Diagnostic and/or therapeutic procedure in which a spinal needle is passed into the subarachnoid space and cerebrospinal fluid (CSF) is removed, CSF opening pressure is measured, and/or medications are injected
Indications for Lumber punctureZ
Diagnostic indications:
- ((Mainly)) Infective pathology of unknown origin
- Inflammatory pathology.
- Subarachanoid hemorrhage (suspection of spontaneous subarachnoid hemorrhage)
- Malignancy and spread contrast dye into spinal canal
- Pressure recordings
Therapeutic indications:
- CSF drainage treatment of idiopathic intracranial hypertension
- Drug delivery chemotherapy
- infusion of anaesthesia
Contraindications for LP
Absolute
- Patient refusal.
- Lack of IV access.
- infection in the tissues near the puncture site.
- Raised (ICP) intracranial pressure.
- uncorrected coagulopathy (Platelets < 50,000) or Disorders of coagulation or blood diathesis.
- acute spinal cord trauma.
- Suspected intracranial mass lesion or space occupying lesion.
- Underlying spinal abscess.
- Imaging evidence of midline shift.Posterior fossa tumour or other suspected 4th ventricular lesion
Relative
- Bacteremia.
- Preexisting neurological disease.
- Aortic/mitral valve stenosis.
- Previous spinal surgery.
- Back problems.
- psychiatric disease or emotional instability (Uncooperative).