Dural Puncture Complications

Neuroimaging Clin N Am. 2025 Feb;35(1):53-76. doi: 10.1016/j.nic.2024.08.015. Epub 2024 Sep 20.

Abstract

Dural puncture, commonly referred to as lumbar puncture (LP), carries the risk of rare but serious complications including post-dural puncture headache, hemorrhage, herniation, and infection. These complications can lead to suboptimal patient outcomes including significant morbidity and mortality in some instances. This review comprehensively examines potential LP complications, including their incidence, pathophysiology, risk factors, clinical presentations, imaging findings, preventative measures, and treatment strategies. Familiarity with these complications will equip clinicians to effectively manage these complications through prompt recognition, timely diagnosis, and implementation of appropriate preventative measures.

Keywords: Dural puncture; Hemorrhage; Herniation; Infection; LP complications; Lumbar puncture; Lumbar spine; Post-dural puncture headache.

Publication types

  • Review

MeSH terms

  • Humans
  • Post-Dural Puncture Headache / etiology
  • Post-Dural Puncture Headache / prevention & control
  • Post-Dural Puncture Headache / therapy
  • Risk Factors
  • Spinal Puncture* / adverse effects
  • Spinal Puncture* / methods