In this review, technical details of these procedures are described and examples of common and uncommon postprocedure appearances on imaging are presented. [ncbi.nlm.nih.gov]

In spinal subdural hematomas, patients present with severe low back, radicular pain, sensory loss or paraparesis hours to days post LP. [meds.queensu.ca]

Overview Snapshot A 59-year-old man presents to the emergency department with altered mental status. The patient is accompanied by his wife who says that the patient had a fever and headache for the past few days. [step1.medbullets.com]

No neutrophils are present. Other results: No infectious organisms (such as bacteria, fungi, or a virus) are found in the CSF sample. No tumor cells are present. [stlukesonline.org]

• Pseudotumor

  It can also provide useful diagnostic information in the evaluation of possible subarachnoid hemorrhage and demyelinating syndromes, and aid in the diagnosis and management of pseudotumor cerebri. [ncbi.nlm.nih.gov]

  Obtain cerebrospinal fluid (the fluid that circulates around the brain and spinal cord) to look for infection or cancer cells Administer a chemotherapy agent for patients with cancer Monitor and relieve cerebrospinal fluid pressure for patients with pseudotumor [chop.edu]

  […] nervous system malignancies and paraneoplastic syndromes Guillain-Barré syndrome Multiple sclerosis Neuroborreliosis Subarachnoid hemorrhage (SAH) Intrathecal administration of pharmaceuticals CSF pressure measurement Idiopathic intracranial hypertension (pseudotumor [amboss.com]

  Pseudotumor cerebri (also called idiopathic intracranial hypertension, or IIH). In this condition,pressure within the subarachnoid space is elevated for reasons that are not clear. [hopkinsmedicine.org]

  Management of pediatric patients with pseudotumor cerebri. Childs Nerv Syst. 2012 Jan 19. [Epub ahead of print]. Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. [emedicine.medscape.com]

• Surgical Procedure

  About surgical procedures Visit the healthdirect surgical procedures page to learn more about surgical procedures in general with information such as: Questions to ask before surgery Preparing for surgery How to find the right health professional Learn [healthdirect.gov.au]

  In addition, lumbar punctures are also used to: * measure the pressure of the CSF * inject a dye for myelography, a type of X-ray for diagnosing spine disease * inject agents such as for chemotherapy or a spinal anaesthetic before a surgical procedure [healthy.net]

  These include: Spinal anesthetics before a surgical procedure Contrast dye for X-ray studies - for example, myelography Chemotherapy drugs used to treat cancer Your healthcare provider may have other reasons to recommend a lumbar puncture. [hopkinsmedicine.org]

• Back Pain

  A 15-year-old boy developed back pain and sciatica after a minor trauma. Magnetic resonance imaging revealed lumbar spinal subdural hematoma. [ncbi.nlm.nih.gov]

  pain Consent should be documented where possible given it is an invasive procedure. [aci.health.nsw.gov.au]

  In spinal subdural hematomas, patients present with severe low back, radicular pain, sensory loss or paraparesis hours to days post LP. [meds.queensu.ca]

• Low Back Pain

  Complications are infrequent, except for headaches and low back pain, but can be severe. Analysis of the cerebrospinal fluid must include a cell count and determination of the glucose and protein concentrations. [ncbi.nlm.nih.gov]

  SLIDESHOW Low Back Pain: Symptoms, Causes, Treatment, Relief See Slideshow Medically Reviewed on 12/13/2019 References Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015. [medicinenet.com]

• Guillain-Barré Syndrome

  Indications Diagnosis of diseases with altered CSF composition Central nervous system infections (bacterial, viral, mycobacterial) Central nervous system malignancies and paraneoplastic syndromes Guillain-Barré syndrome Multiple sclerosis Neuroborreliosis [amboss.com]

  Viral infections N or ↑ 100–2000 L N N or ↑ Idiopathic intracranial hypertension ↑ N L N N or ↓ Cerebral hemorrhage ↑ Bloody RBC N ↑ Cerebral thrombosis N or ↑ 0–100 L N N or ↑ Spinal cord tumor N 0–50 L N N or ↑ Multiple sclerosis N 0–50 L N N or ↑ Guillain-Barré [merckmanuals.com]

  A spinal tap can also help diagnose inflammatory conditions of the nervous system such as Guillain-Barré syndrome and multiple sclerosis. [alsnewstoday.com]

