Lumbar puncture

2010 ◽  
pp. 4749-4752
Author(s):  
Roger A. Barker ◽  
Wendy Phillips ◽  
R. Rhys Davies
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Subarachnoid Haemorrhage ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Central Nervous System Infection ◽  
Intrathecal Administration ◽  
Clinical Suspicion ◽  
Demyelinating Diseases

Lumbar puncture provides the means to sample cerebrospinal fluid for diagnostic purposes and to remove it for some therapeutic purposes. The procedure allows measurement of the pressure of cerebrospinal fluid, its cytological composition, biochemical content, and microbial as well as serological characteristics. Indications—the commonest diagnostic indications are clinical suspicion of central nervous system infection (meningitis, encephalitis), subarachnoid haemorrhage, and demyelinating diseases (central and peripheral); the commonest therapeutic indications are idiopathic intracranial hypertension and for intrathecal administration of drugs....

scholarly journals Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid

2020 ◽  
Author(s):  
Neeraj Singh ◽  
John J. Lansing ◽  
Aparna Polavarapu
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Status Epilepticus ◽  
Central Nervous System Infection ◽  
Case Series ◽  
Refractory Status Epilepticus ◽  
Multiple Drug ◽  
High Morbidity ◽  
Drug Interventions

AbstractStatus epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.

scholarly journals Bone marrow elements in cerebrospinal fluid: Review of literature with a case study

CytoJournal ◽  
2013 ◽  
Vol 10 ◽  
pp. 20 ◽  
Author(s):  
Anitha Ann Thomas ◽  
Felicia Tze Yee Goh
Keyword(s):  
Central Nervous System ◽  
Bone Marrow ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Young Children ◽  
Case Reports ◽  
Central Nervous System Infection ◽  
The Elderly ◽  
Review Of Literature

Presence of bone marrow elements in cerebrospinal fluid is rare. Journal publications on this topic are few and majority of them were written over a decade ago mostly as case reports in young children or the elderly. The increased cellularity and presence of myeloid precursors can be a pitfall and may be misdiagnosed as leukemia or lymphoma or central nervous system infection, when the specimen is actually not representative. With the intention to create awareness of potential pitfalls and avoid erroneous diagnoses, as well as adding on to the current photo archive of bone marrow elements in CSF, we present a recent case of bone marrow contaminants in the CSF of a 16-year-old girl.

scholarly journals Utility of Measuring (1,3)-β-d-Glucan in Cerebrospinal Fluid for Diagnosis of Fungal Central Nervous System Infection: TABLE 1

2014 ◽  
Vol 53 (1) ◽  
pp. 319-322 ◽  
Author(s):  
Jennifer L. Lyons ◽  
Kiran T. Thakur ◽  
Rick Lee ◽  
Tonya Watkins ◽  
Carlos A. Pardo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Fungal Infection ◽  
Fungal Infections ◽  
Central Nervous System Infection ◽  
Fungal Disease ◽  
Cns Disease

(1-3)-β-d-Glucan (BDG) from cerebrospinal fluid (CSF) is a promising marker for diagnostic and prognostic aid of central nervous system (CNS) fungal infection, but its relationship to serum values has not been studied. Herein, we detected BDG from CSF at levels 2-fold lower than those in serum in patients without evidence of fungal disease but 25-fold higher than those in in serum in noncryptococcal CNS fungal infections. CSF BDG may be a useful biomarker in the evaluation of fungal CNS disease.

scholarly journals Viral Molecular Testing of Cerebrospinal Fluid in Adults with Suspected Central Nervous System Infection in an Italian University Hospital Laboratory: A Retrospective Study on 1462 Consecutive Patients

2021 ◽  
Vol 15 (1) ◽  
pp. 26-35
Author(s):  
Monica Basso ◽  
Daniela Zago ◽  
Irene Pozzetto ◽  
Claudia Del Vecchio ◽  
Elisa Franchin ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Central Nervous System Infection ◽  
Human Herpesvirus ◽  
University Hospital ◽  
Unknown Etiology ◽  
Molecular Testing ◽  
Younger Patients ◽  
Hospital Laboratory

Background: Generally, about half of the patients with central nervous system infections cases remain unexplained. Therefore, we aimed to describe which viruses were detected in unselected patients with a suspected central nervous system infection and the first diagnostic workflow in a university hospital laboratory. Methods: A comprehensive virus testing in cerebrospinal fluid with an in-house real-time PCR method was employed. Determining how many and which viruses to test was at the full discretion of the treating physician. Results: 1462 patients were evaluated from 2011 to 2017 and 9 898 viral PCRs were made: 176 subjects (12%) had a positive result. There was great heterogeneity in the frequency of patients tested for each virus, ranging from 97.9% (1431 out of 1462) for herpes simplex virus (HSV) to 1.9% (28 out of 1462) for Parvovirus B19, positive in 1 patient. Enterovirus (EV) was the leading virus detected: the frequency was higher with respect to HSV (5.2% vs 2.4%, p=0.0004), varicella-zoster virus (VZV)(5.2% vs 2.9%, p=0.0052), human herpesvirus-6 (5.2% vs 1.7%, p=0.0014) and human herpesvirus-7 (HHV-7)(5.2% vs 2.5%, p=0.0406). Both VZV (83.5%) and HSV (97.9%) were tested significantly more than EV (68.7%, p<0.0001) and HHV-7 (24.1%, p<0.0001): the latter had a positivity comparable to HSV and it was detected in younger patients (median age 29 years), as for EV (median age 35 years). There was no difference found in the age of positive subjects with respect to negative ones for the other viruses tested. Conclusion: EV was the fifth virus frequently included in the diagnostic workflow but the most frequently detected, mostly in subjects aged less 40, as HHV-7 was. Testing these two viruses in all younger patients could reduce the number of unknown etiology.

scholarly journals When Ventricular Cerebrospinal Fluid Assessment Misleads: Basal Meningitis and the Importance of Lumbar Puncture Sampling

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Sadid F Khan ◽  
Thornton Macauley ◽  
Steven Y C Tong ◽  
Ouli Xie ◽  
Carly Hughes ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Lumbar Puncture ◽  
Cns Infection ◽  
Pathophysiological Mechanisms ◽  
Cns Infections ◽  
Fluid Assessment ◽  
Composition Gradients

Abstract The diagnosis of central nervous system (CNS) infection relies upon analysis of cerebrospinal fluid (CSF). We present 4 cases of CNS infections associated with basal meningitis and hydrocephalus with normal ventricular CSF but grossly abnormal lumbar CSF. We discuss CSF ventricular–lumbar composition gradients and putative pathophysiological mechanisms and highlight clinical clues for clinicians.

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