1,057 results match your criteria LP Lumbar Puncture

Interpretation of white blood cell counts in the cerebrospinal fluid of neonates with traumatic lumbar puncture: a retrospective cohort study.

BMC Pediatr 2022 Aug 16;22(1):488. Epub 2022 Aug 16.

Department of Clinical Analysis Laboratory, Hospital Universitario Nuestra Señora de Candelaria, Carretera General del Rosario 145, 38010, Santa Cruz de Tenerife, Spain.

Background: Difficulty in interpreting white blood cell (WBC) counts in cerebrospinal fluid (CSF) complicates the diagnosis of neonatal meningitis in traumatic lumbar punctures (LP). The aim of our study was to determine the correction factor for WBC counts in traumatic LP that offers the greatest diagnostic efficacy in meningitis.

Methods: We conducted a retrospective observational study of LP in neonates between January 2014 and December 2020. Read More

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T2-Sampling Perfection With Application-Optimized Contrasts by Using Flip Angle Evolution (SPACE) Protocol MRI: A Safe, Minimally Invasive Screening Tool for Spinal CSF Leak Causing Spontaneous Intracranial Hypotension.

Cureus 2022 Jul 7;14(7):e26626. Epub 2022 Jul 7.

Neurology/Headache, University of Arkansas for Medical Sciences (UAMS), Little Rock, USA.

Spontaneous intracranial hypotension (SIH) due to a spinal cerebrospinal fluid (CSF) leak is secondary cause of headache with potentially devastating consequences. Its diagnosis is complicated owing to the lack of a reasonable, minimally invasive screening test. This results in many patients remaining undiagnosed for years after the headache onset. Read More

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Acute Enophthalmos After Lumbar Puncture in a Patient with Type 1 Neurofibromatosis Related Sphenoid Wing Dysplasia.

Neuroophthalmology 2022 15;46(4):270-274. Epub 2022 Feb 15.

Department of Ophthalmology, Ascension Macomb-Oakland Hospital, Warren, Michigan, USA.

A 19-year-old woman with type 1 neurofibromatosis related sphenoid wing dysplasia underwent a lumbar puncture (LP) after an unexplained syncopal event. The cerebrospinal fluid work-up was unremarkable. However, 30-hours post LP, she developed marked enophthalmos ipsilateral to the calvarial dysplasia. Read More

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February 2022

The need for an institution-specific normal pressure hydrocephalus management protocol.

Surg Neurol Int 2022 3;13:236. Epub 2022 Jun 3.

Department of Neurosurgery, Princess Alexandra Hospital, Brisbane, Australia.

Background: Despite the publication of international guidelines, the management of normal pressure hydrocephalus (NPH) varies due to clinician preference and varying clinical evidence. An audit was performed to review the current pathways used in clinical practice with the aim of formulating an institution-specific protocol to optimize and standardize care.

Methods: An internal audit was performed on the management of patients with NPH who presented to the Princess Alexandra Hospital, Brisbane between January 2016 and February 2019. Read More

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Isolated recurrence of acute myeloid leukemia in the cerebellum: illustrative case.

J Neurosurg Case Lessons 2021 Aug 23;2(8):CASE21281. Epub 2021 Aug 23.

Department of Neurosurgery, Dell Medical School, The University of Texas at Austin, Austin, Texas; and.

Background: Myeloid sarcoma is a rare malignant hematopoietic neoplasm that arises at extramedullary sites. Although myeloid sarcoma may involve any organ, central nervous system (CNS) involvement is exceptionally rare. To date, few case reports and case series have described CNS myeloid sarcoma, the majority of which include peripheral disease. Read More

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Post-dural puncture headache: a prospective study on incidence, risk factors, and clinical characterization of 285 consecutive procedures.

BMC Neurol 2022 Jul 14;22(1):261. Epub 2022 Jul 14.

Department of Neurology, Ibn Sina Hospital, Kuwait City, Kuwait.

