Reevaluation of lumbar puncture

Abstract

Lumbar puncture was performed in 70 patients with papilledema and 59 patients with increased cerebrospinal fluid pressure without papilledema. The incidence of possible complications[long dash]any unfavorable changes within 48 hr.[long dash]was significantly higher in the group without papilledema. Complications that did occur were probably not caused by lumbar puncture. From this study and a review of similar studies from the literature, one can say that the actual complications of careful diagnostic lumbar puncture in the presence of papilledema are much less than 1.2%. Use of careful lumbar puncture in the diagnosis and management of patients with papilledema is of definite value and may prevent unnecessary ventriculography or surgery. Therefore, the authors conclude that papilledema and increased intracranial pressure are not absolute contraindications to careful, diagnostic lumbar puncture. Lumbar puncture should be performed to aid in diagnosis or management of the patients with papilledema or increased intracranial pressure.