871 results match your criteria LP Lumbar Puncture


C-reactive protein as a predictor of meningitis in early onset neonatal sepsis: a single unit experience.

J Perinat Med 2020 Aug 7. Epub 2020 Aug 7.

Department of Pediatrics, Neonatal Division, McMaster University, Hamilton, ON, Canada.

Objectives To determine whether there is a cut off value of serum C-reactive protein (CRP) associated with a higher risk of meningitis in suspected early onset sepsis (EOS) (onset birth to seven days of life). Methods A retrospective cohort study on neonates admitted in neonatal intensive care unit at McMaster Children's Hospital from January 2010 to 2017 and had lumbar puncture (LP) and CRP for workup of EOS. Included subjects had either (a) non-traumatic LP or (b) traumatic LP with cerebral spinal fluid (CSF) polymerase chain reaction or gram stain or culture-positive or had received antimicrobials for 21 days. Read More

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http://dx.doi.org/10.1515/jpm-2019-0420DOI Listing

Low cerebrospinal fluid volume and the risk for post-lumbar puncture headaches.

J Neurol Sci 2020 Jul 27;417:117059. Epub 2020 Jul 27.

Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Laboratory of Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel. Electronic address:

Background: Cerebrospinal fluid (CSF) is essential for the medical workup of patients with neurological conditions and for disease-modifying clinical trials. Post- lumbar puncture (LP) headache is influenced by both operator and patient-related factors, including needle type and gauge, age, and gender.

Objectives: We aimed to assess whether CSF volume measured based on pre-procedural brain MRI is associated with the risk of developing a post-LP headache. Read More

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http://dx.doi.org/10.1016/j.jns.2020.117059DOI Listing
July 2020
2.474 Impact Factor

Risk of intervertebral disc joint puncture during lumbar puncture.

Clin Neurol Neurosurg 2020 Jul 24:106107. Epub 2020 Jul 24.

Department of Neurosurgery, Biruni University, Istanbul, Turkey. Electronic address:

Objective: Penetration of intervertebral disc joint during lumbar puncture might be unnoticed during procedure. However, accelerated degeneration of the disc joint is a long-term consequence of inadvertent penetration. In this paper, we aimed to demonstrate and evaluate the risk of disc puncture during standard lumbar puncture. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.106107DOI Listing

False-Negative CSF Cryptococcal Antigen with Meningoencephalitis in Southeastern United States: A Case Report and Literature Review.

Case Rep Infect Dis 2020 13;2020:8232178. Epub 2020 Jul 13.

Department of Internal Medicine, Grand Strand Health, Myrtle Beach, SC, USA.

A 70-year-old immunocompetent male in South Carolina was admitted secondary to altered mental status and headache without focal neurological deficits. Head CT was negative. Lumbar puncture (LP) revealed normal glucose, elevated protein, and lymphocytosis. Read More

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http://dx.doi.org/10.1155/2020/8232178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376414PMC

Herpes zoster in HIV-1 infection: The role of CSF pleocytosis in secondary CSF escape and discordance.

PLoS One 2020 22;15(7):e0236162. Epub 2020 Jul 22.

Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

HIV cerebrospinal fluid (CSF) escape is defined by a concentration of HIV-1 RNA in CSF above the lower limit of quantification of the employed assay and equal to or greater than the plasma HIV-1 RNA level in the presence of treatment-related plasma viral suppression, while CSF discordance is similarly defined by equal or higher CSF than plasma HIV-1 RNA in untreated individuals. During secondary CSF escape or discordance, disproportionate CSF HIV-1 RNA develops in relation to another infection in addition to HIV-1. We performed a retrospective review of people living with HIV receiving clinical care at Sahlgrenska Infectious Diseases Clinic in Gothenburg, Sweden who developed uncomplicated herpes zoster (HZ) and underwent a research lumbar puncture (LP) within the ensuing 150 days. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236162PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375594PMC

The effect of lumbar puncture on the neurodegeneration biomarker neurofilament light in macaque monkeys.

Alzheimers Dement (Amst) 2020 13;12(1):e12069. Epub 2020 Jul 13.

Centre for Neuroscience Studies Queen's University Kingston Ontario Canada.

Introduction: Neurofilament light (NFL) in cerebrospinal fluid (CSF) is elevated in neurodegenerative disease patients, and may track disease progression and treatment. Macaque monkeys are emerging as important translational models of neurodegeneration, and NFL may be a useful biomarker.