Background: Lumbar puncture (LP) is a common and relatively safe neurological procedure. It can be complicated by post-dural puncture headache (PDPH) after both diagnostic and therapeutic procedures. The aim of this study is to identify the incidence, risk factors and clinical characterization of PDPH in the inpatient setting of the main tertiary neurology hospital in Kuwait. Read More

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Neuro-Behcet's syndrome: Case report and literature review.

Radiol Case Rep 2022 Sep 21;17(9):3064-3070. Epub 2022 Jun 21.

Department of Radiology, Detroit Medical Center, Detroit, MI, USA.

Behcet's disease (BD) is a multisystem, autoimmune vasculitis disorder affecting small, medium, and large blood vessels, with poorly understood pathogenesis. It commonly presents with recurrent aphthous ulcers, genital ulcers, skin lesions, and bilateral uveitis. Neurological symptoms are present in less than 10% of cases and develop, on average, 5-6 years after the first non-neurological symptoms. Read More

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September 2022

Clinical management and outcomes for febrile infants 29-60 days evaluated in community emergency departments.

J Am Coll Emerg Physicians Open 2022 Jun 17;3(3):e12754. Epub 2022 Jun 17.

Department of Clinical Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena California USA.

Objective: Describe emergency department (ED) management and patient outcomes for febrile infants 29-60 days of age who received a lumbar puncture (LP), with focus on timing of antibiotics and type of physician performing LP.

Methods: Retrospective observational study of 35 California EDs from January 1, 2010 through December 31, 2019. Primary analysis was among patients with successful LP and primary outcome was hospital length of stay (LOS). Read More

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Case report: Disseminated cryptococcus gattii in an immunocompetent patient.

Reinhardt Dreyer

IDCases 2022 16;29:e01537. Epub 2022 Jun 16.

University of Stellenbosch and Netcare N1 City hospital, PO Box 6126, Cape town 7538, South Africa.

Background: Cryptococcosis is an opportunistic fungal disease, caused by Cryptococcus grubii, C. neoformans, and infrequently by C. gattii. Read More

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Targeted detection and repair of a spinal dural defect associated with successful biochemical resolution of subarachnoid bleeding in classical infratentorial superficial siderosis.

Neurol Sci 2022 Sep 13;43(9):5643-5646. Epub 2022 Jun 13.

Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.

BACKGROUND AND IMPORTANCE  : Classical infratentorial superficial siderosis (iSS) is characterised by repeated insidious bleeding into the subarachnoid space, leading to haemosiderin deposition within the subpial layers of the brainstem, cerebellum and spinal cord, sometimes with supratentorial involvement. Although nearly always associated with a dural defect (usually from previous trauma or neurosurgery) there is little evidence to support definitive investigation and management strategies. Here, we present a novel investigation strategy to identify a dural defect and subsequent successful surgical repair with biochemical resolution of subarachnoid bleeding. Read More

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September 2022

Rochester Criteria and Yale Observation Scale Score to Evaluate Febrile Neonates with Invasive Bacterial Infection.

J Emerg Med 2022 Jun 9. Epub 2022 Jun 9.

State University of New York Downstate Medical Center, Brooklyn, New York; Kings County Hospital New York Health and Hospitals, Brooklyn, New York.

Background: Febrile neonates undergo lumbar puncture (LP), empiric antibiotic administration, and admission for increased risk of invasive bacterial infection (IBI), defined as bacteremia and meningitis.

Objective: Measure IBI prevalence in febrile neonates, and operating characteristics of Rochester Criteria (RC), Yale Observation Scale (YOS) score, and demographics as a low-risk screening tool.

Methods: Secondary analysis of healthy febrile infants < 60 days old presenting to any of 26 emergency departments in the Pediatric Emergency Care Applied Research Network between December 2008 and May 2013. Read More

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Subarachnoid hemorrhage diagnosed by lumbar puncture after negative computed tomography angiography head.

Am J Emerg Med 2022 08 28;58:352.e1-352.e2. Epub 2022 May 28.

Chesapeake Regional Medical Center, Chesapeake, VA, USA.

