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University of Pennsylvania Alzheimers Disease Center
Our Research Diagnostic and Treatment Services Lumbar Puncture: The Process of Cerebrospinal Fluid Sampling

What is Cerebrospinal Fluid (CSF)?
Cerebrospinal Fluid (pronounced sir-'ree-bro-spinal) and known as CSF, is a serum-like fluid that circulates through the ventricles of the brain, and in the cavity of the spinal cord. It acts somewhat like a “shock absorber” for protection of these areas. CSF also contains proteins and other important chemical particles, known as “biomarkers,” that may indicate existence of a disease process, such as Alzheimer’s Disease, in an individual.

Why is CSF Important to Alzheimer’s Disease Research?
By analyzing CSF, researchers can pinpoint the biomarkers that may signal an increased risk of developing disease. This process may be key to the development of tests to diagnose Alzheimer’s Disease earlier and more definitively than is now possible.

How is CSF obtained?
CSF is obtained through a simple and safe process known as a lumbar puncture (LP). Non-medical persons may refer to LP as a “spinal tap.” Performed by an experienced physician, LP is quick and involves no, or only the slightest discomfort. There is no risk of paralysis.

The person giving a CSF sample can lie comfortably on his or her side on an exam table, or sit during the procedure. The doctor will determine which position will work best. Just as in a venipuncture (blood draw), the skin is swabbed with a cleansing solution. A local anesthetic is injected under the skin where the needle will be placed. When the area is totally numb, a small needle is inserted into the lower back, below where the spinal cord itself ends in the spinal cavity. The needle slips easily between — not into — the bones of the spine to reach the fluid. Only about 3 tablespoons of fluid are drawn out, and placed in sterile tubes.

Are there Risks Involved?
You may experience discomfort or bruising of the skin where the needle was inserted — much as you might when giving blood. In less than 10% of cases, individuals report a mild headache. In rare instances, more severe headaches may occur, which usually respond quickly to treatment with over-the-counter pain relievers. A very rare occurrence is infection from the draw itself. The risk for such infection is less than that of a regular blood draw. Persons who feel faint when giving blood may have a similar flushing/ fainting feeling with LP. All precautions are taken to anticipate potential problems and minimize these risks.

Afterward
You will rest for about 30 minutes, after which you can drive home. Drink plenty of fluids, except alcohol, during the next 12 hours, and take it easy for the next 24 hours. Avoid strenuous physical activity for about 48 hours.

If you have any questions about this process, please call us at 215-662-7810.

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