Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study

Flora H. Duits(Amsterdam Neuroscience), Pablo Martínez‐Lage(Fundacion CITA Alzheimer), Claire Paquet(Inserm), Sebastiaan Engelborghs(University of Antwerp), Alberto Lleó(Hospital de Sant Pau), Lucrezia Hausner(Heidelberg University), José Luís Molinuevo(Pasqual Maragall Foundation), Erik Stomrud(Lund University), Lucia Farotti(University of Perugia), Inez H.G.B. Ramakers(Maastricht University), Magda Tsolaki(Aristotle University of Thessaloniki), Constance Skarsgård(Landstinget i Kalmar län), Ragnar Åstrand(Karlstad Central Hospital), Anders Wallin(Sahlgrenska University Hospital), Martin Vyhnálek(Charles University), Marie Holmber‐Clausen(Eskilstuna Municipality), Orestes Vicente Forlenza(Universidade de São Paulo), Laura Ghezzi(University of Milan), Martin Ingelsson(Uppsala University), Erik I. Hoff(Atrium Medisch Centrum Parkstad), Gerwin Roks(St. Elisabeth Hospital), Alexandre de Mendonça(University of Lisbon), Janne M. Papma(Erasmus MC), Andrea Izagirre(Fundacion CITA Alzheimer), Mariko Taga(Inserm), Hanne Struyfs(University of Antwerp), Daniel Alcolea(Hospital de Sant Pau), Lutz Frölich(Heidelberg University), Mircea Balasa(Pasqual Maragall Foundation), Lennart Minthon(Lund University), Jos W. R. Twisk(Amsterdam UMC Location Vrije Universiteit Amsterdam), Staffan Persson(University of Gothenburg), Henrik Zetterberg(University College London), Wiesje M. van der Flier(Amsterdam Neuroscience), Charlotte E. Teunissen(Amsterdam Neuroscience), Philip Scheltens(Amsterdam Neuroscience), Kaj Blennow(University of Gothenburg)
Alzheimer s & Dementia
September 11, 2015
10.1016/j.jalz.2015.08.003
Cited by 254Open Access
Full Text

Abstract

INTRODUCTION: Lumbar puncture (LP) is increasingly performed in memory clinics. We investigated patient-acceptance of LP, incidence of and risk factors for post-LP complications in memory clinic populations. METHODS: We prospectively enrolled 3868 patients (50% women, age 66 ± 11 years, mini mental state examination 25 ± 5) at 23 memory clinics. We used logistic regression analysis using generalized estimated equations to investigate risk factors for post-LP complications, such as typical postlumbar puncture headache (PLPH) and back pain. RESULTS: A total of 1065 patients (31%) reported post-LP complaints; 589 patients (17%) reported back pain, 649 (19%) headache, of which 296 (9%) reported typical PLPH. Only few patients needed medical intervention: 11 (0.3%) received a blood patch, 23 (0.7%) were hospitalized. The most important risk factor for PLPH was medical history of headache. An atraumatic needle and age >65 years were preventive. Gender, rest after LP, or volume of cerebrospinal fluid had no effect. DISCUSSIONS: The overall risk of complications is relatively low. If risk factors shown in this study are taken into account, LPs can be safely performed in memory clinics.

Related Papers

The International Classification of Headache Disorders: 2nd edition
Jes Olesen, Peter J. Goadsby, Tim Steiner|The Lancet Neurology|2003|5.1k
Clinical utility of cerebrospinal fluid biomarkers in the diagnosis of early Alzheimer's disease
Kaj Blennow, Bruno Dubois, Anne M. Fagan et al.|Alzheimer s & Dementia|2014|460
Amyloid-β(1–42), Total Tau, and Phosphorylated Tau as Cerebrospinal Fluid Biomarkers for the Diagnosis of Alzheimer Disease
Cees Mulder, Nicolaas A. Verwey, Wiesje M. van der Flier et al.|Clinical Chemistry|2009|344
Post‐lumbar puncture headaches
Karen M. Kuntz, E. Kokmen, John C. Stevens et al.|Neurology|1992|243
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
Wallace W. Tourtellotte, William G. Henderson, Rhonda Tucker et al.|Headache The Journal of Head and Face Pain|1972|203