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[Complications caused by lumbar puncture].
Mikko Pitkänen1, Johannes Förster
1Orton Oy, Helsinki.
Duodecim; Laaketieteellinen Aikakauskirja
|January 7, 2015
Summary
Lumbar puncture carries risks, including orthostatic headache and hemorrhage, particularly for patients on anticoagulants. While most neurological complications are temporary, persistent issues are rare.
Area of Science:
- Neurology
- Anesthesiology
- Neurosurgery
Context:
- Lumbar puncture (LP) is a common diagnostic and therapeutic procedure.
- Increasing reports link LP to hemorrhages, potentially due to thromboprophylaxis in anesthesia.
- Patients on anticoagulants face elevated hemorrhage risks.
Purpose:
- To review the potential complications associated with lumbar puncture.
- To highlight the risks of hemorrhage and neurological deficits.
- To inform clinicians about patient risk factors.
Summary:
- Lumbar puncture is not without risk, with orthostatic headache being a frequent complication.
- Hemorrhage into the epidural or spinal space is an increasing concern, especially with concurrent thromboprophylaxis.
- Anticoagulant use (e.g., warfarin, LMWH) significantly elevates hemorrhage risk during LP.
- Neurological complications are typically transient, though persistent deficits are possible.
Impact:
- Enhances understanding of lumbar puncture risks for clinicians and patients.
- Promotes cautious application of lumbar puncture in patients with bleeding risks.
- Informs guidelines for managing anticoagulation around spinal procedures.
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