Otherwise, lumbar puncture is also called spinal cord. This is a very serious procedure. For analysis cerebrospinal fluid. Since puncture is in many ways a risky event, it is prescribed only in cases urgent need.
During the puncture procedure, the spinal cord, contrary to the name, should not be affected.
There are situations when a lumbar puncture cannot be avoided. This is due to the identification of infectious diseases in the patient, for example, meningitis, it can be prescribed to patients who have had a stroke, also to confirm multiple sclerosis and inflammation of the brain and spinal cord. In addition to this, puncture and as medical procedure for administering drugs in the presence of a hernia.
In any case, before prescribing a puncture, the doctor will conduct a number of other tests to make sure it is necessary, since the procedure may be. In order to take cerebrospinal fluid for analysis, a puncture is made in the lumbar region with a special needle. The puncture site should be below the spinal cord. After the needle is inserted, liquid begins to flow out of the canal.
In addition to analyzing the liquid itself, conclusions are also drawn based on the flow rate. If the patient is healthy, it will be transparent, only one drop will appear per second.
After the procedure is completed, the patient needs to lie on his back on a hard and flat surface for about two hours. It is also not recommended to sit or stand for about a day.
Is spinal tap dangerous?
What is the danger of a lumbar puncture? If the procedure is carried out correctly, the patient will not experience any serious consequences. The main concerns are damage to the spinal cord and infection. In addition, the consequences include the appearance of bleeding, as well as in case of a brain tumor, increased intracranial pressure.
It should be noted that in qualified clinics only professional doctors perform spinal cord punctures. There should be no fear. A similar procedure can be compared with a conventional biopsy of one of the internal organs. However, without it it is impossible to make a correct diagnosis in time and cure the patient. Modern neuroscience developed enough for the procedure to be the safest for the patient. In addition, anesthesia is given before the puncture. The doctor fully advises on what position the patient should be in.
If we talk about contraindications, then these include even slight suspicions of brain dislocation.
Puncture is a specific procedure that is used to diagnose pathologies, as well as treat internal organs and biological cavities. It is done using special needles and other devices. Before agreeing to such a procedure, it is necessary to take a closer look at what a puncture is, what features it has and how it is performed.
A puncture is a special puncture of the tissues of internal organs, blood vessels, various neoplasms, cavities for collecting fluids for the purpose of diagnosing pathologies. In addition, the use of the procedure in some cases is necessary to introduce medicines. It is used to diagnose pathologies of the liver, bone marrow, lungs, bone tissue. Basically, in this way they are determined oncological diseases. To clarify the diagnosis, materials are taken directly from the tumor. As for the blood vessels, they are punctured for sampling biological fluid, installation of catheters through which medications are administered. Parenteral nutrition is also performed in the same way.
If in the abdominal, articular or pleural cavity observed inflammatory process accompanied by accumulation of fluid or pus, then puncture is used to remove this pathological content. For example, using this procedure, drains are installed for flushing internal organs and administering medications.
Regarding puncture, this is mandatory procedure, used in anesthesiology, especially during operations on the extremities. It is widespread in gynecology to identify a number of diseases and treat them.
Indications for use of the procedure in gynecology
So, to use a puncture puncture there must be appropriate indications. They do it in order to:
- confirm ectopic pregnancy or infertility due to female factor;
- determine the presence of uterine or internal organ rupture;
- exclude peritonitis;
- counting the number of oocytes in the ovaries;
- determine the amount and nature of exudate in the organ cavity, tumors;
- diagnose internal endometriosis, as well as other neoplasms of a malignant or benign nature;
- determine the violation menstrual cycle, uterine bleeding unspecified genesis;
- diagnose or exclude developmental anomalies reproductive organs women;
- collect material to determine the effectiveness of the treatment;
- collect eggs during the IVF procedure.
After the puncture, the patient can go home the next day only if a serious illness is not diagnosed.
