Lumbar Puncture (Family Medicine)

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Suspected central nervous system infection
  • Diagnosis of intracranial disease or pathology
  • Treatment for normal pressure hydrocephalus
  • Dementia
  • Intrathecal antibiotics, chemotherapeutics, or analgesics
  • Imaging procedures
CONTRAINDICATIONS
  • Local skin infection (absolute contraindication)
  • Raised intracranial pressure (except for pseudotumor cerebri or NPH)
  • Supratentorial mass lesions
  • Severe bleeding diathesis, coagulopathy, or anticoagulated patient (INR >1.4)
  • Platelet count less than 50,000/mm3
  • Uncooperative patient
EQUIPMENT
  • Local skin infection (absolute contraindication)
  • Raised intracranial pressure (except for pseudotumor cerebri or NPH)
  • Supratentorial mass lesions
  • Severe bleeding diathesis, coagulopathy, or anticoagulated patient (INR >1.4)
  • Platelet count less than 50,000/mm3
  • Uncooperative patient
ANATOMY

Spinal Column

  • The L4 vertebra rests at the level of the iliac crests (and the umbilicus).

Spinal Cord and Meninges

  • The spinal cord ends in the conus medullaris at L1 to L2.
  • The space between the dura mater/arachnoid membrane and the spinal cord is the subarachnoid space; it is filled with CSF.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Monitor the patient for complications.
  • Arrange for follow-up or further treatment based on results of the lumbar puncture.
COMPLICATIONS
  • Post-lumbar puncture headache
  • Epidermoid tumors
  • Seizures
  • A traumatic or "bloody" tap
  • Brain herniation
  • Paresthesias
  • Local pain
  • Nerve root aspiration
  • Meningitis
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