38 results match your criteria Bedside Ultrasonography Lumbar Puncture

Vertebral level identified by the intercristal line: Confirmation by ultrasound.

Eur J Intern Med 2021 04 22;86:118-120. Epub 2021 Jan 22.

Division of General Internal Medicine, Department of Medicine, University of Calgary Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada; W21C, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada; Division of Emergency Ultrasound, Department of Emergency Medicine, Massachusetts General Hospital, United States. Electronic address:

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Optic nerve sheath diameter ultrasonography for elevated intracranial pressure detection.

Ann Clin Transl Neurol 2020 05 7;7(5):865-868. Epub 2020 May 7.

Department of Neurology, The First Hospital of Jilin University, Changchun, China.

Ultrasonographically measured optic nerve sheath diameter measurement has become a common noninvasive approach for detecting elevated intracranial pressure. We present a case of aneurysmal subarachnoid hemorrhage with elevated intracranial pressure. Postoperative arachnoiditis developed, and lumbar puncture revealed low intracranial pressure. Read More

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Efficacy of three-dimensional rotational fluoroscopic unit guidance for lumbar cerebrospinal fluid drainage among patients with unsuccessful initial attempt at bedside.

Interv Neuroradiol 2019 Jun 4;25(3):357-360. Epub 2019 Feb 4.

2 Department of Neurosurgery, Aichi Medical University, Nagakute, Japan.

Lumbar cerebrospinal fluid drainage has been widely performed in patients at the bedside; however, technical failure can occasionally occur as a result of blind maneuvering. Herein, we present the use of rotational fluoroscopic unit-guided lumbar drainage for patients with an unsuccessful initial attempt at bedside. In four of the 24 patients with aneurysmal subarachnoid hemorrhage, initial lumbar drainage could not be performed at bedside. Read More

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Better With Ultrasound: Lumbar Puncture.

Chest 2018 11 20;154(5):1223-1229. Epub 2018 Jul 20.

Hofstra North Shore-LIJ School of Medicine, Hempstead, NY.

The performance of a lumbar puncture is generally associated with a high rate of success and a favorable risk profile. Nonetheless, the use of ultrasound for procedural guidance has been demonstrated to reduce the rate of failure and the risk of specific complications, especially in patients with difficult surface anatomy. Many individual ultrasound techniques have been described in the literature; this article presents a systematic approach for incorporating these tools into bedside practice and includes a series of illustrative figures and narrated video presentations to demonstrate the techniques described. Read More

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November 2018

Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: The cut-off points.

Neuroradiol J 2018 Oct 19;31(5):490-495. Epub 2018 Jul 19.

3 Human physiology Department, Faculty of Medicine, Cairo University, Egypt.

Purpose Monitoring of raised intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH) is required to prevent secondary optic nerve damage. Sonographic measurement of the optic nerve sheath diameter (ONSD) is a noninvasive method to evaluate intracranial hypertension. Different ONSD cut-off values have been reported probably due to ethnic variations. Read More

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October 2018

Point-of-Care Ultrasound in Established Settings.

South Med J 2018 07;111(7):373-381

From the Departments of Emergency Medicine and Internal Medicine, Greenville Health System, University of South Carolina School of Medicine, Greenville, the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of South Carolina School of Medicine, Columbia, and the Department of Medicine, Division of General and Hospital Medicine, University of Texas Health, San Antonio.

The original and most widely accepted applications for point-of-care ultrasound (POCUS) are in the settings of trauma, shock, and bedside procedures. Trauma was the original setting for the introduction of POCUS and has been standardized under the four-plus view examination called the Focused Assessment with Sonography in Trauma (FAST). This examination was found to be especially practice changing for achieving rapid diagnoses in critically ill patients who are too unstable for the delays and transportation inherent in more advanced imaging with computed tomography. Read More

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Point-of-Care Ultrasound in the Intensive Care Unit.

Clin Chest Med 2018 03;39(1):79-97

Section of Interventional Pulmonology, Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, 201 DHLRI, 473 West 12th Avenue, Columbus, OH 43210, USA. Electronic address:

Spreading beyond the realm of tertiary academic medical centers, point-of-care ultrasound in the intensive care unit is an important diagnostic tool. The real-time feedback garnered can lead to critical and clinically relevant changes in management and decrease potential complications. Bedside ultrasound evaluation in the intensive care setting with a small, portable equipment is well-suited for placement of central lines, lumbar puncture, thoracentesis or other bedside ICU procedures and in the evaluation of cardiac activity, pleural and abdominal cavity and the overall fluid volume. Read More

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Credentialing of Hospitalists in Ultrasound-Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine.

J Hosp Med 2018 02 18;13(2):117-125. Epub 2018 Jan 18.