Types of puncture in gynecology
There are several types of punctures that are used for the diagnosis and treatment of female diseases:
All of these types of punctures are used in gynecology in difficult cases when diagnosis or treatment in another way does not give a positive result.
General rules for puncture
Many women are interested in how a puncture is performed. In most cases, it is painless. However, in order for the procedure to take place without complications, as well as for the psychological comfort of the woman, anesthesia or pain relief is necessary. There are other rules for performing a puncture:
- Before the procedure, all instruments, as well as the external genitalia, must be treated with a disinfectant solution. This will avoid additional infection of internal tissues and cavities.
- If the puncture is done through back wall vagina, the movement should be sharp and light. At the same time, care must be taken not to damage the wall of the rectum.
- If there is very thick exudate in the cyst or cavity that can clog the needle, it is necessary to inject a sterile solution inside.
- Puncture is permitted only in specialized clinics or medical offices.
The procedure is quite complex, so it must be carried out by an experienced specialist with a good reputation.
Possible consequences
In general, the diagnostic operation is painless, but sometimes the following consequences of the puncture can be observed:
- injury to blood vessels or the endometroid layer of the uterus;
- decrease in pressure (during operations accompanied by serious blood loss);
- in the organ or cavity in which the puncture is performed;
- damage to the rectum (often additional treatment not required);
- general deterioration of health;
- dizziness;
- scanty vaginal discharge;
- stupid painful sensations in the abdominal area;
- incorrect diagnosis (blood in the fluid may appear not as a result of the disease, but due to damage to the vessels located in the periuterine tissue).
Puncture in gynecology is a frequently used tool for diagnosing and treating pathologies reproductive system. It can only be done as prescribed by a doctor in a medical facility.
Spinal cord puncture is a widely used, but at the same time complex and responsible diagnostic method in neurology. The procedure involves a certain risk to the patient’s health, so it is done only in exceptional cases in a hospital setting.
Cerebrospinal fluid - cerebrospinal fluid, for diagnostic purposes is taken from the subarachnoid space, the spinal cord itself is not affected. The study of cerebrospinal fluid allows you to obtain the maximum amount useful information for staging accurate diagnosis and prescribing effective treatment.
A spinal cord puncture is prescribed by a doctor and is performed for the following purposes:
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- Collecting cerebrospinal fluid for subsequent laboratory analysis.
- Measurement of cerebrospinal fluid pressure in the spinal canal for diagnostic purposes.
- Removal of cerebrospinal fluid in case of excess to reduce intracranial pressure and pressure in the spinal canal.
- Introduction medicines, anesthesia or contrast agent.
Carrying out the procedure
To perform the procedure, the patient lies on his side with his knees pressed to his stomach. The puncture site is thoroughly disinfected, then local anesthesia- most often, simple novocaine is enough. Most patients claim that although the procedure itself is unpleasant, painful sensations doesn't call. During the procedure, the patient must lie absolutely still.
Using a sterile needle up to 6 cm, a puncture is made in the area of the 3rd and 4th vertebrae, below the end of the spinal cord. The needle is inserted at a slight angle, and cerebrospinal fluid begins to flow from it. For diagnostic purposes, 10 ml is sufficient. During the procedure, the flow rate of the cerebrospinal fluid and its color are assessed. A monometer is connected to the needle - a device for measuring pressure.
If a person is healthy, then the cerebrospinal fluid should be clear and flow at a rate of 1 ml per second. If the patient suffers from high blood pressure, the rate of cerebrospinal fluid leakage increases.
The procedure takes about 30 minutes. Visual control is carried out using fluoroscopy, when the image is displayed on the screen and the doctor has the opportunity to monitor the progress of the procedure.
After the volume of liquid required for analysis has been obtained, the needle is carefully removed and the puncture site is sealed with a sterile bandage. At the end of the procedure, the patient is not allowed to get up or sit for two hours; for the next two days, bed rest and drinking plenty of fluids are also advisable.
