EFakharian MD Assistant Professor of Neurosurgery Kashan University of Medical Sciences ltfakharianekaumsacirgt Lumbar Puncture LP is an invasive procedure for obtaining CSF First reports of CSF is in EdwinSmith Surgical Papyrus written 3700 yrs ago ID: 582357
Download Presentation The PPT/PDF document "Lumbar Puncture" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1Slide2
Lumbar Puncture
E.Fakharian, M.D
Assistant Professor of Neurosurgery
Kashan University of Medical Sciences
<fakharian_e@kaums.ac.ir>Slide3
Lumbar Puncture
LP is an invasive procedure for obtaining CSF.
First reports of CSF is in Edwin-Smith Surgical Papyrus written 3700 yrs ago.
Hippocrates reported CSF presence in brain cavities, 4 centuries B.C.
Galen described ventricular cavities 2 centuries A.C.
In 1891 Heinrich Quincke, of Kiel, Germany, introduced this procedure as we know it today. His original intent was to help babies suffering from hydrocephalus by draining away excess fluid, but
from the outset he was also interested in lumbar puncture's use as a diagnostic tool, & examined CSF for its pressure, sugar, protein, & cell count.
Widal introduced CSF cytological studies in 1901.Slide4
Lumbar PunctureSlide5
Lumbar Puncture
LP for Dx
Infections, e.g. meningitis.
Demyelinating diseases, e.g., M.S.
High ICP, e.g., pseudotumor cerebri.
Bleeding, e.g., SAH.
Introducing contrast agent for Dx, e.g., DH,….
LP for RX
Infections, e.g. meningitis.
High ICP, e.g., pseudotumor cerebri.
Malignancies, e.g., leukemia.
Anesthesia
Others, e.g., CSF leakage.Slide6
Lumbar Puncture
Complications
Low pressure H/A.
Hematoma.
Cerebral herniation.
Infections.
Neural injury.
LBP.ContraindicationsInfection or wound at the site of LP
Bleeding tendency.
Intracranial or intraspinal mass lesions.Slide7
Lumbar Puncture
Procedure
:
Sitting
Lying down
L2/L3 level downwards
Needle between 2 spinal processes
30* cephalad directionBeveled tip direction depends to the aim of LPSlide8
Lumbar PunctureSlide9
Lumbar PunctureSlide10
Lumbar Puncture
Quinke needles
Sprotte needle
Touhy needleSlide11
Lumbar Puncture