What are the indications for CT head imaging prior to LP?

What are the indications for CT head imaging prior to LP?

According to the Infectious Diseases Society of America guidelines, the following are indications for screening head CT before LP in adult patients :

• Immunocompromised state.
• History of CNS disease (eg, mass lesion, stroke, or focal infection)
• Seizure within 1 week of presentation.
• Papilledema.

Why is lumbar puncture avoided in increased intracranial pressure?

As the space-occupying lesion grows, ICP rises. When lumbar puncture is performed in these patients, a low-pressure shunt is formed at the site of LP where CSF can escape. As the CSF pressure drops in the spinal column, CSF and brain mass may then shift towards the low-pressure outlet (the LP site).

What are contraindications for lumbar puncture?

Absolute contraindications for performing a LP include infected skin over the puncture site, increased intracranial pressure (ICP) from any space-occupying lesion (mass, abscess), and trauma or mass to lumbar vertebrae.

Can you do LP without CT?

In the authors’ opinion, patients who are moderately ill with elevated fever and without neurologic deficits should undergo LP without CT. Furthermore, a normal CT scan does not reliably ensure that the CSF pressure is not elevated. In a retrospective study of 112 patients, 42 patients had opening pressures recorded.

What are the indications of lumbar puncture?

Lumbar puncture should be performed for the following indications:

• Suspicion of meningitis.
• Suspicion of subarachnoid hemorrhage (SAH)
• Suspicion of nervous system diseases such as Guillain-Barré syndrome and carcinomatous meningitis.
• Therapeutic relief of pseudotumor cerebri.

Why would you need a lumbar puncture after a CT scan?

A CT or MRI performed prior to the procedure helps determine if there is increased intracranial pressure in advance of a lumbar puncture. There is always a slight chance of cancer from excessive exposure to radiation.

What are the indications for lumbar puncture?

Why might it be advisable to perform a CT scan before doing a lumbar puncture in a patient suspected of any condition causing intracranial hypertension?

A computed tomography (CT) scan of the head is frequently ordered by clinicians prior to performing a lumbar puncture (LP) to rule out an intracranial abnormality with elevated intracranial pressure that could potentially place the patient at risk for brain herniation, a rare, yet fatal complication [1–5].

Why do a CT scan before lumbar puncture?

Who needs CT before LP?

When should you not do LP?

We recommend not performing an LP in patients with coagulation defects who are actively bleeding, have severe thrombocytopenia (eg, platelet counts <50,000 to 80,000/microL), or have an international normalized ratio (INR) >1.4, without correcting the underlying abnormalities.

What should you do before a lumbar puncture?

Before having a lumbar puncture

1. you can eat, drink and take medicine as normal.
2. you’ll be asked to sign a consent form.
3. you’ll usually need to undress and change into a hospital gown before the procedure – you might also want to use the toilet.

When to do brain CT before lumbar puncture?

Indications for performing brain CT scanning before lumbar puncture in patients with suspected meningitis include the following: Patients who are older than 60 years. Patients who are immunocompromised. Patients with known CNS lesions. Patients who have had a seizure within 1 week of presentation.

When is a brain CT scan indicated prior to performing a?

Indications for performing brain CT scanning before lumbar puncture in patients with suspected meningitis include the following [ 8] : Patients with papilledema seen on physical examination, with clinical suspicion of an elevated ICP Farley A, McLafferty E. Lumbar puncture.

Who is a good candidate for a lumbar puncture?

Our findings indicate that adults with suspected meningitis who have none of the significant base-line features that we identified are good candidates for immediate lumbar puncture, since they have a low risk of brain herniation as a result of lumbar puncture.

What are the IDSA guidelines for screening head CT?

According to the Infectious Diseases Society of America guidelines, the following are indications for screening head CT before LP in adult patients: Immunocompromised state. History of CNS disease (eg, mass lesion, stroke, or focal infection) Seizure within 1 week of presentation. Papilledema.