Lumbar Puncture: What To Think About

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What To Think About

• A lumbar puncture is not done if the person has:
  • A suspected tumor, swelling, or increased pressure in the brain. A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be done first to see if it is safe to do the lumbar puncture.
  • A skin infection on the lower back. Doing a lumbar puncture in this case may allow the infection to spread into the spinal canal.
  • Bleeding disorders, which may increase the chance of bleeding during the procedure.
• Other tests that may be done include:
  • A cisternal or ventricular puncture. Cerebrospinal fluid (CSF) can be collected from the upper spinal canal at the base of the skull (cisternal puncture) or from within the skull (ventricular puncture) when it is not possible to get CSF from the lumbar area. These procedures are done by a trained radiologist or neurosurgeon. Special X-ray methods are used to guide the placement of the needle.
  • Bacterial marker studies. In cases of suspected bacterial meningitis, bacterial marker (bacterial antigen) studies can quickly find the common types of bacteria that cause meningitis. Antibiotic treatment for that bacteria can be started immediately.

Last updated:	September 12, 2008
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Joseph O'Donnell, MD - Hematology/Oncology
Editors:	Maria Essig, Tracy Landauer