Spinal puncture: algorithm and technique. Indications, consequences, complications. Bone marrow puncture: indications, preparation for research, technique Diagnostic puncture

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Pleural puncture

Technique:
For the procedure, a needle with a length of at least 7 cm and a 20-ml syringe are used. The procedure is carried out under local anesthesia using novocaine. During the procedure, the patient sits with his back to the doctor, leaning his elbows on the table. The hand from the side of tissue sampling should be raised, which will slightly push the ribs apart. The exact location is determined based on preliminary diagnostic measures.

If it is necessary to pump out excess fluid from the pleural cavity, a pleuroaspirator is used. A container is attached to the puncture needle with a tube, from which air is pumped out. Under the action of a pressure drop, the fluid from the organ flows into the container. The procedure is done several times in a row.

Puncture of the spinal cord

Technique:
A puncture is performed using a needle up to 6 cm long, for children - with a regular needle. The patient lies on his side, pressing his knees to his stomach, and his chin to his chest. This allows you to slightly push the spinous processes of the vertebrae. The procedure is performed under local anesthesia ( novocaine). The puncture site is treated with iodine and alcohol.

The puncture is carried out in the lumbar region, usually between the third and fourth vertebrae. To determine the disease, 10 ml of cerebrospinal fluid is needed. An important indicator is the flow rate of the liquid. In a healthy person, it should be released at a rate of 1 drop per 1 second. The liquid should be clear and colorless. If the pressure is increased, the liquid may even flow out in a trickle.

For 2 hours after the procedure, the patient is prescribed to lie on his back on a flat surface. For 24 hours, it is forbidden to take a sitting or standing position.
A number of patients experience nausea, migraine-like pain, pain in the spine, lethargy, urinary disorders after the procedure. Such patients are prescribed phenacetin, urotropine, amidopyrine.

Sternal puncture - bone marrow examination

Indications:

• myeloplastic syndromes,
• Metastases of neoplasms.

Liver biopsy

Indications:

• Neoplasm of the liver
• Violation of the liver,
• Diseases of the gallbladder and ducts,
• Toxic damage to liver tissue.

A blind puncture is performed using a long needle, similar to a regular medical needle. The puncture can be done in the abdominal wall or in the chest - the place is chosen by the doctor, depending on which tissues are needed for the study. The procedure is carried out under ultrasound control.

You need to know that this manipulation can harm the health of the patient. Therefore, it is prescribed only in extreme cases.

After the operation, the patient experiences pain for approximately two days. In rare cases, a fistula is formed at the site of the procedure, bleeding develops, inflammation of the peritoneum. There is a possibility of infection, violation of the integrity of other organs of the abdominal cavity.

Contraindications:

• Inflammation of the peritoneum
• Inflammation of the diaphragm
• vascular disease,
• Possibility of liver hemangioma.

Kidney biopsy

A kidney biopsy makes it possible to:

• Determine the exact disease
• Predict the development of the disease and plan an organ transplant,
• Determine the treatment regimen
• Determine the processes taking place in the body.

• The presence of protein in the urine in an amount of more than a gram in 24 hours,
• nephrotic syndrome,
• The presence of blood in the urine
• urinary syndrome,
• acute renal failure,
• Kidney dysfunction caused by systemic diseases,
• Violation of the tubules of the kidneys.
• To prescribe treatment, as well as to monitor the course of treatment.

• One kidney removed
• Poor blood clotting
• Blockage of the veins of the kidneys
• aneurysm of the renal arteries,
• Violation of the right ventricle,
• pyonephrosis,
• kidney neoplasm,
• polycystic kidney,
• Inadequate condition of the patient.

• kidney failure,
• Periarteritis in nodular form,
• Kidney mobility.

• Most patients experience hematomas that pass in a short time,
• Bleeding ( very rarely).

Thyroid puncture under ultrasound guidance

After the puncture, the patient may feel a slight soreness at the site of manipulation, which quickly passes.
A very thin needle is used for the puncture, so the possibility of malignancy of the tumor is excluded.

This method is prescribed only if no other methods provide sufficient information for prescribing treatment.

Joint puncture

Indications:

• The presence of excess synovial fluid in the joints,
• The infusion of drugs into the joint cavity helps to reduce pain and improve joint mobility,
• The puncture helps in some cases to test the effect of infectious arthritis therapy,
• After an injury, blood may accumulate in the joint, and a puncture is also prescribed to eliminate it.

