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Addendum to assessment: Prevention of post–lumbar puncture headaches

Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

From the Division of Neurology (Dr. Armon), Baystate Medical Center, Springfield and Department of Neurology, Tufts University School of Medicine, Boston, MA; and Department of Neurology (Dr. Evans), University of Texas at Houston Medical School and Baylor College of Medicine.

Address correspondence and reprint requests to the American Academy of Neurology, 1080 Montreal Avenue, St. Paul, MN 55116.

Review of the literature on prevention of post–lumbar puncture headaches (PLPHAs) since the publication of the original assessment in 2000 yielded one study comparing use of cutting to atraumatic needles in diagnostic lumbar punctures, providing Class I evidence in favor of the atraumatic needle. Taken in conjunction with data from most studies in the anesthesiology literature, the Therapeutics and Technology Assessment Subcommittee concluded that use of an atraumatic spinal needle in adult patient populations reduces the frequency of PLPHA (Level A recommendation). It affirmed a previous conclusion that smaller needle size is associated with reduced frequency of PLPHA (Level A recommendation).

Disclosure: The authors report no conflicts of interest.

Approved by the Therapeutics and Technology Assessment Subcommittee on November 19, 2004; by the Practice Committee on April 13, 2005; and by the AAN Board of Directors on June 26, 2005.

Received December 30, 2004. Accepted in final form May 23, 2005.

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