Methods: To determine the influence of a previous lumbar puncture (LP) on NFL, we collected CSF at multiple time points in macaque monkeys via LP or cisterna magna puncture. Read More

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http://dx.doi.org/10.1002/dad2.12069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366296PMC

Lumbar Puncture Increases Risk of Lumbar Degenerative Disc Disease: Analysis from the Rochester Epidemiology Project.

Spine (Phila Pa 1976) 2020 Jul 15. Epub 2020 Jul 15.

Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA.

MINI: We performed a population-based retrospective cohort study that included 950 cases with lumbar puncture (LP) and 1876 matched control without LP, the proportion of degenerative disc disease (DDD) diagnosis was 20.5% with LP vs 16.4% without LP corresponding to a hazard ratio of 1. Read More

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http://dx.doi.org/10.1097/BRS.0000000000003595DOI Listing

Is Lumbar Puncture Avoidable in Low-Risk Neonates with Suspected Sepsis?

Am J Perinatol 2020 Jul 21. Epub 2020 Jul 21.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Objective:  Performing lumbar punctures (LP) in all clinically suspected neonatal sepsis, as per current recommendations, results in many "negative" LPs. LPs are not without their own risks. With the intention of minimizing unnecessary LPs among neonates, we aimed to identify a subgroup at extremely low risk of developing possible meningitis so that an LP could be safely avoided in it. Read More

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http://dx.doi.org/10.1055/s-0040-1714397DOI Listing
July 2020
1.597 Impact Factor

Optic Nerve Sheath Diameter and Retinal Artery Resistive Index Measurements with Bedside Ophthalmic Ultrasound in Pediatric Patients with Pseudotumor Cerebri Syndrome.

J Pediatr Intensive Care 2020 Sep 6;9(3):181-187. Epub 2020 Mar 6.

Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey.

Pseudotumor cerebri syndrome (PTCS) is characterized by raised intracranial pressure (ICP) with no neuroradiological abnormalities. Ocular ultrasound has been in use to measure optic nerve sheath diameter (ONSD), and retinal artery Doppler indices have been used for indirect assessment of ICP by pediatric intensivists. Here, we aimed to evaluate the correlation of the lumbar puncture (LP) opening pressure with the ultrasonographic ONSD and retinal resistive index (RRI) measures in patients with PTCS. Read More

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http://dx.doi.org/10.1055/s-0040-1705112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360385PMC
September 2020

Excluding subarachnoid haemorrhage within 24 hours: to LP or not to LP?

Br J Neurosurg 2020 Jul 10:1-6. Epub 2020 Jul 10.

Nottingham University Hospitals NHS Trust, City Campus, Nottingham, UK.

Subarachnoid haemorrhage (SAH) is a potentially life-threatening cause of acute headache. Current conventional practice in the United Kingdom (UK) is for head computed tomography (CT) followed by cerebrospinal fluid (CSF) xanthochromia analysis if the head CT is normal. However, with increasing radiological accuracy, head CT alone may be sufficient to exclude SAH without requiring CSF xanthochromia for confirmation. Read More

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http://dx.doi.org/10.1080/02688697.2020.1781055DOI Listing

Development of an App to Facilitate Communication and Shared Decision-Making with Parents of Febrile Infants ≤60 Days Old.

Acad Emerg Med 2020 Jul 9. Epub 2020 Jul 9.

Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.

Objectives: We aimed to develop and test a tool to engage parents of febrile infants ≤60 days of age evaluated in the emergency department (ED). The tool was designed to improve communication for all parents and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age.

Methods: We conducted a multi-phase development and testing process: 1) individual, semi-structured interviews with parents and clinicians (pediatric and general emergency medicine (EM) physicians, and pediatric EM nurses) to learn their preferences for a communication and SDM tool; 2) design of a "storyboard" of the tool with design impression testing; 3) development of a software application (i. Read More

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http://dx.doi.org/10.1111/acem.14082DOI Listing

Measurement of Choroid Thickness Using Optical Coherence Tomography to Monitor Intracranial Pressure in an Idiopathic Cranial Hypertension Model.

Neurol India 2020 May-Jun;68(3):636-639

Department of Neurosurgery, Memorial Sisli Hospital, Istanbul, Turkey.

Background: Idiopathic intracranial hypertension (IIH) is a condition with increased intracranial pressure (ICP) without mass lesion or a known etiology with normal cerebrospinal fluid (CSF) composition. With optical coherence tomography (OCT), which is a noninvasive imaging technique, cross-sectional scans of the retina, choroid, and optic nerve head can be obtained with a resolution that is close to histological resolution.

