A lumbar puncture (or LP, and colloquially known as a spinal tap) is a diagnostic and at times therapeutic medical procedure.
Therapeutically it may be used to reduce increased intracranial pressure.
The procedure is typically performed under local anesthesia and aseptic technique. A needle is used to access the subarachnoid space and fluid collected. Fluid may be sent for biochemical, microbiological, and cytological analysis.
Lumbar puncture was first introduced in 1891 by the German physician Heinrich Quincke.
Lumbar puncture is a safe and commonly performed procedure, with an overall complication rate of 0.1% to 0.5%.
Under some circumstances, lumbar puncture cannot be performed safely (e.g. a severe bleeding tendency). It is regarded as a safe procedure, but post-dural-puncture headache is common.
Lapadula et al. report a case of a young man with epilepsy who, after a lumbar puncture performed for research purposes, presented with an intracerebral hematoma and neurological deficits. To the best of our knowledge, post-tap intraparenchymal hematoma is extremely rare and only 1 case has been reported previously. In consideration, all patients undergoing a lumbar puncture should be informed about this possible rare complication, even in the absence of documented hemorrhagic risk factors 1).
The Department of Neurosurgery, Hospital Network Antwerp, Belgium published a case of severe bilateral subdural hematomas as a complication of diagnostic lumbar puncture for possible Alzheimer's disease 2).