Is hydrocephalus a contraindication to lumbar puncture?
Suspected increased intracranial pressure (ICP) due to an intracranial mass lesion, cerebral edema, or obstructive hydrocephalus is a relative contraindication to performance of an LP and also requires independent assessment and treatment.
Can you do LP with hydrocephalus?
Repeat lumbar punctures (LPs) can be performed for cases of hydrocephalus after intraventricular hemorrhage, since this condition can resolve spontaneously. If reabsorption does not resume when the protein content of cerebrospinal fluid (CSF) is less than 100 mg/dL, spontaneous resorption is unlikely to occur.
Why do you not do a lumbar puncture with increased intracranial pressure?
Patients with increased ICP from mass lesions often display decreased levels of consciousness, focal neurological signs or papilledema on physical exam. Any of these findings make lumbar puncture contraindicated until further evaluation can be undertaken.
What is the risk of doing a lumbar puncture on a patient with intracranial hypertension?
Idiopathic intracranial hypertension patients with mild (numeric rating scale 1–3) or no headache (on the day of lumbar puncture, prior to lumbar puncture) had a high risk of post- lumbar puncture headache exacerbation (81% and 67% respectively).
What are contraindications for lumbar puncture?
Absolute contraindications for performing a LP include infected skin over the puncture site, increased intracranial pressure (ICP) from any space-occupying lesion (mass, abscess), and trauma or mass to lumbar vertebrae.
When should you not do lumbar puncture?
Absolute contraindications for lumbar puncture are the presence of infected skin over the needle entry site and the presence of unequal pressures between the supratentorial and infratentorial compartments.
What is a VP shunt for hydrocephalus?
A ventriculoperitoneal (VP) shunt is a thin plastic tube that helps drain extra cerebrospinal fluid (CSF) from the brain. CSF is the saltwater that surrounds and cushions the brain and spinal cord.
What congenital condition s are contraindications to lumbar puncture?
Congenital spine abnormalities and spinal cord abnormalities (e.g., tethered cord), or local skin infections at the LP site can be contraindications to perform an LP.
When should you avoid a lumbar puncture?
Avoid lumbar puncture in patients in whom the disease process has progressed to the neurologic findings associated with impending cerebral herniation (ie, deteriorating level of consciousness and brainstem signs that include pupillary changes, posturing, irregular respirations, and very recent seizure)
What are the possible complications of a lumbar puncture?
Risks
- Post-lumbar puncture headache. Around 25% of people who have undergone a lumbar puncture develop a headache afterward due to a leak of fluid into nearby tissues.
- Back discomfort or pain. You may feel pain or tenderness in your lower back after the procedure.
- Bleeding.
- Brainstem herniation.
Is aspirin a contraindication for lumbar puncture?
Aspirin has not been shown to increase the risk of serious bleeding following minor procedures such as LP and so can be continued safely.
What are the risks of a CSF shunt?
Some of the most common risks of CSF shunts include infection, shunt malfunction, and improper drainage. Infection from a shunt may produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract.
What CT criteria are considered contraindications to a diagnostic lumbar tap?
Wesuggestthefollowing CTcriteria that are anatomical correlates to unequal intracranial pressures and should be considered contraindications to a proposed diagnostic lumbar tap.
What are the symptoms of hydrocephalus and shunt infection?
In addition to the common symptoms of hydrocephalus, infections from a shunt may also produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract.
What are the symptoms of a malfunctioning shunt?
Infection from a shunt may produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract. Shunt malfunction is most commonly due to a blockage or some obstruction within the shunt system. If the blockage is not corrected,…