Division of General & Hospital Medicine, The University of Texas School of Medicine at San Antonio, San Antonio, Texas, USA.

Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing. Read More

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February 2018

Bedside Ultrasound for the Evaluation of Epidural Hematoma After Infant Lumbar Puncture.

Pediatr Emerg Care 2020 Sep;36(9):e508-e512

Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO.

Background: Unsuccessful lumbar puncture (LP) attempts may lead to epidural hematoma (EH) formation within the spinal canal at the site of needle insertion, which can affect subsequent attempts. We aimed to determine the rate of EH formation after infant LP using bedside ultrasound (US). Furthermore, we aimed to correlate both perceived trauma during LP and cerebral spinal fluid (CSF) red blood cell (RBC) counts with EH formation. Read More

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September 2020

[A selection of advances in neuromuscular medicine].

Ther Umsch 2018 ;75(7):458-464

2 Neurologische Klinik, Inselspital Bern.

A selection of advances in neuromuscular medicine Abstract. Significant developments in the realm of neuromuscular medicine have occurred in both non-invasive diagnostics as well as treatments. Whole body muscle MRI can detect disease specific patterns and lead to the implementation of direct molecular genetic diagnostics. Read More

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Lumbar Spine Anatomy in Women Sustaining Unintentional Dural Puncture During Labor Epidural Placement: A Descriptive Study Using Magnetic Resonance Imaging and Ultrasound.

Reg Anesth Pain Med 2018 Jan;43(1):92-96

Background And Objectives: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia. Read More

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January 2018

Bedside ultrasound improves the success rate of lumbar puncture in infants.

Arch Dis Child Educ Pract Ed 2018 04 27;103(2):111-112. Epub 2017 Jul 27.

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Noninvasive and quantitative intracranial pressure estimation using ultrasonographic measurement of optic nerve sheath diameter.

Sci Rep 2017 02 7;7:42063. Epub 2017 Feb 7.

Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.

We aimed to quantitatively assess intracranial pressure (ICP) using optic nerve sheath diameter (ONSD) measurements. We recruited 316 neurology patients in whom ultrasonographic ONSD was measured before lumbar puncture. They were randomly divided into a modeling and a test group at a ratio of 7:3. Read More

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February 2017

How to do it: bedside ultrasound to assist lumbar puncture.

Pract Neurol 2017 Jan 28;17(1):47-50. Epub 2016 Nov 28.

Department of Neurology, Harrogate and District NHS Foundation Trust, Harrogate, UK.

For many neurologists, lumbar puncture is the only practical procedure that they undertake on a regular basis. Although anaesthetists and emergency physicians routinely employ ultrasound to assist lumbar puncture, neurologists do not. In this article, we outline the technique that we use for an ultrasound-assisted lumbar puncture, together with the evidence base that suggests that ultrasound has significant benefits. Read More

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January 2017

The Effect of Bedside Ultrasonographic Skin Marking on Infant Lumbar Puncture Success: A Randomized Controlled Trial.

Ann Emerg Med 2017 May 14;69(5):610-619.e1. Epub 2016 Nov 14.

Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.

Study Objective: Lumbar puncture is a commonly performed procedure, although previous studies have documented low rates of successful completion in infants. Ultrasonography can visualize the anatomic landmarks for lumbar puncture and has been shown in some studies to reduce the failure rate of lumbar puncture in adults. We seek to determine whether ultrasonography-assisted site marking increases success for infant lumbar punctures. Read More

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Voltage-gated potassium channel antibody limbic encephalitis: a case illustrating the neuropsychiatric and PET/CT features with clinical and imaging follow-up.

Australas Psychiatry 2016 Dec 2;24(6):538-540. Epub 2016 Sep 2.

Neurologist, Fiona Stanley Hospital, Perth, WA, Australia.

Objective: To illustrate the neuropsychiatric and imaging findings in a confirmed case of voltage-gated potassium channel antibody limbic encephalitis.

Method: Case report and review of the literature.

Results: A 64-year-old man presented with several months' history of obsessive thoughts and compulsions associated with faciobrachial dystonic seizures. Read More

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December 2016

Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?

J Clin Monit Comput 2017 Apr 14;31(2):459-467. Epub 2016 Mar 14.

Department Radiation Sciences - Biomedical Engineering, Umeå University, Umeå, Sweden.

Measurement of intracranial pressure (ICP) is necessary in many neurological and neurosurgical diseases. To avoid lumbar puncture or intracranial ICP probes, non-invasive ICP techniques are becoming popular. A recently developed technology uses two-depth Doppler to compare arterial pulsations in the intra- and extra-cranial segments of the ophthalmic artery for non-invasive estimation of ICP. Read More

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Bedside Optic Nerve Sheath Diameter Assessment in the Identification of Increased Intracranial Pressure in Suspected Idiopathic Intracranial Hypertension.