Aim: The study aimed to evaluate the efficacy of OCT in providing practical and sensitive measurements to follow-up patients with IIH. Read More

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http://dx.doi.org/10.4103/0028-3886.288980DOI Listing

Stress and Perception of Procedural Pain Management in Chinese Parents of Children With Cancer.

J Pain Symptom Manage 2020 Jul 5. Epub 2020 Jul 5.

School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address:

Objectives: Children with cancer are exposed to repeated painful and invasive procedures. This study examines Chinese parents' stress and perception toward their children's procedural pain control.

Methods: We recruited 265 parents of children (aged <18 years) diagnosed with hematological cancer (74. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2020.06.028DOI Listing

Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single-Center Study.

J Neuroimaging 2020 Jul 8. Epub 2020 Jul 8.

Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY.

Background And Purpose: Despite increasing demand for fluoroscopy-guided lumbar puncture (FG-LP), there is limited quantitative and epidemiological data on patients undergoing this procedure. Additionally, data are scarce on the correlation of iliac crest landmarks to the actual anatomical lumbar level (intercristal line). The aim of this study is to determine if (1) body mass index (BMI) correlates with skin to spinal canal distance (SCD) and (2) the iliac crest landmark correlates with the presumed anatomical landmark on cross-sectional imaging. Read More

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http://dx.doi.org/10.1111/jon.12760DOI Listing

Quality of life, need for retreatment, and the re-equilibration phenomenon after venous sinus stenting for idiopathic intracranial hypertension.

J Neurointerv Surg 2020 Jul 1. Epub 2020 Jul 1.

Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, United States

Background: Long term failure rates after venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) are poorly understood.

Methods: Retrospective analysis was performed on a prospectively-maintained single center database to identify patients with medically refractory IIH who underwent VSS. Patients with persistent or severe recurrent symptoms after VSS undergo lumbar puncture (LP), therefore LP serves as a marker for treatment failure. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016124DOI Listing

Safety of bedside lumbar puncture in adult patients with thrombocytopenia.

Ann Hematol 2020 Aug 20;99(8):1755-1762. Epub 2020 Jun 20.

Department of Medicine, University of Rochester Medical Center, Box MED, 601 Elmwood Ave., Rochester, NY, 14642, USA.

The risk of lumbar puncture (LP) hemorrhagic complications is believed to be exacerbated by thrombocytopenia, yet evaluations in clinical practice are lacking. We conducted a retrospective cohort study to examine the risk of traumatic tap (TT) and significant hemorrhagic complications in thrombocytopenic patients undergoing bedside LP. Two hundred sixty-two adult patients undergoing initial bedside LP were analyzed. Read More

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http://dx.doi.org/10.1007/s00277-020-04148-6DOI Listing

Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis.

Iran J Microbiol 2020 Apr;12(2):89-97

Department of Midwifery, Faculty of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

Background And Objectives: Neonatal meningitis is one of the most important and serious neonatal infections with a high mortality and morbidity rate. The present study aimed to investigate the causes, clinical signs, laboratory parameters and mortality rates in newborns with bacterial meningitis.

Materials And Methods: This cross-sectional study was performed on 468 neonates aged 2-28 days admitted to NICU in Ghaem Hospital Mashhad, Iran by available sampling method during 2009-2018. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244827PMC

Impact of a Multiplex Polymerase Chain Reaction Assay on the Clinical Management of Adults Undergoing a Lumbar Puncture for Suspected Community-Onset Central Nervous System Infections.

Antibiotics (Basel) 2020 May 26;9(6). Epub 2020 May 26.

Division of Infectious Diseases, Allegheny General Hospital, Allegheny Health Network, 320 East North Avenue 4th Floor East Wing, Suite 406, Pittsburgh, PA 15212, USA.

Patients admitted from the community with a suspected central nervous system (CNS) infection require prompt diagnostic evaluation and correct antimicrobial treatment. A retrospective, multicenter, pre/post intervention study was performed to evaluate the impact that the BioFire FilmArray meningitis/encephalitis (ME) panel run in-house had on the clinical management of adult patients admitted from the community with a lumbar puncture (LP) performed for a suspected CNS infection. The primary outcome was the effect that this intervention had on herpes simplex virus (HSV) polymerase chain reaction (PCR) turnaround time (TAT). Read More

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http://dx.doi.org/10.3390/antibiotics9060282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344633PMC

Parental Refusal to Lumbar Puncture: Effects on Treatment, Hospital Stay and Leave Against Medical Advice.

