Log in to search using one of your social media accounts:

 

Letter to the Editor: Pneumocephalus: Is the needle size significant?

Discussion. Pneumocephalus is defined by two mechanisms: a ball-valve and an inverted bottle concept.1 The ball-valve type implies positive pressure events, such as coughing or valsalva maneuvers, that prevent air escape. Tension pneumocephalus is included in this mechanism, causing a parenchymal mass effect. The inverted bottle theory includes a negative intracranial pressure gradient following cerebrospinal fluid drainage, relieved by air influx. A small pneumocephalus is usually sealed by blood clots or granulation, allowing spontaneous reabsorption and resolution.[1] Otherwise, the lateral positioning of a patient during spinal tap might create a lower intrathecal pressure with air being allowed into the subarachnoid space. Pneumocephalus also can develop when a stylet is reinserted into the needle before needle retraction, usually performed to minimize post-dural-puncture headache.[6] Pneumocephalus can be avoided by performing the LP in a sitting position, monitoring the amount of fluid drainage, carefully replacing the stylet to make sure the needle does not contain air, and instructing patients to briefly hold their breath and prevent making sudden movements during the procedure.[3] It is also important to consider needle size during a spinal tap. A smaller gauge makes a smaller dural perforation, causing less damage compared to larger ones; that also prevents cerebrospinal fluid leakage.[7,8] There is an inverse correlation between the needle gauge and post-dural-pun...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Assessment Tools CNS Infections Current Issue Letters to the Editor Neurologic Systems and Symptoms Neurology Stroke Traumatic Brain Injury epidural needle size Pneumocephalus spinal tap Source Type: research

Related Links:

Study into ‘health attacks’ on embassy staff sparks controversy, with some experts claiming situation is being spun for political gainWhen amystery illness rippled through the US embassy in Cuba in late 2016, the diplomatic fallout was rapid.The US slashed the number of people at its Havana mission and expelled 15 Cuban diplomats after at least 24 American staff and family reported a mix of headaches, dizziness, eyesight, hearing, sleep and concentration problems.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Cuba US foreign policy Science Espionage Health Americas US news Psychology Source Type: news
Abstract PURPOSE: The implementation of a chronic pain protocol (CPP) and its effects on the management of long-term opioid therapy are described. SUMMARY: The CPP used at a federally qualified health center and primary care clinic was updated in 2015 and included a prescribing ceiling in morphine equivalent dose (MED) per day and standardized the prescribing of chronic opioids. Intermittent urine drug screening performed at least once annually was added as a requirement of the pain management contract between the provider and the patient. An electronic report was developed to identify patients who were recei...
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
CONCLUSION: Patient and catheter phlebitis rates were not significantly different with infusions of 3% sodium chloride injection versus RCSs, suggesting that an osmolarity cutoff value of 900 mOsm/L for peripheral infusions of hypertonic saline solutions may not be warranted. PMID: 29472509 [PubMed - in process]
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
CONCLUSION: Other healthcare providers more consistently documented 5 Stage 1 MU criteria than did clinical pharmacists. Clinical pharmacists more consistently documented 2 core objectives than did other healthcare providers. PMID: 29472277 [PubMed - in process]
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
Abstract PURPOSE: Results of a study to compare the impact of clinical pharmacy specialist (CPS) interventions with primary care physician (PCP) interventions in veterans with type 2 diabetes mellitus (T2D) in a rural setting are presented. METHODS: A retrospective analysis was performed examining veterans diagnosed with T2D with a glycosylated hemoglobin (HbA1c) of ≥8% receiving treatment at a rural community-based outpatient clinic associated with the Memphis Veterans Affairs Medical Center. Propensity score matching was used to create a 1:1 cohort of patients managed by physicians or clinical pharmacy s...
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
CONCLUSIONS: The use of echocardiographic criteria for the presence of PH is adequate for the screening of COPD patients. Patients with acute exacerbation of COPD and possible/likely PH demonstrate worse mortality compared to patients unlikely to have PH. PMID: 29471029 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Cardiology - Category: Cardiology Tags: Hellenic J Cardiol Source Type: research
CONCLUSION: Isolated BAD may cause variable clinical manifestations and the outcome can be favorable. Application of different and advanced imaging studies with serial image follow-up are useful to confirm the diagnosis. PMID: 29468623 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
CONCLUSION: CNS Fusarium infection should be considered when an immunocompromised patient presenting with fever, conscious change, cranial nerve palsies, and angioinvasion suggested by brain imaging. To properly manage the disease, early effective antifungal therapy and neurosurgical intervention are important. PMID: 29468621 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
CONCLUSION: Nutritional status was poor in stroke patients across all stroke severities within weeks. Further longitudinal outcome studies to identify the poor outcome and the evolution of nutritional status are warranted. PMID: 29468620 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
Authors: Anner P, Mayerhöfer M, Wadsak W, Geleff S, Dudczak R, Haug A, Hacker M, Karanikas G Abstract The current study aimed to determine the optimum diagnostic imaging technique out of magnetic resonance imaging (MRI), 18F-fludeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT, otherwise known as PET/CT) and [18F]FDG-PET/MRI (otherwise known as PET/MRI) for the pelvic lymph node staging (N-staging) of untreated cervical carcinoma (CC). A total of 27 patients were included in the present study. All patients had undergone pre-treatment with PET/CT and MRI ≤45 days prior to undergo...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
More News: Alcoholism | Anesthesia | Anesthesiology | Aphasia | Back Pain | Brain | Computers | Craniofacial Surgery | CT Scan | Diabetes | Diabetes Mellitus | Encephalitis | Endocrinology | Fentanyl | Funding | Headache | Hemorrhagic Stroke | Hydrocephalus | Hypertension | Infectious Diseases | Insulin | Internal Medicine | Lumbar Puncture | Migraine | MRI Scan | Neurology | Neurosurgery | Nurses | Nursing | Pain | PET Scan | Psychiatry | Radiography | Stroke | Training | Universities & Medical Training