UUCI Health · Department of Neurology
APP Class II · Procedural Competency Series · 2026
●  Procedure 03·Neurocritical Care·High-risk tier
03.

Lumbar Drain

Placement & Removal.

Aneurysmal SAH · NPH workup · CSF-leak management · TAA/TAAA spinal-cord protection.
Chadwycke R. Smith, MSN, NP, AGACNP-BC
APP Education · Department of Neurology
Approving authority: Claire Henchcliffe, MD, DPhil · Chair, Department of Neurology
Version 2.0 · 2026-05-11
Source-of-truth: 01_Lumbar_Drain_Learning_Objectives.docx
Lumbar Drain · UCI Neurology APP Class II
01 / 21
UUCI · APP Class II
Procedure 03 · Lumbar Drain
02 · Why this matters
Complication rate · unstandardized practice
~30%
drops substantially with standardized lab thresholds, ASRA anticoag holds, midline Tuohy technique, and tragus-leveled drainage with a hard hourly cap.
  • Over-drainage subdural hematoma is the most dangerous complication — downward brain sag.
  • Catheter-associated meningitis incidence rises sharply after 5 days of dwell time.
  • Retained catheter fragments are 100% preventable with the never-withdraw-through-Tuohy rule.
  • Post-dural puncture headache, nerve-root irritation, and CSF leak round out the morbidity profile.
Açıkbaş SC et al. Acta Neurochir (Wien). 2002;144(5):475–80 · PMID 12111503
Governale LS et al. Neurosurgery. 2008;63(4 Suppl 2):379–84
Lumbar Drain · Why this matters
02 / 21
UUCI · APP Class II
Procedure 03 · Lumbar Drain
03 · Course objectives

What you'll leave with — six competencies.

01 · Cognitive · C-1, C-2

Anatomy & landmarks.

Conus medullaris terminates L1–L2; cauda equina within the lumbar cistern. Tuffier's line locates L3–L4 / L4–L5 — landmark accuracy ~70%.

02 · Cognitive · C-3, C-4

Indications & thresholds.

SAH vasospasm, NPH workup, CSF leak, TAA/TAAA protection. Absolute contras: site infection, mass effect, uncorrected coagulopathy.

03 · Psychomotor · P-3

Tuohy insertion.

Bevel cephalad, midline, ~15° cephalad angle. Describe tactile feedback through skin → supraspinous → interspinous → ligamentum flavum → dura.

04 · Psychomotor · P-5

Catheter advancement.

5–7 cm into the subarachnoid space. Stop on lancinating radicular pain — withdraw to prior depth, never through the Tuohy.

05 · Psychomotor · P-7

Drainage system & tragus.

Level drip chamber to the external auditory meatus / tragus, zero the transducer, set ordered rate with hourly maximum.

06 · Psychomotor · P-8

Removal sequence.

4-h clamp trial · stable neuro exam · slow withdrawal · tip-completeness inspection · stop on resistance, consult neurosurgery.

Lumbar Drain · Course objectives
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UUCI · APP Class II
Section I of IV
I.
Section one

Pre-procedure ·
placement & removal.

Both touchpoints — placement and removal — earn the same pre-procedure discipline. Consent, labs, ASRA holds, time-out, positioning. The clamp trial is the removal-side time-out.
Objectives C-3 · C-4 · C-5 · A-1 · A-2 — slides 5–8
Lumbar Drain · Section I
04 / 21
UUCI · APP Class II
Procedure 03 · Lumbar Drain
04 · Indications · contraindications

When to place — and when not to.