Therapeutic puncture is done with the aim of:

• Infusions into the joint cavity of hormonal drugs. This helps to reduce the intensity of the inflammatory process. It is forbidden to do if the joint is infected,
• Infusions of hyaluronic acid to reduce the intensity of pain in osteoarthritis, as well as increase joint mobility,
• Infusions of chondroprotectors - substances that help restore the tissues of the affected joint in osteoarthritis. Relieve pain, stop the development of the disease.

• The presence of infection in the joint or in the skin over the joint,
• Presence of a psoriatic skin lesion or wound at the site where the needle should be inserted,
• Problems with blood clotting.

Breast biopsy

Indications:

• Seals, knots,
• ulcers,
• Change in skin condition

Preparation for puncture:

• Do not take aspirin or drugs that reduce blood clotting 7 days before the procedure.

• Pregnancy,
• Individual intolerance to painkillers.

In some cases, it is necessary to use a biopsy gun or a needle with a large diameter. Then anesthesia with novocaine or lidocaine is used. This technique is used if the tumor is already so large that it can be felt.

After a puncture, the breast may swell slightly. However, after a couple of days everything passes. If the pain and discomfort are very annoying, you need to put ice on your chest and drink painkillers without aspirin. Infection from a puncture is very rare.

A puncture is performed through the abdominal wall with ascites. The procedure can be both therapeutic and diagnostic. The patient assumes a sitting position. This manipulation is carried out using a special tool - a trocar. Fluid from the abdominal cavity is sucked out slowly.

prostate biopsy

Puncture biopsy of the prostate gland is performed by two methods:

• transrectal . The trocar is inserted through the rectum. The procedure is carried out "blindly", by touch. The doctor inserts a finger into the patient's rectum and gropes and guides the instrument. After the procedure, a gauze flagellum is inserted into the rectum for a day. The needle is used very thin, a small amount of secretion is sucked out through it for research.
• perineal . An incision no more than 3 cm long is made in the perineum. The prostate is found through it and a trocar is inserted.

Complications:

• Violation of the integrity of the rectum or nearby vessels,
• pulmonary embolism,
• Transfer of malignant cells to other organs.

Preparing for a biopsy:

• On the evening before, a cleansing bowel lavage is done,
• taking antibiotics,
• Taking medications that reduce intestinal motility.

Technique:
The patient lies on his back, he is given local anesthesia. If the patient is too agitated, he is given a light general anesthesia. The procedure is carried out using a trocar. The needle is inserted through the skin of the perineum. In order to prevent the needle from entering too deeply and injuring other organs, a special washer is put on it. It is enough to insert a needle to a depth of a centimeter - one and a half into the prostate gland to take the material.
There are needles that simultaneously inject a small amount of alcohol to prevent the spread of cancer cells through the urethra.
To prevent bleeding from the wound, the doctor inserts a finger into the rectum and presses down on the puncture site.

Puncture of the maxillary sinus

• Obstruction of the fistula of the sinuses,
• The ineffectiveness of drug therapy of sinusitis in chronic or acute form,
• Poor health of the patient, pain in the projection of the sinuses, headaches,
• Stagnation of blood in the sinus,
• An increase in the level of exudate in the sinus,
• For the introduction of a radiopaque substance.

• early childhood,
• General severe illnesses
• Acute infectious processes,
• Violation of the formation of the paranasal sinuses.

Possible complications:

• Perforation of the upper wall of the sinus,
• Violation of the integrity of blood vessels and bleeding,
• air embolism,
• Perforation of the anterior wall of the sinuses.

You should not think that having made a puncture once, you will have to resort to this procedure several more times. It depends on the individual course of the disease.

Pericardial puncture

Designed for biopsy of all types of soft tissues (liver, kidneys, thyroid, pancreas, prostate, mammary glands, etc.)

Three groups of needles are used for puncture biopsy: aspiration; modified aspiration; cutting. Aspiration needles have thin-walled cannulas with tips sharpened at different angles and are used for targeted fine-needle biopsy with aspiration of material for cytological examination. Modified aspiration needles have a cannula with sharp sharp edges and tips of various shapes, designed to take both cytological and histological samples. Cutting needles are of three types: Menghini, with a sharpened working end, Tru-Cut, which has a cannula with sharp edges and an internal stylet with a notch, and spring-cutting with a special “gun”. Designed to obtain a tissue sample for histological examination. The technique of execution and diagnostic accuracy of the study depends on the type of needle used and can reach 93-95%, which is comparable to conventional histology.

