Do I still need a lumbar puncture in this case?

Lumbar puncture, also known as lumbar puncture, is a method of measuring intracranial pressure through lumbar puncture and removing cerebrospinal fluid for examination. Before the advent of CT, lumbar puncture was basically performed for diagnosing cerebrovascular disease. Since CT was widely used, although lumbar puncture was relatively less, CT still could not completely replace lumbar puncture. Some cerebrovascular diseases must also be diagnosed and differentially diagnosed by lumbar puncture. When a patient has symptoms of meningeal irritation such as headache, vomiting, and neck stiffness, is it subarachnoid hemorrhage or meningitis? To make a differential diagnosis, CT examination is powerless, but lumbar puncture examination can be clear at a glance. At the same time, if subarachnoid hemorrhage is diagnosed, 5-10 ml of cerebrospinal fluid is released during lumbar puncture, and there is a certain therapeutic effect. In addition to relieving headache, it can also avoid the sequelae of subarachnoid adhesions. In addition, lumbar puncture also has the functions of directly measuring intracranial pressure and testing the composition of cerebrospinal fluid.

Although lumbar puncture still plays a very important role in clinical practice, there are still some patients and their families who are afraid of doing lumbar puncture, mainly because they are worried that lumbar puncture will damage the spinal cord and affect their health. In fact, these worries are unnecessary. Because the spinal cord has a certain length in the spinal canal. The upper end is connected to the medulla oblongata at the foramen magnum, and the lower end is conical when it is level with the lower border of the first lumbar vertebra, called the spinal vertebra. In adults, there is no spinal cord below the first lumbar vertebra, but a larger pool of cerebrospinal fluid in which many cauda equina nerves float. Lumbar puncture often takes 3 to 4 or 4 to 5 lumbar intervertebral spaces, so as not to damage the spinal cord. Furthermore, in addition to containing a small amount of sugar, chloride, protein and white blood cells in the cerebrospinal fluid, most of it is water, and it circulates very quickly. The total amount of cerebrospinal fluid in adults is 120-150 ml, and its production rate is 400-500 ml in 24 hours, and it is renewed 4-5 times a day. Therefore, 2 to 4 ml of cerebrospinal fluid is taken out during lumbar puncture, and it can be replenished in 10 minutes, which will not affect the body. Therefore, if the condition requires a lumbar puncture examination, the patient and family members should cooperate well with the doctor.

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