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Reducing post-lumbar puncture headaches with small bore atraumatic needles
Institution:1. University of Kansas Alzheimer’s Disease Center, 4350 Shawnee Mission Parkway, MS 6002 Fairway, KS 66205, USA;2. University of Kansas School of Medicine, Kansas City, KS, USA;1. Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA;2. Department of Neurological Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07103, USA;3. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, USA;1. Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India;2. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India;3. Rainbow Children’s Hospital and Perinatal Centre, Hyderabad, India;4. Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi, DL 110029, India;1. Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA;2. Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA, USA;3. Departments of Neuroradiology and Neurosurgery, Brigham and Women’s Hospital, Boston, MA, USA;4. Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA;5. Department of Neurological Surgery, UPMC Presbyterian Hospital, Pittsburgh, PA, USA;1. Department of Anesthesiology, Columbia University, 630 West 168th Street, P&S Box 46, New York, NY 10032, USA;2. Department of Neurological Surgery, Columbia University, New York, NY, USA;3. Department of Neurology, Columbia University, New York, NY, USA;1. Movement Disorders Unit, Department of Neurology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia;2. Sydney Medical School, University of Sydney, Camperdown, NSW, Australia;3. Department of Neurosurgery, Westmead Hospital, Westmead, NSW, Australia;1. Melbourne Brain Centre, The University of Melbourne, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia;2. The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Melbourne, VIC, Australia;3. National Stroke Research Unit, Florey Neuroscience Institute, Melbourne, VIC, Australia;4. NeuroIntervention Service, The Royal Melbourne Hospital, Melbourne, VIC, Australia
Abstract:Lumbar puncture for testing of Alzheimer’s disease pathophysiology for diagnostic confirmation is likely to become more common in the coming years. Minimizing adverse effects from this testing will be essential for clinical practice. Small bore, atraumatic needles reduce the occurrence of post-lumbar puncture headache (PLPH). Our goal was to extend this recommendation specifically to a well-characterized aging population. We assessed PLPH in the Alzheimer’s Disease Neuroimaging Initiative cohort and found that PLPH occurrence was reduced only when using a 24 gauge atraumatic needle. We recommend that lumbar punctures for clinical and research purposes in Alzheimer’s disease be conducted with 24 gauge atraumatic needles.
Keywords:Alzheimer’s  Biomarkers  Dementia
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