You will lie curled up on your side, with your knees pulled into your chest and your back lined up with the edge of the bed. Alternatively, the doctor or nurse may ask you to sit on the bed with your head and shoulders bent forward so that your back curves out.
This numbs the area. Then they insert a very thin needle between two vertebrae spinal bones at the base of your back and through the membrane a thin skin-like layer that surrounds the spinal cord and contains the CSF. Sometimes, a special x-ray or ultrasound may be used to help the doctor or nurse guide the needle into the right place. Once the needle is in position, the pressure of the CSF is measured and some fluid is collected through the needle.
The amount of CSF taken will depend on whether you are undergoing the procedure for the purpose of an investigation or a treatment.
It may be necessary to remove more fluid if the lumbar puncture is being done as treatment for a condition. A lumbar puncture is most often described as uncomfortable. The local anaesthetic injection should prevent you from finding the procedure painful. There is a chance you may feel a sudden sharp pain in one of your legs if the needle touches a nerve in your spinal column.
The doctor or nurse will immediately adjust the position of the needle if this happens. Once enough CSF has been taken, the needle is carefully removed and a plaster is put over the puncture site. You can remove the plaster the following day. Usually, you can go home on the same day, but you should rest and avoid strenuous very tiring activity, as well as too much bending, lifting, stretching or straining. You should not drive yourself home following a lumbar puncture, so it is a good idea to make other arrangements for getting to and from your appointment.
A number of people experience headaches after having a lumbar puncture. This is a common side effect. It is caused by the drop in pressure around the brain that happens when the membrane is punctured and fluid is removed. The body will naturally replace the lost fluid but, in the meantime and while the membrane heals, it is a good idea to keep well-hydrated by drinking plenty of fluids.
A sometimes fatal disease that causes severe problems with the brain and other organs. Although the exact cause of the disease is not known, it has been linked to giving aspirin to children. It is now advised not to give aspirin to children during illnesses, unless prescribed by your child's healthcare provider. A stage of syphilis during which the bacteria invades the central nervous system. A disorder in which the body's immune system attacks part of the nervous system.
Demyelinating diseases. Diseases that attack the protective coating that surrounds certain nerve fibers - for example, multiple sclerosis or acute demyelination polyneuropathy. Headaches of unknown cause. After evaluation and head imaging if necessary, a lumbar puncture may be done to diagnose certain inflammatory conditions that can result in a headache. Pseudotumor cerebri also called idiopathic intracranial hypertension, or IIH. In this condition,pressure within the subarachnoid space is elevated for reasons that are not clear.
A lumbar puncture is only done in this condition after evaluation and head imaging. Normal pressure hydrocephalus. A rare condition affecting mainly older people in which there is a triad of loss of urinary control, memory problems, and an unsteady gait. A lumbar puncture is done to see if the pressure of the CSF is elevated or not. In addition, a lumbar puncture may be used to measure the pressure of the CSF. The healthcare provider uses a special tube called a manometer to measure s the pressure during a lumbar puncture.
Finally, a lumbar puncture may be done to inject medicine directly into the spinal cord. These include:. Your healthcare provider may have other reasons to recommend a lumbar puncture. Because this procedure involves the spinal cord and brain, the following complications may occur:.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure. I f you are having a lumbar puncture at Johns Hopkins Hospital or Bayview Medical Center, a neuroradiologist or radiology nurse will contact you by phone two or three days prior to your lumbar puncture to discuss the procedure and answer any questions you may have.
Please inform the neuroradiology physician if:. Other options should be discussed with you and your doctor. A gown will be provided for you. However, the procedure may also be done while you remain in your clothes from home. For this reason, try to wear non-restrictive, comfortable clothing and slip on shoes if possible.
Please remove all piercings and leave all jewelry and valuables at home. If you are not sure if it is safe for you, contact your primary care provider or referring provider. However, on the day of the procedure, do not eat for three hours before the procedure. You may have liquids and can take your usual medications unless previously advised to hold certain medications in preparation for the lumbar puncture.
Please bring a current list of your medications and allergies with you. This is for your safety and comfort. A lumbar puncture procedure may be done on an outpatient basis or as part of your stay in a hospital. If you develop a headache after a lumbar puncture, lying flat for several hours may help. Rest when you feel tired.
Getting enough sleep will help you recover. Ask your doctor when you can drive again. Drink extra fluids after the procedure to help prevent a headache or make it less severe. If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do. If you have pain, take pain medicines exactly as directed.
If the doctor gave you a prescription medicine for pain, take it as prescribed. If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach: Take your medicine after meals unless your doctor has told you not to. Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. For example, call if: You passed out lost consciousness. Call your doctor or nurse call line now or seek immediate medical care if: You have a new or higher fever and a stiff neck.
You have a severe headache. You have any drainage or bleeding from the puncture site. You feel numb or lose strength below the puncture site.
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