Ultrasound Guided Lumbar Puncture in Idiopathic Intracranial Hypertension

Lumbar puncture (LP) remains the predominant method of intracranial pressure measurement. This procedure is often challenging in the idiopathic intracranial hypertension (IIH) population owing to body habitus and loss of anatomical landmarks. Opening pressure (OP) is often the most important piece of information and can be measured inaccurately by repeated punctures. Often, patients require fluoroscopy guidance, and the radiation dose may be significant, especially when considering the need for repeated LP over the frequently long course of this disease. Finally, the conventional method of LP is often associated with morbidity in the form of post-dural puncture low tension headache and cerebrospinal fluid (CSF) leaks, requiring further intervention. The purpose of the current investigation is to describe a method of lumbar puncture using ultrasound guidance and to report our experience using this method in IIH patients.