Sources of information

• Diagnostic and therapeutic technique / ed. Mayata V.S. - Moscow, 1969.

• Nurse's Handbook for Nursing / ed. Kovanova V. V. - "Medicine", Moscow, 1974. - 464 p. - 255 thousand copies.

Notes

Wikimedia Foundation. 2010 .

• Simplified checkpoint
• Poons, Larry

See what "Puncture" is in other dictionaries:

PUNCTURE- PUNCTION, and, wives. (specialist.). Puncture (tissue, cavity, vessel) for therapeutic or diagnostic purposes. | adj. puncture, oh, oh. Explanatory dictionary of Ozhegov. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 ... Explanatory dictionary of Ozhegov

PUNCTURE- (punctio), puncture of the cavity with a syringe with a diagnostic or therapist. purpose. P. is used for emptying various kinds of liquids and gases from tissues and cavities (P. emptying), determining their presence (P. test), for bacterial., Chem. and… … Big Medical Encyclopedia

PUNCTURE- (from the Latin punctio injection), a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes ... Modern Encyclopedia

PUNCTURE- (from Latin punctio injection) a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes ... Big Encyclopedic Dictionary

PUNCTURE- PUNCTION, punctures, for women. (lat. punctio injection) (med.). A puncture in the skin, produced by a syringe or some other device for removing or introducing liquids, air or any gases. Explanatory Dictionary of Ushakov. D.N. Ushakov. ... ... Explanatory Dictionary of Ushakov

puncture- noun, number of synonyms: 4 venipuncture (2) culdocentesis (1) paracentesis (2) ... Synonym dictionary

Puncture- (from the Latin punctio injection), a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes. … Illustrated Encyclopedic Dictionary

Today, there are many methods by which you can diagnose various diseases. One of them is spinal cord puncture. Thanks to this procedure, it is possible to identify such dangerous diseases as meningitis, neurosyphilis, and cancerous tumors.

Lumbar puncture is performed in the lumbar region. To obtain a sample of cerebrospinal fluid, a special needle is inserted between two vertebrae. In addition to diagnostic purposes, a puncture can be performed for the administration of drugs, for pain relief. The procedure is not always safe. Therefore, you need to know all the contraindications and possible complications before carrying out the procedure.

Objectives and indications for the study

Liquor (cerebrospinal fluid) is taken from the subarachnoid space, the spinal cord remains untouched during the procedure. The study of the material makes it possible to obtain information about a particular disease, prescribe the correct treatment.

Purpose of a lumbar puncture:

• laboratory study of cerebrospinal fluid;
• reducing pressure in the brain and spinal cord by removing excess fluid;
• measurement of cerebrospinal fluid pressure;
• the introduction of drugs (, chemotherapy), contrast agents (for myelography, cisternography).

More often, the study is prescribed to those patients who presumably have such pathologies:

• CNS infections (encephalitis, meningitis);
• abscess;
• inflammation in the spinal cord and brain;
• ischemic stroke;
• skull trauma;
• tumor formations;
• bleeding in the subarachnoid space;
• multiple sclerosis.

For therapeutic purposes, lumbar puncture is often used to administer drugs. Considering the certain danger of the procedure for the patient, it is recommended to carry it out only in cases where it is absolutely necessary.

Contraindications

The sampling of cerebrospinal fluid is not carried out with large formations of the posterior fossa of the skull or the temporal region of the brain. Such a procedure for these pathologies can cause infringement of the brain stem in the opening of the occiput and lead to death.

You can not make a puncture if a person has purulent inflammation of the skin, the spinal column at the site of the proposed puncture. A high risk of complications after the procedure exists with obvious spinal deformities (,). Very carefully it is necessary to carry out a puncture for problems with blood clotting, as well as for people taking certain drugs (Aspirin,), anticoagulants (Warfarin, Clopidogrel).

There are no special preparatory measures before a lumbar puncture. Before the procedure, patients are given allergy tests to determine the tolerance of the administered painkillers. Before taking the cerebrospinal fluid, local anesthesia is required.

On a note! Since the upcoming procedure is stressful for many subjects, there is often a need for psychological preparation. An experienced specialist must create an atmosphere in which the patient will feel relaxed, calm. This is especially important if the patients are children.

Process

The patient is laid on the couch on his side. Knees should be pressed to the stomach. Press the chin as close to the chest as possible. Thanks to this position, the processes of the spinal column move apart, the needle can be inserted freely.

