Lumbar puncture – indications and contraindications to the procedure, course, complications

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Among the many important diagnostic procedures, one of the most frequently performed is the lumbar puncture. It is carried out for many different reasons, especially when there is a suspicion of diseases or ailments of the central nervous system. What is a lumbar puncture? How is the procedure going? When is it recommended to do so? Here’s everything you want to know about a lumbar puncture.

What is a lumbar puncture?

Lumbar puncture, otherwise known as a lumbar puncture, is a diagnostic procedure as a result of which it is collected cerebro-spinal fluid. This is done through a special puncture in the spine. Cerebrospinal fluid should be collected in order to measure its pressure, but also to diagnose some diseases of the central nervous system. Lumbar puncture it is also used when it is necessary to administer the drug into the spinal canal.

What is cerebrospinal fluid?

Cerebro-spinal fluid it is a clear liquid that is produced in the ventricles of the brain and from there it reaches the spinal canal and the subarachnoid space. Task cerebrospinal fluid is, among other things, the maintenance of proper intracranial pressure, as well as the protection of brain tissues and the spinal cord.

What are the diagnostic indications for lumbar puncture?

Performing a lumbar puncture may be necessary for diagnostic and therapeutic reasons. As for diagnostic indications, lumbar puncture it is recommended to perform when there is suspicion of subarachnoid bleeding or meningitis. The doctor will also recommend surgery to diagnose some autoimmune diseases, dystrophic disease, and to find out why there is an acute headache.

What are the therapeutic indications for a lumbar puncture?

Lumbar puncture it is also performed for several diagnostic reasons. First of all, it is used to lower the pressure of the cerebrospinal fluid. High blood pressure can be caused by various diseases and conditions, such as hydrocephalus. In addition, an indication for performance lumbar puncture it may also be the intrathecal administration of antibiotics, anesthetics or cytostatics.

Contraindications for the lumbar puncture

As with almost every procedure, also with lumbar puncture there are some contraindications to its implementation. Lumbar puncture people with a tumor of the central nervous system, empyema or abscess, as well as brain edema should not be treated. In addition, exercise is also not recommended lumbar puncture in patients with certain skin lesions at the puncture site, defects in the spine and spinal cord, and abnormal blood clotting. However, the final decision was to be made lumbar puncture in these cases the doctor will take care of it.

Lumbar puncture – how to prepare for it?

Lumbar puncture cannot be performed without prior tests ordered by a doctor. It is especially necessary to exclude a tumor or swelling of the brain. However, it is equally important to analyze the blood clotting system to rule out possible side effects.

Lumbar puncture – how is the procedure performed?

Lumbar puncture is a procedure that is performed in a specially designed office. The person commissioned puncture, should be on your side with your legs tucked in and your head as close to your chest as possible so that your spine is as curved outward as possible. Most often, a roller is placed under the head so that the spine forms a plane.

Before executing lumbar puncture local anesthesia is used and the puncture area is thoroughly cleaned. The procedure is most often performed between the fourth and fifth lumbar vertebrae, although in some cases cerebro-spinal fluid it is taken between the third and fourth vertebrae. The fluid is collected through a special needle, and after the entire procedure, a sterile dressing is placed over the puncture site. After lumbar puncture the patient should lie flat on their back for at least 12 hours. Otherwise, a characteristic headache may develop.

How is cerebrospinal fluid tested?

After lumbar puncture it is possible to carefully examine the cerebrospinal fluid. Usually about 3-5 ml of liquid is enough to perform a thorough analysis, but for additional tests it may be necessary to withdraw more. Cerebro-spinal fluid is analyzed taking into account the number and type of its cells, color and clarity, concentration of protein, lactic acid, glucose and chlorine, as well as bacteriological evaluation.

What are the complications after a lumbar puncture?

As with any treatment, also after lumbar puncture there may be some side effects. The most common are post-puncture headache and the so-called post-operative team. The thinner the needle used for puncture and the more we follow the recommendation to lie down for about 12 hours after the procedure, the less chance of this type of ailments. In addition, swelling, hematoma or bleeding may occur at the puncture site.

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