title: Pediatric lumbar puncture and cerebrospinal fluid analysis.
abstract: BACKGROUND
  Lumbar puncture (LP) is a commonly performed procedure in pediatrics. Accurate analysis of cerebrospinal fluid (CSF) profile is essential in diagnosing and managing a variety of infectious and inflammatory conditions involving the brain, meninges, and spinal cord. It can also provide useful diagnostic information in the evaluation of possible subarachnoid hemorrhage and demyelinating syndromes, and aid in the diagnosis and management of pseudotumor cerebri.
  
  
  OBJECTIVE
  To review anatomic, physiologic, and pathologic aspects of performing pediatric lumbar puncture and CSF analysis.
  
  
  CONCLUSIONS
  Although still a commonly performed procedure in the outpatient setting, effective vaccines to prevent invasive infection due to Streptococcus pneumoniae and Haemophilus influenzae type b have greatly reduced pediatric bacterial meningitis rates due to these pathogens, resulting in decreased opportunity for physician-trainees to perfect this important skill (among nonneonates) during the 3 years of supervised residency training. Success in performing pediatric LP is augmented by a thorough understanding of medical aspects related to this procedure. This article discusses technical aspects involved in successfully performing a lumbar puncture to obtain CSF, and interpreting a CSF profile in children.
  
  
  CONCLUSIONS
  A thorough understanding of anatomic, physiologic, and pathologic considerations regarding performing lumbar puncture and CSF analysis can augment success in diagnosing a variety of potentially serious pediatric conditions.
authors.affiliation: Pediatric Emergency Medicine, Maimonides Medical Center, Brooklyn, New York.
authors.forename: William
authors.initials: W
authors.lastname: Bonadio
mesh_terms: D000772:Anesthesia, Local / Q000379:methods; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000382:microbiology; D002648:Child; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis; D006801:Humans; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000382:microbiology; D011559:Pseudotumor Cerebri / Q000134:cerebrospinal fluid / Q000175:diagnosis; D013129:Spinal Puncture / Q000009:adverse effects / Q000379:methods*; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid / Q000175:diagnosis
keywords: CSF analysis; lumbar puncture; meningitis; pediatrics