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Spinal puncture through a large lumbar tattoo
  1. Sara García-Bellido Ruiz,
  2. Carlos Santos Martín,
  3. Alejandro Herrero San Martín,
  4. Carlos Pablo de Fuenmayor Fernández de la Hoz
  1. Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
  1. Correspondence to Dr Sara García-Bellido Ruiz, Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; sara.garciabellidoruiz{at}

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Case report

A 41-year-old man was evaluated in the emergency room for symptoms suggesting an infective or inflammatory central nervous system (CNS) lesion. He needed cerebrospinal fluid (CSF) analysis as part of the initial diagnostic process. However, he had a 5-year-old, well-healed, multicoloured lumbar tattoo covering the entire skin surface of his back. We therefore performed a lumbar puncture using a technique to avoid contact between the spinal needle and the pigmented dermis and epidermis (figure 1). We first anaesthetised the subcutaneous and muscular layers with 4 mL of 2% mepivacaine. We then inserted an 18 gauge×51 mm Abbocath catheter along the same trajectory of a usual lumbar puncture in L3–L4 space, which overpasses the pigmented skin but does not reach the dural plane. Finally, we passed through the …

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  • Contributors Writing of the first draft of the manuscript: SGBR. Review and critique of the manuscript: CSM, CPdFFdlH and AHSM. Last revision and guarantor: SGBR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally reviewed by Stefan Williams, Leeds, UK.