Lumbar Puncture  5

Good patient positioning and an experienced assistant are the most important factors for success. 

After the lumbar puncture 

Common practice has been to lay the patient flat for a period of time - hours. There is no evidence to support this practice. 

 Post lumbar puncture headache

Although some headache is common after lumbar puncture, most clear up after a day or two.
If the patient has a headache suggestive of dural leak
(worse on sitting up, relieved by lying down) 48 hours after having had a lumbar puncture, it would be wise to consult an anaesthetist about offering the patient a blood patch.

A blood patch is an injection of the patient's own (freshly drawn) blood, which is injected around the epidural space. The aim is to seal the leak.

There is limited evidence supporting this practice.

The headache after lumbar puncture is typically:

 

1) worse on sitting up.

2) worse on lying down.

3) worse on sitting down.

4) worse on deep inspiration.

5) worse in the morning.

 

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