Accepted indications
  • Aneurysmal SAH — vasospasm management / communicating hydrocephalus
  • NPH diagnostic workup — high-volume drainage trial
  • CSF-leak management — spontaneous intracranial hypotension; skull-base CSF rhinorrhea / otorrhea
  • TAA / TAAA spinal-cord protection (perioperative)
  • Idiopathic intracranial hypertension — salvage when refractory to medical therapy
Wolf S et al. EARLYDRAIN RCT. JAMA Neurol. 2023 · PMID 37330974 · Lee Y et al. World Neurosurg. 2024 · PMID 38246528
Schievink WI. JAMA. 2006 · PMID 16705110 · Schlosser RJ, Bolger WE. Otolaryngol Clin North Am. 2006 · PMID 16757229
Leone N et al. J Vasc Surg. 2024 · PMID 38636609 · Zhou C et al. CNS Neurosci Ther. 2024 · PMID 39097911
Contraindications & eligibility floor
  • Absolute: localized infection at insertion site
  • Absolute: mass effect / impending herniation / posterior-fossa lesion
  • Absolute: uncorrected coagulopathy
  • Platelets ≥ 100,000/µL elective · INR ≤ 1.4
  • Intact skin at planned puncture site
  • LP competency at UCI is a prerequisite — no LP, no lumbar drain
Kopp SL et al. ASRA Evidence-Based Guidelines (5th ed). Reg Anesth Pain Med. 2025 · PMID 39880411
Lumbar Drain · Indications & contraindications
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
05 · Anticoag holds · time-out

ASRA at the door — TJC at the gate.

ASRA 5th-edition holds (Kopp 2025)
AgentHold
WarfarinVerify INR ≤ 1.4 before placement
LMWH prophylactic≥ 12 h since last dose
LMWH therapeutic≥ 24 h since last dose
DOAC48–72 h hold per renal function
Aspirin / NSAIDNo mandated hold for monotherapy
Kopp SL et al. ASRA Evidence-Based Guidelines (5th ed). Reg Anesth Pain Med. 2025 · PMID 39880411
TJC standard

UP.01.03.01

Pre-procedure verification, site identification, formal time-out — correct patient, correct procedure, correct side / level, correct equipment, consent confirmed aloud. Consent documented before, never after.
The Joint Commission. Universal Protocol UP.01.03.01.
TJC Hospital Accreditation Standards · 2024.
Lumbar Drain · ASRA holds & time-out
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UUCI · APP Class II
Key fact · drain-associated meningitis
IDSA · Healthcare-Associated Ventriculitis & Meningitis · 2017
Day 5
catheter-associated meningitis incidence rises sharply after 5 days of dwell time. Treat day 5 as a decision point — pull the drain, or justify in writing why it stays.
> 72 h
Daily CSF cell
count + glucose.
Day 5
Decision point —
pull or justify.
Suspect
Fever · neck stiff ·
CSF pleocytosis.
Tunkel AR et al. Clin Infect Dis. 2017;64(6):e34–e65 · PMID 28203777
07 / 21
UUCI · APP Class II
Procedure 03 · Lumbar Drain
06 · Kit · positioning · pre-scan

What's in your hand — and how the patient lies.

Kit checklist (Integra / Medtronic)
  • Tuohy needle (curved-tip, cephalad bevel)
  • Lumbar drainage catheter
  • Luer connector + drip chamber + transducer
  • Sterile preservative-free saline (priming)
  • 1% lidocaine + 25g + 22g needles
  • CHG-alcohol prep (or povidone-iodine alt.)
  • Sterile gown, gloves, mask, eye protection
  • Large fenestrated sterile drape
  • Transparent occlusive dressing (Tegaderm)
  • Suture (institutional protocol)
  • Skin marker · ultrasound (if indicated)
  • Specimen tubes for CSF
Cook Medical. Tuohy epidural needle IFU. 2024 · Integra LifeSciences. Lumbar drainage system IFU. 2024
Tuohy epidural needle with stylet beside silicone catheter on calibrated ruler, illustrating the curved bevel tip and depth markings used for lumbar drain placement
Erich Schulz · Wikimedia Commons (File:Tuohy.jpg)Public domain
Positioning & pre-scan
  • Lateral decubitus — knees-to-chest, chin-tuck, spine maximally flexed
  • Seated alternative — if lateral not tolerated; same flexion principle
  • Tuffier's line — superior iliac crests → L3–L4 / L4–L5
  • Landmark accuracy ~70% — Boon 2004
  • Ultrasound when indicated: obesity · scoliosis · prior spine surgery · failed-LP history
  • OPPE indicator: US use in indicated cases ≥ 95%
Boon JM et al. Clin Anat. 2004;17(7):544–53
Anterior dissection of the human caudal spinal cord showing conus medullaris terminating around L1-L2 with the cauda equina nerve roots descending through the lumbar cistern
John A. Beal, PhD · LSU Health Sciences Center ShreveportCC BY 2.5
Lumbar Drain · Kit & positioning
08 / 21
UUCI · APP Class II
Section II of IV
II.
Section two

The placement
sequence.

