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Lumbar Puncture

A procedure in which a thin needle called a spinal needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give drugs. Also called spinal tap.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Lumbar Puncture

Cerebrospinal fluid analysis involves the removal of a small amount of the fluid that protects the brain and spinal cord. The fluid is tested to detect any bleeding or brain hemorrhage, diagnose infection to the brain and/or spinal cord, identify some cases of multiple sclerosis and other neurological conditions, and measure intracranial pressure.

The procedure is usually done in a hospital. The sample of fluid is commonly removed by a procedure known as a lumbar puncture, or spinal tap.

The patient is asked to either lie on one side, in a ball position with knees close to the chest, or lean forward while sitting on a table or bed. The doctor will locate a puncture site in the lower back, between two vertebrate, then clean the area and inject a local anesthetic. The patient may feel a slight stinging sensation from this injection.

Once the anesthetic has taken effect, the doctor will insert a special needle into the spinal sac and remove a small amount of fluid (usually about three teaspoons) for testing. Most patients will feel a sensation of pressure only as the needle is inserted.

A common after-effect of a lumbar puncture is headache, which can be lessened by having the patient lie flat. Risk of nerve root injury or infection from the puncture can occur but it is rare. The entire procedure takes about 45 minutes. NIH - National Institute of Neurological Disorders and Stroke

What works? Research summarized

Evidence reviews

Drugs for preventing headache after a lumbar puncture

Lumbar puncture is an invasive procedure that medical personnel use to get a sample of cerebrospinal fluid for diagnostic purposes (e.g. to diagnose meningitis or subarachnoid haemorrhage) by inserting a needle into the lower spinal region. It can also be used to inject medications such as anaesthetics and analgesics (to perform regional anaesthesia), chemotherapy or radiological contrast agents.

Drugs for treating headache after a lumbar puncture

Lumbar puncture involves getting a sample of spinal fluid though a needle inserted into the lower back. Post‐dural puncture headache (PDPH) is the most common side effect of a lumbar puncture. The symptom of PDPH is a constant headache that gets worse when upright and improves when lying down. Lots of drugs are used to treat PDPH, so the aim of this review was to assess the effectiveness of these drugs.

Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage

Intraventricular hemorrhage (IVH) is a major complication of premature birth and a cause of cerebral palsy and hydrocephalus. Repeated early lumbar puncture or ventricular taps have been advocated as a way of avoiding hydrocephalus and protecting the brain from pressure. It was thought that the risk of hydrocephalus and the need for a ventriculoperitoneal shunt might be reduced by the removal of protein and old blood in the cerebrospinal fluid. This hypothesis has been tested in four randomised trials involving premature infants in whom IVH (with or without established enlargement) was diagnosed by ultrasound. There is no evidence that early tapping of cerebrospinal fluid by lumbar puncture or ventricular tap reduces the risk of shunt dependence, disability, multiple disability or death. The use of repeated taps was associated with an increased risk of central nervous system infection. Thus the early use of early tapping cannot be recommended. Removing cerebrospinal fluid should be reserved for cases where there is symptomatic raised intracranial pressure.

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Summaries for consumers

Drugs for preventing headache after a lumbar puncture

Lumbar puncture is an invasive procedure that medical personnel use to get a sample of cerebrospinal fluid for diagnostic purposes (e.g. to diagnose meningitis or subarachnoid haemorrhage) by inserting a needle into the lower spinal region. It can also be used to inject medications such as anaesthetics and analgesics (to perform regional anaesthesia), chemotherapy or radiological contrast agents.

Drugs for treating headache after a lumbar puncture

Lumbar puncture involves getting a sample of spinal fluid though a needle inserted into the lower back. Post‐dural puncture headache (PDPH) is the most common side effect of a lumbar puncture. The symptom of PDPH is a constant headache that gets worse when upright and improves when lying down. Lots of drugs are used to treat PDPH, so the aim of this review was to assess the effectiveness of these drugs.

Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage

Intraventricular hemorrhage (IVH) is a major complication of premature birth and a cause of cerebral palsy and hydrocephalus. Repeated early lumbar puncture or ventricular taps have been advocated as a way of avoiding hydrocephalus and protecting the brain from pressure. It was thought that the risk of hydrocephalus and the need for a ventriculoperitoneal shunt might be reduced by the removal of protein and old blood in the cerebrospinal fluid. This hypothesis has been tested in four randomised trials involving premature infants in whom IVH (with or without established enlargement) was diagnosed by ultrasound. There is no evidence that early tapping of cerebrospinal fluid by lumbar puncture or ventricular tap reduces the risk of shunt dependence, disability, multiple disability or death. The use of repeated taps was associated with an increased risk of central nervous system infection. Thus the early use of early tapping cannot be recommended. Removing cerebrospinal fluid should be reserved for cases where there is symptomatic raised intracranial pressure.

See all (33)

More about Lumbar Puncture

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Also called: Spinal tap, Cerebrospinal fluid analysis

Other terms to know:
Cerebrospinal Fluid

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