Consequences
The edges of the hole at the puncture site heal slowly, since the dura mater is not elastic enough. Therefore, at first, cerebral fluid may leak into the epidural tissue. If the puncture does not heal for a long time, the doctor prescribes the injection of 10 ml of autologous blood into the epidural space - this will be the so-called blood patch.
After the procedure, some patients may experience headache, nausea and vomiting, pain in the puncture area, dizziness, sleep may be disturbed for 1-2 days. To alleviate the condition, the doctor may prescribe painkillers.
In general, taking a cerebrospinal fluid test does not carry with it any negative consequences and all unpleasant symptoms disappear quite quickly. The use of ultra-thin puncture needles significantly reduces the incidence of post-puncture syndrome.
Risk of complications
Many patients are prejudiced against spinal puncture because they fear for their health. One of the most common myths is the rumor that there is a danger of damage to the spinal cord and, as a result, paralysis.
If the procedure is carried out medical personnel in a hospital setting, then everything dangerous consequences completely excluded. The puncture is always done below the spinal cord, so it simply cannot be touched. As a rule, the collection of cerebrospinal fluid is entrusted only to highly professional personnel, who have practiced this procedure to the point of automaticity.
There is a risk of infection during needle insertion, but it is minimal. Everything is done under as sterile conditions as possible using a disposable needle, so infection is unlikely.
One patient in 1000 may be injured spinal nerve, but it does not pose any danger and heals itself, without any consequences.
In patients with high pressure cerebral fluid as a result of oncology, abscess or cerebral bleeding, spinal cord puncture may be contraindicated, therefore, to find out how safe the procedure is for such patients, the doctor first conducts a thorough examination.
Every experienced neurosurgeon will confirm that in the absence of contraindications and the patient complies with all rules and restrictions, this necessary procedure completely safe.
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Have you ever experienced unpleasant discomfort in your joints or annoying back pain? Judging by the fact that you are reading this article, you or your loved ones have encountered this problem. And you know firsthand what it is.
Spinal cord puncture (lumbar puncture) is a type of diagnosis that is quite complex. The procedure removes a small amount of cerebrospinal fluid or injects drugs and other substances into the lumbar spinal canal. In this process, the spinal cord is not directly affected. The risk that arises during puncture contributes to the rare use of the method exclusively in a hospital setting.
Purpose of a spinal tap
Spinal cord puncture is performed for:
Performing a spinal tap
- collecting a small amount of cerebrospinal fluid (CSF). Subsequently, their histology is carried out;
- measuring the pressure of cerebrospinal fluid in the spinal canal;
- removal of excess cerebrospinal fluid;
- administration of drugs into the spinal canal;
- relief of difficult labor in order to prevent painful shock, as well as as anesthesia before surgery;
- determining the nature of the stroke;
- isolation of tumor markers;
- performing cisternography and myelography.
Using a spinal tap, the following diseases are diagnosed:
- bacterial, fungal and viral infections(meningitis, encephalitis, syphilis, arachnoiditis);
- subarachnoid bleeding (bleeding in the brain);
- malignant tumors of the brain and spinal cord;
- inflammatory conditions nervous system(Guillain-Barré syndrome, multiple sclerosis);
- autoimmune and dystrophic processes.
Often a spinal tap is equated with a bone marrow biopsy, but this statement is not entirely correct. During a biopsy, a tissue sample is taken for further research. Access to the bone marrow is achieved through a puncture of the sternum. This method allows you to identify bone marrow pathologies, some blood diseases (anemia, leukocytosis and others), as well as metastases in bone marrow. In some cases, a biopsy can be performed during the puncture process.
To prevent and treat JOINT DISEASES, our regular reader uses the increasingly popular NON-SURGERY treatment method recommended by leading German and Israeli orthopedists. After carefully reviewing it, we decided to offer it to your attention.
Indications for spinal cord puncture
IN mandatory spinal cord puncture is performed when infectious diseases, hemorrhages, malignant neoplasms.