Pediatr Neurol 2016 Jan 28;54:35-8. Epub 2015 Aug 28.

Department of Pediatrics, University of Florida, Division of Pediatric Critical Care, Jacksonville, Florida.

Objective: We determined whether the bedside assessment of the optic nerve sheath diameter could identify elevated intracranial pressure in individuals with suspected idiopathic intracranial hypertension.

Methods: This was a single-center, prospective, rater-blinded study performed in a freestanding pediatric teaching hospital. Patients aged 12 to 18 years scheduled for an elective lumbar puncture with the suspicion of idiopathic intracranial hypertension were eligible to participate. Read More

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January 2016

Fluoroscopy-Guided Lumbar Drainage of Cerebrospinal Fluid for Patients in Whom a Blind Beside Approach Is Difficult.

Korean J Radiol 2015 Jul-Aug;16(4):860-5. Epub 2015 Jul 1.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.

Objective: To evaluate the rates of technical success, clinical success, and complications of fluoroscopy-guided lumbar cerebrospinal fluid drainage.

Materials And Methods: This retrospective study was approved by the Institutional Review Board of our hospital, and informed consent was waived. Ninety-six procedures on 60 consecutive patients performed July 2008 to December 2013 were evaluated. Read More

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February 2016

Can sonographic measurement of optic nerve sheath diameter be used to detect raised intracranial pressure in patients with tuberculous meningitis? A prospective observational study.

Indian J Radiol Imaging 2015 Apr-Jun;25(2):173-6

Department of Emergency Medicine, BJ Medical College, Civil Hospital, Ahmedabad, Gujarat, India.

Unlabelled: CNS Tuberculosis can manifest as meningitis, arachnoiditis and a tuberculoma. The rupture of a tubercle into the subarachnoid space leads to Tuberculosis Meningitis (TBME); the resulting hypersensitivity reaction can lead to an elevation of the intracranial pressure and hydrocephalus. While bedside optic nerve sheath diameter (ONSD) ultrasonography (USG) can be a sensitive screening test for elevated intracranial pressure in adult head injury, little is known regarding ONSD measurements in Tuberculosis Meningitis. Read More

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Simulation-based educational curriculum for fluoroscopically guided lumbar puncture improves operator confidence and reduces patient dose.

Acad Radiol 2015 May;22(5):668-73

Department of Radiology, University of Tennessee Graduate School of Medicine, 1924 Alcoa Hwy, UTMC Nuclear Medicine, Knoxville, TN 37920; Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee. Electronic address:

Rationale And Objectives: Fluoroscopically guided lumbar puncture (FGLP) is a commonly performed procedure with increased success rates relative to bedside technique. However, FGLP also exposes both patient and staff to ionizing radiation. The purpose of this study was to determine if the use of a simulation-based FGLP training program using an original, inexpensive lumbar spine phantom could improve operator confidence and efficiency, while also reducing patient dose. Read More

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Transcranial ultrasound to detect elevated intracranial pressure: comparison of septum pellucidum undulations and optic nerve sheath diameter.

Ultrasound Med Biol 2015 May 28;41(5):1233-40. Epub 2015 Jan 28.

Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany. Electronic address:

Two ultrasound tests that can be used to assess increased intracranial pressure (ICP) at the bedside are described. In outpatients receiving lumbar puncture and in intensive care patients with invasive ICP monitoring, we measured the optic nerve sheath diameter (ONSD) with transbulbar B-mode sonography and septum pellucidum undulation (SPU) induced by repeated passive head rotation with transtemporal M-mode sonography. We assessed the sensitivity and specificity of ONSD and SPU in the prediction of ICP >20 cm H2O. Read More

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Real-time optic nerve sheath diameter reduction measured with bedside ultrasound after therapeutic lumbar puncture in a patient with idiopathic intracranial hypertension.

Am J Emerg Med 2015 Jun 19;33(6):860.e5-7. Epub 2014 Dec 19.

Department of Emergency Medicine at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Idiopathic intracranial hypertension (IIH), also referred to as pseudotumor cerebri, is a condition of raised intracranial pressure (ICP) with unknown etiology. Sonographic measurement of optic nerve sheath diameter (ONSD) has been shown to be a reliable, noninvasive method to characterize elevated ICP in a variety of settings. However, little is known about the immediate response of ONSD to an acute reduction in ICP after lumbar puncture. Read More

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The role of bedside ultrasound in pretherapeutic and posttherapeutic lumbar puncture in patient with idiopathic intracranial hypertension.

Am J Emerg Med 2014 Oct 26;32(10):1298.e3-4. Epub 2014 Mar 26.

NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY.

