LUMBAR PUNCTURE

LUMBAR PUNCTURE is a topic covered in the Harrison's Manual of Medicine.

To view the entire topic, please or .

Harrison’s Manual of Medicine 20th edition provides 600+ internal medicine topics in a rapid-access format. Download Harrison’s App to iPhone, iPad, and Android smartphone and tablet. Explore these free sample topics:

-- The first section of this topic is shown below --

Evaluation of cerebrospinal fluid (CSF) is essential for the diagnosis of suspected meningeal infection, subarachnoid hemorrhage, leptomeningeal neoplastic disease, and noninfectious meningitis. Relative contraindications to LP include local skin infection in the lumbar area and suspected intracranial or spinal cord mass lesion. Any bleeding diathesis should also be corrected prior to performing LP to prevent the possible occurrence of an epidural hematoma. Guidelines for performing LP in pts receiving anticoagulant or antiplatelet medications can be found in Chap. S9 of Harrison’s Principles of Internal Medicine, 20th edition. A functional platelet count >50,000/µL and an international normalized ratio (INR) <1.5 are advisable to perform LP safely.

In pts with an altered level of consciousness, focal neurologic deficits, or evidence of papilledema, an imaging study should generally be obtained prior to performing LP.

-- To view the remaining sections of this topic, please or --

Evaluation of cerebrospinal fluid (CSF) is essential for the diagnosis of suspected meningeal infection, subarachnoid hemorrhage, leptomeningeal neoplastic disease, and noninfectious meningitis. Relative contraindications to LP include local skin infection in the lumbar area and suspected intracranial or spinal cord mass lesion. Any bleeding diathesis should also be corrected prior to performing LP to prevent the possible occurrence of an epidural hematoma. Guidelines for performing LP in pts receiving anticoagulant or antiplatelet medications can be found in Chap. S9 of Harrison’s Principles of Internal Medicine, 20th edition. A functional platelet count >50,000/µL and an international normalized ratio (INR) <1.5 are advisable to perform LP safely.

In pts with an altered level of consciousness, focal neurologic deficits, or evidence of papilledema, an imaging study should generally be obtained prior to performing LP.

There's more to see -- the rest of this entry is available only to subscribers.