What are the contraindications of lumbar puncture?

Contraindications. Absolute contraindications for performing a LP include infected skin over the puncture site, increased intracranial pressure (ICP) from any space-occupying lesion (mass, abscess), and trauma or mass to lumbar vertebrae.

What are the possible risks or complications of a cisternal tap?

Subarachnoid hemorrhage is the commonest major complication of cisternal puncture, with at least 30 reported fatalities. Other serious complications result from direct puncture of brain substance.

Is lumbar puncture contraindicated in meningitis?

Meningitis and other infections are rare complications of LP. (See ‘Infection’ above.) LP is contraindicated in patients with a suspected spinal epidural abscess. Suspected bacteremia is not a contraindication to LP.

Why is LP contraindicated in raised ICP?

Increased intracranial pressure (pressure in the skull) is a contraindication, due to risk of brain matter being compressed and pushed toward the spine. Sometimes, lumbar puncture cannot be performed safely (for example due to a severe bleeding tendency).

Are there any contraindications to a lumbar puncture?

Lumbar Puncture Indications and Contraindications | Proceduralist.org Indications Urgent Meningitis 1 It is very difficult to clinically rule out meningitis with out an LP. Fever, neck stiffness, altered mental status, and headache are the most common symptoms.

When was the cisternal puncture for CSF described?

Cisternal puncture for acquiring CSF was described by Obregia in 1908 and by Ayer in 1919 [ 3 – 5 ]. The procedure was performed from a posterior suboccipital approach with the patient in the lateral decubitus position or sitting upright with the head flexed.

When to perform a lateral C1-C2 puncture?

Lateral C1–C2 puncture is often performed for either CSF collection or myelography ( Table 1 ). Reasons for CSF collection include suspected meningitis, demyelination, or leptomeningeal tumor dissemination.

How big of a needle is needed for a CSF puncture?

A 63 mm (2.5 inch) or 88 mm (3.5 inch) needle is sometimes required for cisternal puncture in giant breeds and most lumbar punctures. The author does not recommend aspirating the CSF as there is risk of damaging neural tissue.