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Lumbar Puncture in Children
A lumbar puncture
is a procedure used to collect cerebrospinal fluid (CSF). CSF is a clear, protective fluid that flows around the brain and inside the spinal canal. A lumbar puncture is usually done to check for an infection, inflammation, bleeding, or other conditions that affect the brain. It may also be done to remove CSF to reduce pressure in the brain.
How to prepare your child for a lumbar puncture:
- Depending on your child's age, it may be helpful to explain what to expect during the procedure. Tell your child that his or her skin will be numb to prevent pain from the needle. Explain that there might be some discomfort, but that it should not be painful.
- Your child may need to have blood tests, x-rays, or other tests. Brain imaging tests, such as CT scan or MRI, may also be done.
- Tell your child's provider if your child has a blood disorder or has ever had a bleeding problem. Tell the provider if he or she is taking any medicine that may make him or her more likely to bleed. These include aspirin, clot busters, or blood thinners. The provider will have to decide if it is safe for your child to have a lumbar puncture. He or she may have your child stop taking certain blood thinners a few days before the procedure. Do not stop giving your child this medicine unless directed by his or her healthcare provider.
- Tell your child's healthcare provider if he or she has any allergies. This includes an allergy to a cleansing solution, such as iodine, or any numbing medicine.
- Do not let your adolescent drive himself or herself home after the procedure.
What will happen during a lumbar puncture:
- You may be able to stay in the room during the procedure. If your child is an infant or young child, he or she may be held by a healthcare provider during the procedure. This is to make sure that he or she is in the correct position. If your child is older, he or she will be asked to lie on his or her side. Your child's neck will be tucked toward his or her chest and he or she may be given a pillow. If your child is sitting, he or she will need to bend forward with the neck tucked toward the chest. Your child may be given medicine to help him or her relax or become drowsy.
- Your child's healthcare provider will feel his or her lower spine to find the best place to do the lumbar puncture. Your child may be given one or more shots of numbing medicine under the skin. A needle is inserted between the vertebrae (spine) in your child's lower back. Your child may feel some pushing or discomfort as the needle enters his or her back. It should only last a few seconds. If it does not, the provider may need to remove, reinsert, or change the position of the needle.
- Your child's healthcare provider may take readings of your child's CSF pressure. This is done by connecting a measuring device to the needle. After the pressure is measured, the device is removed and CSF is allowed to flow out of the needle. Samples of your child's CSF may be taken and placed in sterile bottles. The needle will then be taken out and the area will be covered with a bandage.
What happens after a lumbar puncture:
Your child will need to lie flat in bed until a healthcare provider says it is okay to get up. Tell a healthcare provider if your child says he or she has a headache, back pain, or tingling, numbness, or weakness below the waist.
- Medicines may be given to relieve pain.
- Your child may develop a headache during the first few hours after the procedure. The headache may last for several days. It may be mild to severe and may get worse when you sit or stand.
Risks of a lumbar puncture:
Your child may have neck or back pain. There may be bleeding, infection, or injury to a disc in your child's spine. Spinal fluid may leak from the puncture site. Your child's nerves or spinal cord may be damaged. Your child is at higher risk if he or she has a blood disorder or is taking certain medicines.
Seek care immediately if:
- Your child has a severe headache that does not get better after he or she lies down.
- Your child has vision or hearing problems, such as blurred or double vision, dizziness, or ringing in his or her ears.
- Your child has nausea, or is vomiting or dizzy.
- Your young child is irritable and crying more than usual.
- Your child has a fever.
- Your child has a stiff neck or has trouble thinking clearly.
- Your child's legs, feet, or other parts below the waist feel numb, tingly, or weak.
- Your child has a severe pain in his or her back or neck.
- Your child has bleeding or discharge coming from the area where the needle was put into his or her back.
Call your child's doctor if:
- You have questions or concerns about your child's condition or care.
Your child may need any of the following:
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Prescription pain medicine may be given. Ask your child's healthcare provider how to give this medicine safely. Some prescription pain medicines contain acetaminophen. Do not give your child other medicines that contain acetaminophen without talking to a healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your child's healthcare provider how to prevent or treat constipation.
- Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Care for a post-lumbar puncture headache:
- Have your child drink more liquid than usual after the procedure. Your child's healthcare provider may recommend caffeine to help treat your child's headache. He or she will tell you if caffeine is safe for your child and how to give the caffeine.
- Have your child lie down or rest to ease the headache pain.
Follow up with your child's healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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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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