Introduction: Evaluation of the cerebrospinal fluid (CSF) white blood cell (WBC) count and glucose and protein concentrations is used to assess the probability of the presence of central nervous system (CNS) infection. Although normal values are well established for CSF cell counts and protein and glucose contents in children and adults, this is not the case for neonates. The purpose of this st...

Hospital Physician June 2007 51 Lumbar puncture is a common procedure performed for diagnostic, anesthetic, and obstetric purposes; however, up to one third of patients may experience headache after the procedure.1,2 In 1898, Bier was the first to report on post–lumbar puncture headache (PLPH) after he and his associates underwent lumbar puncture themselves and experienced headaches first-hand....

Myelography of the entire spinal cord was performed in 64 consecutive patients using metrizamide via lumbar puncture. Adequate to good opacification of the cervical and thoracic subarachnoid space was obtained in 63 patients. The technical factors responsible for this success rate are patient cooperation, high iodine concentration, high iodine concentration (250 mg/ml), slow injection rate, del...

Post lumber puncture headache (PLPH) has been a problem for patients, following dural puncture. Headache after lumbar puncture is a common occurrence (32%) and carries a considerable morbidity, with symptoms lasting for several days, at times severe enough to immobilize the patient. If untreated, it can result in serious complications such as subdural haematoma and seizures, which could be fata...

Lumbar puncture is performed routinely for diagnostic and therapeutic purposes in idiopathic intracranial hypertension, despite lumbar puncture being classically contraindicated in the setting of raised intracranial pressure. We report the case of a 30-year-old female with known idiopathic intracranial hypertension who had cerebellar tonsillar herniation following therapeutic lumbar puncture. M...

CLINICAL QUESTION How many patients who had a negative computed tomography and lumbar puncture result on initial evaluation were diagnosed with subarachnoid hemorrhage in the subsequent 6 months to 3 years? ARTICLE CHOSEN Perry J, Spacek A, Forbes M, et al. Is the combination of negative computed tomography result and negative lumbar puncture result sufficient to rule out subarachnoid hemorrh...

BACKGROUND The use of the lumbar puncture in the diagnosis of central nervous system infection in acutely ill children is controversial. Recommendations have been published but it is unclear whether they are being followed. METHODS The medical case notes of 415 acute medical admissions in a children's hospital were examined to identify children with suspected central nervous system infection ...

Papilloedema is not always an adequate predictor of potential complications from lumbar puncture, and many clinicians are using computed tomography (CT) before lumbar puncture in an effort to identify more accurately the "at risk" patient. This paper identifies the following anatomical criteria defined by CT scanning that correlate with unequal pressures between intracranial compartments and pr...

Background. The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP) or previously performed lumbar puncture (LP). Case Summery. We report a 29-year-old Indian female who presented with a clinically isolated spinal cord syndrome according to the revi...