Inflammatory polyneuropathy
A puncture is taken in some cases for relative indications:
- inflammatory polyneuropathy;
- fever of unknown pathogenesis;
- demyelinating diseases (multiple sclerosis);
- systemic connective tissue diseases.
Preparatory stage
Before the procedure, medical workers explain to the patient: why the puncture is being performed, how to behave during the manipulation, how to prepare for it, and possible risks and complications.
Spinal cord puncture requires the following preparation:
- Registration of written consent for the manipulation.
- Taking blood tests to evaluate blood clotting, as well as the functioning of the kidneys and liver.
- Hydrocephalus and some other diseases require computed tomography and MRI of the brain.
- Collection of information on the medical history, recent and chronic pathological processes.
The specialist must be informed about the medications the patient is taking, especially those that thin the blood (Warfarin, Heparin), relieve pain, or have an anti-inflammatory effect (Aspirin, Ibuprofen). The doctor must be aware of the existing allergic reaction caused by local anesthetics, anesthesia drugs, iodine-containing agents (Novocaine, Lidocaine, iodine, alcohol), as well as contrast agents.
It is necessary to stop taking blood thinning drugs, as well as analgesics and non-steroidal anti-inflammatory drugs in advance.
Before the procedure, water and food are not consumed for 12 hours.
Women must provide information about their suspected pregnancy. This information is required due to the intended x-ray examination during the procedure and the use of anesthetics, which may have undesirable effect for the unborn child.
Your doctor may prescribe a medication to take before the procedure.
The presence of a person who will be next to the patient is mandatory. A child is allowed to undergo a spinal puncture in the presence of his mother or father.
Technique of the procedure
A spinal cord puncture is performed in a hospital ward or treatment room. Before the procedure, the patient empties bladder and changes into hospital clothes.
Spinal cord puncture
The patient lies on his side, bends his legs and presses them to his stomach. The neck should also be in a bent position, with the chin pressed to the chest. In some cases, spinal puncture is performed with the patient sitting. The back should be as motionless as possible.
The skin in the puncture area is cleaned of hair, disinfected and covered with a sterile napkin.
The specialist may use general anesthesia or use a local anesthetic. In some cases, a drug with a sedative effect may be used. Also during the procedure, heartbeat, pulse and blood pressure are monitored.
The histological structure of the spinal cord provides for the safest needle insertion between the 3rd and 4th or 4th and 5th lumbar vertebrae. Fluoroscopy allows you to display a video image on a monitor and monitor the manipulation process.
Next, the specialist takes cerebrospinal fluid for further research, removes excess cerebrospinal fluid or injects necessary drug. The liquid is released without outside help and fills the test tube drop by drop. Next, the needle is removed skin covered with a bandage.
CSF samples are sent to laboratory test, where the histology itself takes place.
Spinal cord cerebrospinal fluid
The doctor begins to draw conclusions on the nature of the fluid exit and its appearance. In its normal state, the cerebrospinal fluid is transparent and flows out one drop per second.
At the end of the procedure you must:
- adherence to bed rest for 3 to 5 days as recommended by a doctor;
- finding the body in horizontal position at least three hours;
- getting rid of physical activity.
When the puncture site is very painful, you can resort to painkillers.
Adverse consequences after spinal cord puncture occur in 1–5 cases out of 1000. There is a risk of:
Intervertebral hernia
- axial wedging;
- meningism (symptoms of meningitis occur in the absence of an inflammatory process);
- infectious diseases of the central nervous system;
- severe headache, nausea, vomiting, dizziness. Your head may hurt for several days;
- damage to the spinal cord roots;
- bleeding;
- intervertebral hernia;
- epidermoid cyst;
- meningeal reaction.
If the consequences of the puncture are expressed in chills, numbness, fever, a feeling of tightness in the neck, or discharge at the puncture site, you should immediately consult a doctor.
