| Strupp M et al, 1998, Germany | 600 neurology patients undergoing diagnostic LP randomly assigned (patient blinded) 300 to stylet replacement before needle removal, other 300 not reinserted. Similar sex and age. Used 21 gauge atraumatic needle | Prospective randomised controlled trial | Post-lumbar puncture syndrome (headache, tinnitus, dizziness) reproducible by position and improved laying down, over seven days | Not reinserted 49/300 (16%) post-lumbar puncture syndrome v 15/300 (5%) when stylet reinserted. Post-lumbar puncture syndrome was also less severe (2.8 v 4.5 scale of 10) if stylet reinserted | Excluded patients with headache before LP |
| Post-lumbar puncture syndrome intensity scale not clearly defined |
| Follow up not clearly described |