Acute headache is a common emergency department (ED) chief complaint that usually has a benign course. Rare etiologies such as subarachnoid hemorrhage (SAH) can lead to extensive disability or even death. If suspected, SAH requires an intricate and intensive diagnostic investigation. Read More

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The necessity of lumbar puncture in adult emergency patients with fever-associated seizures.

Am J Emerg Med 2022 08 1;58:120-125. Epub 2022 Jun 1.

Department of Emergency Medicine, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminami-machi, Chuo-ku, Kobe-shi, Hyogo 650-0047, Japan.

Objective: Central nervous system (CNS) infections are often suspected in adult patients with fever-associated seizures. However, it is unclear whether lumbar puncture (LP) is routinely required in patients with fever-associated seizures. This study aimed to examine the prevalence of meningitis and encephalitis in adult patients with fever-associated seizures and to evaluate whether LP is routinely required. Read More

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Repeated lumbar puncture in search of oligoclonal bands - What is the yield?

J Neurol Sci 2022 Aug 26;439:120298. Epub 2022 May 26.

Department of Neurology, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Background: Cerebrospinal fluid (CSF) oligoclonal bands (OCBs) are immunoglobulins that represent intrathecal synthesis during central nervous system infection or inflammation. As repeated lumbar puncture (LP) is usually not performed unless clinically indicated, there is very limited data on the natural history and course of OCBs status in the CSF, its relation to disease activity, duration of persistence, and the rate of either CSF conversion of OCBs or disappearance.

Methods: We retrospectively collected data from adult patients with various neurological syndromes who had repeated CSF samplings. Read More

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Cerebrospinal fluid and plasma procalcitonin for the diagnosis of neonatal bacterial meningitis.

J Paediatr Child Health 2022 08 2;58(8):1425-1430. Epub 2022 Jun 2.

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Aim: There is a paucity of data on cerebrospinal fluid (CSF) procalcitonin (PCT) to diagnose neonatal meningitis. We evaluated CSF PCT to diagnose bacterial meningitis among neonates with suspected sepsis.

Methods: Neonates undergoing lumbar puncture (LP) as part of sepsis workup were included. Read More

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Nusinersen for Patients With Spinal Muscular Atrophy: 1415 Doses via an Interdisciplinary Institutional Approach.

Pediatr Neurol 2022 07 30;132:33-40. Epub 2022 Apr 30.

Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Spinal deformity and prior spinal fusion pose technical challenges to lumbar puncture (LP) for nusinersen administration for patients with spinal muscular atrophy (SMA). In this retrospective study over two study phases, we evaluated (1) factors associated with difficult LP or unscheduled requirement for image guidance and (2) effectiveness of a triage pathway for selective use of image guidance and nonstandard techniques, particularly for patients with spinal instrumentation/fusion to the sacrum.

Methods: With institutional review board approval, electronic health records, imaging, and administrative databases were analyzed for patients receiving nusinersen from January 2012 through September 2021. Read More

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Cryptococcal Meningoencephalitis in an Immunocompetent Patient.

J Coll Physicians Surg Pak 2022 Apr;32(4):S49-S51

Department of Internal Medicine, The Aga Khan University, Hospital, Karachi, Pakistan.

Cryptococcal meningitis (CM) is an uncommon opportunistic infection in immunocompetent hosts; and causes significant mortality and long-term morbidity. Cryptococci primarily cause disease in immunocompromised hosts, but rarely can lead to severe disease in immunocompetent individuals. A 64-year man, with no known immunosuppressive illnesses, presented in the Emergency Department with gait disturbances and lethargy for one year, which got worsened recently. Read More

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Callosal Angle Sub-Score of the Radscale in Patients with Idiopathic Normal Pressure Hydrocephalus Is Associated with Positive Tap Test Response.

J Clin Med 2022 May 20;11(10). Epub 2022 May 20.

1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vass. Sophias Ave., 11528 Athens, Greece.