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is often a debilitating condition characterized by headaches, blurry vision, nausea, and vomiting. Lumbar puncture (LP) is an essential component of the diagnostic and therapeutic approach; however, the procedure itself can cause postlumbar puncture headache. In addition to the clinical presentation, the use of bedside ultrasound to measure the optic nerve sheath diameter may aid in differentiating the 2 conditions. Read More

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October 2014

Advanced ultrasound procedures.

Crit Care Clin 2014 Apr 4;30(2):305-29, vi. Epub 2013 Dec 4.

EM Residency Program, Department of Emergency Medicine, Maricopa Medical Center, University of Arizona College of Medicine-Phoenix, 2601 East Roosevelt Street, Phoenix, AZ 85008, USA.

Ultrasound guidance has become the standard of care for many bedside procedures, owing to its portability, ease of use, and significant reduction in complications. This article serves as an introduction to the use of ultrasonography in several advanced procedures, including pericardiocentesis, thoracentesis, paracentesis, lumbar puncture, regional anesthesia, and peritonsillar abscess drainage. Read More

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Usefulness of transcranial Doppler-derived cerebral hemodynamic parameters in the noninvasive assessment of intracranial pressure.

J Neuroimaging 2015 Jan-Feb;25(1):111-6. Epub 2014 Mar 5.

Division of Neurology, National University Health System, Singapore.

Background: Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside tool that can evaluate cerebral blood flow hemodynamics in major intracranial arteries. TCD-derived pulsatility index (PI) is believed to be influenced by intracranial pressure (ICP).

Objective: To correlate TCD-PI with cerebrospinal fluid (CSF) pressure (representing ICP), measured by standard lumbar puncture (LP) manometry. Read More

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September 2015

Ultrasound-guided procedures in the emergency department-diagnostic and therapeutic asset.

Emerg Med Clin North Am 2013 Feb;31(1):117-49

Department of Emergency Medicine, Florida Hospital-East Orlando, 7727 Lake Underhill Road, Orlando, FL 32822, USA.

Bedside ultrasound is an extremely valuable and rapidly accessible diagnostic and therapeutic modality in potentially life- and limb-threatening situations in the emergency department. In this report, the authors discuss the role of ultrasound in quick assessment of pathologic conditions and its use to aid in diagnostic and therapeutic interventions. Read More

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February 2013

Bedside ultrasound education in pediatric emergency medicine fellowship programs in the United States.

Pediatr Emerg Care 2012 Sep;28(9):845-50

Division of Emergency Medicine, Children's National Medical Center, Washington, DC, USA.

Objectives: As the use of bedside ultrasound becomes more prevalent in pediatric emergency departments, the need for a national curriculum for fellows' training in pediatric emergency medicine (PEM) has increased. The objectives of this study were to describe the current state of bedside ultrasound education among existing PEM fellowship programs and to explore the interest in a national curriculum.

Methods: A 20-question survey was sent to all 57 PEM fellowship directors in the United States in February 2011. Read More

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September 2012

Positioning of infants in the neonatal intensive care unit for lumbar puncture as determined by bedside ultrasonography.

Arch Dis Child Fetal Neonatal Ed 2013 Mar 9;98(2):F133-5. Epub 2012 Jun 9.

Department of Paediatrics and Child Health, Kocaeli University Faculty of Medicine, Umuttepe Yerleskesi, Izmit, Kocaeli, 41380, Turkey.

Realising the paucity of data in the standardisation of the optimal position for lumbar puncture (LP) in hospitalised neonates, we have designed an observational study to measure the interspinous distance in infants in a university hospital setting. The infants were placed in two lateral recumbent and two upright positions (lateral recumbent without flexing the hips, lateral recumbent with maximal hip flexion, sitting without flexing the hips and sitting with maximal hip flexion) with concomitant heart rate (HR), transcutaneous oxygen saturation (OS) and interspinous distance (with ultrasonography) measurements. Having the patient sit with maximal hip flexion provided the largest interspinous space for the grand majority of the infants. Read More

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The lumbar sedimentation sign: spinal MRI findings in patients with subarachnoid haemorrhage with no demonstrable intracranial aneurysm.

Br J Radiol 2011 Mar;84(999):279-81

Department of Neuroradiology, Derriford Hospital, Plymouth Hospitals NHS trust, Plymouth, Devon.

We present a new MRI finding within the lumbar spine in a series of six patients admitted with CT proven subarachnoid haemorrhage (SAH) where cerebral angiography demonstrated no aneurysm and who had not had a lumbar puncture. A retrospective audit of 130 patients presenting to a regional neurosciences centre over a 13 month period with a suspected diagnosis of SAH was performed. Seven patients with proven SAH underwent MRI of the lumbar spine during the same admission. Read More

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