The needle insertion area should be well disinfected with alcohol and iodine. Then an anesthetic is injected (usually Novocaine). While the puncture is being performed, the patient should lie still. For the procedure, a disposable sterile 6-centimeter needle is taken, which is inserted at a slight angle. The puncture is made between the 3rd and 4th vertebra below the end of the spinal cord. In newborns, CSF is taken from the upper part of the tibia.

If cerebrospinal fluid is taken for diagnostic purposes, only 10 ml is enough. A monometer is attached to the needle, which measures the intracerebral pressure of the cerebrospinal fluid. In a healthy person, the liquid is transparent, flows out in 1 second in a volume of 1 ml. With increased pressure, this speed increases.

The pickup lasts up to half an hour. The specialist monitors the progress of the procedure with the help of fluoroscopy. After the required amount of liquid is taken, the needle is carefully removed, a patch is glued to the puncture site.

After the procedure

After the manipulation, the person should lie down on a flat hard surface and lie motionless for 2 hours. During the day you can not get up and sit. Then within 2 days you need to observe bed rest and drink as much liquid as possible.

Immediately after taking the material, the patient may feel headaches resembling a migraine. They may be accompanied by nausea or vomiting. During the restoration of the body's lack of cerebrospinal fluid, bouts of lethargy and weakness occur. There may be pain in the puncture area.

On the page, read about the characteristic symptoms and effective methods of treating back strain.

Liquor research

When analyzing a liquid, first of all, its pressure is estimated. The norm in a sitting position is 300 mm. water. Art., in the prone position - 100-200 mm. water. Art. pressure is estimated based on the number of drops per minute. If the pressure is elevated, then this may indicate inflammatory processes in the central nervous system, the presence of tumors, hydrocephalus.

The liquid is divided in two (5 ml in a test tube) and the liquor is sent for further research:

• immunological;
• bacteriological;
• physical and chemical.

A healthy person has a clear, colorless cerebrospinal fluid. When a pink, yellow tint, dullness appears, we can talk about the presence of an infectious process.

The study of the concentration of proteins makes it possible to identify the inflammatory process in the body. A protein index of more than 45 mg / dl is an abnormality indicating the presence of an infection. Infection is also indicated by an increase in the concentration of mononuclear leukocytes (the norm is up to 5 pieces). Liquor is also examined for glucose concentration, detection of viruses, bacteria, fungi, detection of atypical cells.

Complications and possible consequences

Spinal cord puncture is a procedure that can be associated with dangerous consequences. Therefore, it should only be carried out by a qualified specialist with extensive experience and in-depth knowledge.

Possible complications:

• leakage of fluid into nearby tissues, which can cause severe headaches
• paralysis of the lower extremities, convulsions if the anesthetic gets on the spinal membrane;
• massive hemorrhage due to increased stress on the brain;
• damage to the spinal nerves by a needle can cause back pain;
• if the rules of antisepsis are violated, infection may occur, an inflammatory process or abscess of the meninges may develop;
• infringement of the nerve center, and as a result - a violation of the respiratory function.

If, after a lumbar puncture, the rules of rehabilitation are not followed, this can also lead to serious complications.

Puncture of the spinal cord is an informative diagnostic method, thanks to which many diseases can be detected. Subject to all the rules and contraindications, the procedure is practically safe, but the risk of complications still exists. Experts advise resorting to spinal puncture only in case of emergency and no more than once every six months.

Designed for biopsy of all types of soft tissues (liver, kidneys, thyroid, pancreas, prostate, mammary glands, etc.)

Three groups of needles are used for puncture biopsy: aspiration; modified aspiration; cutting. Aspiration needles have thin-walled cannulas with tips sharpened at different angles and are used for targeted fine-needle biopsy with aspiration of material for cytological examination. Modified aspiration needles have a cannula with sharp sharp edges and tips of various shapes, designed to take both cytological and histological samples. Cutting needles are of three types: Menghini, with a sharpened working end, Tru-Cut, which has a cannula with sharp edges and an internal stylet with a notch, and spring-cutting with a special “gun”. Designed to obtain a tissue sample for histological examination. The technique of execution and diagnostic accuracy of the study depends on the type of needle used and can reach 93-95%, which is comparable to conventional histology.

Sources of information

• Diagnostic and therapeutic technique / ed. Mayata V.S. - Moscow, 1969.

