961 results match your criteria LP Lumbar Puncture

Real-time ultrasound-guided lumbar puncture in the neonatal intensive care unit.

J Perinatol 2021 Jul 17. Epub 2021 Jul 17.

Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Objective: To determine the rates of traumatic lumbar puncture (LP) and overall success rates using the real-time ultrasound-guided technique when performed by a neonatal point-of-care ultrasound provider.

Study Design: Retrospective observational study of 17 infants in the neonatal intensive care unit who underwent a real-time ultrasound-guided LP between March 2015 and November 2016. Spearman's correlation was calculated. Read More

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Eliminating Lumbar Puncture for Low-Risk Febrile Infants: A Quality Improvement Initiative.

Pediatr Emerg Care 2021 Jul 6. Epub 2021 Jul 6.

From the Department of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, Pennsylvania, PA.

Background: Bacterial meningitis in low-risk febrile young infants (FYIs) aged >28 days has become increasingly rare. Routine performance of lumbar puncture (LP) in these infants is associated with adverse consequences and may be unnecessary. We modified our clinical practice guideline (CPG) to reduce the number of FYIs 29 to 56 days old who receive LP. Read More

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Evaluation of the signs and symptoms of pseudotumor cerebri syndrome in pediatric population.

Childs Nerv Syst 2021 Jul 14. Epub 2021 Jul 14.

Department of Pediatrics, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.

Purpose: Pseudotumor cerebri syndrome (PTC) is characterized by increased intracranial pressure without a space-occupying lesion and a normal cerebrospinal fluid (CSF) composition without evidence of CSF infection. In this study, we aimed to compare the symptoms, signs, and clinical characteristics of patients presenting with a preliminary diagnosis of pseudotumor cerebri syndrome (PTC) who were diagnosed and not diagnosed with PTC.

Method: We conducted a retrospective study of patients who were referred to our clinic with signs and symptoms of PTC. Read More

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Cognitive impairment in syphilis: Does treatment based on cerebrospinal fluid analysis improve outcome?

PLoS One 2021 13;16(7):e0254518. Epub 2021 Jul 13.

Department of Neurology, Division of Infectious Diseases, University of Washington, Seattle, Washington, United States of America.

Background: Individuals with previous syphilis may experience cognitive impairment. The goal of this study was to determine if those at high risk for laboratory-defined neurosyphilis are cognitively impaired, and whether treatment based on cerebrospinal fluid (CSF) findings results in better outcomes.

Methods: Participants had a new syphilis diagnosis, serum RPR titer ≥ 1:32 or peripheral blood CD4+ T cells ≤ 350/ul (in persons living with HIV) and did not endorse neurological symptoms. Read More

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Assessment of a Third Neonatal Lumbar Puncture Position by Ultrasound Measurement.

Acad Emerg Med 2021 Jul 10. Epub 2021 Jul 10.

UCLA, Department of Emergency Medicine, Los Angeles, California, USA.

Neonatal lumbar punctures (LPs) are most often performed when a baby younger than 30 days of age presents with a fever. The procedure can be challenging, even for experienced providers. The challenge is compounded when the patient is having respiratory or other issues such that they cannot tolerate a sitting or lateral decubitus position. Read More

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The patients' perspective on the burden of idiopathic intracranial hypertension.

J Headache Pain 2021 Jul 8;22(1):67. Epub 2021 Jul 8.

Department of Neurology, University Hospital Bonn, Venusberg-Campus, 1, 53127, Bonn, Germany.

Background: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure without evidence of a tumor or any other underlying cause. Headache and visual disturbances are frequent complaints of IIH patients, but little is known about other symptoms. In this study, we evaluated the patients' perspective on the burden of IIH. Read More

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Effect of Child Position on Pain Experience During Lumbar Puncture: A Prospective Pilot Study.

J Pediatr Hematol Oncol 2021 Jul 1. Epub 2021 Jul 1.

Department of Pediatric Hematology-Oncology, University Hospital of Archet-2 Department of Pedo-psychiatrist, University Hospital of Lenval, Nice, France.

Background: This study aimed to evaluate the impact of patient's position on pain and anxiety during lumbar puncture (LP).

Materials And Methods: A randomized controlled trial included children between 2 and 18 years old receiving at least 2 therapeutic LPs. They were randomly assigned to undergo lateral decubitus position or sitting position LP. Read More

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Safety and Success of Lumbar Puncture in Young Infants: A Prospective Observational Study.

