Indications and contraindications for lumbar puncture

Lumbar puncture is a very important examination and diagnostic method in clinical practice and has important value in the treatment of diseases. Because lumbar puncture is mainly performed in the neurology department, it is more sensitive to indications and contraindications. If the operation is improper, it may aggravate the patient's condition, and in severe cases even threaten the patient's life. Therefore, these two factors must be fully considered in actual use. So, what are the indications and contraindications of lumbar puncture?

Indications for lumbar puncture

1. Diagnosis and differential diagnosis of inflammatory diseases of the central nervous system: including purulent meningitis, tuberculous meningitis, viral meningitis, fungal meningitis, Japanese encephalitis, etc.

2. Diagnosis and differential diagnosis of cerebrovascular accident: including cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage, etc.

3. Diagnosis and treatment of tumor diseases: used to diagnose meningeal leukemia and treat meningeal leukemia by intrathecal injection of chemotherapy drugs through lumbar puncture.

4. Measure the intracranial pressure and understand whether the subarachnoid space is blocked.

5. Intrathecal administration.

Contraindications to lumbar puncture

1) It is absolutely contraindicated for patients with signs of brain herniation.

2) Patients clinically diagnosed with intracranial space-occupying lesions and significantly increased intracranial pressure.

3) If the skin and soft tissue at the puncture site are infected, lumbar puncture can easily spread the infection into the spinal canal or even into the skull.

4) In case of open head injury or infected cerebrospinal fluid leakage, lumbar puncture to release cerebrospinal fluid may inhale the infection into the subarachnoid space. 5) The lumbar vertebrae at the puncture site are deformed or have bone destruction.

6) Severe systemic infection (sepsis), patients in shock or on the verge of clinical shock, or patients who are restless and unable to cooperate.

7) In case of compressive lesions in the upper cervical spinal cord and complete disappearance of spinal cord function, the condition may worsen or even lead to respiratory arrest after lumbar puncture.

8) Lumbar puncture is prohibited without a neurological examination, especially a fundus examination.