• Nurse's Handbook for Nursing / ed. Kovanova V. V. - "Medicine", Moscow, 1974. - 464 p. - 255 thousand copies.

Notes

Wikimedia Foundation. 2010 .

See what "Puncture" is in other dictionaries:

PUNCTION, and, wives. (specialist.). Puncture (tissue, cavity, vessel) for therapeutic or diagnostic purposes. | adj. puncture, oh, oh. Explanatory dictionary of Ozhegov. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 ... Explanatory dictionary of Ozhegov

PUNCTURE- (punctio), puncture of the cavity with a syringe with a diagnostic or therapist. purpose. P. is used for emptying various kinds of liquids and gases from tissues and cavities (P. emptying), determining their presence (P. test), for bacterial., Chem. and… … Big Medical Encyclopedia

- (from the Latin punctio injection), a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes ... Modern Encyclopedia

- (from Latin punctio injection) a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes ... Big Encyclopedic Dictionary

PUNCTION, punctures, for women. (lat. punctio injection) (med.). A puncture in the skin, produced by a syringe or some other device for removing or introducing liquids, air or any gases. Explanatory Dictionary of Ushakov. D.N. Ushakov. ... ... Explanatory Dictionary of Ushakov

Exist., number of synonyms: 4 venipuncture (2) culdocentesis (1) paracentesis (2) ... Synonym dictionary

Puncture- (from the Latin punctio injection), a puncture of the wall of any body cavity (for example, pleural), joint, vessel, organ, normal or pathological tissue for therapeutic or diagnostic purposes. … Illustrated Encyclopedic Dictionary

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

For many, brain puncture is subconsciously considered dangerous, but in fact it is not. If it is carried out by an experienced doctor, then it is absolutely safe. It is thanks to her that it is possible to detect abscesses in the brain tissues, determine the contents of neoplasms and the state of other pathologies.

But there are also a number of dangers that can be encountered with this procedure. Let's figure it out.

The puncture is carried out with a special needle, which, penetrating into the brain tissue, can draw fluid from it. To make the puncture safe, you need to follow a number of rules:

1. The area of ​​the head where the puncture will be made must be thoroughly disinfected. First, it is treated with hydrogen peroxide, and then liberally lubricated with iodine.
2. For the procedure, you can not use an ordinary needle, only a special, puncture, which has a blunt end. It is produced wide enough and equipped with a mandrin.
3. There should be 2 needles available, one of which will be spare if the first is blocked by brain tissue.
4. The puncture should be made to a depth of no more than 4 cm. This is the only way to ensure the safety of the fence and prevent the penetration of a purulent secret into.
5. Before the procedure, the patient must defecate.
6. Complete immobility of the patient is required, so it can be fixed with special devices.

Areas of conduct, indications, contraindications

Such a study is carried out in areas where there is a suspicion of the formation of pus, most often it is:

• the lower part of the frontal lobe;
• the lower part of the temporal lobe;
• drum space;
• near the mastoid process.

A puncture is taken to diagnose brain pathologies, such as:

• infectious lesion of the central nervous system;
• inflammatory process in the central nervous system;
• bacterial, viral, fungal diseases;
• infection of brain tissue with tuberculosis or syphilis;
• bleeding;
• multiple sclerosis;
• neoplasms of any type;
• neuralgic pathology;
• swelling of the brain tissue;
• problems with the vascular system.

Important! Before the procedure, the patient in a special questionnaire must indicate the list of drugs that he is currently taking, whether he is allergic to anesthetics or drugs, and whether he has problems with blood clotting.

The procedure is prohibited if:

• the patient is at any stage of pregnancy;
• he is in a state of traumatic shock;
• lost a lot of blood;
• there are intracranial hematomas;
• a brain abscess was diagnosed;
• abundant present;
• diagnosed with hypertension
• on the back there are abundant infectious and purulent lesions;
• have lumbar bedsores;
• brain is injured.

How is the procedure carried out

Why do the procedure determined, now you need to figure out the methods of its implementation. They are different and directly depend on the area where the fluid is taken.

