubMed  Google Scholar 

  • Kaukinen S, Kaukinen L, Kannisto K, Kataja M (1981) The prevention of headache following spinal anaesthesia. Ann Chir Gynaecol 70(3):107–111

    CAS  PubMed  Google Scholar 

  • Keeling D, Baglin T, Tait C, Watson H, Perry D, Baglin C et al (2011) Guidelines on oral anticoagulation with warfarin – fourth edition. Br J Haematol 154(3):311–324

    PubMed  Google Scholar 

  • Kim M, Yoon H (2011) 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 48(11):1315–1322

    PubMed  Google Scholar 

  • Kleyweg RP, Hertzberger LI, Carbaat PA (1998) Significant reduction in post-lumbar puncture headache using an atraumatic needle. A double-blind, controlled clinical trial. Cephalalgia 18(9):635–637

    CAS  PubMed  Google Scholar 

  • Knowles PR, Randall NP, Lockhart AS (1999) Vascular trauma associated with routine spinal anaesthesia. Anaesthesia 54(7):647–650

    CAS  PubMed  Google Scholar 

  • Kokki H, Hendolin H (1996) Comparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints. Paediatr Anaesth 6(2):115–119

    CAS  PubMed  Google Scholar 

  • Kokki H, Salonvaara M, Herrgard E, Onen P (1999) 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 9(5):429–434

    CAS  PubMed  Google Scholar 

  • Kokki H, Heikkinen M, Turunen M, Vanamo K, Hendolin H (2000) Needle design does not affect the success rate of spinal anaesthesia or the incidence of postpuncture complications in children. Acta Anaesthesiol Scand 44(2):210–213

    CAS  PubMed  Google Scholar 

  • Kovanen J, Sulkava R (1986) Duration of postural headache after lumbar puncture: effect of needle size. Headache 26(5):224–226

    CAS  PubMed  Google Scholar 

  • Kuntz KM, Kokmen E, Stevens JC, Miller P, Offord KP, Ho MM (1992) Post-lumbar puncture headaches: experience in 501 consecutive procedures. Neurology 42(10):1884–1887

    CAS  PubMed  Google Scholar 

  • Lambert DH, Hurley RJ, Hertwig L, Datta S (1997) Role of needle gauge and tip configuration in the production of lumbar puncture headache. Reg Anesth 22(1):66–72

    CAS  PubMed  Google Scholar 

  • Lavi R, Yarnitsky D, Rowe JM, Weissman A, Segal D, Avivi I (2006) Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial. Neurology 67(8):1492–1494

    CAS  PubMed  Google Scholar 

  • Lavi R, Rowe JM, Avivi I (2007) Traumatic vs. atraumatic 22 G needle for therapeutic and diagnostic lumbar puncture in the hematologic patient: a prospective clinical trial. Haematologica 92(7):1007–1008

    PubMed  Google Scholar 

  • Leibold RA, Yealy DM, Coppola M, Cantees KK (1993) Post-dural-puncture headache: characteristics, management, and prevention. Ann Emerg Med 22(12):1863–1870

    CAS  PubMed  Google Scholar 

  • Lenaerts M, Pepin JL, Tombu S, Schoenen J (1993) No significant effect of an “atraumatic” needle on incidence of post-lumbar puncture headache or traumatic tap. Cephalalgia 13(4):296–297

    CAS  PubMed  Google Scholar 

  • Levine JF, Hiesiger EM, Whelan MA, Pollock AA, Simbekoff MS, Rahal JJ Jr (1982) Pneumococcal meningitis associated with retroperitoneal abscess. A rare complication of lumbar puncture. JAMA 248(18):2308–2309

    CAS  PubMed  Google Scholar 

  • Linker G, Mirza N, Manetti G, Meyer M, Putnam K, Sunderland T (2002) Fine-needle, negative-pressure lumbar puncture: a safe technique for collecting CSF. Neurology 59(12):2008–2009

    CAS  PubMed  Google Scholar 

  • Lowery S, Oliver A (2008) 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 18(3):230–234

    PubMed  Google Scholar 

  • Luostarinen L, Heinonen T, Luostarinen M, Salmivaara A (2005) Diagnostic lumbar puncture. Comparative study between 22-gauge pencil point and sharp bevel needle. J Headache Pain 6(5):400–404

    PubMed Central  PubMed  Google Scholar 

  • Martin R, Jourdain S, Clairoux M, Tetrault JP (1994) Duration of decubitus position after epidural blood patch. Can J Anaesth 41(1):23–25

    CAS  PubMed  Google Scholar 

  • McConaha C, Bastiani AM, Kaye WH (1996) Significant reduction of post-lumbar puncture headaches by the use of a 29-gauge spinal needle. Biol Psychiatry 39(12):1058–1060

    CAS  PubMed  Google Scholar 

  • McDonald JV, Klump TE (1986) Intraspinal epidermoid tumors caused by lumbar puncture. Arch Neurol 43(9):936–939