Six numbered steps. Every step is a verification gate. The Tuohy's curved tip directs the catheter cephalad — that's why we use it, and why it never withdraws back through.
Objectives P-1 · P-2 · P-3 · P-4 · P-5 · P-6 · P-7 — slides 10–12
Lumbar Drain · Section II
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
07 · Steps 1–3

Position, prep, Tuohy.

01

Position &
landmark.

  • Lateral decubitus · knees-to-chest · chin-tuck · max flexion
  • Tuffier's line — superior iliac crests
  • Mark L3–L4 or L4–L5 interspace
  • Ultrasound for obesity / scoliosis / prior surgery / failed-LP
02

Sterile field ·
anesthesia.

  • Hand hygiene · gown · gloves · mask · eye protection
  • CHG-alcohol prep · appropriate dry time · sterile drape
  • 1% lidocaine — skin wheal then planned track
  • Wait for onset before Tuohy advance
03

Tuohy ·
bevel cephalad.

  • Midline approach · cephalad angle ~15°
  • Tactile planes: skin → supraspinous → interspinous → lig. flavum → dura
  • Dural "pop" — controlled, reliable in flexed lateral decubitus
  • Bevel oriented cephalad for catheter direction
Macro close-up of a Tuohy needle tip showing the curved Huber bevel that directs the catheter cephalad through the dura
A. P. Marques Jr · remade by LamiotCC BY-SA 3.0
CDC. Hand-hygiene guideline. MMWR Recomm Rep. 2002;51(RR-16):1–45 · Boon JM et al. Clin Anat. 2004;17(7):544–53
Lumbar Drain · Steps 1–3
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UUCI · APP Class II
Procedure 03 · Lumbar Drain · Critical checkpoint
Critical safety checkpoint · mandatory before catheter advance

Confirm clear CSF
before you advance.

Method 01 · stylet withdrawal

Withdraw the stylet at the hub. Clear CSF return at the hub is the gate. Document CSF appearance: clear, bloody, or xanthochromic.

Method 02 · dry-tap recovery

Rotate bevel → advance 1–2 mm → withdraw slightly → redirect. Three-attempt ceiling at any one interspace, then move levels.

No CSF after 3 attempts
STOP. Move levels — or
consult neurosurgery.
Dry-tap discipline is how you avoid
nerve-root injury and retained fragments.
Açıkbaş SC et al. Acta Neurochir. 2002;144:475–80
Lumbar Drain · CSF-return checkpoint
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
08 · Steps 4–6

Catheter, secure, tragus.

04

Catheter ·
5–7 cm.

  • Advance 5–7 cm into subarachnoid space
  • No excessive force at any plane
  • Lancinating radicular pain → STOP, withdraw to prior depth
  • NEVER withdraw catheter through Tuohy — shear risk.
05

Tuohy out ·
secure.

  • Withdraw Tuohy over the catheter — never through
  • Tunneled or sutured securement per institutional protocol
  • Transparent occlusive dressing (Tegaderm)
  • Document depth marker at skin
06

System ·
tragus level.

  • Connect drainage system · prime with sterile saline
  • Level drip chamber to external auditory meatus / tragus
  • Zero the transducer · set ordered rate
  • Hourly maximum — institutional cap 20 mL/h
Cook Medical. Tuohy IFU 2024 · Integra LifeSciences. Lumbar drainage system IFU 2024 · Leone N et al. J Vasc Surg. 2024;80(2):586–594.e5 · PMID 38636609
Lumbar Drain · Steps 4–6
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UUCI · APP Class II
Section III of IV
III.
Section three

Removal ·
post-procedure care.

