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Neurology (Expert Forum)
Spinal Tap
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Spinal Tap
by motox320, Oct 26, 2009 09:20AM
Is a x-ray guided spinal tap really safe?
Does everyone get a really bad headache?
Is there any danger to ones life from the procedure?
I am supposed to get one tommorow, and am freaking out about it.
I had a MRI of my brain that was normal, but that was 1.5 months ago. (is that too long ago?)
Had an eye exam by my eye doctor last week, he said everything looked good.
My main concern, is I heard if you have Increased intercranial pressure, this would not be good.
Well, how do they know if I have or dont have increased pressure? Does my normal MRI 1.5 months ago and normal eye exam rule that out?
My current symtons are bascially headache (migrain) that usually in in the afternoon-evening. Most morning I am fine, no pain, same as night. Light sensative also.
I just dont want to do the test, if I am at risk for something bad.
(the reason they are testing me is for lyme, and looking for any fungus, ect... due to migrains, and facial numbness, nero was thining either lyme or a super chronic (3 year) menningitious, which is doubtfull)
Does everyone get a really bad headache?
Is there any danger to ones life from the procedure?
I am supposed to get one tommorow, and am freaking out about it.
I had a MRI of my brain that was normal, but that was 1.5 months ago. (is that too long ago?)
Had an eye exam by my eye doctor last week, he said everything looked good.
My main concern, is I heard if you have Increased intercranial pressure, this would not be good.
Well, how do they know if I have or dont have increased pressure? Does my normal MRI 1.5 months ago and normal eye exam rule that out?
My current symtons are bascially headache (migrain) that usually in in the afternoon-evening. Most morning I am fine, no pain, same as night. Light sensative also.
I just dont want to do the test, if I am at risk for something bad.
(the reason they are testing me is for lyme, and looking for any fungus, ect... due to migrains, and facial numbness, nero was thining either lyme or a super chronic (3 year) menningitious, which is doubtfull)
Doctor's Answer
by Lama Chahine, MD, Oct 28, 2009 08:02PM
, Oct 28, 2009 08:02PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
I will try to provide you with some useful general information about LPs but I can not discuss with you specific risks in your case without knowing your history.
An LP guided by x-ray allows for more precise entrance of the needle into the spinal fluid space, more precisely without x-ray guidance. However, x-ray guidance is not needed in most cases the procedure can even be done with out.
About 30% of people will get a transient relatively mild headache that resolves within 1 hour, and can be avoided by hydrating well by increasing fluid intake, and with caffeine. A small minority get a more prolonged severe headache, and should this occur, there are specific treatments for it. Severe long term headaches with LP are unlikely.
Any procedure can have certain risks associated with it, and with LP, risks can include bleeding, particularly in those with bleeding tendency, and infection though with use of sterile technique this is exceedingly rare. There is not a risk of spinal cord injury because the LP is done below the level of where the spinal cord ends, though sometimes some nerve irritation can rarely occur. With a normal MRI of the brain, risks of pressure changes leading to pushing down of the brain (what is medically termed herniation) is exceedingly rare.
LP is in general safe procedure. When it is indicated to investigate neurologic symptoms, such as your severe headaches, the benefits of the procedure (ruling out potentially serious disorders) are felt to far outweigh the risks, which are rare. However, the person who will be conducting the procedure on you can let you know more about the risks, and you can give consent for the procedure after you have been informed of all the details.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
I will try to provide you with some useful general information about LPs but I can not discuss with you specific risks in your case without knowing your history.
An LP guided by x-ray allows for more precise entrance of the needle into the spinal fluid space, more precisely without x-ray guidance. However, x-ray guidance is not needed in most cases the procedure can even be done with out.
About 30% of people will get a transient relatively mild headache that resolves within 1 hour, and can be avoided by hydrating well by increasing fluid intake, and with caffeine. A small minority get a more prolonged severe headache, and should this occur, there are specific treatments for it. Severe long term headaches with LP are unlikely.
Any procedure can have certain risks associated with it, and with LP, risks can include bleeding, particularly in those with bleeding tendency, and infection though with use of sterile technique this is exceedingly rare. There is not a risk of spinal cord injury because the LP is done below the level of where the spinal cord ends, though sometimes some nerve irritation can rarely occur. With a normal MRI of the brain, risks of pressure changes leading to pushing down of the brain (what is medically termed herniation) is exceedingly rare.
LP is in general safe procedure. When it is indicated to investigate neurologic symptoms, such as your severe headaches, the benefits of the procedure (ruling out potentially serious disorders) are felt to far outweigh the risks, which are rare. However, the person who will be conducting the procedure on you can let you know more about the risks, and you can give consent for the procedure after you have been informed of all the details.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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