User:Mr. Ibrahem/Lumbar puncture

Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF). This can help diagnose meningitis, subarachnoid hemorrhage, and inflammatory disorders of the CNS. These inflammatory disorders include multiple sclerosis, Guillain–Barré syndrome, leukoencephalopathies, and paraneoplastic syndromes. It may also be used treat idiopathic intracranial hypertension and give certain medications.

Contraindications include certain types of increased intracranial pressure, skin infection at the site of puncture, and low platelets under 50 x 109 per L. Though the procedure can be done despite people being on aspirin, or if required clopidogrel; it is not recommended in those on a DOAC or on warfarin with an INR above 1.5. While generally safe, side effects may include pain at the puncture site, post-dural-puncture headache, infection, and bleeding. The risk of headache may be reduced by using a small non cutting needle. Very rarely a spinal hematoma or nerve root injury may occur.

It is typically performed using local anesthesia and sterile technique. Midazolam or fentanyl may help with anxiety. The procedure is done with the person sitting or on their side. A needle is then advanced in the mid-line or just off mid-line of the back between the L3/4 or L4/5 vertebra into the subarachnoid space and fluid collected. A "syringe hickie" can be used to mark the spot. Ultrasound to landmark may increase success.

Following the procedure a bandage is applied and the person may walk around. Fluid is often sent for cell count, microbial culture, protein and glucose levels, color analysis, and cytopathology. Other tests may include PCR testing and oligoclonal bands. Lumbar punctures are commonly carried out. It was first performed in 1891 by the German physician Heinrich Quincke.