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Minerva anestesiologica · Apr 1998
Review[Reasons in favor of lumbar puncture diagnosis (or lavage)].
- G Schisano.
- Divisione di Neurochirurgia, Ospedale Nuovo Pellegrini, Napoli.
- Minerva Anestesiol. 1998 Apr 1; 64 (4): 135-6.
AbstractIn patients with strong suspicion of SAH, CT is the initial diagnostic procedure of choice. A lumbar puncture (LP) should be done if a CT is not available. If the patient has no focal deficit or papilloedema there is a little risk in LP. When a CT is negative there can be indication to do a LP: small leaks can be overlooked by CT, and they are often important premonitory events preceding larger and severe haemorrhages. The accuracy of CT in documenting SAH diminishes after 24 hours: thereafter, diagnosis is often dependent on LP. In some cases LP can be useful because the procedure may alleviate headache and remove some blood. LP can also quantify cerebro-spinal fluid (CSF) pressure, provide a baseline for future CSF determination, and allow the study of some parameters like arachidonate metabolites, lactic acid, fibrinogen degradation products (FDP) and thrombin-antithrombin complex (TAT).
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