The following is a list of contraindications for performing a lumbar puncture:
Overlying skin or soft tissue infection.
Bleeding tendencies- prolonged PT, platelet count <50,000/mm3, administration of heparin, bleeding diathesis such as hemophilia. Correct the coagulation defect prior to the LP.
Increased intracranial pressure from a mass lesion or obstruction of the ventricular system.
Signs or symptoms of cerebral herniation syndromes.
Papilledema- must have a neuroimaging study prior to the LP to R/O mass.
Spinal subarachnoid block-spinal block by intradural or extradural mass can be made worse with a LP causing further cord compression and acute deterioration.
