CT before lumbar puncture

Revision as of 23:38, 1 March 2011 by Robot (talk | contribs)

LP without CT is likely safe if:


  • History
  • Age < 60
  • Not immunocompromised
  • No history of CNS disease
  • No seizure within 1 week of presentation
  • Physical Exam
  • No ALOC
  • No inability to answer two consecutive questions successfully
  • No inability to follow two consecutive commands successfully
  • No gaze palsy
  • No abnormal visual fields
  • No facial palsy
  • No arm drift
  • No leg drift
  • No abnormal language



  • If none of the above, chance of normal ct is 97%, none of the patients herniated
  • CT before LP often results in longer average delay to abx


Source:

NEJM 2001; 345; 1727-33