Chapter 114

1. What is the role of brain CAT scan imaging prior to lumbar puncture?

2. What is the best patient positioning to perform lumbar puncture?

3. What are important factors to consider in preventing post dural puncture headache?

Lumbar puncture (LP) is a procedure to sample the cerebrospinal fluid (CSF) surrounding the brain and spinal cord. It can be performed on an inpatient or outpatient basis using local anesthesia. Individuals trained to perform this procedure generally include hospitalists and other internists, proceduralists, emergency physicians, pediatricians, neurologists, and radiologists. It has been estimated that 400,000 diagnostic lumbar punctures are performed in the United States annually with charges estimated between $2000 to$3000 for each uncomplicated procedure.