When is Cisternal puncture used?
A suboccipital puncture or cisternal puncture is a diagnostic procedure that can be performed in order to collect a sample of cerebrospinal fluid (CSF) for biochemical, microbiological, and cytological analysis, or rarely to relieve increased intracranial pressure.
Where is Cisternal puncture done?
Cisternal puncture uses a needle placed below the occipital bone (back of the skull). It can be dangerous because it is so close to the brain stem. It is always done with fluoroscopy. Ventricular puncture may be recommended in people with possible brain herniation.
What happens if you puncture spinal cord?
A lumbar puncture is where a thin needle is inserted between the bones in your lower spine. It should not be painful, but you may have a headache and some back pain for a few days. It’s carried out in hospital by a doctor or specialist nurse.
Why is L3 and L4 used for lumbar puncture?
The insertion of a needle under local anaesthetic requires careful positioning to prevent injury to the spinal cord. Since the spinal cord ends as a solid structure around the level of the second lumbar vertebra (L2) the insertion of a needle must be below this point, usually between L3 and L4 (Fig 2).
What happens when a lumbar puncture goes wrong?
Bleeding. Bleeding may occur near the puncture site or, rarely, in the epidural space. Brainstem herniation. Increased pressure within the skull due to a brain tumor or other space-occupying lesion can lead to compression of the brainstem after a sample of cerebrospinal fluid is removed.
What is the most serious complication of lumbar puncture?
Cerebral herniation — The most serious complication of LP is cerebral herniation.
Is Spinal fluid sweet or salty?
The classic presentation of CSF leaks is the expression of clear, watery drainage from the nose. This occurs usually on one side; however if fluid drains into the back of the throat there may be a salty taste.
Why is pneumoencephalography no longer used?
Pneumoencephalography was performed extensively throughout the twentieth century. By the late 1980s, the procedure was largely abandoned by the medical community, having been supplanted by the CT scan and metrizamide cisternography.
What is a pneumoencephalography procedure?
Pneumoencephalography (abbreviated as PEG; sometimes called an ‘air study’) is an old invasive technique that involved the draining of the majority of the cerebrospinal fluid (CSF) from around the brain through a lumbar puncture.
What should I avoid after a lumbar puncture?
Avoid strenuous or vigorous exercise for a day or so following the lumbar puncture. If you have a headache, lay down as much as possible and drink plenty of fluids. Contact your health care provider if the headache persists.
What are two nursing interventions after lumbar puncture?
The nurse should note of the following nursing interventions post-lumbar puncture:
- Apply brief pressure to the puncture site.
- Place the patient flat on bed.
- Monitor vital signs, neurologic status, and intake and output.
- Monitor the puncture site for signs of CSF leakage and drainage of blood.