The aim of the present study was the implementation of the composite imaging "Radscale" in patients with idiopathic normal pressure hydrocephalus (iNPH) and the evaluation of its score, as well as absolute stroke volume and peak flow velocity of cerebrospinal fluid (CSF) in aqueduct as indicators of a positive response following a tap test. Forty-five patients with iNPH were included. Clinical evaluation involved the 10 m timed walk test before and every 24 h for 3 consecutive days after evacuative lumbar puncture (LP). Read More

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A Case of Cryptococcal Meningitis and Fungemia With Relapse in an HIV-Negative, Non-transplant Patient on Azathioprine Therapy for Mixed Connective Tissue Disorder.

Cureus 2022 Apr 21;14(4):e24356. Epub 2022 Apr 21.

Infectious Disease, Yale New Haven Bridgeport Hospital, Bridgeport, USA.

Cryptococcal meningitis typically occurs in immunocompromised patients. Approximately 80% of cryptococcal infections occur in HIV patients. Non-HIV, non-transplant recipient patients are the least numerous population groups affected by cryptococcal infections. Read More

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Outcomes of children presenting to the emergency department with fever and bulging fontanelle.

Am J Emerg Med 2022 07 14;57:153-155. Epub 2022 Apr 14.

Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children's Hospital, University of Tel Aviv, Israel; Division of Clinical Pharmacology and Toxicology, Tel Aviv Sourasky Medical Center, University of Tel Aviv, Israel. Electronic address:

Background: In infants aged 3-18 months presenting with a bulging fontanelle and fever it is often necessary to exclude central nervous system infection by performing a lumbar puncture. Several studies have shown that well-appearing infants with normal clinical, laboratory and imaging studies have a benign (non-bacterial) disease. At our institution, we often observe such infants and withhold lumbar puncture. Read More

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Establishment of achievable benchmarks of care in the neurodiagnostic evaluation of simple febrile seizures.

J Hosp Med 2022 May 13;17(5):327-341. Epub 2022 May 13.

Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.

Background: Current guidelines recommend against neurodiagnostic testing for the evaluation of simple febrile seizures.

Objectives: (1) Assess overall and institutional rates of neurodiagnostic testing and (2) establish achievable benchmarks of care (ABCs) for children evaluated for simple febrile seizures at children's hospitals.

Design, Setting, And Participants: Cross-sectional study of children 6 months to 5 years evaluated in the emergency department (ED) 2016-2019 with simple febrile seizures at 38 children's hospitals in Pediatric Health Information System database. Read More

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Idiopathic intracranial hypertension in atypical demographics.

J Neurol Sci 2022 06 29;437:120271. Epub 2022 Apr 29.

Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: Idiopathic intracranial hypertension (IIH) is a condition that most often occurs in women of reproductive age with elevated body mass index (BMI) (typical patients). Individuals outside of this demographic group (atypical patients) may have a different pathophysiology underlying raised intracranial pressure (ICP) leading to unique clinical presentations and prognosis.

Methods: Retrospective chart review of patients with IIH in typical and atypical demographic groups: men, those diagnosed at age 40 or older and those with BMI <26. Read More

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Incidence of Traumatic Lumbar Punctures in Neonates and Infants.

Am J Perinatol 2022 05 6. Epub 2022 May 6.

Department of Pediatrics, and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent and Maternal Health Research, Tampere University Hospital, Tampere, Finland.

Objective: The objective of this study is to examine factors accounting for the incidence of traumatic lumbar puncture (TLP) in infants younger than 1 year old.

Study Design: Retrospective analysis of cerebrospinal fluid (CSF) data from 1,240 neonatal (≤28 days) and 399 infant lumbar puncture (LP) procedures was conducted. Data from two successive LP procedures were obtained from 108 patients. Read More

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Report of cerebral vasospasm as a complication of intracranial subarachnoid hemorrhage following traumatic lumbar puncture.

Surg Neurol Int 2022 8;13:128. Epub 2022 Apr 8.

Department of Neurosurgery, Weill Cornell Medicine, New York, NY, United States.

