This collaboration between the American Academy of Neurology (AAN) and the Child Neurology Society (CNS) represents a collection of reprinted cases from the past 15 years from the Neurology Resident & Fellow Section.
ICU-acquired delirium frequently complicates critical illness with the elderly and those with pre-existing neurocognitive disorders at greatest risk. Primary central nervous system (CNS) diseases frequently present similarly to ICUacquired delirium. Whether to perform lumbar puncture (LP) in all cases of diagnostic uncertainty remains unknown. Previous retrospective studies of hospitalized patients have shown that nosocomial meningitis is rare. In these cohorts, LP yield depended on indication and timing of the procedure and pretest probability of neurological disease processes. These studies are largely descriptive and are hampered by small sample sizes. The aims of this study were to establish the diagnostic yield of LP among the critically ill and to determine therapeutic efficacy i.e. how often management changed based on LP results.
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