Lumbar Puncture

Posted by e-Medical PPT Thursday, September 2, 2010
Lumbar puncture is a diagnostic and a therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis.The most common purpose for a lumbar puncture is to collect cerebrospinal fluid in a case of suspected meningitis.In any age group, subarachnoid hemorrhage, hydrocephalus, benign intracranial hypertension and many other diagnoses may be supported or excluded with this test.Lumbar punctures may also be done to inject medications into the cerebrospinal fluid ("intrathecally"), particularly for spinal anesthesia or chemotherapy.
Lumbar puncture should not be performed when increased intracranial pressure (ICP) is present.Also, lumbar puncture should not be attempted when there is coagulopathy, abnormal respiratory pattern,hypertension with bradycardia and deteriorating consciousness.Post spinal headache with nausea is the most common complication.Spinal or epidural bleeding, and trauma to the spinal cord or spinal nerve roots resulting in weakness or loss of sensation, or paraplegia are extremely rare.
The presence of white blood cells in cerebrospinal fluid is called pleocytosis.A small number of monocytes can be normal; the presence of granulocytes is always an abnormal finding. A large number of granulocytes often heralds bacterial meningitis.Glucose is usually present in the CSF; the level is usually about 60% that in the peripheral circulation.Decreased glucose levels can indicate fungal, tuberculous or pyogenic infections.Changes in total protein content of cerebrospinal fluid can result from meningitis,brain abscesses, subarachnoid hemorrhage,Guillain-Barré syndrome etc.

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1 Response to Lumbar Puncture

  1. amina Says:
  2. LP is also contrandicated when there are decreased levels of platelets in the blood (less than 50 x 109/L)

     

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