What Conditions Require a Lumbar Drain?

A lumbar drain is a small tube that is inserted into the lumbar area of the lower back. One is typically used to drain excess cerebral spinal fluid (CSF) from the spine or brain. Most lumbar drains are left in for about a week. During this time, the doctors will usually try to fix the problem that is causing the CSF leakage. Conditions that may require a lumbar drain include hydrocephalus, head trauma due to an accident, or brain surgery.

A lumbar drain is normally an in-patient procedure that is performed in a hospital operating room or at bedside in the patient's room. A doctor commonly inserts a small needle in the lower back, and then runs a tiny tube through the puncture and up the spine. The tube is then attached to a drainage bag. Most of the time, the lumbar drain is stitched into place so the likelihood of it being pulled out is decreased.

One cause of excess CSF can be hydrocephalus, most commonly referred to as water in the brain. This condition can cause pressure inside the skull and around the brain. There are a wide range of symptoms for this condition, which generally include headache and vomiting. Without treatment, this condition can cause a person to go into a coma.

Hydrocephalus is often found in critically ill children. In infants affected by it, the soft spot on the top of their head may bulge. Older children may cry out for no reason or have their facial features appear different due to the building pressure of the CSF. Such a build-up can be caused by genetic or neural tubal defects. Sometimes a complicated birth can cause a brain bleed in the infant and also cause hydrocephalus. A lumbar drain must be utilized to relieve this pressure, even in very young patients.

Two other types of this accumulation of CSF are hydrocephalus ex-vacuo and normal pressure hydrocephalus. The first type normally happens when there has been an injury to the brain through a stroke or an accident. Normal pressure hydrocephalus can happen at any age, but is typically seen among the elderly. This condition can be caused by a hemorrhage in the brain, brain tumors, or infection.

Sometimes when a person has sustained a major head injury, cerebral spinal fluid leakage can occur. This type of injury can result from falls, car accidents, or any blunt force trauma to the head. A lumbar drain may be also used in patients that have had such a brain surgery to keep pressure from building inside the skull due to the invasive surgery.