Cureus 2020 Apr 22;12(4):e7781. Epub 2020 Apr 22.

Pediatrics, Dow Medical College, Karachi, PAK.

Introduction Lumbar puncture (LP) is an effective method in the diagnosis and management of central nervous system infections. Refusal to LP is associated with severe consequences. This study aims to examine the impact of parental LP refusal on treatment, the length of hospital stay, and the frequency of patients leaving against medical advice (LAMA). Read More

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http://dx.doi.org/10.7759/cureus.7781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243628PMC

A Rare Case of Isolated Pulmonary Cryptococcoma in an Immunocompromised Host.

Cureus 2020 Apr 20;12(4):e7748. Epub 2020 Apr 20.

Internal Medicine, Wayne State University, Detroit Medical Center, Detroit, USA.

Cryptococcosis is an opportunistic fungal infection found in both immunocompromised and non-immunocompromised patients; however, it is particularly prevalent in those with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). Patients with isolated pulmonary cryptococcosis can present with heterogeneous symptoms. The rarity of this entity makes it difficult to recognize and diagnose. Read More

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http://dx.doi.org/10.7759/cureus.7748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241226PMC

Composite contributions of cerebrospinal fluid GABAergic neurosteroids, neuropeptide Y and interleukin-6 to PTSD symptom severity in men with PTSD.

Neurobiol Stress 2020 May 18;12:100220. Epub 2020 Apr 18.

VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA, 02130, USA.

Given that multiple neurobiological systems, as well as components within these systems are impacted by stress, and may interact in additive, compensatory and synergistic ways to promote or mitigate PTSD risk, severity, and recovery, we thought that it would be important to consider the , as well as separate effects of these neurobiological systems on PTSD risk. With this goal in mind, we conducted a proof-of-concept study utilizing cerebrospinal fluid (CSF) collected from unmedicated, tobacco- and illicit substance-free men with PTSD (n = 13) and trauma-exposed healthy controls (TC) (n = 17). Thirteen neurobiological factors thought to contribute to PTSD risk or severity based on previous studies were assayed. Read More

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http://dx.doi.org/10.1016/j.ynstr.2020.100220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231970PMC

Optimizing Analgesic Use During Infant Lumbar Puncture in the Emergency Department.

Pediatr Qual Saf 2020 Mar-Apr;5(2):e292. Epub 2020 Apr 14.

Department of Emergency Medicine, The University of Minnesota Masonic Children's Hospital, Minneapolis, Minn.

Introduction: Lumbar puncture (LP) for the collection of cerebrospinal fluid is an important diagnostic tool for the evaluation of febrile or ill-appearing infants. This invasive procedure is painful for patients; inadequate analgesia may have lasting effects. The American Academy of Pediatrics recommends analgesia during all LP procedures, and oral sucrose alone does not offer sufficient analgesia. Read More

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http://dx.doi.org/10.1097/pq9.0000000000000292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190259PMC

Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture.

Ultrasound J 2020 May 13;12(1):26. Epub 2020 May 13.

Department of Emergency Medicine, University of Pittsburgh, and University of Pittsburgh, Medical Center (UPMC), 3600 Forbes at Meyran Avenue Forbes Tower, Suite 10028, Pittsburgh, PA, 15213, USA.

Background: To test the hypothesis that optic nerve sheath diameter (ONSD) correlates with real-time changes in intracranial pressure, we performed ultrasound measurements of the ONSD in ambulatory patients undergoing elective lumbar puncture (LP). We conducted a prospective cohort study, including adult patients undergoing LP in a non-emergent setting. We measured ONSD perpendicular to the optic nerve at 3 mm behind the globe in both eyes in the traverse and sagittal planes, with the patient supine. Read More

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http://dx.doi.org/10.1186/s13089-020-00173-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218034PMC

Intracerebral hematoma at the basal ganglia following lumbar puncture.

J Stroke Cerebrovasc Dis 2020 Jul 7;29(7):104847. Epub 2020 May 7.

Department of Neurology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

Background: In patients with normal pressure hydrocephalus (NPH), lumbar puncture (LP) is an effective method for assessing both the diagnosis as well as the possible efficacy of ventriculoperitoneal shunting based on symptom improvement. However, it should be considered that there exists a low risk of complications and that these risks may result in morbidity and mortality. We present a patient who developed hematoma in the basal ganglia following LP. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104847DOI Listing

Reactive increase of cerebrospinal fluid white blood cell count after lumbar puncture: Fact or fiction?

