Jul 21, 2016A CSF sample obtained by lumbar puncture from a healthy patient generally contains two cell types, that is, lymphocytes and monocytes. The ratio
Jul 21, 2016A CSF sample obtained by lumbar puncture from a healthy patient generally contains two cell types, that is, lymphocytes and monocytes. The
Jul 21, 2016CSF is usually collected by means of lumbar puncture between the third and fourth or between the fourth and fifth lumbar vertebrae. Where
Can a lumbar puncture show a lymphocytic predominance?
Repeat lumbar puncture after 12 to 24 hours, if performed, generally shows an evolution to a lymphocytic predominance.
CSF PCR for enteroviruses yields a diagnosis in up to 75 percent of patients with culture-negative aseptic meningitis8.
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Cause
While some cases of post-LP meningitis due to staphylococci, pseudomonas, and other gram-negative bacilli have been attributed to contaminated instruments or solutions or poor technique [37], other studies have suggested that post-LP meningitis could arise from aerosolized oropharyngeal secretions from personnel present during the procedure, especi.
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Contraindications
The techniques, indications, contraindications, and complications of LP in adults will be reviewed here.
Technique of LP in children and for spinal and other types of neuraxial anesthesia is discussed separately. (See \\"Lumbar puncture: Indications, contraindications, technique, and complications in children\\" and \\"Spinal anesthesia: Technique\\" a.
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Epidemiology
Meningitis is an uncommon complication of LP.
In a review of 179 cases of post-LP meningitis reported in the medical literature between 1952 and 2005, half of all cases occurred after spinal anesthesia; only 9 percent occurred after diagnostic LP.
The most commonly isolated causative organisms were Streptococcus salivarius (30 percent), Streptococc.
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Medical uses
Face masks should be used by individuals who place a catheter or inject material into the spinal canal as recommended by the Healthcare Infection Control Practices Advisory Committee and the Centers for Disease Control and Prevention (CDC) [14].
While routine use of face masks during diagnostic LP and neuroradiologic imaging procedures involving LP.
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Operation
Once CSF appears and begins to flow through the needle, the patient should be instructed to slowly straighten or extend the legs to allow free flow of CSF within the subarachnoid space.
While the pressure measurement is affected by the position of the legs, the available evidence suggests that the effect is likely to be small.
In one review, pressu.
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Research
An alternate approach to obtaining cerebrospinal fluid (CSF) with a paramedian needle insertion through the L5-S1 space (Taylor approach) (figure 1) has been successfully used in a patient with advanced ankylosing spondylitis [8].
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Results
No trials have shown that bed rest following LP significantly decreases the risk of post-LP headache compared with immediate mobilization [27,28]. (See \\"Post dural puncture headache\\", section on 'Prevention of PDPH after dural puncture'.)
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Treatment
When the LP is delayed or deferred in the setting of suspected bacterial meningitis, it is important to obtain blood cultures (which reveal the pathogen in more than half of patients) and promptly institute antibiotic therapy.
Urgent evaluation and treatment of increased ICP, along with the administration of antibiotics and steroids, should be inst.
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What is a lumbar puncture with examination of cerebrospinal fluid (CSF)?
INTRODUCTION Lumbar puncture (LP) with examination of cerebrospinal fluid (CSF) is an important diagnostic tool for a variety of infectious and noninfectious neurologic conditions.
The techniques, indications, contraindications, and complications of LP in adults will be reviewed here.
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What is cerebrospinal fluid cytology?
Abstract Cerebrospinal fluid (CSF) cytology, i.e., the cytologic evaluation of its cellular composition, forms an integral part of the neurologist's armamentarium.
Total and differential cell counts provide important first information across a spectrum of pathologic conditions involving the central nervous system and its coverings.
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Where is a lumbar puncture performed?
It's performed in your lower back, in the lumbar region.
During a lumbar puncture, a needle is inserted into the space between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid.
This is the fluid that surrounds your brain and spinal cord to protect them from injury.
Rare procedure to collect cerebrospinal fluid
A suboccipital puncture or cisternal puncture is a diagnostic procedure that can be performed in order to collect a sample of cerebrospinal fluid (CSF) for biochemical, microbiological, and cytological analysis, or rarely to relieve increased intracranial pressure.
It is done by inserting a needle through the skin below the external occipital protuberance into the cisterna magna and is an alternative to lumbar puncture.
Indications for its use are limited.
Subarachnoid hemorrhage and direct puncture of brain tissue are the most common major complications.
Fluoroscopic guidance decreases the risk for complications.
The use of this procedure in humans was first described by Ayer in 1920.