  High protein levels are often a sign of a spinal cord tumor or an acute peripheral nerve disorder such as Guillain-Barré syndrome (GBS) or chronic inflammatory demyelinating polyneuropathy (CIDP). Abnormal antibodies may suggest multiple sclerosis. [foundationforpn.org]

• Stroke

  […] societies: American Academy of Neurology, American Stroke Association Disclosure: Medscape Neurology Editorial Advisory Board for: Stroke Adjudication Committee, CREST2; Executive Committee for the NINDS-funded DEFUSE3 Trial; Physician Advisory Board [emedicine.medscape.com]

  Resources Family Doctor—American Academy of Family Physicians http://familydoctor.org National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov Canadian Resources About Kids Health—The Hospital For Sick Children http://www.aboutkidshealth.ca [winchesterhospital.org]

  Indications for CT head scan prior to LP Age >60 years Immunocompromised state Neurological findings, such as ALOC or focal neurological deficits Objective evidence of raised ICP such as papilloedema, bradycardia and headache History of CNS lesion (e.g. stroke [lifeinthefastlane.com]

  100 mL 40–75 mg/100 mL (60% of serum levels) Multiple sclerosis Normal Colorless and transparent ↑ WBCs (< 50) Normal Normal to ↑ Normal Guillain-Barré syndrome Normal Colorless and transparent ↑ WBCS (< 10) Normal ↑↑ Normal Subarachnoid hemorrhage, stroke [amboss.com]

• Irritability

  […] controlled analgesia (0·44, 95% CI 0·29-0·64; p<0·0001), need for epidural blood patch (0·50, 0·33-0·75; p=0·001), any headache (0·50, 0·43-0·57; p<0·0001), mild headache (0·52, 0·38-0·70; p<0·0001), severe headache (0·41, 0·28-0·59; p<0·0001), nerve root irritation [ncbi.nlm.nih.gov]

  Moderate More 89 126 Risk of Bias No serious concerns Imprecision No serious concerns Indirectness Serious Inconsistency No serious concerns Publication bias No serious concerns Use of atraumatic needles decreases the risk of nerve root irritation Maximal [doi.org]

  Potential side effects may include: headache backache nausea and vomiting dizziness irritation of a nerve may cause temporary numbness, tingling or pain down your legs infection where the needle was inserted bleeding into the spinal canal Call the doctor [cancer.ca]

  Headache, numbness and nausea are due to the stretching and irritation of pain-sensitive structures, including the dura, cranial and spinal nerves, and veins as the body tries to compensate. [healthy.net]

CT or MR imaging as part of the diagnostic workup may reveal expected or unexpected findings which may explain these symptoms. Small foci of gas within the spinal canal or intracranial compartment are common but are usually self-limited. [ncbi.nlm.nih.gov]

When babies develop a fever high enough or abrupt enough to cause a seizure, frightened parents often rush them to the emergency room, where their workup frequently includes a spinal tap to rule out bacterial meningitis. [childrenshospital.org]

Abnormal results A lumbar puncture is sometimes used as part of a diagnostic cancer workup. [encyclopedia.com]

CSF containing less than 10 red blood cells (RBCs)/mm³ constitutes a "negative" tap in the context of a workup for subarachnoid hemorrhage, for example. [en.wikipedia.org]

Young infants commonly require lumbar puncture as a part of the routine workup for fever without a source, as they have a much higher risk of meningitis than older persons and do not reliably show signs of meningeal irritation. [house.wikia.com]

" 31 Aug. 2019 Blue Horizon treatments include injecting cells into an injured area of the body, an IV infusion of the cells for anti-aging effects, or in the case of treating brain injuries, a lumbar puncture. — Sarah Blaskey, miamiherald, "Step right [merriam-webster.com]

There may be variations in treatment that your physician may recommend based on individual facts and circumstances. URL: http://www.virtualpediatrichospital.org/ [virtualpediatrichospital.org]

If your treatment allows, you will be requested to drink plenty of fluids. ^ Top [leukemiabmtprogram.org]

Treatment with hydrocortisone plus conventional treatment showed better VAS scores at six, 24 and 48 hours when compared with conventional treatment alone and also when compared with placebo. [cochrane.org]

The epidural blood patch represents a first choice treatment of PDPH, significantly superior to the conventional treatment. [jurnalul-anestezie.ro]

Spinal hematomas typically present with severe and localized back pain, rapidly progressive myelopathy and a poor prognosis for functional recovery unless immediate decompression is performed. [ncbi.nlm.nih.gov]