J Neurol Sci 2020 Jul 1;414:116876. Epub 2020 May 1.

Department of Neurology, University Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany. Electronic address:

Lumbar puncture (LP) is commonly used in the diagnostic workup of neurological patients, often to exclude inflammatory diseases of the central nervous system. In clinical practice, an increase of white blood cell count (WBC) in the cerebrospinal fluid (CSF) after a LP is often assumed as reactive to the first puncture. Scientific evidence of this hypothesis, however, is lacking. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116876DOI Listing

Acute Subdural Haemorrhage as a Complication of Diagnostic Lumbar Puncture.

Cureus 2020 Apr 2;12(4):e7515. Epub 2020 Apr 2.

Neurology Department, International Medical Centre, Jeddah, SAU.

Lumbar puncture (LP) is done daily for both spinal anesthesia and emergency cases for cerebrospinal fluid (CSF) analysis. Subdural hemorrhage (SDH) is a rare but severe complication following diagnostic LP, which could be potentially fatal, and early diagnosis may be life-saving. We present a 28-year-old female patient who presented to our emergency department with a headache, fever, and vomiting, with normal initial laboratory and imaging. Read More

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http://dx.doi.org/10.7759/cureus.7515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198077PMC

Superior Mesenteric Artery Dissection After Lumbar Puncture.

Cureus 2020 Apr 2;12(4):e7507. Epub 2020 Apr 2.

Internal Medicine, Texas A&M Health Science Center, Bryan, USA.

We hereby present a case of iatrogenic dissection of the superior mesenteric artery dissection in a 63-year-old female undergoing a lumbar puncture (LP). She presented with severe diffused abdominal pain accompanied by lower back pain, nausea and vomiting a few hours after undergoing an LP due to ongoing headaches. Abdominal CT showed evidence of hemoperitoneum. Read More

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http://dx.doi.org/10.7759/cureus.7507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195201PMC

Progressive multifocal leukoencephalopathy presenting with acute sensorineural hearing loss in an intestinal transplant recipient.

Transpl Infect Dis 2020 Aug 19;22(4):e13304. Epub 2020 May 19.

Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA.

A 20-year-old male presented 3.5 years after intestinal transplantation with rapidly progressive sensorineural hearing loss. Initial brain imaging was consistent with inflammation and/or demyelination. Read More

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http://dx.doi.org/10.1111/tid.13304DOI Listing

Styloidogenic jugular venous compression syndrome: a case report and review of the literature.

Childs Nerv Syst 2020 Apr 28. Epub 2020 Apr 28.

Department of Neurosurgery, University of Alabama at Birmingham, 1802 6th Avenue South, FOT 1001, Birmingham, AL, 35233, USA.

Background: Styloidogenic jugular venous compression syndrome (SJVCS) has been shown to present with a similar symptomatology to idiopathic intracranial hypertension (IIH) and is caused by compression of the internal jugular vein (IJV) between the lateral tubercle of C1 and the styloid process. Treatments including venous stenting and styloidectomy have been reported with good outcomes; however, treatment of a pediatric patient with SJVCS with styloidectomy has not previously been reported in the literature.

Case Report: A 12-year-old male presented with refractory positional headaches, nausea, and vomiting, and after, workup including lumbar puncture (LP) and intracranial pressure (ICP) monitoring was found to have intracranial hypertension associated with contralateral neck turning. Read More

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http://dx.doi.org/10.1007/s00381-020-04622-6DOI Listing

The role of ICP monitoring in paediatric IIH.

Childs Nerv Syst 2020 Apr 22. Epub 2020 Apr 22.

Department of Paediatric Neurosurgery, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6423609, Tel Aviv, Israel.

Introduction: Diagnosis of idiopathic intracranial hypertension (IIH) in children is an extrapolation of the guidelines suggested for adult population. Lumbar puncture (LP) plays a crucial role in the diagnosis. The diagnosis of IIH at times is solely dependent on the interpretation of the opening pressure (OP). Read More

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http://dx.doi.org/10.1007/s00381-020-04618-2DOI Listing

The Variability of Preferred Infant Lumbar Puncture Insertion Site Between Novice and Experienced Physicians.

AEM Educ Train 2020 Apr 12;4(2):123-129. Epub 2019 Sep 12.

Division of Emergency Medicine Boston Children's Hospital Boston MA.

Background: We sought to determine if vertebral interspace selection for performance of infant lumbar puncture (LP) varies between less experienced trainees and more experienced pediatric emergency medicine (PEM) attending physicians.

