Purpose The most common reason for a lumbar puncture is to collect cerebrospinal fluid in a case of suspected meningitis.
Infants commonly require lumbar puncture as a part of the routine workup for fever without a source, as they have a much higher risk of meningitis than older persons and do not reliably show signs of meningeal irritation.
Diagnostics Lumbar puncture is used as a diagnostic procedure for the following: Increased CSF pressure: can indicate conditions causing increased intracranial pressure, such as congestive heart failure, cerebral edema, subarachnoid hemorrhage, meningeal inflammation, purulent meningitis or tuberculous meningitis, hydrocephalus, or pseudotumor cerebri.
The presence of white blood cells in cerebrospinal fluid, called pleocytosis: a large number of these cells often heralds bacterial meningitis.
Increased levels of lactate can occur the presence of cancer of the central nervous system, multiple sclerosis, low blood pressure, low serum phosphorus, respiratory alkalosis, idiopathic seizures, traumatic brain injury, cerebral ischemia, brain abscess, hydrocephalus, or bacterial meningitis.
Other medical conditions which affect the meninges include meningitis (usually from fungal, bacterial, or viral infection) and meningiomas arising from the meninges or from meningeal carcinomatoses (tumors) formed elsewhere in the body which metastasize to the meninges.
Diseases of the ventricular system include abnormal enlargement (hydrocephalus) and inflammation of the CSF spaces (meningitis, ventriculitis) caused by infection or introduction of blood following trauma or hemorrhage.
Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis), the lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis), and the bones and joints (osseous tuberculosis).
It may occur early, being either asymptomatic or in the form of syphilitic meningitis, or late as meningovascular syphilis, general paresis, or tabes dorsalis, which is associated with poor balance and lightning pains in the lower extremities.
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