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 DEFINITION
The central nervous system constituted essentially by the brain, the cerebellum and the spinal cord, stays inside the skull and the spine. There are structures which injury can cause serious and irreversible disorders, therefore in addition to being hard protected by the bone, they are immersed in a liquid that he avoids that they rub against the bone, and that when there are sudden movements it does the same that we feel when we want to run inside the water: it prevents strong displacements. This way, for example in a sudden braking in a car in march the brain does not hit the skull inside because this liquid does of shock absorber. It is known as "a Spinal Liquid", alluding in that it is in the head and in the spine, also called "a rachis". Also, the central nervous system is covered by a hard membrane, although less than the bone, that it gives him additional protection, and that it is called "Meninge". The spinal liquid (that we will call LCR) also bathes the meninge.
WHY IS IT STUDIED?
When any alteration takes place both in the meninge and in the central nervous system, there are liberated substances and/or abnormal cells that finish in this LCR, so that when we want information about these structures, instead of extracting a brain pedacito or of meninge, we can obtain a few LCR droplets and study it. Generally, it contributes the sufficient information to come to the precise diagnosis.
HOW IS IT OBTAINED
Since in addition to in the skull, it is in the spinal cord, we can obtain a sample puncionando in the spine. For it, the doctor will make sure that the fact of puncturing will not cause any problem, for which it can want to see the fund of the eye with a special device, or even to ask a TAC (axial scanner computarizada or scanner) before to the lumbar puncture. If everything is normal and the coagulation of the patient allows it, one proceeds to puncionar to obtain LCR. The prick happens in the lumbar region, or, in the vertebrae that are below the ribs, and normally further down possibly. This is because at these levels space full of liquid exists very much in the column, and nervous system remains small inside, that also it is slightly probable that it is damaged (although it can happen occasionally this way). One asks the patient that should be placed sat, or knocked down of side and in fetal position, to minimize the problems risk during the achievement of the test. The doctor is feeling in search of the place that seems better to him to puncture, between two vertebrae. When it finds it, it introduces a very thin needle up to finding the space at which the LCR stays, and when this one begins flowing gathers a few drops in different receptacles to send them to the different laboratories. When it has already obtained sufficient material, it closes the liquid exit, withdraws the needle, covers the small letter hurt with sterile dressings and asks the patient mouth to lie down arrives and that drinks abundant liquid. This is done so that there are few side effects, and to be able to be none. The most habitual is, in any case, the headache during a maximum of 24 hours after the puncture.
HOW IS IT PROCESSED
Once it has been extracted, is sent to the laboratory where he will suffer different processes what the diagnostic suspicion is. If an infection is suspected, already be of meninges (meningitis) or of another type, the chemical characteristics of the sample will be analyzed, and also it will be analyzed if it has gérmenes or not. If other not infectious problems are suspected, the chemical characteristics will be analyzed, and any others that are needed to come to the diagnosis.
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WHAT DOCTOR CAN TREAT ME?
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DEFINITION 
