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Lumbar Puncture Side Effects

Side Effects of Lumbar (Spinal) Puncture That We All Must Know

Lumbar puncture is a procedure used for diagnosing and treating certain serious medical conditions. Know more about the side effects of this procedure, through this write-up.
Chandramita Bora
Last Updated: May 30, 2018
Lumbar puncture, a.k.a. spinal tap or spinal puncture, is a diagnostic procedure employed for collecting a sample of cerebrospinal fluid (CSF) -- a fluid that surrounds the brain and the spinal cord. The CSF is then tested for diagnosing a number of conditions, including bacterial meningitis. On rare occasions, lumbar puncture is also used for therapeutic purposes, especially for injecting medication into the cerebrospinal fluid, to combat certain illnesses.

Now, this procedure can have some side effects, both minor and serious. Besides having a look at what they are, and listing out some useful pointers that can be taken note of, we will also discuss in detail, when it is done and the way it is gone about.

Fallouts of a Spinal Tap
The most commonly encountered side effect of a spinal tap is a headache, which usually lasts for two to three days after going through the procedure. Although, in a few cases, the headache can be experienced even after almost 12 to 13 days.

Treated with - regular analgesics and painkillers such as paracetamol.

A typical headache which aggravates when sitting in an upright position and lessens when you lie flat, might be an indicator of cerebrospinal fluid leak.

Treated with - an epidural blood patch (patient's own blood is injected into the site of the leakage, so that the blood clot formed can seal off the leakage), and ample bed rest.

Heeding Headache with Caffeine
To complement recovery post-lumbar puncture, caffeine is one trusted pain reliever. Known to contract enlarged blood vessels responsible for causing headaches, beverages such as coffee, tea, and soda serve to be potent in this regard. Besides, specific conditions encourage administering an intravenous dose of caffeine as well.

Young and lean women or pregnant women (18 - 30 year olds), are at a higher risk of developing a headache after a spinal puncture. The actual reason behind experiencing the headache in not yet clear. However, one hypothesis says that, the brain sags due to the temporary interruption in the fluid that surrounds it. This eventually puts pressure on the pain-sensitive areas of the brain.

Headaches caused by a lumbar puncture are generally felt either at the front of the head or near the base of the skull, and are experienced by about 40% of people who have gone through this procedure. This pain can, many a time, spread to the neck, shoulders, and the lower back.

Serious side effects of a lumbar puncture are very rare. Approximately, one in a thousand cases experience the following side effects.
  • Seizures
  • Minor nerve injury
  • Spinal or epidural bleeding
  • Spinal cord or spinal nerve roots injury
  • Paraplegia or paralysis of the lower half of the body
A few more serious side effects:
  • Tonsillar herniation - a fatal side effect of high intracranial pressure from an injury or tumor
  • Cranial neuropathy - impairment of one or more of the twelve cranial nerves
  • Spinal hematomas - accumulation of blood between the skull and the dura mater - the hard outermost membrane of the central nervous system
  • Vasovagal syncope - an uneasiness mediated by the nervus vagus, which leads to fainting
  • Arachnoid cyst - a liquid-filled cyst between the levels of two innermost layers of the meninges lined with the arachnoid membrane, usually in the sylvian fissure.

How and When?

How is it Done?
  • A lumbar puncture typically involves the insertion of a needle between the third and fourth, or fourth and fifth lumbar vertebrae, in order to collect cerebrospinal fluid.
  • Before inserting the needle, the patient is usually asked to lie down in a lateral position, with the neck and knees bent completely. The knees should ideally be bent up to the chest. In rare cases, the process is also carried out with the patient sitting on a chair or a stool, with his head and shoulder bent forward towards the knees.
  • Local anesthesia is applied on the skin of the lumbar area, after which, a needle is inserted between the appropriate lumbar vertebrae, and pushed into the spinal canal to collect the CSF. While collecting this fluid, a liquid column manometer is used to measure the pressure of the spinal fluid.

When is it Done?
A lumbar puncture is usually performed when meningitis is suspected, as this procedure is the most reliable tool for diagnosing the disease. Other than meningitis, medical conditions that may require this procedure include:
  • Subarachnoid hemorrhage
  • Hydrocephalus
  • Benign intracranial hypertension
  • Tumor and multiple sclerosis
  • Other spinal cord and brain disorders

Diagnosis of these diseases are mainly carried out on the basis of the pressure of the CSF, and the presence of blood cells in it, especially the white blood cells like granulocytes. Occasionally, a spinal tap is also used for administering certain medication like cancer drugs, antibiotics, etc., into the CSF.

Important Pointers
A spinal puncture is not recommended for individuals having/taking...

... epidural infection
... bleeding problems
... brain tumor
... bleeding inside the brain
... blood thinning medicines

The above-mentioned conditions raise the pressure inside the brain, which can lead to some serious side effects. Therefore, physicians usually examine the entire nervous system, including the brain and spinal cord, before performing a lumbar puncture. Many a time, a CT scan and/or MRI of the brain is done to decide whether this procedure can be carried out safely. Thus, the physician carries out a complete analysis and evaluation of the patient's health condition, before opting for this procedure, which is generally recommended only in the case of potentially serious medical conditions.

Contact your health care provider, if after having a spinal puncture, you feel any of the following symptoms:
  • Sensitivity to vivid lights
  • Nausea or vomiting
  • Fever of 100.4° F and above, with inflammation and swelling around the injected area

Disclaimer: This article is for informative purposes only, and should not be used as a replacement for professional medical advice.