Front Pediatr 2021 14;9:692652. Epub 2021 Jun 14.

Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy.

This study aims to evaluate safety and success rates of lumbar puncture (LP) and to identify factors associated with adverse events or failure of LP in infants. This two-center prospective observational study investigated infants younger than 90 days of age who underwent LP. Need for resuscitation oxygen desaturation (SpO < 90%), bradycardia and intraventricular hemorrhage were considered adverse events. Read More

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Backstabbed: routine lumbar puncture complicated by retroperitoneal hematoma and hemorrhagic shock.

Radiol Case Rep 2021 Aug 18;16(8):2295-2298. Epub 2021 Jun 18.

Department of Critical Care Medicine, St. Joseph's University Medical Center, 703 Main St., Paterson, NJ 07503.

Lumbar punctures (LPs) are commonly performed procedures, serving diagnostic and therapeutic purposes. They are generally safe, and serious, life-threatening complications are rare. We report a case of a patient who underwent an LP and subsequently developed shock. Read More

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Addison's Disease Presenting With Idiopathic Intracranial Hypertension in a Young Female.

Cureus 2021 May 23;13(5):e15195. Epub 2021 May 23.

Endocrinology and Diabetes, Western Sussex Hospitals National Health Service Foundation Trust, Worthing, GBR.

Addison's disease presenting with idiopathic intracranial hypertension (IIH) is rare but well reported in the literature. IIH has also been reported to occur with other endocrine conditions. We explore some interesting diagnostic and management challenges of a young female that presented with IIH and Addison's disease. Read More

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Lung Masses as a Presenting Sign of Disseminated Cryptococcus.

Cureus 2021 May 22;13(5):e15185. Epub 2021 May 22.

Internal Medicine, University of California Irvine, Orange, USA.

Cryptococcosis is an invasive fungal disease that most commonly affects immunocompromised individuals, typically causing pulmonary and central nervous system (CNS) symptoms. The fungus that causes cryptococcosis, is globally disseminated and often transmitted through bird droppings. The two most frequent and pertinent species responsible for clinical infections in humans include , which has been known to cause the majority of cryptococcosis globally until recently, during which has been identified and reported more frequently. Read More

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Sensorineural Hearing Loss and Tinnitus Characteristics in Patients With Idiopathic Intracranial Hypertension.

Otol Neurotol 2021 Jun 25. Epub 2021 Jun 25.

Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC.

Objectives: To characterize patterns of sensorineural hearing loss (SNHL) and tinnitus in patients with idiopathic intracranial hypertension (IIH).

Study Design: Retrospective chart review.

Setting: Tertiary referral center. Read More

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Association of semi-quantitative cryptococcal antigen results in plasma with subclinical cryptococcal meningitis and mortality among patients with advanced HIV disease.

Med Mycol 2021 Jun 25. Epub 2021 Jun 25.

National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.

Blood cryptococcal antigen (CrAg) titres > 160 are associated with concurrent subclinical cryptococcal meningitis (CM). When lumbar puncture (LP) is not immediately available in a CrAg screening programme, semi-quantitative CrAg assays may provide risk stratification for CM. Two semi-quantitative assays (SQ [Immuno-Mycologics, Norman, OK, USA] and CryptoPS [Biosynex, Strasbourg, France]) were evaluated against a qualitative lateral flow assay (LFA) using 194 plasma samples from a cohort of HIV-seropositive individuals with CD4 counts < 100 cells/µL. Read More

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Herpes Simplex Virus-2 Meningitis Masquerading as Pseudotumor Cerebri.

Cureus 2021 Jun 19;13(6):e15764. Epub 2021 Jun 19.

Internal Medicine, Northwestern Medicine McHenry Hospital, Metro Infectious Disease Consultants, McHenry, USA.

We report a case of a 27-year-old obese female presenting with headache, blurry and double vision. She was found to have bilateral papilledema by an ophthalmologist and sent to the emergency department (ED). Cerebrospinal fluid (CSF) analysis showed elevated opening pressure and lymphocytic pleocytosis. Read More

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Effect of lumbar puncture educational video on parental knowledge and self-reported intended practice.

Int J Pediatr Adolesc Med 2021 Jun 19;8(2):112-116. Epub 2020 Nov 19.

