Are some of the contraindications for lumbar punction outdated today? A Case Report

Česká verzia

Authors: M. Kala ¹; M. Vaverka ²; M. Kolář ¹
Authors place of work: Neurochirurgická klinika LF UP a FN Olomouc ¹; Ústav mikrobiologie LF UP a FN Olomouc ²
Published in the journal: Cesk Slov Neurol N 2007; 70/103(5): 570-573
Category: Kazuistika

Summary

In the era of imaging methods, lumbar punction retains its significance as a diagnostic procedure. Its contraindication is intercranial hypertension together with symptoms of focal neurological disorder of the brain. Examination of the intracranial anatomic situation with the use of magnetic resonance imaging allows for detailed analysis of the status of subarachnoid spaces and, primarily, the cisterns at the base of the brain, thus largely suppressing the risk associated with lumbar punction in some patients or, in the opposite case, alerting for a higher risk associated with the procedure in other patients (e.g. in the case of Chiari malformation). In case of existence of a higher risk associated with lumbar punction, we recommend to perform the procedure with the patient lying on his or her flank and always under the control of an anaesthesiologist, at an intensive care unit where the patient will be observed after the procedure.

Key words:
lumbar punction – contraindications – intracranial hypertension – rombencephalitis – Chiari malformation

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