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To the Editor:—
I should like to voice my exception to the statement in Dr. Alexander's excellent paper on "Lumbar Puncture" (JAMA201:316, 1967) that increased intracranial pressure is the absolute contraindication to the performance of a routine lumbar puncture, except in the hands of a surgeon who is prepared to handle the entire problem.This has been repeated over and over again for many years.Lumbar puncture should never be considered as a routine procedure. The need for specifying indications and contraindications can be eliminated by this simple statement: lumbar puncture and examination of the spinal fluid are indicated only when the information that can be obtained in this way, and in no other way, is absolutely necessary for the diagnosis.Lumbar puncture is occasionally necessary in the presence of signs of increased intracranial pressure in order to obtain diagnostic information from the examination of the spinal fluid
Poser CM. Indications for Lumbar Puncture. JAMA. 1967;202(3):244-245. doi:10.1001/jama.1967.03130160118036