Lumbar puncture, what does it consist of?

What is a lumbar puncture?

The spinal cord is made up of a nerve group that run down the back from the base of the brain. Both the brain and spinal cord are surrounded by a fluid called "cerebrospinal fluid", that cushions and protects them, and that can contain important clues about the health of both. For example, it can be used to determine if there is an infection or bleeding in the brain.

Why is it done?

Your doctor may order a lumbar puncture to look for problems affecting the brain or spinal cord. Here are some examples of those problems:

• An infection affecting the brain or spinal cord, such as the
• When we have the suspicion of or bleeding in a part of the head.
• causing vision problems, numbness, tingling, muscle weakness ...
• cancer spread to the tissues around the brain or spinal cord (carcinomatous meningitis).
• Nervous system diseases like syndrome Guillain barre.
• Pseudotumor cerebri a disease that puts pressure on the inside of the skull.

In some cases, doctors also perform a lumbar puncture. to administer certain types of medicines directly in the area around the spinal cord. Examples of medicines that can be administered in this way include anesthesia, antibiotics ...

Preparation for lumbar puncture

• Lie on your side and hold your legs between your arms so that your back is curved in a "C" shape.
• During the procedure, it is very important stay very still.
• The doctor will touch the spine and choose where to perform the lumbar puncture. It will be in the Lower back, below the point where the spinal cord ends.
• Before doing the lumbar puncture, the doctor will clean the area of the lower back.
• A injection of local anesthetic to numb the area.
• The doctor insert a needle in the back, between two of the bones (called "vertebrae") that make up the spine. The needle goes through the skin and tissues around the spinal cord and into the fluid-filled space.
• Once the needle is in place, the doctor will measure the liquid pressure. Will also take a small sample of liquid to analyze, or inject medicine if necessary.

What are the possible side effects after a lumbar puncture?

After a lumbar puncture, in some cases you may have a severe headache. This happens because the point where the lumbar puncture needle enters does not always close immediately. If the hole remains open, cerebrospinal fluid may leak out, causing a headache.

In most cases, the hole closes on its own, and the headache goes away in one to two days. It is likely to improve if we lie down. If the headache does not improve after a day or two, doctors may offer us a treatment called 'Patch of blood«. In this procedure, a small amount of blood is taken and injected into the area where the lumbar puncture was performed. blood fills the hole and cerebrospinal fluid levels return to normal.

Problems that can appear in isolated cases after a lumbar puncture are:

• Infection
• Bleeding: Before performing a lumbar puncture, we must inform the doctor if we take aspirin or a blood thinning medicine. These include warfarin (brand name: Jantoven), apixaban (brand name: Eliquis), edoxaban (brand name: Savaysa, Lixiana), and rivaroxaban (brand name: Xarelto). These medications may increase the risk of bleeding during a lumbar puncture.
• A brain problem called "Brain herniation", life-threatening. This problem is very rare and usually appears only in people who already have a life-threatening brain disease.
• pain or numbness on the back or legs.
• Abnormal growths (called "squamous cell tumors") that form in the spine long after the lumbar puncture is smoothed. This is more likely in children than adults.

Do you have any contraindications?

In some cases, lumbar puncture is contraindicated when:

• There is a skin infection at the puncture site,
• If the patient has a coagulation disease or if the patient has high intracranial pressure.
• Patients over 60 years of age, immunosuppressed, or with clinical seizures of less than a week,
• Patients with papilledema (increased fluid inside the eye with retinal involvement),
• Patients with altered consciousness or with alterations in the neurological examination and with a high suspicion of meningitis, a Cranial CT before performing the lumbar puncture.

• A lumbar puncture is a procedure that doctors use to obtain a sample of fluid from the area around the spinal cord.
• Your doctor may order a lumbar puncture to look for problems that affect the brain or spinal cord.
• After a lumbar puncture, in some cases you can have a very bad headache.

If you need to have a lumbar puncture, it is best to put yourself in the hands of the best professionals included in the medical directory of insurance.

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