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Diagnosing Migraines and Headaches With a Spinal Tap

A spinal tap, also called lumbar puncture, is a procedure in which the fluid surrounding the spinal cord and the brain (called the cerebrospinal fluid, or CSF) is withdrawn through a needle and examined in a lab. The cerebrospinal fluid circulates around the brain and spinal cord. It has many vital functions, including protecting the brain and spinal cord from injury.

Testing the CSF can help in the diagnosis of disorders of the central nervous system that may involve the brain, spinal cord, or their coverings (meninges). The analysis includes looking at the number and types of white blood cells, the level of glucose, and the types and levels of proteins. The analysis also includes a test for bacteria, fungus, or abnormal cells.

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This procedure may be performed to:

  • Look for signs of infection
  • Measure the pressures around the brain and to relieve pressure if its high
  • Give spinal anesthesia (pain medication)
  • Inject dye for an X-ray diagnostic test
  • Inject medications such as antibiotics or cancer drugs
  • Check for bleeding in the brain or spinal cord caused by disease or trauma

What Should I Do Before a Spinal Tap?

Before having a spinal tap to diagnose migraines or headaches:

  • Inform your doctor of any medications you are currently taking, including non-prescription drugs. Also tell your doctor if you are allergic to any drugs. Do not discontinue any medication without consulting with your primary doctor and the doctor requesting this study.
  • Inform your doctor if you are pregnant or think you may be pregnant or if you have diabetes.
  • Do not take Persantine, Plavix (clopidogrel), or Coumadin (warfarin) within 72-hours prior to the test. These medications are often referred to as blood thinners.
  • Do not take aspirin or any products containing aspirin within one week prior to the test.
  • Ask your doctor for specific guidelines regarding alcohol use before the test. Generally, you should not consume any alcohol for at least 24-hours prior to the test.
  • Make arrangements for transportation, as you should not drive immediately after the test.
  • Do not bring valuables such as jewelry or credit cards.
  • You will need to provide verbal and written consent for the procedure. Be sure to discuss any questions you may have regarding the procedure before you give consent. Questions you may want to ask include the steps of the procedure and the risks and benefits anticipated with a spinal tap.

If you have diabetes:

  • Take your usual dose of insulin and eat a light breakfast before 8:00 a.m.
  • When you arrive for the test, please be sure to remind the doctor that you have diabetes.

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