Spinal Puncture and Cerebrospinal Fluid Examination

Euerle, Brian D.

doi:10.1016/b978-1-4160-3623-4.00061-4

Cited by 10 publications

(13 citation statements)

References 132 publications

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“…Almost twothirds (64%) record the OP when the CSF meniscus stops rising as opposed to the traditional, and likely more accurate, teaching of OP measurement when systolic-diastolic or respi- ratory fluctuation begins. 2 This may result in falsely high or low opening pressure measurements.…”

Section: Discussionmentioning

confidence: 99%

Practice Patterns and Opening Pressure Measurements Using Fluoroscopically Guided Lumbar Puncture

Abel

Brace

McKinney³

et al. 2012

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Practice Patterns and Opening Pressure Measurements Using Fluoroscopically Guided Lumbar Puncture

Abel

Brace

McKinney³

et al. 2012

AJNR Am J Neuroradiol

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“…Opening pressure measured sitting upright, however, may be falsely elevated and is not commonly practiced. 17 New diagnostic criteria propose the removal of this requirement and favour using a low opening pressure , 60 mm H 2 O regardless of position. 16 Despite having low or even negative CSF pressures (that create a suction effect when entering the dural space), there have been no reported cases of herniation, and suspected or confirmed low CSF pressure headache is not a contraindication to LP.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous low cerebrospinal fluid pressure headache: an emergency medicine perspective

Ahn

Akincioğlu²,

Gulka³

et al. 2013

CJEM

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Spontaneous low cerebrospinal fluid pressure headaches are a rare but treatable cause of debilitating headaches. The condition is characterized by a postural headache in the absence of any recent spinal procedures and is exacerbated when upright and relieved when supine. Diagnosis and treatment are often delayed, however, due to a lack of recognition and awareness, as illustrated by this case report of a patient who had multiple emergency department visits before further investigations were sought. RÉ SUMÉUne diminution spontané e de la pression du liquide cé phalorachidien est une cause rare mais soignable de cé phalé es dé bilitantes. L'affection se caracté rise par des cé phalé es orthostatiques, en l'absence de toute intervention rachidienne ré cente, qui s'intensifient en position debout et s'atté nuent en position couché e. La pose du diagnostic et la mise en route du traitement sont souvent retardé es en raison d'un manque de reconnaissance de l'affection et de prise de conscience de son existence, comme en té moigne le pré sent exposé de cas d'une patiente qui a consulté à plusieurs reprises au service des urgences avant que ne soit entreprise une exploration approfondie.

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“… Ask the patient to ‘Arch your back like an angry cat.’ Patients understand this simple description. Neck flexion should be avoided in all age groups as it does not add value and increases patient discomfort For young children continuous pulse‐oximetry during LP is recommended, as the hyper‐flexed position might compromise ventilation …”

Section: Any Tips To Optimise the Patient Position?mentioning

confidence: 99%

“… Ensure the patient is relaxed and legs straightened slightly so as to avoid abdominal compression Measure the CSF meniscus when it stops rising and begins to swing with respiration or arterial pulsations, confirming the needle is free in the subarachnoid space Use the fluid collected in the manometer to fill the first tube. Opening pressure measurement is inaccurate in a crying or struggling child, and is not commonly attempted in infants and young children …”

Section: Any Tips For Measuring Opening Pressure?mentioning

confidence: 99%