Cerebrospinal fluid and lumbar puncture: a practical review

Cerebrospinal fluid is vital for normal brain function. Changes to the composition, flow, or pressure can cause a variety of neurological symptoms and signs. Equally, disorders of nervous tissue may alter cerebrospinal fluid characteristics. Analysis of cerebrospinal fluid can provide information on diagnosis, may be therapeutic in certain conditions, and allows a research opportunity into neurological disease. However, inappropriate sampling, inaccurate technique, and incomplete analysis can contribute to significant patient morbidity, and reduce the amount of accurate information obtained. In this article, we will review how cerebrospinal fluid is produced, circulated, and resorbed. We will also review lumbar puncture technique, equipment, and cerebrospinal fluid analysis. We also discuss how to minimize the risks and address the complications associated with lumbar puncture.