Lumbar Puncture Needle

22 or 25 Gauge needle with stylet.
1. What are the indications for lumbar puncture
Can be divided into diagnostic and therapeutic
a. Diagnostic : meningitis, pyrexia of unknown origin, subarachnoid hemorrhage
Myelography- introduction of radiological dyes
b. Therapeutic : spinal anaesthesia
Chemotherapy of leukemia ( intrathecal methotrexate)
Administration of intracranial antibiotics
At times, to lower the intracranial pressure.
2. What are the contraindications for lumbar puncture
a. Increased intracranial pressure
b. Deformity of the spine
c. Local infection
d. Bleeding diathesis
3. What is the site of lumbar puncture
It is the intervertebral space between L3&L4 or L4&L5.
4. What are the complications of lumbar puncture
a. Failure to obtain a specimen or the tap can be traumatic
b. Infection can be introduced if proper aseptic precautions are not followed.
c. Headache after the procedure
d. Brainstem herniation can occur when there is increased pressure or swelling of the brain before the procedure.
e. Very rarely spinal hematoma or abscess can occur