Lumbar Puncture

• Written informed consent.
• Position: lateral position with flexed knee/ hip joint / sitting position in elder children Preparation of the parts: Site - L2 – L3 / L3- L4

During the procedure

• Give local anesthesia
• A L.P. needle is inserted in vertebral space
• Through the spinal membrane (dura) and to reach the subarachnoid space.
• CSF is collected in sterile containers.
• The needle is removed, and the puncture site is covered with a bandage.

• Elevated Intracranial pressure owing to a suspected mass lesion of the brain or spinal cord. (So fundus examination & head CT are mandatory)
• Severe respiratory distress & shock etc. as that may worsen with positioning in flexion.
• Thrombocytopenia. (˂ 20,000 cells/mm3)
• Local infection at the site

• Post LP headache and backache
• Latrogenic meningitis
• Cerebral herniation in sudden drop of elevated intracranial pressure.