Removal is a procedure, not a casual pull. Clamp trial, stable exam, sterile prep, slow withdrawal, tip inspection. Resistance is a stop — not a tug.
Objectives C-8 · P-8 · A-3 · A-5 — slides 14–15
Lumbar Drain · Section III
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
09 · Removal · post-procedure orders

The clamp trial — and the order set.

Removal sequence
  • 01
    Clamp trial — 4 h. Clamp the drain · monitor for any neurological change · stable exam across the window is the gate.
  • 02
    Sterile prep. CHG-alcohol prep at the site · sterile drape · gloves.
  • 03
    Slow steady withdrawal. Do not yank · maintain axial alignment.
  • 04
    Tip inspection. Inspect catheter tip for completeness — catch a retained fragment in the room, not on a CT three days later.
  • 05
    Resistance → STOP. Do not pull harder. Consult neurosurgery · consider imaging before any further attempt.
  • 06
    Occlusive dressing. Sterile occlusive dressing · monitor for CSF leak / PDPH.
Post-procedure orders (placement)
  • Strict supine bedrest · head of bed flat × 4 h
  • Hourly neuro checks × 4 h, then per institutional protocol
  • Hourly drain output charting · maximum drainage limit set
  • No flushing · no manipulation by non-credentialed staff
  • Notify MD for output change > 25%, new neuro change, or any CSF appearance change
  • Daily CSF cell count + glucose if dwell > 72 h
  • Day 5 — decision point: pull or justify in writing
Tunkel AR et al. Clin Infect Dis. 2017;64(6):e34–e65 · PMID 28203777
Lumbar Drain · Removal & orders
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
10 · Complications

Eight events you diagnose on sight.

01 · Most dangerous

Over-drainage SDH.

Downward brain sag → acute subdural hematoma. F-BEVAR SR/MA: CSFD-related mortality 1.4%, morbidity 25.6% (Leone 2024). Hard cap 20 mL/h.

02 · After day 5

Drain-associated meningitis.

Incidence rises sharply after 5 days. Pull drain · tip + CSF for culture + Gram stain · empiric vanc + cefepime (Tunkel 2017).

03 · Common

Post-dural puncture HA.

Pathogenesis = CSF hypotension. Supine rest, hydration, caffeine first-line. Epidural blood patch if refractory (Uppal 2024).

04 · Intra-procedural

Radicular pain.

Lancinating leg pain on advance → STOP, withdraw to prior depth. Never through Tuohy — shear risk.

05 · Preventable

Retained fragment.

Withdraw catheter through Tuohy → bevel shears it. 100% preventable. IR retrieval ± surgical removal if it occurs (Açıkbaş 2002).

06 · Anticoag

Spinal hematoma.

ASRA-5 holds prevent this. Warfarin INR ≤1.4, LMWH 12–24 h, DOAC 48–72 h (Kopp 2025).

07 · Mechanical

Catheter migration.

Skin-marker depth change · plain film confirms position · do not flush a suspected occlusion (Açıkbaş 2002).

08 · Procedural

Dry tap.

3-attempt ceiling at one interspace. Rotate bevel · advance 1–2 mm · withdraw · redirect · move levels.

Lumbar Drain · Complications
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
11 · Pitfalls

Four errors we see — repeatedly.

01

Withdrawing catheter through the Tuohy.

The bevel shears the catheter. You have a retained fragment in the patient. Withdraw the Tuohy over the catheter — never the reverse.

02

Drip chamber off the tragus.

Drip chamber not leveled to the external auditory meatus, or missing the hourly cap, drives over-drainage SDH. Re-zero on every reposition.

03

Pushing past a dry tap.

Three attempts is the ceiling at any one interspace. After that, move levels or escalate to neurosurgery — you do not keep stabbing.

04

Pulling on resistance during removal.

Resistance on withdrawal is a stop, not a tug. Forceful traction tears nerve roots and breaks catheters. Image · consult · do not improvise.

Lumbar Drain · Pitfalls
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UUCI · APP Class II
Section IV of IV
IV.
Section four

Competency ·
FPPE & OPPE.

