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[Post-lumbar puncture syndrome--its pathogenesis, prophylaxis and treatment].

Post-lumbar puncture syndrome (PLPS) is a frequent and important complication of diagnostic lumbar puncture. PLPS is primarily caused by perforation of the dura mater, leading to persistent leak of the cerebrospinal fluid, and, as a result, intracranial hypotension. Effective therapeutic options are limited to symptomatic treatment until natural improvement occurs, or, in cases of prolonged complaints, invasive treatment (epidural blood patch with patient's own venous blood), which makes prophylaxis of PLPS essential. Prophylactic measures of confirmed efficacy are: reducing needle size, positioning the needle bevel parallel to the long axis of the spine, re-inserting the stilet before withdrawal of the needle, and, if possible, using a so-called "atraumatic" needle, minimizing the perforation of the meninx. The volume of the cerebrospinal fluid collected and the position of the patient after the procedure do not have a significant influence on PLPS frequency.

Blood Patch, Epidural↗
PubMed1985

Neonatal ventricular haemorrhage: treatment by puncture.

Transfontanellar ventricular puncture and intermittent lumbar punctures were carried out in 10 patients affected by intraventricular haemorrhage during the period between 1980 and 1983. In only three of them was later a shunt necessary for treatment of hydrocephalus. Six children developed normally, in two severe mental retardation ensued, and two died later, one of heart failure after cardiac surgery and one of ventriculitis following shunt implantation. Puncture therapy can be recommended for intraventricular haemorrhage of the neonate.

Brain Damage, Chronic↗