There is an opinion that during a spinal tap the spinal cord can be damaged. It is erroneous, since the spinal cord is located higher than the lumbar spine, where the puncture is directly made.
Contraindications to spinal cord puncture
Spinal cord puncture, like many research methods, has contraindications. Puncture is prohibited in case of sharply increased intracranial pressure, dropsy or cerebral edema, or the presence of various formations in the brain.
It is not recommended to take a puncture if there are pustular rashes in the lumbar region, pregnancy, impaired blood clotting, taking blood thinning drugs, or ruptured aneurysms of the brain or spinal cord.
In each individual case, the doctor must analyze in detail the risk of the manipulation and its consequences for the life and health of the patient.
It is advisable to contact an experienced doctor, who will not only explain in detail why it is necessary to perform a spinal cord puncture, but will also carry out the procedure with minimal risk to the patient’s health.
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Spinal tap (lumbar puncture)- one of the most complex and responsible diagnostic methods. Despite the name, the spinal cord is not directly affected, but cerebrospinal fluid (CSF) is collected. The procedure is associated with a certain risk, therefore it is carried out only in case of urgent need, in a hospital and by a specialist.
Why is a spinal cord puncture performed?
Spinal cord puncture is most often used to identify infections (meningitis), clarify the nature of a stroke, diagnose subarachnoid hemorrhage, multiple sclerosis, identify inflammation of the brain and spinal cord, and measure cerebrospinal fluid pressure. Also, a puncture can be performed to administer medications or a contrast agent during an X-ray examination to determine herniated intervertebral discs.
How is a spinal cord puncture taken?
During the procedure, the patient takes a position lying on his side, pressing his knees to his stomach and his chin to his chest. This position allows you to slightly move apart the processes of the vertebrae and facilitate the penetration of the needle. The area around the puncture is disinfected first with iodine and then with alcohol. Then local anesthesia is performed with an anesthetic (most often novocaine). The anesthetic does not provide complete pain relief, so the patient must tune in to some discomfort in order to remain completely still.
The puncture is carried out with a special sterile needle up to 6 centimeters long. A puncture is made in the lumbar region, usually between the third and fourth vertebrae, but always below the spinal cord.
After inserting a needle into the spinal canal, cerebrospinal fluid begins to flow out of it. Typically, about 10 ml of cerebrospinal fluid is required for the study. Also, when taking a spinal cord puncture, the rate of its flow is assessed. U healthy person Cerebrospinal fluid is clear and colorless and flows at a rate of approximately 1 drop per second. In case high blood pressure the flow rate of the liquid increases, and it can even flow out in a trickle.
After receiving the required volume of liquid for research, the needle is removed and the puncture site is sealed with a sterile napkin.
Consequences of spinal cord puncture
After the procedure, for the first 2 hours the patient should lie on his back, on a flat surface (without a pillow). In the next 24 hours, it is not recommended to take a sitting or standing position.
Some patients may experience nausea, migraine-like pain, pain in the spine, and lethargy after a spinal tap is performed. For such patients, the attending physician prescribes painkillers and anti-inflammatory drugs.
If the puncture was performed correctly, then any negative consequences she does not suffer, and the unpleasant symptoms disappear quite quickly.
Why is spinal puncture dangerous?
The spinal cord puncture procedure has been performed for more than 100 years, and patients often have a prejudice against its use. Let us consider in detail whether spinal puncture is dangerous and what complications it can cause.
One of the most common myths is that during a puncture the spinal cord can be damaged and paralysis can occur. But, as mentioned above, a lumbar puncture is performed in the area lumbar region, below the spinal cord, and thus cannot touch it.
There is also a concern about the risk of infection, but usually the puncture is carried out under the most sterile conditions. The risk of infection in this case is approximately 1:1000.
Possible complications after a spinal tap include the risk of bleeding (epidural hematoma), the risk of increased intracranial pressure in patients with tumors or other brain pathologies, and the risk of spinal nerve injury.
