Cerebrospinal fluid collection and its analysis in equine neurological disease

Schwarz, Benedikt; Piercy, Richard J.

doi:10.1111/j.2042-3292.2006.tb00456.x

Cited by 23 publications

(22 citation statements)

References 18 publications

(49 reference statements)

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“…Blood contamination is likely due to the perforation of the dura mater or residual blood on the bevel of the needle that occurred when the needle passed through the cervical musculature. Changing syringes after the initial 5 ml to help clear any initial blood contamination may help minimize the red blood cell count . In addition, minimizing the number of needle redirections during the procedure minimized the blood contamination in the sample.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound guidance has been described to help guide needle placement in the lumbosacral cistern in standing and recumbent horses to minimize the risk of blood contamination . Also, since it is a large distance from the cranial vault, the sample may not be as accurate as a centesis closer to the foramen magnum for cranial disease , . During lumbosacral centesis, it is possible for a violent reaction to occur in some horses.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound‐guided Cervical Centesis to Obtain Cerebrospinal Fluid in the Standing Horse

Pease

Behan

Bohart

2011

Vet Radiology Ultrasound

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Horses with intracranial lesions and severe ataxia are not good anesthesia candidates; however, only one method to obtain cerebrospinal fluid (CSF) from the cervical region in a standing horse has been reported. This method is not performed routinely due to the difficulty for sample acquisition. Our hypothesis is that standing cervical centesis can be performed in horses without complication. Ultrasound-guided centesis of the CSF between C1 and C2 in 11 clinically normal horses and two horses with neurologic signs were performed. Horses were sedated and ultrasound was used to identify the subarachnoid space and spinal cord between C1 and C2. With ultrasound guidance, a needle was introduced into the dorsal aspect of the subarachnoid space using a lateral approach. Ten milliliters of CSF was obtained and analyzed. Two normal horses in this study had moderate red blood cell contamination in the CSF (940 and 612 RBC/microl). One horse had 11 RBC/microl and the remaining horses had < 4 RBC/microl. The total procedure time was approximately 2 min. No reaction was observed and no complications were detected up to 48 h after the procedure. Ultrasound-guided centesis between C1 and C2 is a rapid procedure that causes minimal to no reaction in standing, sedated horses used in this study. The use of ultrasound to guide a standing C1-2 centesis of the subarachnoid space provides an additional route to obtain CSF for analysis in the equine patient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound‐guided Cervical Centesis to Obtain Cerebrospinal Fluid in the Standing Horse

Pease

Behan

Bohart

2011

Vet Radiology Ultrasound

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“…Blood contamination can limit the diagnostic usefulness of the sample, artifactually increasing the protein concentration and nucleated cell count in the sample, or giving false‐positive results when testing for equine protozoal myeloencephalitis (EPM) using Western blot analysis . Although LS centesis is the technique of choice in horses with suspected spinal cord lesions or multifocal disease, if intracranial disease is suspected it may be preferable to collect CSF from a location closer to the foramen magnum . Finally, penetration of the dura mater with the needle has been associated with violent reactions in some horses .…”

Section: Introductionmentioning

confidence: 99%

“…Until recently, the only alternative technique was atlanto‐occipital (AO) thecal puncture, which typically requires general anesthesia. This technique is simpler than LS centesis but does present a greater risk of iatrogenic trauma, particularly in horses with increased intracranial pressure . Recovery from general anesthesia presents a greater risk for horses that are weak or uncoordinated due to neurologic disease .…”

Section: Introductionmentioning

confidence: 99%

Comparison of 2 collection methods for cerebrospinal fluid analysis from standing, sedate adult horses

Chidlow

Giguère

Camus

et al. 2020

Veterinary Internal Medicne

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Background Cerebrospinal fluid (CSF) analysis is an important component of the evaluation of horses with neurologic disease. Lumbosacral (LS) centesis is routine, but CSF is also collected from the space between the first and second cervical vertebrae (C1‐C2). Objectives To compare collection times, CSF cytology results, and equine protozoal myelitis (EPM) titers of CSF collected from the C1‐C2 and LS sites. Animals Fifteen university‐owned adult horses with no evidence of neurologic disease, and 9 horses with signs of neurologic disease: 3 university‐owned and 6 client‐owned. Methods Prospective study. Cerebrospinal fluid collection from the LS space and C1‐C2 space of each horse was performed in randomized order. Continuous data were analyzed using mixed‐effects linear models and count data using mixed‐effects negative binomial regression. Statistical significance was set at P < .05. Results Cerebrospinal fluid collected from the C1‐C2 site had a significantly lower mean protein concentration (49 [95% CI: 43‐55.8] mg/dL C1‐C2 versus 52.1 [95% CI: 45.7‐59.3] mg/dL LS; P = .03) and red blood cell count (6 [95% CI: 2‐16] cells/μL versus 33 [95% CI: 13‐81] cells/μL; P = .02). Collection time, total nucleated cell count, EPM titers, and serum:CSF EPM titer ratios were not significantly different between collection sites. Conclusions and Clinical Importance Cerebrospinal fluid from the C1‐C2 space provides an acceptable alternative to LS CSF collection with decreased likelihood of clinically important blood contamination of samples.

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“…CSF puncture is commonly achieved in the lumbosacral (LS) cistern in the standing horse, or at the atlanto-occipital (AO) space in horses under general anaesthesia (Johnson and Constantinescu 2000). Due to the closer position of the AO site to the foramen magnum, collection of CSF in this area is more relevant for cranial disease evaluation, compared to the LS site (Johnson and Constantinescu 2000, Schwarz and Piercy 2006). In addition, these samples are reported to be less contaminated by blood (Mayhew 1975).…”

mentioning

confidence: 99%

Ultrasound‐guided atlanto‐occipital puncture for cerebrospinal fluid analysis on the standing horse

2014

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The atlanto-occipital site (AO) is convenient for retrieving an adequate volume and quality of cerebrospinal fluid (CSF) in the diagnosis of neurological disease in horses. However, general anaesthesia is not always possible for horses displaying severe neurological signs, or for economical reasons. The objectives of the present work were to determine the feasibility and safety of ultrasound-guided CSF puncture at the AO site on the standing horse. Seven horses (six healthy and one mildly ataxic) were sedated with acepromazine (0.02 mg/kg bodyweight intravenously or 0.04 mg/kg bodyweight intramuscularly) and detomidine (0.01 mg/kg bodyweight intravenously), and placed in stocks or in a recovery stall with the head kept on a headstand. Puncture was performed by ultrasonographic guidance with a parasagittal technique, as previously described, using a 20 g, 3.5 inch spinal needle. In all horses, no adverse reaction was observed when crossing the dura mater and 20 ml of CSF was rapidly retrieved without any blood contamination. Ultrasound-guided CSF puncture can be performed easily at the AO site on a healthy standing horse. Regarding the potential risk of this procedure, safety measures and close observation are essential. Further studies on a larger amount of ataxic horses are also required before considering this technique as an alternative option for CSF puncture.

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Cerebrospinal fluid collection and its analysis in equine neurological disease

Cited by 23 publications

References 18 publications

Ultrasound‐guided Cervical Centesis to Obtain Cerebrospinal Fluid in the Standing Horse

Ultrasound‐guided Cervical Centesis to Obtain Cerebrospinal Fluid in the Standing Horse

Comparison of 2 collection methods for cerebrospinal fluid analysis from standing, sedate adult horses

Ultrasound‐guided atlanto‐occipital puncture for cerebrospinal fluid analysis on the standing horse

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