    CAS  PubMed  Google Scholar 

  • Moller A, Afshari A, Bjerrum OW (2013) Diagnostic and therapeutic lumbar puncture performed safely and efficiently with a thin blunt needle. Dan Med J 60(9):A4684

    PubMed  Google Scholar 

  • Muller B, Adelt K, Reichmann H, Toyka K (1994) Atraumatic needle reduces the incidence of post-lumbar puncture syndrome. J Neurol 241(6):376–380

    CAS  PubMed  Google Scholar 

  • Ohman S, Ernerudh J, Forsberg P, Roberg M, Vrethem M (1995) Lower values for immunoglobulin M in cerebrospinal fluid when sampled with an atraumatic Sprotte needle compared with conventional lumbar puncture. Ann Clin Biochem 32(Pt 2):210–212

    PubMed  Google Scholar 

  • Palmers Y, Kuhn FP, Petersen D, De Greef D (2002) 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 12(3):686–691

    PubMed  Google Scholar 

  • Pedersen ON (1996) 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 6(2):184–187

    CAS  PubMed  Google Scholar 

  • Peskind ER, Riekse R, Quinn JF, Kaye J, Clark CM, Farlow MR et al (2005) Safety and acceptability of the research lumbar puncture. Alzheimer Dis Assoc Dis 19(4):220–225

    Google Scholar 

  • Puolakka R, Andersson LC, Rosenberg PH (2000) Microscopic analysis of three different spinal needle tips after experimental subarachnoid puncture. Reg Anesth Pain Med 25(2):163–169

    CAS  PubMed  Google Scholar 

  • Quincke H (1891) Die lumbarpunktion des hydrocephalus. Klin Wochenschr 28(929–33):65–68

    Google Scholar 

  • Quinn C, Macklin EA, Atassi N, Bowser R, Boylan K, Cudkowicz M et al (2013) Post-lumbar puncture headache is reduced with use of atraumatic needles in ALS. Amyotroph Lateral Scler Frontotemporal Degener 14(7–8):632–634

    PubMed  Google Scholar 

  • Raskin NH (1990) Lumbar puncture headache: a review. Headache 30(4):197–200

    CAS  PubMed  Google Scholar 

  • Ready LB, Cuplin S, Haschke RH, Nessly M (1989) Spinal needle determinants of rate of transdural fluid leak. Anesth Analg 69(4):457–460

    CAS  PubMed  Google Scholar 

  • Reynolds F, O’Sullivan G (1998) Lumbar puncture and headache. “Atraumatic needle” is a better term than “blunt needle”. BMJ 316(7136):1018

    CAS  PubMed Central  PubMed  Google Scholar 

  • Sharma S, Gambling D, Joshi G, Sidawi J, Herrera E (1995) Comparison of 26-gauge Atraucan® and 25-gauge Whitacre needles: insertion characteristics and complications. Can J Anaesth 42(8):706–710

    CAS  PubMed  Google Scholar 

  • Sinclair AJ, Carroll C, Davies B (2009) Cauda equina syndrome following a lumbar puncture. J Clin Neurosci 16(5):714–716

    PubMed  Google Scholar 

  • Stangel M, Fredrikson S, Meinl E, Petzold A, Stuve O, Tumani H (2013) The utility of cerebrospinal fluid analysis in patients with multiple sclerosis. Nat Rev Neurol 9(5):267–276

    CAS  PubMed  Google Scholar 

  • Stendell L, Fomsgaard JS, Olsen KS (2012) There is room for improvement in the prevention and treatment of headache after lumbar puncture. Dan Med J 59(7):A4483

    PubMed  Google Scholar 

  • Stiffler KA, Jwayyed S, Wilber ST, Robinson A (2007) The use of ultrasound to identify pertinent landmarks for lumbar puncture. Am J Emerg Med 25(3):331–334

    PubMed  Google Scholar 

  • Strupp M, Schueler O, Straube A, Von Stuckrad-Barre S, Brandt T (2001) “Atraumatic” Sprotte needle reduces the incidence of post-lumbar puncture headaches. Neurology 57(12):2310–2312

    CAS  PubMed  Google Scholar 

  • Thomas SR, Jamieson DR, Muir KW (2000) Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture. BMJ 321(7267):986–990

    CAS  PubMed Central  PubMed  Google Scholar 

  • Tourtellotte WW, Henderson WG, Tucker RP, Gilland O, Walker JE, Kokman E (1972) 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 12(2):73–78

    CAS  PubMed  Google Scholar 

  • Tung CE (2013) Education research: changing practice. Residents’ adoption of the atraumatic lumbar puncture needle. Neurology 80(17):e180–e182

    PubMed  Google Scholar 

  • Tung CE, So YT, Lansberg MG (2012) Cost comparison between the atraumatic and cutting lumbar puncture needles. Neurology 78(2):109–113

    PubMed Central  PubMed  Google Scholar 

  • Turnbull DK, Shepherd D (2003) Post‐dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 91(5):718–729

    CAS  PubMed  Google Scholar 

  • Vakharia VN, Lote H (2012) Introduction of Sprotte needles to a single-centre acute neurology service: before and after study. JRSM Short Rep 3(12):82

