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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 ]
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 ...
The CSF tap test, sometimes lumbar tap test or Miller Fisher Test, is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be helpful in a patient with suspected normal pressure hydrocephalus (NPH).
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 management of scoliosis is complex and is determined primarily by the type of scoliosis encountered: syndromic, congenital, neuromuscular, or idiopathic. [1] Treatment options for idiopathic scoliosis are determined in part by the severity of the curvature and skeletal maturity, which together help predict the likelihood of progression.
ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O , which is a common scale used in lumbar punctures . [ 1 ] The body has various mechanisms by which it keeps the ICP stable, with CSF pressures varying by about 1 mmHg in normal adults through shifts in production and ...
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.
Radionuclide cisternography may be used to diagnose a spinal cerebrospinal fluid leak. CSF pressure is measured and imaged over 24 hours. [2] A radionuclide (radioisotope) is injected by lumbar puncture (spinal tap) into the cerebral spinal fluid to determine if there is abnormal CSF flow within the brain and spinal canal which can be altered by hydrocephalus, Arnold–Chiari malformation ...