Lumbar Puncture

WHAT YOU SHOULD KNOW:

• Lumbar puncture, also called LP, is a procedure where a needle is inserted in your back and into the spinal canal. This is done to collect cerebrospinal fluid (CSF) or treat certain medical conditions. The spinal canal contains the spinal cord, which carries messages between your brain and your body, and CSF. CSF is a clear fluid that flows around the brain and inside the spinal canal. This fluid contains information about body functions and disease processes. It also acts as a cushion to protect the brain and spinal cord from injury. LP may be used to check for an infection, inflammation (swelling), or other conditions affecting the brain. You cannot have an LP if you have increased pressure in the brain. This increased pressure may be caused by a tumor or blockage. If you bleed easily or an infection is present in the area where the needle will be inserted, a LP will not be done.
  
  
• During a lumbar puncture, CSF may be collected and sent to a lab for tests. The tests check for changes in the CSF, including the presence of blood, protein, glucose (sugar), and germs. The sample may also be used to do certain tests that check for an infection. Sometimes, medicine may be put through the LP into your back to treat a disease. CSF pressure may also be measured during LP.

AFTER YOU LEAVE:

Medicines:

• Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

• Ask your caregiver when the results of your procedure will be available.
  
  

Post-lumbar puncture headache: You may develop a headache during the first few hours after your LP, which may last up to several days. This happens when the amount of CSF and the CSF pressure are decreased, such as with a CSF leak. The headache may range from mild to severe (very bad) and may get worse when you sit or stand. You may have neck or back pain as well. The following may help ease or prevent a post-lumbar puncture headache:

• Drinking liquids: You may be asked to drink more liquid than usual after your LP. For most people, good liquids to drink include water, milk, and juices. Do not drink alcohol. Tell your caregiver if you cannot drink a lot of liquid because of another medical condition, such as a heart or kidney condition.
  
  
• Lying down: You may need to lie flat for some time after your LP. Ask your caregiver how long you need to lie down.
  
  
• Treatment options: You may have any of the following:
  
  
  • Medicines:
    
    
    • Caffeine: Caffeine may be used to treat a LP headache. As CSF pressure decreases, such as with a leak, blood vessels in the brain will dilate (get bigger) to get more fluid to the brain. Headache pain is caused by the blood vessels getting bigger. Caffeine causes the blood vessels in the brain to narrow (get smaller), which will decrease your headache pain. Drink caffeinated drinks, such as coffee or soda, every 4 to 6 hours. If this does not relieve your headache, call your caregiver. You may need to be given caffeine intravenously (IV) through a tube placed in your vein.
      
      
    • Pain medicine: You may need medicine to relieve or decrease your headache pain. These medicines may include NSAIDS (non-steroidal anti-inflammatory medicine), such as ibuprofen, acetaminophen, or medicine that your caregiver orders (prescription) for you. Your caregiver will decide which medicine is best for you to take for your headache. Follow your caregiver's instructions on how to take your medicine. Tell your caregiver if the pain medicine does not help or if you have any questions about your medicine.
    
    
  • Procedures: You may need to have any of the following if your headache is not relieved by the treatments above:
    
    
    • Blood patch: If your headache is caused by a leakage of CSF from the LP site, a blood patch procedure may be needed. This procedure uses a small amount of your blood, that is taken from a vein, to patch (seal) the LP leak. The blood is put through a needle into your spinal canal in the same way that the LP was done. You will need to lie in bed for 1 to 2 hours after this procedure. This procedure may need to be repeated if your headache is not relieved.
      
      
    • Saline epidural: A saline epidural may be given if your headache is caused by low CSF pressure due to a leak. This procedure puts saline (an IV fluid) back into your spinal canal to increase CSF pressure. The increased pressure may help to seal the leak. The saline is put through a needle into your spinal canal in the same way that the LP was done.

CONTACT A CAREGIVER IF:

• You have severe (bad) pain in your back or neck.
  
  
• You have bleeding or a discharge coming from the area where the needle was put into your back.
  
  
• You have questions or concerns about your procedure or medicine.

SEEK CARE IMMEDIATELY IF:

• You have a headache that is very bad and does not get better after lying down.
  
  
• You have a fever (increased body temperature).
  
  
• You have a stiff neck or have trouble thinking clearly.
  
  
• Your legs, feet, or other parts below the waist feel numb, tingly, or weak.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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