3 doctors weighed in:

If increased intracranial pressure(icp) is contraindicated in lumbar puncture, why one of the indication of this procedure is to decrease the icp?

3 doctors weighed in
Dr. Jefferson Chen
Neurosurgery
1 doctor agrees

In brief: Different situations

It depends on the clinical situation.
If there is a mass lesion in the brain that causes a differential pressure between the supratentorial and infratentorial areas, lumbar puncture can accentuate the difference and lead to herniation of brain downward. If there isn't this differential (communicating hydrocephalus), a spinal tap can decrease the pressure uniformly throught the CSF system.

In brief: Different situations

It depends on the clinical situation.
If there is a mass lesion in the brain that causes a differential pressure between the supratentorial and infratentorial areas, lumbar puncture can accentuate the difference and lead to herniation of brain downward. If there isn't this differential (communicating hydrocephalus), a spinal tap can decrease the pressure uniformly throught the CSF system.
Thank
Dr. Martin Raff
Internal Medicine - Infectious Disease

In brief: Depends

Lp is contraindicated when the icp is due to some process that is creating a midline shift in the brain and sudden loss of pressure can cause herniation of the midbrain and consequent death.
You can reduce some icp with LP but better to place intraventricular drain and then decide whether permanent shunt may be necessary.

In brief: Depends

Lp is contraindicated when the icp is due to some process that is creating a midline shift in the brain and sudden loss of pressure can cause herniation of the midbrain and consequent death.
You can reduce some icp with LP but better to place intraventricular drain and then decide whether permanent shunt may be necessary.
Thank
Get help from a real doctor now
Dr. Eric Weisman
Board Certified, Neurology
34 years in practice
9M people helped
Continue
111,000 doctors available