DONALD FORESTER, M.D.
To the editor: The indications for, and usefulness of, the spinal tap are reviewed by Marton and Gean (1) in the June issue. However, two contraindications to the lumbar puncture not mentioned by the authors are local lumbar skin infection and platelet counts below 50 000/mm3 (2). Overlying skin infection creates a medium for the introduction of bacteria into the spinal canal. Thrombocytopenia creates the risk of intraspinal hemorrhage as the advancing spinal needle passes into the subarachnoid space (3); correcting this abnormality before the lumbar puncture can avoid such a complication.
FORESTER D. Contraindications to Lumbar Puncture. Ann Intern Med. ;105:805. doi: 10.7326/0003-4819-105-5-805_1
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Published: Ann Intern Med. 1986;105(5):805.
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