1/5/2024 0 Comments Lumbar puncture positionA serum bottle for electrophoresis paired with CSF when checking for oligoclonal bands (when diagnosing multiple sclerosis for instance).A serum glucose bottle is part of the equipment (a paired serum with CSF glucose is usually sent particularly in infective diagnosis).Some centres use up to three, others four, but this will depend on the number of tests needed. These should normally be pre-labelled with a number (1-6). Up to 6 sample bottles (usually white top) depending on the tests required from the sample.It is good practice that consent is obtained before undertaking any invasive intervention or procedure, and this is the case for performing a lumbar puncture. Posterior fossa tumour or other suspected 4 th ventricular lesion.Disorders of coagulation or blood diathesis.Suspected intracranial mass lesion or space occupying lesion.It important to note that in suspected SAH, a lumbar puncture 12 hours after onset of symptoms is ideal, but can be diagnostic after 2 weeks of onset. Administration of therapeutic agents (for chemotherapy, analgesia/anaesthesia, antimicrobial therapy).Exclusion of neurological, vasculitic, autoimmune or paraneoplastic disorders and syndromes. ![]() Aid diagnosis of normal pressure hydrocephalus.Treat raised intracranial pressure (idiopathic intracranial hypertension or other causes such as meningitis).Diagnosis of meningitis (bacterial, viral, fungal, malignant, atypical).In cases of suspected subarachnoid haemorrhage (SAH).It has subsequently become a procedure that can be diagnostic or therapeutic, and the technique has become more refined with improved instruments, awareness of aseptic techniques and the increased availability and knowledge of anaesthesia. The Lumbar Puncture was a procedure dedicated to the relief of symptoms (at that time mainly meningitis or raised intracranial pressure). One month after Quincke’s report to the congress, Walter Essex Wynter, a Registrar at the time, published in the Lancet 4 cases of cerebrospinal fluid (CSF) aspiration in patients with meningitis suspected. Lumbar puncture in this patient relieved the symptoms. The other case was in a patient that had chronic hydrocephalus and suffered headaches. The procedures were done at 3 day intervals and the patient recovered. Heinrich Irenaeus Quince (with whom the Lumbar Puncture is commonly associated with) reported to the tenth congress of Internal Medicine in April 1891 that he had performed in one case 3 lumbar punctures in a patient with suspected tuberculous meningitis who was comatose. The first reports of a lumbar puncture (LP) being undertaken are from the late 19 th century. Author(s): Clarence Mwelwa Patrick ChikusuĬlinical Fellow, Acute and Elderly Care Medicine, Ashford and St Peter’s Hospitals NHS Foundation TrustĬorrespondence to:Clarence Chikusu Background
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