Thus, if a spinal cord puncture is performed by a qualified doctor, the risk is minimal and does not exceed the risk of performing a biopsy of any internal organ.
Spinal cord puncture (subarachnoid puncture, lumbar puncture) - insertion of a needle into the subarachnoid space of the spinal canal to take a sample of cerebrospinal fluid, administer medications, and provide anesthesia. It should be noted right away that the concept of “spinal cord puncture”, or “ spinal tap", is fundamentally wrong: the target of the puncture is the space between the protective membranes, and getting the needle directly into the medulla can lead to severe complications up to the death of the patient.
It is in order to avoid the instrument getting into the medulla that the puncture of the subarachnoid space is performed at levels below the second lumbar vertebra, where the spinal cord ends, turning into the so-called “cauda equina” - a bundle of spinal roots. Damage to the root is also fraught with complications, but not so fatal. Therefore, such a puncture has another – more common (and correct) – name: lumbar (lumbar) puncture.
Protective membranes of the spinal cord
The spinal cord is located in the spinal canal formed by the vertebral arches, but does not fill its entire volume. In addition to the brain, three spinal membranes pass along the entire length of the spinal canal, providing its protection:
- hard (dural);
- arachnoid (arachnoid);
- soft (vascular).
The dural shell consists of two hard plates, one of which is fused to the periosteum of the spinal canal, and the other surrounds the spinal cord. Space between outer and inner sheet dura shell– epidural space – filled connective tissue, rich in blood vessels.
Located closer to the brain arachnoid, separated from inner sheet hard lumen - subdural space filled with bundles of connective tissue fibers.
The arachnoid is followed by a soft membrane, penetrated by vessels supplying the spinal cord. Between these membranes there is a subarachnoid or subarachnoid space filled with cerebrospinal fluid (CSF).
It is the subarachnoid space that is the target of the “spinal” puncture. Subarachnoid puncture should not be confused with another type of spinal puncture - epidural puncture, during which a needle is inserted into the space between the sheets of the dura mater. These punctures have different purposes.
Why is a subarachnoid puncture needed?
Lumbar puncture may serve the following purposes:
- diagnostic;
- medicinal;
- anesthesiological.
In most cases, spinal cord puncture is performed for diagnostic purposes.
Diagnostic puncture
A diagnostic puncture of the subarachnoid space is performed to take a sample of cerebrospinal fluid in order to identify diseases and damage to the spinal cord and brain:
- encephalitis (inflammation of the brain);
- meningitis (inflammation of the choroid and arachnoid meninges);
- syphilis of the nervous system;
- polio;
- multiple sclerosis;
- hemorrhagic stroke;
- brain abscess;
- brain tumors;
- tumors of the spinal cord, its membranes, roots;
During the study, the pressure of the cerebrospinal fluid is measured and a small amount is taken for laboratory testing.
Laboratory testing allows you to determine the nature of inflammation (non-infectious, infectious, infectious agent), identify hemorrhage, and with a high probability suspect a tumor, abscess, multiple sclerosis.
Measuring cerebrospinal fluid pressure using liquorodynamic tests allows us to identify at what level partial or complete obstruction of the subarachnoid space has developed, caused by a tumor, intervertebral disc herniation, or vertebral displacement.
Spinal cord puncture with insertion into subarachnoid space contrast agent is a stage of preparation for myelography - x-ray examination spinal cord and its structures.
Puncture for therapeutic purposes
Therapeutic spinal cord puncture is performed:
With hydrocephalus, a certain amount of cerebrospinal fluid is evacuated, as a result of which intracranial pressure decreases and the patient’s condition is alleviated.
For infections of the brain and its membranes, antibiotics are injected into the cerebrospinal fluid. Such treatment is rarely prescribed, in extreme cases, due to the toxicity of many antibacterial drugs to the nervous system.
