Difference between revisions of "CT before lumbar puncture"

m (Rossdonaldson1 moved page CT Before Lumbar Puncture to CT before lumbar puncture)
(Text replacement - "Category:Neuro" to "Category:Neurology")
Line 7: Line 7:
 
<references/>
 
<references/>
  
[[Category:Neuro]]
+
[[Category:Neurology]]
 
[[Category:Procedures]]
 
[[Category:Procedures]]
 
[[Category:Rads]]
 
[[Category:Rads]]

Revision as of 14:15, 22 March 2016

LP without CT is likely safe if:[1]

  • History
    • Age < 60
    • Not immunocompromised
    • No history of CNS disease
    • No seizure within 1 week of presentation
  • Physical Exam

If none of the above, chance of normal ct is 97%; none of the patients herniated

CT findings that prohibit LP:[2]

  • Midline shift
    • Unequal pressures between the 3 cerebral compartments (left/right supretentorial compartments, posterior fossa)
    • Intracerebral masses not causing midline shift
  • Obstructive Hydrocephalus
    • Enlargement of ventricles prox to lesions and normal ventricles distal (especially 4th ventricle)
  • Basilar cisterns compressed
    • Lateral/3rd ventricles may be small due to diffuse cerebral edema or enlarged due to obstr. hydroceph. +/- shift
  • Posterior fossa mass
    • Displacement/compression of 4th ventricle

See Also

Source

  1. Computed Tomography of the Head before Lumbar Puncture in Adults with Suspected Meningitis. NEJM 2001; 345; 1727-33
  2. Emergency Radiology: Case Studies Schwartz