Anterior horn of the lateral ventricle

The ventricular procedure of this area is carried out as follows:

1. The patient lies on his back when a tumor in the brain is to be detected. Usually the patient lies on the healthy side, so that it is more convenient for the doctor to puncture from the affected side.
2. The head is slightly tilted towards the chest.
3. The puncture site is thoroughly disinfected and smeared twice with iodine.
4. A puncture line is drawn, which should pass with a focus on the swept seam, passing the Kocher point. It is covered with a layer of brilliant green solution.
5. The head is covered with a sterile sheet.
6. Any local anesthetic, to which the patient is not allergic, anesthetizes the puncture area, most often it is Novocain.
7. Using a scalpel, an incision is made along the intended line.
8. They make a cut of a trepanation window on a bare skull.
9. The neurosurgeon makes a cruciform incision on the dura mater. Rub wax or produce electrocoagulation. What for? To stop bleeding, the latter being the most effective.
10. The cannula is inserted into the brain tissue to a depth of no more than 5-6 cm so that it runs parallel to the incision line. When the wall of the lateral ventricle is punctured, the doctor will feel a small dip.
11. Through the immersed cannula, yellowish cerebrospinal fluid will begin to flow. Having penetrated into the cavity of the ventricle, the doctor fixes the needle and, using a mandrel, regulates the volume and speed of the fluid being withdrawn.

Often there is high pressure in the cavity of the ventricle, and if it is not controlled, then the fluid will come out with a jet. This will lead to the fact that the patient will begin neuralgic problems.

The allowable volume of fluid intake is in the range of 3-5 ml. It is important to note that in parallel with the preparation of the room for the puncture, the operating room is also prepared, since there is a high risk that air can enter the area under study, or the puncture depth will be excessive, which can cause injury to the blood vessel. In these cases, the patient will be urgently operated on.

In cases of puncture, children use the CSF sampling methods according to Dogliotti and Geimanovic:

1. In the first case, the puncture is carried out through the orbit.
2. In the second - through the lower part of the temporal bone.

Both of these options have a significant difference from the traditional procedure - they can be repeated as much as needed. For infants, this procedure is carried out through an open fontanel, simply by cutting the skin over it. In this case, there is a serious danger that the baby will develop a fistula.

Posterior horn of the brain

The technology for taking cerebrospinal fluid from the area is carried out in the following order:

1. The patient lies on his stomach. His head is tightly fixed in such a way that the sagittal suture falls strictly in the median cavity.
2. The preparatory process is identical to the above procedure.
3. The incision of the tissues of the skull is carried out parallel to the sagittal suture, but in such a way that it passes along the Dandy point, which should be strictly in its middle.
4. Take a number 18 needle, which is used strictly for this kind of puncture.
5. It is inserted at an angle, directing the tip of the needle to the outer upper edge of the orbit to a depth of no more than 7 cm. If the procedure is performed on a child, then the puncture depth should not exceed 3 cm.

lower horn of the brain

The principle of the procedure is similar to the previous two:

• the patient should lie on his side, since the lateral part of the head and the auricle will be the operating field;
• the incision line will go 3.5 cm from the external auditory meatus and 3 cm above it;
• part of the bone in this area will be removed;
• make an incision in the dura mater;
• introduce a 4 cm puncture needle, directing it to the top of the auricle;
• will carry out the collection of liquor.

Clinical picture after the procedure

Of course, the symptoms after puncture sampling are different for everyone, but it can be combined into a general clinical picture:

1. Pain in the head of varying intensity and duration.
2. Prolonged nausea and vomiting.
3. Convulsions and fainting.
4. Failure of the cardiovascular system.
5. Violation of respiratory function, in rare cases, the patient may need artificial ventilation.
6. neuralgic problems.

It directly depends on the experience of the neurosurgeon and his skills whether the patient will have the above symptoms. The procedure must be performed strictly according to medical instructions, which can guarantee the absence of complications after the puncture.

It is important not only to fix the patient correctly, but also to accurately determine the puncture zone. Treatment of the affected area is important both at the stage of preparation for the procedure and after it. Upon completion of the fence, a sterile bandage is necessarily applied.

It is important that the patient at the time of the puncture does not feel any discomfort, and pain even more so.

Due to the fact that the procedure is most often prescribed for the diagnosis of pathologies, it, like any other diagnostic measure, should be painless. The patient will be conscious all the time, so he should immediately inform the doctor about the discomfort that has arisen. This will help avoid a number of complications. The doctor will change the technology or completely interrupt the procedure.

A puncture is an important procedure in medicine, and the collection of cerebrospinal fluid from the brain is even more so. Before it is carried out, the patient will undergo a series of studies that will help identify possible contraindications. Do not worry, a brain puncture is trusted to be carried out only by experienced specialists who know their business.