College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Lumbar puncture (LP) remains an essential diagnostic procedure for neurological and infectious diseases. However, it remains a source of anxiety to patients and families. This research aimed to assess the impact of a newly developed educational simplified video about LP, in the parents' native language, that is tailored to their social background and beliefs and to assess whether it can facilitate their consent for the procedure. Read More

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Tumefactive multiple sclerosis versus high-grade glioma: A diagnostic dilemma.

Surg Neurol Int 2021 3;12:199. Epub 2021 May 3.

Department of Neurosurgery, Westmead Hospital, Westmead, New South Wales, Australia.

Background: Tumefactive demyelinating lesions (TDLs) share similar clinical features and MRI characteristics with high-grade glioma (HGG). This study develops an approach to navigating this diagnostic dilemma, with significant treatment implications as the management of both entities is drastically different.

Methods: A retrospective analysis of 41 TDLs and 91 HGG with respect to demographics, presentation, and classical MRI characteristics was performed. Read More

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Paraneoplastic Cerebellar Degeneration (PCD) associated with PCA-1 antibodies in established cancer patients.

J Neurooncol 2021 Jul 2;153(3):441-446. Epub 2021 Jun 2.

Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0431, Houston, TX, 77030, USA.

Introduction: Paraneoplastic cerebellar degeneration (PCD) is a rare set of neurological disorders arising from tumor-associated autoimmunity against antigens within the cerebellum. Anti-Purkinje cell cytoplasmic antibody 1 (PCA-1), or anti-Yo, is the most commonly linked antibody and is classically associated with breast and ovarian cancers.

Methods: Medical records of patients at our institution who developed PCA-1 associated PCD were reviewed. Read More

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State-of-the-art of lumbar puncture and its place in the journey of patients with Alzheimer's disease.

Alzheimers Dement 2021 May 27. Epub 2021 May 27.

Eisai Inc., Neurology Business Group, Woodcliff Lake, New Jersey, USA.

Recent advances in developing disease-modifying therapies (DMT) for Alzheimer's disease (AD), and the recognition that AD pathophysiology emerges decades before clinical symptoms, necessitate a paradigm shift of health-care systems toward biomarker-guided early detection, diagnosis, and therapeutic decision-making. Appropriate incorporation of cerebrospinal fluid biomarker analysis in clinical practice is an essential step toward system readiness for accommodating the demand of AD diagnosis and proper use of DMTs-once they become available. However, the use of lumbar puncture (LP) in individuals with suspected neurodegenerative diseases such as AD is inconsistent, and the perception of its utility and safety differs considerably among medical specialties as well as among regions and countries. Read More

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Previous Syphilis Alters the Course of Subsequent Episodes of Syphilis.

Clin Infect Dis 2021 May 17. Epub 2021 May 17.

Medicine (Infectious Diseases), Seattle, WA, USA.

Background: The influence of previous syphilis on the course of a subsequent episode is unknown.

Methods: Individuals enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis were allowed to enroll in the study again with subsequent syphilis. For each participant, the index episode was defined as the most recent syphilis episode for which the study entry visit was performed within 30 days of the syphilis diagnosis date. Read More

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Leptomeningeal Carcinomatosis in Epithelial Ovarian Cancer: A Diagnostic Challenge.

Cureus 2021 Apr 12;13(4):e14440. Epub 2021 Apr 12.

Internal Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, McHenry, USA.

Leptomeningeal carcinomatosis (LCM), also known as neoplastic meningitis, is a rare entity. It is generally seen in solid tumors. Ovarian cancers can infrequently cause LCM. Read More

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Prevalence of Bacterial Meningitis Among Febrile Infants Aged 29-60 Days With Positive Urinalysis Results: A Systematic Review and Meta-analysis.

JAMA Netw Open 2021 May 3;4(5):e214544. Epub 2021 May 3.

Division of Pediatric Emergency Medicine, Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Importance: Fever in the first months of life remains one of the most common pediatric problems. Urinary tract infections are the most frequent serious bacterial infections in this population. All published guidelines and quality initiatives for febrile young infants recommend lumbar puncture (LP) and cerebrospinal fluid (CSF) testing on the basis of a positive urinalysis result to exclude bacterial meningitis as a cause. Read More

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Complications associated with intrathecal drug delivery in a paediatric patient with Niemann-Pick type C.

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Neurosurgery, Great Ormond Street Hospital for Children, London, UK.

We report on a male subject with a diagnosis of Niemann-Pick type C (NPC). He received an experimental medicinal product intrathecally initially via lumbar puncture (LP) and eventually via intrathecal drug delivery device. Shortly after implantation, the device catheter migrated outside of the intrathecal space and coiled subcutaneously. Read More

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Serial Tap Test of patients with idiopathic normal pressure hydrocephalus: impact on cognitive function and its meaning.