Background: This case report is the first documented and illustrated case of the identification and treatment of intracranial vasospasm as a sequalae of traumatic lumbar puncture (LP). LP is a routine procedure performed for both diagnostic and therapeutic purposes. Although rare, this procedure has risks and complications that should be considered before performing. Read More

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

Surg Neurol Int 2022 15;13:146. Epub 2022 Apr 15.

Neurology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.

Background: Tumefactive demyelinating lesions (TDL) share similar clinical features and magnetic resonance imaging (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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Sinking Skin Flap Syndrome After Decompressive Hemicraniectomy in a Patient With Calvarial Multiple Myeloma Who Underwent a Lumbar Puncture: A Case Report.

Cureus 2022 Apr 25;14(4):e24458. Epub 2022 Apr 25.

Internal Medicine, Overlook Medical Center, Summit, USA.

Sinking skin flap syndrome (SSFS) or "syndrome of the trephined" is a rare complication that can occur after decompressive craniectomy. Disabling neurologic deficits, as well as the impairment of overall mental status with the development of a concave deformity and relaxation of the skin flap, are frequently observed. This usually develops several weeks to months after craniectomy. Read More

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Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia.

Sci Rep 2022 04 26;12(1):6799. Epub 2022 Apr 26.

Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, and Cancer Center, Tampere University Hospital, Tampere, Finland.

In this prospective single-arm study of 50 pediatric patients with acute lymphoblastic leukemia (ALL), we evaluated the clinical performance of a novel bioimpedance spinal needle system in 152 intrathecal treatment lumbar punctures (LP) of these patients. The system detects in real-time when the needle tip reaches the cerebrospinal fluid (CSF) in the spinal canal. The success was defined as getting a CSF sample and/or administering the intrathecal treatment with one needle insertion. Read More

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Traumatic lumbar punctures in diagnostic and intrathecal treatment punctures of pediatric hemato-oncology patients.

Pediatr Hematol Oncol 2022 Apr 23:1-10. Epub 2022 Apr 23.

Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.

Successful first diagnostic lumbar puncture (LP) is crucial because intrathecal chemotherapy has not yet protected the central nervous system against cancer cells. If blood contaminates the cerebrospinal fluid (CSF) with blasts, they may enter the central neural system and compromise the patient's health. We retrospectively determined the incidence of traumatic lumbar punctures (TLP) in 2,507 LPs of 250 pediatric hemato-oncology patients aged from one to 18 years, including both diagnostic and intrathecal treatment procedures, and 2,617 LPs of 1,525 other age-matched pediatric patients. Read More

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Retrospective study comparing success rates of lumbar puncture positions in infants.

Am J Emerg Med 2022 06 12;56:228-231. Epub 2022 Apr 12.

Pediatric Emergency Medicine, Cohen Children's Medical Center Queens, NY 11040, USA.

Background: A lumbar puncture (LP) is performed in the emergency room for diagnostic purposes; unsuccessful or traumatic LPs can complicate decision making. The sitting position has a larger interspinous process compared to lateral recumbent and is safer in sick neonates at risk for cardiac and respiratory instability.

Purpose: Our study aims to determine which position (lateral recumbent or sitting) is associated with a greater likelihood of successful lumbar puncture in infants <3 months when performed in the emergency room. Read More

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Comparison of the Range of Lumbar Cerebrospinal Fluid Pressure in Adults With Normal Cerebrospinal Fluid Pressure and in Idiopathic Intracranial Hypertension.

J Neuroophthalmol 2022 Mar 25. Epub 2022 Mar 25.

City Hospitals Sunderland (DEB), United Kingdom; and RN City Hospitals (BW), Sunderland, United Kingdom.

Background/methods: Lumbar puncture CSF pressure measurements in a large group of adults (116) having lumbar puncture (LP) for diagnostic reasons with no clinical indication of raised intracranial pressure were used to establish the normal range of CSF pressure. The cerebrospinal fluid (CSF) pressure was also measured in a smaller unselected series of patients (35) with the syndrome of idiopathic intracranial hypertension (IIH). All the lumbar punctures were performed by the same highly skilled operator, a consultant nurse, to ensure accuracy of measurement. Read More

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