    PubMed Central  PubMed  Google Scholar 

  • van de Beek D, Drake JM, Tunkel AR (2010) Nosocomial bacterial meningitis. N Engl J Med 362(2):146–154

    PubMed  Google Scholar 

  • Van Dellen JR, Bill PL (1978) Lumbar puncture – an innocuous diagnostic procedure? S Afr Med J 53(17):666–668

    CAS  PubMed  Google Scholar 

  • Van Kooten F, Oedit R, Bakker SL, Dippel DW (2008) Epidural blood patch in post dural puncture headache: a randomised, observer-blind, controlled clinical trial. J Neurol Neurosurg Psychiatry 79(5):553–558

    CAS  PubMed  Google Scholar 

  • Vidoni ED, Morris JK, Raider K, Burns JM, Alzheimer’s Disease Neuroimaging I (2014) Reducing post-lumbar puncture headaches with small bore atraumatic needles. J Clin Neurosci 21(3):536–537

    PubMed  Google Scholar 

  • Vilming ST, Schrader H, Monstad I (1988) Post-lumbar-puncture headache: the significance of body posture. A controlled study of 300 patients. Cephalalgia 8(2):75–78

    CAS  PubMed  Google Scholar 

  • Vilming ST, Kloster R, Sandvik L (2001) The importance of sex, age, needle size, height and body mass index in post-lumbar puncture headache. Cephalalgia 21(7):738–743

    CAS  PubMed  Google Scholar 

  • Wee LH, Lam F, Cranston AJ (1996) The incidence of post dural puncture headache in children. Anaesthesia 51(12):1164–1166

    CAS  PubMed  Google Scholar 

  • Wilkinson AG, Sellar RJ (1991) The influence of needle size and other factors on the incidence of adverse effects caused by myelography. Clin Radiol 44(5):338–341

    CAS  PubMed  Google Scholar 

  • Winsvold BS, Hagen K, Aamodt AH, Stovner LJ, Holmen J, Zwart JA (2011) Headache, migraine and cardiovascular risk factors: the HUNT study. Eur J Neurol 18(3):504–511

    CAS  PubMed  Google Scholar 

  • Wright BL, Lai JT, Sinclair AJ (2012) Cerebrospinal fluid and lumbar puncture: a practical review. J Neurol 259(8):1530–1545

    PubMed  Google Scholar 

  • You JS, Gelfanova V, Knierman MD, Witzmann FA, Wang M, Hale JE (2005) The impact of blood contamination on the proteome of cerebrospinal fluid. Proteomics 5(1):290–296

    CAS  PubMed  Google Scholar 

  • Zetterberg H, Tullhog K, Hansson O, Minthon L, Londos E, Blennow K (2010) Low incidence of post-lumbar puncture headache in 1,089 consecutive memory clinic patients. Eur Neurol 63(6):326–330

    PubMed  Google Scholar 

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Acknowledgments

This work was supported by the University of Antwerp Research Fund; the Alzheimer Research Foundation (SAO-FRA); the Research Foundation Flanders (FWO); the Agency for Innovation by Science and Technology (IWT); the Belgian Science Policy Office Interuniversity Attraction Poles (IAP) program; and the Flemish Government initiated Methusalem excellence grant, Belgium.

This is an EU Joint Programme – Neurodegenerative Disease Research (JPND) project, which is supported through the following funding organization under the aegis of JPND: ZonMw (the Netherlands).

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Authors and Affiliations

  1. Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Universiteitsplein 1, Antwerp, BE-2610, Belgium

    Ellis Niemantsverdriet, Hanne Struyfs & Sebastiaan Engelborghs

  2. Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands

    Flora Duits

  3. Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center Amsterdam, Amsterdam, The Netherlands

    Charlotte E. Teunissen

  4. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium

    Sebastiaan Engelborghs

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  1. Ellis Niemantsverdriet
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  2. Hanne Struyfs
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  3. Flora Duits
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  4. Charlotte E. Teunissen
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  5. Sebastiaan Engelborghs
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Correspondence to Sebastiaan Engelborghs .

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Editors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Florian Deisenhammer

  2. Department of Neurology, Danish Multiple Sclerosis Center Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Finn Sellebjerg

  3. Department of Clinical Chemistry, VU University Medical Center Amsterdam Neurochemistry Laboratory and Biobank, Amsterdam, The Netherlands

    Charlotte E Teunissen

  4. Department of Neurology, University of Ulm, Ulm, Germany

    Hayrettin Tumani

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Niemantsverdriet, E., Struyfs, H., Duits, F., Teunissen, C.E., Engelborghs, S. (2015). Techniques, Contraindications, and Complications of CSF Collection Procedures. In: Deisenhammer, F., Sellebjerg, F., Teunissen, C., Tumani, H. (eds) Cerebrospinal Fluid in Clinical Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-01225-4_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-01224-7

  • Online ISBN: 978-3-319-01225-4

  • eBook Packages: MedicineMedicine (R0)

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