Persistently elevated CSF cryptococcal antigen in HIV-infected patients carries a poor prognosis and indicates ongoing production of viable Cryptococcus neoformans in tissue. [doi.org]

Post-dural puncture headache: Part I, Prevention, Management, and Prognosis. Headache: The Journal of Head and Face Pain, 50, 1144-1152. doi: 10.1111/j.1526-4610.2010.01758.x. Bezov, D., Ashina, S., & Lipton, R. (2010). [profinf.net]

© Nordland Hospital Bodø Treatment and prognosis Post-dural puncture headache has in principle a self-limiting course. [tidsskriftet.no]

Changes and Fall Risk in MCI and Dementia Gilles Allali & Joe Verghese Current Treatment Options in Neurology (2017) Finger tapping and verbal fluency post-tap test improvement in INPH: its value in differential diagnosis and shunt-treatment outcomes prognosis [nature.com]

(Viral meningitis caused by HSV-1) Introduction Lumbar puncture (LP) is a procedure where a spinal needle is advanced into the subarachnoid space in order to collect cerebral spinal fluid (CSF) the LP can allow the physician to determine the etiology [step1.medbullets.com]

It is an essential part of establishing the etiology (cause) of persistent headache, fever, or other problems such as weakness and numbness in the legs. It may also be used to assess the tumour severity. [aidsmap.com]

Despite a large number of hypotheses and publications over the past decade, the etiology of IIH is still unknown. There continues to be no evidence-based consensus or formal guidelines regarding management and treatment of the disease. [ncbi.nlm.nih.gov]

[…] studies on the CSF List complications Recognize special considerations in select patients Indications for lumbar puncture Signs and symptoms concerning for meningitis (bacterial, viral, fungal, and tubercular) Altered mental status without other clear etiology [cdemcurriculum.com]

Transient neurologic symptoms: etiology, risk factors, and management. Regional anesthesia and pain medicine, 27(6), 581-586. Richardson, W.S., Wilson, M.C., Nishikawa, J., & Hayward, R.S. (1995). [profinf.net]

Clinical epidemiological study of 171 cases of cryptococcosis. Clin. Infect. Dis. 18 : 369 -380. Wu, G., R. A. Vilchez, B. Eidelman, J. Fung, R. Kormos, and S. Kusne. 2002. [doi.org]

Trenkwalder C et al. (1995) Starnberg trial on epidemiology of Parkinsonism and hypertension in the elderly: prevalence of Parkinson's disease and related disorders assessed by a door-to-door survey of inhabitants older than 65 years. [nature.com]

Epidemiology of cryptococcosis in France: a 9 year survey (1985-1993). Clin Infect Dis 1996;23(1):82-90. 5. Dismukes WE. Cryptococcal meningitis in AIDS. J Infect Dis 1998;157:624-628. 6. Hajjeh RA, Conn LA, Stephen DS, Baughman W, Hamill R, et al. [ijmm.org]

Epidemiology and clinical management of meningococcal disease in west Gloucestershire: retrospective, population based study. Br Med J. 1997 ;315: 774 - 779. [jic.sagepub.com]

In many reports, LP is temporally strongly associated with this event of herniation and is most likely causative based on pathophysiologic arguments. [ncbi.nlm.nih.gov]

Patients with neurologic symptoms are approached in a stepwise manner termed the neurologic method, which consists of the following: Identifying the anatomic location of the lesion or lesions causing symptoms Identifying the pathophysiology involved Generating [merckmanuals.com]

From a pathophysiological viewpoint, the post LP headache occurs because of the tear in the dura mater caused by the LP needle. [meds.queensu.ca]

In terms of the prevention and treatment of post-LP headaches, both are equally important in management. Following, is a discussion of which techniques and preventative measures are evidence based and which are not. [rebelem.com]

[…] headache and consider resting and lying flat for first 12 hours to help prevent possible headaches while things heal Editors & Reviewers Editors: Anthony J. [ebmconsult.com]

Chemotherapy can also be given into the spinal fluid, either to treat leukemia that has entered the spinal fluid, or to prevent it from developing in the spinal fluid. [leukemiabmtprogram.org]

Pencil-point needle in prevention of postspinal headache. JAMA. 1951; 147 657-658 3 Sprotte G, Schedel R, Pajunk H. Eine "atraumatische" Universalkanule fur einzeitige Regionalanasthesien. [oadoi.org]