Methods: We performed an observational prospective study using a convenience sample of infants aged 0 to 12 months presenting to a single emergency department. Trainees with limited LP experience (defined as less than 10 infant LPs performed) marked their preferred LP insertion site with an invisible ultraviolet pen. Read More

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http://dx.doi.org/10.1002/aet2.10385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163203PMC

Study protocol: NeoCLEAR: Neonatal Champagne Lumbar punctures Every time - An RCT: a multicentre, randomised controlled 2 × 2 factorial trial to investigate techniques to increase lumbar puncture success.

BMC Pediatr 2020 Apr 15;20(1):165. Epub 2020 Apr 15.

Newborn Care Unit, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.

Background: The neonatal period carries the highest risk of bacterial meningitis (~ 1 in 5000 births), bearing high mortality (~ 10%) and morbidity (20-50%) rates. Lumbar puncture (LP) remains essential to the diagnosis of meningitis. Though LP is a common procedure in neonates, success rates are lower (50-60%) than in other patient populations. Read More

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http://dx.doi.org/10.1186/s12887-020-02050-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160994PMC

Post-dural puncture headache incidence after cerebrospinal fluid aspiration. A prospective observational study.

Arq Neuropsiquiatr 2020 04;78(4):187-192

Instituto de Neurologia de Curitiba (INC), Departamento de Neurologia, Curitiba PR, Brazil.

Background: Post-dural puncture headache (PDPH) is an iatrogenic condition following lumbar puncture (LP). Incidence is variable and often associated with young females. Technical features of the procedure (i. Read More

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http://dx.doi.org/10.1590/0004-282X20190197DOI Listing

Comparison of high-dose intracisterna magna and lumbar puncture intrathecal delivery of AAV9 in mice to treat neuropathies.

Brain Res 2020 Jul 11;1739:146832. Epub 2020 Apr 11.

Gene Therapy Center, University of North Carolina at Chapel Hill, United States; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address:

Gene therapy clinical trials for neurological disorders are ongoing using intrathecal injection of adeno-associated virus (AAV) vector directly into the cerebral spinal fluid. Preliminary findings from these trials and results from extensive animal studies provides compelling data supporting the safety and benefit of intrathecal delivery of AAV vectors for inherited neurological disorders. Intrathecal delivery can be achieved by a lumbar puncture (LP) or intracisterna magna (ICM) injection, although ICM is not commonly used in clinical practice due to increased procedural risk. Read More

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http://dx.doi.org/10.1016/j.brainres.2020.146832DOI Listing

Complications of Ventriculoperitoneal Shunt for Idiopathic Intracranial Hypertension: A Single-Institution Study of 32 Patients.

J Neuroophthalmol 2020 Mar 24. Epub 2020 Mar 24.

Department of Ophthalmology and Visual Sciences (AJB, JDT), Neurology (JDT), Kellogg Eye Center, Ann Arbor, Michigan; University of Michigan Medical School (TG), Ann Arbor, Michigan; and Neurosurgery (JDT), Kellogg Eye Center, Ann Arbor, Michigan.

Background: Because there are no head-to-head studies of the efficacy of surgical options in the treatment of medically-intractable idiopathic intracranial hypertension (IIH), procedure selection is often based on expected complications. Cerebrospinal fluid (CSF) diversion by shunting has been reported to have a 23%-67% rate of shunt failure. But these figures derive from small cohorts or studies that do not separate the complication rates of the different shunt options-ventriculoperitoneal (VP), lumboperitoneal (LP), and ventriculoatrial (VA). Read More

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http://dx.doi.org/10.1097/WNO.0000000000000922DOI Listing

Focus on the Use of Resveratrol as an Adjuvant in Glioblastoma Therapy.

Curr Pharm Des 2020 ;26(18):2102-2108

Department of Chemistry, Biology and Biotechnologies, University of Perugia, Via Elce di Sotto 8, 06132 Perugia, Italy.

Glioblastoma (GB) represents the most common and malignant form of glioma cancer. The Gold Standard in Glioblastoma is neurosurgical tumor removal and radiotherapy treatment in concomitant with temozolomide (TMZ). Unfortunately, because of tumor chemo and radio-resistance during this therapy, the patient's outcome remains very poor, with a median overall survival of about 14. Read More

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http://dx.doi.org/10.2174/1381612826666200401085634DOI Listing
January 2020

Postdural puncture headache leads to clinical worsening of pre-existing chronic headache.

J Clin Neurosci 2020 May 26;75:30-34. Epub 2020 Mar 26.

