How does a LP cause herniation with increased ICP?

[TooterIA]

I have googled and gotten nowhere. I see an increased ICP is a contraindication for a LP d/t risk of herniation. But how would the LP cause herniation?

Thanks!

[GilaRRT]

Rare but potential exist regardless. As a provider I would never consider doing a LP on anyone with increased ICP, the evidence does not support performing the procedure and therefore would be negligent on my part to do so. The outcome is death and the reason that it's rare may be reflected by the fact that increased ICP is a contraindication in performing LP's.

On a side note, not sure what you mean by the Hypoxic drive scarecrow thing. I assume your talking about COPD pts and O2 use but may be wrong.

Not always the case. Again, in some circles, it is suggested that doing a CT in the case of meningitis may actually delay treatment and in fact, the potential for "herniation" may not even be detectable by CT in some patients. So, the evidence can be interpreted in many ways. Never say never when it comes to grey areas and ambiguous concepts. So, the decision to perform or not perform an LP in cases that are potentially questionable is debatable.

Obviously, we follow our facility protocols and guidelines.