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Heme from red blood cells (RBC) that are in the cerebrospinal fluid because a blood vessel was damaged during the lumbar puncture (a "traumatic tap") has no time to be metabolized, and therefore no bilirubin is present. After the cerebrospinal fluid is obtained, a variety of its parameters can be checked, including the presence of xanthochromia.
Illustration depicting lumbar puncture (spinal tap) Spinal needles used in lumbar puncture Illustration depicting common positions for lumbar puncture procedure. The person is usually placed on their side (left more commonly than right). The patient bends the neck so the chin is close to the chest, hunches the back, and brings knees toward the ...
Ultrasound-guided lumbar puncture is a medical procedure used in some emergency departments to obtain cerebrospinal fluid for diagnostic purposes. In contrast to standard lumbar puncture by palpation , the use of ultrasound imaging may reduce the number of failed punctures, needle insertions, and needle redirections. [ 1 ]
An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive function is clinically reassessed. [1] The name "Fisher test" is after C. Miller Fisher , a Canadian neurologist working in Boston, Massachusetts, who described the test.
Quincke's puncture" is a somewhat outdated eponym for lumbar puncture, [4] [5] used for the examination of the cerebrospinal fluid in numerous diseases such as meningitis and multiple sclerosis. In 1893 he described what is now known as idiopathic intracranial hypertension , which he labeled "serous meningitis".
Decay correction is one way of working out what the radioactivity would have been at the time it was taken, rather than at the time it was tested. For example, the isotope copper-64, commonly used in medical research, has a half-life of 12.7 hours.
Given normal anatomy, the intracranial pressure will be reflected as a rapidly rising pressure measured from the lumbar needle, within 10–12 seconds. If there is a stenosis in the spine, there will be a damped, delayed response in the lumbar pressure, thus a positive Queckenstedt's maneuver.