22-item skills checklist · 15-item post-test · 5 proctored independent cases for FPPE · OPPE every 6 months. Six critical actions on the checklist must rate Independent — or the packet doesn't move.
Source: 05_Lumbar_Drain_FPPE_OPPE_Plan.docx — slides 18–19
Lumbar Drain · Section IV
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
12 · UCI FPPE · OPPE

Your competency pathway.

StageTriggerScope
FPPEBoard approval of LD privilegeFirst 5 independent cases · concurrent review within 14 d · aggregate at 5 cases · closed within 6 mo
OPPEContinuous baseline · q6 mo10% sample (min 2, max 10) · 100% review on any complication · TJC MS.08.01.03
Triggered FPPESevere complication · 2 failed placements / 90 d · RL Solutions event · M&M reviewScope per trigger · min 5 subsequent cases · §3 structure
Lapse / Reinstatement< 3 cases over 24 moSimulation (Stream C) + 2 proctored cases · FPPE restarts on next 5
Core OPPE indicators
  • Successful first-attempt placement ≥ 80%
  • Ultrasound use in indicated cases ≥ 95%
  • 100% review of any complication occurrence
  • Documentation completeness 100% — time-out, consent, CSF, depth, orders
  • Order-set adherence 100% — bedrest, neuro checks, hourly output, no-flush, notify
High-risk tier Departures require written justification.
Lumbar Drain · FPPE / OPPE pathway
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
13 · Post-test preview

Three case stems — stop, image, escalate.

Q13 · SAH · day 4 post-coiling

Declining output · new deficit.

Drain output drops from 10 mL/h to <2 mL/h over 3 h. Patient becomes lethargic with new right-sided weakness.

Best next step: Stop drainage · stat neuro exam · emergent non-contrast head CT. Not: flush, lower the chamber, or replace the drain.

Q14 · NPH workup · 72 h dwell

Possible drain-associated meningitis.

Serosanguinous discharge, 2 cm halo erythema, fever 38.2 °C, slightly cloudy CSF from the drain.

Best next step: Remove the drain · catheter tip + CSF for culture & Gram stain · empiric vancomycin + cefepime pending results. Not: continue drainage on antibiotics.

Q15 · Removal at 48 h

Resistance during withdrawal.

Clamp trial × 4 h with stable exam. On withdrawal, sudden resistance at ~4 cm.

Best next step: STOP · do not pull harder · neurosurgery consult · consider imaging before further attempts. Not: firm steady traction, cut at skin, or saline lubrication.

Source: 04_Lumbar_Drain_Post_Test.docx · pass threshold ≥ 12/15 (80%) per TJC HR.01.06.01
Lumbar Drain · Post-test preview
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
14 · References & acknowledgments

Sources of truth.