Faculty of Medicine, University of Belgrade, Clinic for Neurology, Clinical Center of Serbia, Belgrade, Serbia.

The incidence of postdural puncture headache (PDPH) in relation to pre-existing chronic headache (CH) was assessed, as was the clinical course of CH, at one, three, and six months after PDPH. The study was conducted as a single center cohort prospective study that included 252 patients (105 men and 147 women), average age of 47.3 ± 15. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.03.043DOI Listing

Eyes As the Window to Syphilis: A Rare Case of Ocular Syphilis As the Initial Presentation of Syphilis.

Cureus 2020 Feb 14;12(2):e6998. Epub 2020 Feb 14.

Internal Medicine, Upstate Medical University, Syracuse, USA.

In the pre-antibiotic era, neurosyphilis (NS) was common, occurring in 34% of patients with syphilis. Currently, there has been a rising trend in syphilis with HIV-infected patients being more prone to develop NS. Ocular involvement is very rare in NS and accounts for only 1%-5% of the cases in the United States. Read More

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http://dx.doi.org/10.7759/cureus.6998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077063PMC
February 2020

Emergency physician performed ultrasound-assisted lumbar puncture in children: A randomized controlled trial.

Am J Emerg Med 2020 Feb 19. Epub 2020 Feb 19.

Department of Pediatric Emergency Medicine, CHU Sainte-Justine, Montreal, QC, Canada.

Background And Objective: Lumbar puncture (LP) is one of the most common procedures performed in pediatric emergency departments but first-attempt success rates remain low and traumatic LP remains frequent. The aim of this study was to determine if ultrasound performed by emergency physicians improves the probability of first-attempt success for lumbar puncture in children.

Methods: This was a prospective randomized controlled trial conducted in two tertiary care, pediatric, university-affiliated emergency departments in 2017-2018. Read More

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http://dx.doi.org/10.1016/j.ajem.2020.02.036DOI Listing
February 2020

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

J Neurol 2020 Jul 20;267(7):2002-2006. Epub 2020 Mar 20.

Department of Anesthesiology, Duke University Medical Center, Duke South Orange Zone, Rm 4317, Box 3094, Durham, NC, 27710, USA.

Objective: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort studies who underwent LPs using a standardized protocol and 25 g needle.

Methods: Eight hundred and nine LPs performed in 262 patients age ≥ 60 years in the MADCO-PC and INTUIT studies were analyzed. Read More

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http://dx.doi.org/10.1007/s00415-020-09797-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336280PMC

Utility of lumbar puncture after a normal brain computed tomography scan in patients presenting to the emergency department with suspected subarachnoid haemorrhage: A new more rational approach?

Emerg Med Australas 2020 Mar 20. Epub 2020 Mar 20.

Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.

Objective: The diagnostic approach for patients presenting to EDs with headaches suspicious for subarachnoid haemorrhage (SAH) remains challenging. Modern third-generation computed tomography (CT) has been shown to be extremely sensitive in identifying SAH and may eliminate the need for lumbar puncture (LP) which is an invasive, time-consuming procedure with limited accuracy and complications. The aim of this study is to assess the utility of LP in patients being evaluated for possible SAH in the ED after a negative non-contrast CT scan of the brain, as well as addressing the knowledge gap in regard to rational diagnostics among clinicians. Read More

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http://dx.doi.org/10.1111/1742-6723.13502DOI Listing

Cerebrospinal Fluid Collected by Lumbar Puncture Has a Higher Diagnostic Accuracy than Collected by Ventriculostomy.

World Neurosurg 2020 Jun 16;138:e683-e689. Epub 2020 Mar 16.

Graduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil.

Background: Patients harboring an external ventricular drain (EVD) who develop signs of infection require screening for infection in the central nervous system (CNS). The cerebrospinal fluid (CSF) can be collected by the EVD or by lumbar puncture (LP). If only one sample is analyzed, the diagnosis might be dubious or false-negative. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.045DOI Listing

First case report of tuberculous meningitis secondary to endometrial tuberculosis following a clandestine abortion.

Infez Med 2020 Mar;28(1):82-86

Department of Clinical Pathology, Hospital Regional Lambayeque, Chiclayo, Peru.

Tuberculous meningitis (TBM) is a medical emergency: it is the most severe, lethal and disabling clinical form of tuberculosis. We report the case of a 44-year-old woman who had undergone a clandestine abortion six weeks before admission. One week later, she had abnormal vaginal discharge. Read More

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Escherichia coli: a rare cause of meningitis in immuno-competent adult.

