Diagnostic lumbar puncture: minimizing complications

Authors: Williams; Lye¹; Umapathi²

Source: Internal Medicine Journal, Volume 38, Number 7, July 2008 , pp. 587-591(5)

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Abstract:

Diagnostic lumbar puncture (LP) is essential to the diagnosis of central nervous system infections and subarachnoid haemorrhage. Life or limb-threatening adverse events due to the procedure are rare, but less severe complications may be common. Clinical practice in diagnostic LP is often not evidenced based. The aim of the study was to use best available published evidence to address questions on minimizing complications associated with diagnostic LP. We searched PubMed for studies in the English language using key words relevant to the complications of diagnostic LP. We emphasized randomized controlled trials and systematic reviews enrolling adult patients undergoing diagnostic LP. Uncontrolled studies and studies involving children or spinal anaesthesia were considered when no other evidence was available. There were nine prospective studies and three systematic reviews on reducing complications from LP. Recommendations on interventions to minimize complications of LP are graded based on the quality and strength of evidence.

Keywords: lumbar puncture; complication; headache; meningitis

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1445-5994.2008.01631.x

Affiliations: 1: Department of Infectious Diseases, Tan Tock Seng Hospital 2: Department of Neurology, National Neuroscience Institute, Singapore

Publication date: 2008-07-01