Spinal anesthesia
Spinal anesthesia is a type of local anesthesia. A local anesthetic is injected into the subarachnoid space, the anesthetic effect is achieved by loss of sensitivity of the spinal cord area. During the action of the anesthetic, the “frozen” area stops receiving pain impulses emanating from the organs and tissues located below the navel, and the person does not feel pain. Consciousness may remain clear or be partially suppressed.
This anesthesia is an alternative general anesthesia and is prescribed for operations on the pelvic organs, perineum, lower limbs, widely used in obstetrics.
Contraindications
Absolute contraindications to lumbar puncture of the spinal cord:
- tumor, abscess, hematoma - any space-occupying formation in the area of the posterior cranial fossa and temporal lobe;
- displacement (dislocation) of brain structures;
A relative contraindication is severe cerebral atherosclerosis, accompanied by a significant increase in blood pressure.
In addition, the following conditions may increase the risk of spinal cord puncture:
- inflammation of the skin in the puncture area;
- curvature spinal column in the puncture area;
- decreased blood clotting;
- epilepsy;
- exacerbation of any infectious disease;
- cardiovascular and respiratory failure;
- pregnancy.
How does the procedure work?
No special preparation is required for the procedure.
The puncture is being performed qualified doctor In a hospital setting, it is not recommended to perform the procedure on an outpatient basis. Manipulation can be carried out under local anesthesia, but more often you can do without it.
After the procedure, the patient is transported in a horizontal position to a hard couch, where he spends two to three hours lying on his stomach - this prevents the development of dislocation of brain structures. After the puncture, strict bed rest is recommended. within three days.
According to most patients, lumbar puncture is no more painful than an injection in the buttock. Sometimes, when inserting a needle, acute short-term pain may occur - a signal that a nerve has been damaged. In this case, the doctor pulls the needle back and slightly changes its direction. Such damage usually does not lead to any negative consequences.
Possible complications and consequences
Complications of lumbar puncture include:
- post-puncture syndrome;
- traumatic nerve damage with impaired sensitivity or functional insufficiency of the pelvic organs and legs;
- epidural hematoma - in the area of the spine or skull;
- dislocation of brain structures.
The most common complication of lumbar puncture, observed in several patients out of a hundred, is post-puncture syndrome associated with a decrease in the volume of circulating cerebrospinal fluid and irritation of the meninges. Symptoms of this complication:
- headache;
- nausea;
- vomit;
- dizziness.
The complication may appear immediately or several days after the puncture. Symptoms become more pronounced when changing body position and can last for 7-10 days. In this case, the patient needs bed rest (up to two weeks), plenty of fluids, caffeine, painkillers and sedatives, intravenous drips. The symptoms are extremely unpleasant, but pass without a trace, leaving no adverse consequences. In some patients, puncture is complicated only by muscle tension in the back and neck. This condition does not require treatment and goes away on its own within a week.
Other complications of lumbar puncture develop extremely rarely. If your general condition worsens after the procedure, you should immediately consult a doctor.
Where can the procedure be performed in Moscow?
Complications can develop after a puncture performed according to all the rules, but performing the procedure by an experienced, qualified specialist minimizes their risk. Therefore, it is more appropriate to perform a lumbar puncture in specialized centers where many such operations are performed.
Examples of such centers in Moscow:
- Institute of Surgery named after. A.V. Vishnevsky, st. Bolshaya Serpukhovskaya, 27. Advantages – low price(976 rubles), experienced, highly qualified personnel.
- FGBNU " Science Center neurology”, Volokolamskoye Highway, 80. Here the price of the procedure will be 1300 rubles. Advantages – neurological specialization medical institution, highly qualified personnel.
The cost of a lumbar puncture in Moscow ranges from 950 to 12,000 rubles.
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Meningitis in general is an inflammation of the membranes of the spinal cord and brain, which can develop in both the arachnoid and soft shells(leptomeningitis) and hard (pachymeningitis). In general, the most common case is inflammation of the soft meninges, which is what is meant by the general term “meningitis”. At the same time, meningitis of the spinal cord is practically no different in symptoms and consequences from meningitis of the brain, therefore, as a rule, this disease is considered regardless of where exactly the focus of the disease is located.
