According to recent studies, atraumatic needles (ATN) reduce the rate of post-dural puncture headache (PDPH) when compared to traumatic needles (TN – or bevel-tip needles such as Quincke needles) (27% vs 60%). Also, the mean duration of PDPH from ATN is 50 h, whereas, the mean of PDPH from TN is 94 h.
The American Academy of Neurology recommends ATNs as standard for diagnostic lumbar punctures. When a cutting needle is used the bevel direction should be parallel/longitudinal to the spine in order to minimize occurrence of a PDPH. The risk of PDPH is decreased by having the bevel direction parallel rather than perpendicular to the spine (OR = 0.29).