J Community Hosp Intern Med Perspect 2020 10;10(1):69-72. Epub 2020 Feb 10.

Internal Medicine Department, Dow University Hospital, DUH, Karachi, Pakistan.

A 35-year-old male of Asian ethnicity presented with complaints of high-grade fever, severe headache, vomiting, generalized seizures, deteriorated conscious level and neck stiffness. After all baseline workup Computed Tomography (CT) scan of the brain was done, which turned out to be unremarkable. CT scan was then followed by lumbar puncture (LP) and Cerebrospinal fluid (CSF) detailed report was sent, which was highly suggestive of bacterial meningitis with the predominance of polymorphonuclear leukocytes. Read More

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http://dx.doi.org/10.1080/20009666.2020.1715190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034454PMC
February 2020

Evaluation of the patients diagnosed as idiopathic intracranial hypertension with and without papilledema visual pathways by analysis of visual evoked potential.

Int J Neurosci 2020 Mar 27:1-8. Epub 2020 Mar 27.

Department of Neurology, Celal Bayar University, Manisa, Turkey.

Idiopathic intracranial hypertension (IIH) is a clinical syndrome characterized by increased intracranial pressure in the absence of clinical, laboratory, or radiological findings of space-occupying lesion in the cranium. Papilledema is found in majority of the patients with IIH while it is absent in only about 5-6% of the patients. Our primary objective was to evaluate the patients with IIH with (n: 45) and without (n: 15) papilledema using cranial MRI and VEP analyses and to compare the obtained results. Read More

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http://dx.doi.org/10.1080/00207454.2020.1736581DOI Listing

Correlation between the total number of features of paediatric pseudotumour cerebri syndrome and cerebrospinal fluid pressure.

Childs Nerv Syst 2020 Mar 2. Epub 2020 Mar 2.

Paediatric Neurology, Department of Paediatrics, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.

Purpose: Accurate diagnosis of pseudotumour cerebri syndrome (PTCS) in children is challenging. We aimed to see if the clinical and radiological assessment that is carried out before lumbar puncture could predict subsequently recorded CSF pressures, and thus whether it could be used to increase diagnostic certainty of paediatric PTCS.

Methods: We used internationally recognised diagnostic criteria to derive a list of clinical, brain neuroimaging and venography features that were accepted to be associated with a diagnosis of PTCS. Read More

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http://dx.doi.org/10.1007/s00381-020-04537-2DOI Listing

Surgical outcomes of the endonasal endoscopic approach within a standardized management protocol for repair of spontaneous cerebrospinal fluid rhinorrhea.

J Neurosurg 2020 Feb 28:1-7. Epub 2020 Feb 28.

Departments of1Neurological Surgery and.

Objective: Spontaneous CSF leaks are rare, their diagnosis is often delayed, and they can precipitate meningitis. Craniotomy is the historical "gold standard" repair for these leaks. An endonasal endoscopic approach (EEA) offers potentially less invasiveness and lower surgical morbidity than a traditional craniotomy but must yield the same surgical success. Read More

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http://dx.doi.org/10.3171/2019.12.JNS192891DOI Listing
February 2020

Prevalence of Self-Reported Neurologic and Ocular Symptoms in Early Syphilis Cases.

Clin Infect Dis 2020 Feb 26. Epub 2020 Feb 26.

Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Background: Neurosyphilis, a complication of syphilis, can occur at any stage of infection. Measuring the prevalence of neurosyphilis is challenging and there are limited data on the prevalence of neurologic or ocular symptoms among patients with syphilis. We sought to describe the prevalence of neurologic and/or ocular symptoms among early syphilis (ES) cases and the clinical management of symptomatic cases enrolled in the STD Surveillance Network (SSuN) Neuro/Ocular Syphilis Surveillance project. Read More

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http://dx.doi.org/10.1093/cid/ciaa180DOI Listing
February 2020

Ultrasonographic optic nerve sheath diameter monitoring of elevated intracranial pressure: two case reports.

Ann Transl Med 2020 Jan;8(1):20

Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China.

Ultrasonography assessments of optic nerve sheath diameter (ONSD) is a non-invasive method that may help identify elevated intracranial pressure (ICP). However, this technique was used to evaluate the elevated ICP caused by traumatic brain injury. The objective of this study was to examine clinical cases of the changes in ICP with venous sinus stenosis and venous sinus thrombosis found the advantage of this technique in the application. Read More

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http://dx.doi.org/10.21037/atm.2019.12.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995732PMC
January 2020