Fluids Barriers CNS 2021 May 6;18(1):22. Epub 2021 May 6.

Neurology Service, Internal Medicine Department, Hospital Clinics, Federal University of Paraná, Curitiba, Paraná, Brazil.

Background: Idiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, urinary incontinence and cognitive decline. Symptoms are potentially reversible and treatment is based on cerebrospinal fluid shunting. The tap test (TT) is used to identify patients that will benefit from surgery. Read More

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Cerebrospinal fluid hemoglobin levels as markers of blood contamination: relevance for α-synuclein measurement.

Clin Chem Lab Med 2021 May 6. Epub 2021 May 6.

Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.

Objectives: Cerebrospinal fluid α-synuclein (CSF α-syn) represents a possible biomarker in Parkinson's disease (PD) diagnosis. CSF blood contamination can introduce a bias in α-syn measurement. To date, CSF samples with a red blood cells (RBC) count >50 RBC × 10/L or haemoglobin (Hb) concentration >200 μg/L are excluded from biomarker studies. Read More

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Has the introduction of an advanced practitioner led service had an impact on radiation dose for fluoroscopy guided lumbar punctures? A service review.

P Crosthwaite

Radiography (Lond) 2021 Apr 28. Epub 2021 Apr 28.

The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK. Electronic address:

Introduction: Historically, procedures requiring fluoroscopic guidance such as myelography; barium and video swallows; and fluoroscopy guided lumbar punctures (LP) have been performed by radiologists with the assistance of radiographers. As the National Health Service (NHS) evolves, more responsibilities are being disseminated to specifically trained radiographers to relieve workload due to a national shortage of radiologists. One step taken by the trust was to train an Advanced Practitioner (AP) in fluoroscopy to perform fluoroscopy guided LPs. Read More

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Eutectic Mixture of Lidocaine and Prilocaine Decreases Movement and Propofol Requirements for Pediatric Lumbar Puncture During Deep Sedation: A Randomized, Placebo-Controlled, Double Blind Trial.

J Pediatr Hematol Oncol 2021 Apr 21. Epub 2021 Apr 21.

Departments of Anesthesiology Pediatrics Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Deep sedation/general anesthesia is commonly used in pediatric oncology patients undergoing lumbar puncture (LP). Propofol is often used for sedation, with or without a narcotic. We hypothesized that eutectic mixture of lidocaine and prilocaine (EMLA) would allow for lower cumulative doses of propofol and less movement. Read More

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Spasm of the near reflex: a common diagnostic dilemma?

Int J Ophthalmol 2021 18;14(4):541-546. Epub 2021 Apr 18.

Department of Ophthalmology, University Hospital of Larissa, Larissa 41222, Greece.

Aim: To report the clinical characteristics and diagnostic procedures used in patients with spasm of the near reflex (SNR), in order to present common investigation strategies and diagnostic pitfalls.

Methods: Retrospective case series of twenty-two patients, mainly children, with SNR or accommodation spasm (AS). AS was diagnosed on the basis of blurred vision and a difference of ≥2 dioptres between manifest and cycloplegic retinoscopy. Read More

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Use of Alzheimer's Disease Cerebrospinal Fluid Biomarkers in A Tertiary Care Memory Clinic.

Can J Neurol Sci 2021 Apr 13:1-7. Epub 2021 Apr 13.

Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, QC, Canada.

Introduction: Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers are promising tools to help identify the underlying pathology of neurocognitive disorders. In this manuscript, we report our experience with AD CSF biomarkers in 262 consecutive patients in a tertiary care memory clinic.

Methods: We retrospectively reviewed 262 consecutive patients who underwent lumbar puncture (LP) and CSF measurement of AD biomarkers (Aβ1-42, total tau or t-tau, and p-tau181). Read More

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Noninvasive Intracranial Pressure Assessment in Patients with Suspected Idiopathic Intracranial Hypertension.

Acta Neurochir Suppl 2021 ;131:325-327

Department of Neurology, Chemnitz Medical Centre, Chemnitz, Germany.

Introduction: Idiopathic intracranial hypertension (IIH) usually occurs in obese women of childbearing age. Typical symptoms are headache and sight disorders. Besides ophthalmoscopy, lumbar puncture is used for both diagnosis and therapy of IIH. Read More

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