  1. 01Açıkbaş SC, Akyuz M, Kazan S, Tuncer R. Complications of closed continuous lumbar drainage of cerebrospinal fluid. Acta Neurochir (Wien). 2002;144(5):475–480. PMID 12111503.
  2. 02Governale LS, Fein N, Logsdon J, Black PM. Techniques and complications of external lumbar drainage for normal pressure hydrocephalus. Neurosurgery. 2008;63(4 Suppl 2):379–384. PMID 18981847.
  3. 03Boon JM, Abrahams PH, Meiring JH, Welch T. Lumbar puncture: anatomical review of a clinical skill. Clin Anat. 2004;17(7):544–553.
  4. 04Wolf S, Mielke D, Barner C, et al. Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage (EARLYDRAIN): A Randomized Clinical Trial. JAMA Neurol. 2023;80(8):833–842. PMID 37330974.
  5. 05Kopp SL, Vandermeulen E, McBane RD, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: ASRA Evidence-Based Guidelines (5th ed). Reg Anesth Pain Med. 2025. PMID 39880411.
  6. 06Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 IDSA Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017;64(6):e34–e65. PMID 28203777.
  7. 07Uppal V, Russell R, Sondekoppam RV, et al. Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group. Reg Anesth Pain Med. 2024;49(7):471–501. PMID 37582578.
  8. 08Leone N, Bath J, D'Oria M, et al. Systematic review and meta-analysis of cerebrospinal fluid drain-related mortality and morbidity after fenestrated-branched endovascular aortic repair. J Vasc Surg. 2024;80(2):586–594.e5. PMID 38636609.
  9. 09Lee Y, et al. Effectiveness of Cerebrospinal Fluid Lumbar Drainage Among Patients with Aneurysmal Subarachnoid Hemorrhage: An Updated Systematic Review and Meta-Analysis. World Neurosurg. 2024;183:246–253.e12. PMID 38246528.
  10. 10Lee Y, et al. The Benefits and Feasibility of External Lumbar Cerebrospinal Fluid Drainage for Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: Meta-Analysis and Trial Sequential Analysis. World Neurosurg. 2022;167:e549–e560. PMID 35977676.
  11. 11Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA. 2006. PMID 16705110.
  12. 12Schlosser RJ, Bolger WE. Endoscopic management of cerebrospinal fluid rhinorrhea. Otolaryngol Clin North Am. 2006;39(3):523–538. PMID 16757229.
  13. 13Zhou C, et al. Progress and recognition of idiopathic intracranial hypertension: A narrative review. CNS Neurosci Ther. 2024;30(8):e14895. PMID 39097911.
  14. 14The Joint Commission. Universal Protocol UP.01.03.01. TJC Hospital Accreditation Standards; 2024.
  15. 14aThe Joint Commission. Universal Protocol UP.01.01.01 — preprocedure verification; use a standardized list (H&P, signed consent, nursing & preanesthesia assessment, labeled imaging, required equipment/devices). National Patient Safety Goals (HAP); effective January 2025.
  16. 14bThe Joint Commission. NPSG.01.01.01 EP 1 — use at least two patient identifiers (room number is not an identifier) before any treatment or procedure. National Patient Safety Goals (HAP); effective January 2025.
  17. 14cThe Joint Commission. NPSG.07.01.01 EP 1 — implement CDC and/or WHO hand-hygiene categories IA, IB, IC. National Patient Safety Goals (HAP); effective January 2025.
  18. 14dThe Joint Commission. Universal Protocol UP.01.02.01 — mark the procedure site; mark by the accountable licensed practitioner (APRN/PA delegation permitted per institutional policy); unambiguous, visible after prep & drape. National Patient Safety Goals (HAP); effective January 2025.
  19. 14eThe Joint Commission. NPSG.03.04.01 — label all medications, medication containers, and solutions on and off the sterile field (name, strength, amount, diluent, expiration). EP 4 requires two-individual verification when preparer ≠ administrator. National Patient Safety Goals (HAP); effective January 2025.
  20. 14fThe Joint Commission. NPSG.03.05.01 EP 3 — perioperative management of patients on oral anticoagulants per approved protocols and evidence-based guidelines (bridging, hold timing, restart). Pairs with the ASRA-PM 5th-edition antithrombotic guideline cited above. National Patient Safety Goals (HAP); effective January 2025.
  21. 14gThe Joint Commission. NPSG.06.01.01 — clinical alarm safety; clinically appropriate settings, authority to change parameters, monitoring/response, and periodic accuracy checks for high-risk alarms. National Patient Safety Goals (HAP); effective January 2025.
  22. 15CDC. Guideline for hand hygiene in health-care settings. MMWR Recomm Rep. 2002;51(RR-16):1–45.
  23. 16Cook Medical. Tuohy epidural needle instructions for use. 2024 · Integra LifeSciences. Lumbar drainage system IFU. 2024.
  24. 17UCI APP Class 2 Training Plan Process. Department of Neurology, University of California, Irvine. April 2026.
Lumbar Drain · References
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UUCI · APP Class II
Procedure 03 · Lumbar Drain
End of module · Procedure 03

Now —
the post-test.

Stream A
15-item post-test
≥ 12/15
Stream B
22-item skills
on task-trainer
Stream C
Sim center
HIGH-risk gate
Live
5 proctored cases
FPPE aggregate
Routing: IDPC → Credentials Committee → MEC → Board per UCI Medical Staff Bylaws.
Approving authority: Claire Henchcliffe, MD, DPhil · Chair, Department of Neurology.
UCI Health · APP Education
Version 2.0 · 2026-05-11
Lumbar Drain · End
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