Lumbar Puncture (LP)

Lumbar Puncture is an essential test in the investigation of many severe headache disorders.

It is mandatory in first episodes of thunderclap headache - especially if a CT Brain Scan has not revealed Subarachnoid Haemorrhage or Venous Sinus Thrombosis.

Conditions where LP can help diagnosis are:

  1. Meningitis
  2. Subarachnoid Haemorrhage - especially in the 2% of cases with negative CT Brain Scan
  3. Intracranial Hypotension
  4. Venous Sinus Thrombosis
  5. Idiopathic Intracranial Hypertension
  6. Malignant Meningitis

An LP will not help diagnosis of sinusitis(unless you want to know if there is secondary meningitis), nor will it help in temporal arteritis diagnosis.

Carotid dissection or vertebral dissection are not diagnosed by LP, although a small number of cases of vertebral dissection are associated with subarachnoid haemorrhage.

Analysis of Cerebrospinal Fluid

It is very, very important to make sure that you take enough fluid (a minimum of 2ml per bottle in adults), and that your hard won sample is properly analysed.

The most important part of analysis is testing for bilirubin, commonly known as xanthochromia testing.

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