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60 y/o male with a lumbar puncture 13 days ago

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Posted on Sun, 10 Feb 2019
Question: 60 y/o male with a lumbar puncture 13 days ago no opening pressure obtained used 25 gauge 1.5 in needle- 4 days later had a second LP under fluoroscopy I’m prone position with a 20 gauge 3.5 in. needle - after second day had soreness 1 in above and lateral to the insertion site- still have a small scab and the soreness in that area- anything to worry about?
doctor
Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
I think not a reason to be worried about.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and here is my advice.

Only soreness in the area of insertion site is acceptable after lumbar puncture and I think that you have nothing to worry about.

It is a minor adverse effect and should subside gradually.

Simple painkillers such ibuprofen may be required for a couple of days if the discomfort is bothering significantly.

You should be aware of any headaches especially after getting up, in such case you should see your Doctor, this for about one week period.

Hope you found the answer helpful.

Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Erion Spaho (3 hours later)
Thank you for the response there are times when I’m sitting and will feel a slight cool sensation my concern was if I had a complication like a hematoma or an abscess because I read about this and don’t have the expertise to know- I also noted if I’m sitting and flex my neck a couple times I feel a pain in my lower back and hamstring - I was also wondering how long should I have the soreness thx
doctor
Answered by Dr. Erion Spaho (18 hours later)
Brief Answer:
There are no serious complications in your case.

Detailed Answer:
Welcome back.

Hematoma or abscess are serious conditions or complications and can't pass without noticing them.

These may happen very rarely and symptoms related to them result in moderate to severe headaches, limbs paralysis, lethargy, fever, etc., so, it is not your case.

Pain in lower back and hamstring after you stretch your muscles is most likely caused by inflamed muscles coverings ( fascia ) and should subside in a couple of weeks gradually.

Hope this helps.

Feel free to discuss with me if you have further questions.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Erion Spaho (5 hours later)
The one medication that has helped me the most is Diamox but I developed paresthesias muscle spasms and acidosis venous CO2 18 - it also helped with episodic increases in BP when headache pain was severe- would it be feasible to try it again- ty
doctor
Answered by Dr. Erion Spaho (20 hours later)
Brief Answer:
Diamox seems inappropriate in your case.

Detailed Answer:
Hello again.

Diamox may help in cases of increased intracranial pressure, so, if there was no increase in intracranial pressure, it isn't necessary to use it.

Furthermore, you experienced adverse effects.

I think that a correct diagnosis about the cause of headaches should be achieved first.

Discuss with your Neurologist for these issues.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3917 Questions

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60 y/o male with a lumbar puncture 13 days ago

Brief Answer: I think not a reason to be worried about. Detailed Answer: Hello and welcome to "Ask a Doctor " service. I have read your query and here is my advice. Only soreness in the area of insertion site is acceptable after lumbar puncture and I think that you have nothing to worry about. It is a minor adverse effect and should subside gradually. Simple painkillers such ibuprofen may be required for a couple of days if the discomfort is bothering significantly. You should be aware of any headaches especially after getting up, in such case you should see your Doctor, this for about one week period. Hope you found the answer helpful. Let me know if I can assist you further.