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Lumbar Puncture for Diagnostics and Intrathecal Administration of Chemotherapy

General

Indications

  • A diagnostic tool for suspicion of disease in the brain or meninges.
  • Intrathecal chemotherapy treatment, either as prophylaxis or for treatment of disease.

Goal 

  • Diagnose disease in spinal fluid.
  • Treat or prevent disease and/or CNS affection.

If possible, a lumbar puncture should be avoided in cases of:

  • Thrombocyte values < 30,000 (give thrombocyte transfusion first).
  • For INR values > 1.8. Give Octaplas® or Konakion® first, but weigh this with risk of raised anticoagulation. The effect of Konakion® appears first the day after administration. 
  • Heparin combined with an antiplatelet agent such as Albyl-E®, Plavix®, Tielid®, ReoPro®, Aggrastat®. Confer with an hematologist.
  • Disseminated intravascular coagulation.
  • In cases where a patient is undergoing fibrinolytic treatment or where similar treatment concluded less than 2 days prior.
  • Hemophilia C – confer with an hematologist.
  • Full heparinization.

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