25G Sprotte Needle Strongly Reduces The Risk Of Post-Lumbare Puncture Headache In Clinical Practice. (P7.252)

OBJECTIVE: to evaluate the frequency of post-lumbar puncture headache (PLPH) using five types of needles. BACKGROUND: AAN guidelines (2005) suggest the use of 22G (gauge) atraumatic Sprotte needle; however in clinical practice the 20G traumatic needle is the most used one. Moreover 25G needles have been used only in few experimental settings. DESIGN/METHODS: 363 lumbar punctures were performed using five different types of needles as follows: 39 with 20G Quincke traumatic needle, 11 with 22G Quincke needle, 53 with 22G Withacre needle, 134 with 25G Whitacre needle, 126 with 25G Sprotte needle. The patient was blinded for the needle used; a neurologist, blinded for the type of the needle, interviewed the patient for PLPH. Safety and time consuming were evaluated. RESULTS: PLPH developed in 36.8% using 20G Quincke needle, in 18.2% using 22G Quincke needle, in 15.1% using 22G Whitacre needle, in 6.7% using 25G Whitacre needle and in 1.6% using 25G Sprotte needle. Development of PLPH was significanlty lower with the use of 25G Sprotte needle compared with any other needle (25G Sprotte vs 20G Quincke p<0.0001; vs 22G Quincke p= 0.034; vs 22G Whitacre p= 0.0012; vs 25G Whitacre p= 0.063). CONCLUSIONS: our data indicate that two factors influence PLPH: gauge and shape of the tip. 25G Sprotte needle can be used safely in clinical practice. Study Supported by: Disclosure: Dr. Bertolotto has received personal compensation for activities with Biogen Idec, Merck & Co. Inc., Farmades, Novartis, and Aventis Pharmaceuticals Inc. Dr. Bertolotto has received research support from Serono, Inc., Farmades, Aventis Pharmaceuticals Inc., and Biogen Idec. Dr. Sperli has received personal compensation for activities with Biogen Idec, and Novartis. Dr. Capobianco has received personal compensation for activities with Merck & Co. Inc., Teva Neuroscience, Genzyme Corporation, Sanofi-Aventis Pharmaceuticals Inc., Biogen Idec, and Novartis. Dr. Malentacchi has received personal compensation for activities with Biogen Idec. Dr. Pulizzi has received personal compensation for activities with Biogen Idec. Dr. Malucchi has received personal compensation for activities with Biogen Idec, Merck Serono, Teva Neuroscience, and Novartis.