Meningitis can appear as a complication of certain diseases, or as an independent disease. But regardless of its type, a delay in starting treatment is extremely dangerous, since in this case a number of serious and often irreversible complications can develop, for example, deafness, hydrocephalus, delay mental development in children, etc.
Diagnostics of this disease is quite complex - to make an accurate diagnosis, a spinal cord puncture for meningitis is required, during which the cerebrospinal fluid is examined for the presence of pathogens. Let's figure out what types of this disease exist and how they manifest themselves.
Meningococcal meningitis
The causative agent of the disease is meningococcus, and only humans can be the source of the pathogen. It should be noted that in most cases, the human body successfully copes with the infection without any visible manifestations, and only about 10% of cases of meningococcus getting on the mucous membranes lead to the development of inflammation.
This disease manifests itself unexpectedly and quite “sharply” - the temperature suddenly rises, a severe headache appears due to increased intracranial pressure, and vomiting begins, which does not bring relief. In this case, the patient assumes a characteristic position in which tension occipital muscles(causing the head to be thrown back), the stomach to be pulled in, the back to be arched, and the bent legs to be pulled towards the stomach.
Depending on how severe the patient’s condition is, delirium, loss of consciousness, blackouts, and convulsions may appear. If the course of the disease is unfavorable, then after a week the patient falls into a coma, after which convulsions become more frequent, which lead to the death of the patient.
IN general case The duration of this disease is up to 6 weeks. But there are cases of “lightning-fast” development of the disease, when a person dies in a few hours, as well as “protracted” ones, when elevated temperature lasts a very long time. However, nothing good should be expected in this case either; usually this is either the hydrocephalic stage of the disease, or the development of meningococcal sepsis.
The most severe manifestation of this disease is bacterial shock, which develops very acutely. In this case, the temperature also suddenly rises, a rash appears, the pulse weakens and becomes frequent, the uniformity of breathing is disrupted, and convulsions may appear. After this, the patient falls into a coma and often dies without ever regaining consciousness.
Secondary purulent meningitis
Represents purulent inflammation, which develops into meninges. The pathogens in children and adults are different, the only common risk factors are neck or head surgery, traumatic brain injury and immunodeficiency conditions. The disease usually enters the body through the mucous membranes of the nose, but contact penetration through a surgical opening or wound is also possible.
IN in this case the disease develops as acutely as in the previous case - the temperature rises, the general state, a feeling of chills appears. In severe cases, convulsions, loss of consciousness, delirium, severe meningeal symptoms are observed, and tachycardia may develop.
The course of the disease is usually acute, although both chronic and fulminant courses of the disease occur. Sometimes clinical picture the disease is masked behind the phenomena of a septic condition.
Serous meningitis
This form of the disease develops due to exposure to enteroviruses (ECHO and Coxsackie), as well as some other viruses. The source of infection can be a virus carrier or a sick person. There are many ways of transmitting this disease - through food products, water, dirty hands, etc. Sometimes even airborne spread is possible. Children are most susceptible to this form of meningitis; adults are extremely rarely affected by this disease.
It is also necessary to know that insects can be carriers of this virus. For example, a tick that is a carrier tick-borne encephalitis. To the group serous meningitis also include tuberculosis (develops when there is a focus of tuberculosis in the body) and viral meningitis.
This disease develops gradually, the acute phase is preceded by a prodromal period of 2-3 weeks. During this period, fever and general malaise appear. When entering the acute phase, headache, vomiting, heat, a number of other characteristic symptoms.
Protozoal meningitis
In this case, the disease proceeds quite “calmly”, with intermittent fever, enlarged lymph glands, the appearance of a rash, and pain in muscles and joints. Then vomiting and headache appear, as well as meningeal syndrome.
