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Procedure: Lumbar Puncture

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Total 141 results found since Jan 2013.

HSV-2 Encephalitis Presenting as Multifocal Ischemic Stroke (P4.375)
CONCLUSION A high index of suspicion needs to be maintained to diagnose infectious vasculitis. A history of immunosuppression and headache preceding cerebral infarction were important factors that ultimately led to the appropriate work up and diagnosis in this case. Lumbar puncture and prompt initiation of antiviral treatment is essential in stroke case of suspected CNS infection with HSV-2.Disclosure: Dr. Zhang has nothing to disclose. Dr. Sumida has nothing to disclose. Dr. Margolesky has nothing to disclose. Dr. Tornes has nothing to disclose. Dr. Ramos has nothing to disclose. Dr. Koch has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Zhang, F., Sumida, A., Margolesky, J., Tornes, L., Ramos, A., Koch, S. Tags: Cerebrovascular Case Reports Source Type: research

Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Clinical Sciences
Conclusions— In patients presenting with thunderclap headache and normal neurological examination, normal brain CT within 6 hours of headache is extremely sensitive in ruling out aneurysmal SAH.
Source: Stroke - February 22, 2016 Category: Neurology Authors: Dubosh, N. M., Bellolio, M. F., Rabinstein, A. A., Edlow, J. A. Tags: Computerized Tomography (CT), Cerebral Aneurysm, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage Clinical Sciences Source Type: research

Perceived Appropriateness of Shared Decision‐Making in the Emergency Department: A Survey Study
ConclusionsAcceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - January 25, 2016 Category: Emergency Medicine Authors: Marc A. Probst, Hemal K. Kanzaria, Dominick L. Frosch, Erik P. Hess, Gary Winkel, Ka Ming Ngai, Lynne D. Richardson Tags: Original Contribution Source Type: research

Perceived Appropriateness of Shared Decision-Making in the Emergency Department: A Survey Study.
CONCLUSIONS: Acceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective. This article is protected by copyright. All rights reserved. PMID: 26806170 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 25, 2016 Category: Emergency Medicine Authors: Probst MA, Kanzaria HK, Frosch DL, Hess EP, Winkel G, Ngai KM, Richardson LD Tags: Acad Emerg Med Source Type: research

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Cortical laminar necrosis due to refractory status epilepticus in a kidney transplant patient with cryptococcal meningitis
Publication date: Available online 17 November 2015 Source:Indian Journal of Transplantation Author(s): Zaheer Virani, Prashant Rajput, Pankaj Agarwal, Rashmi Badhe A 56-year-old diabetic male underwent kidney transplant in 2010. He was brought to the hospital with complaints of vomiting and altered sensorium of 10 days duration. Lumbar puncture revealed cryptococcal meningitis. He was promptly initiated on liposomal amphotericin B and flucytosine. Immunosuppressive agents tacrolimus and mycophenolate mofetil were discontinued. There was an initial improvement in his sensorium but a few days later, he developed super...
Source: Indian Journal of Transplantation - November 17, 2015 Category: Transplant Surgery Source Type: research

Serum TRSUT Titer ≥1: 16 Is a Predictor for Neurosyphilis Among HIV-Infected Patients With Concurrent Syphilis and No Neurological Symptoms
Abstract: Investigating the predictors for lumbar puncture to diagnose the asymptomatic neurosyphilis among HIV and syphilis co-infected patients in Shanghai, China. Respectively, screening the medical records from August 1, 2009 to June 30, 2015. Those HIV-infected patients with concurrent syphilis who had received lumbar puncture were selected and their clinical and demographic data were recorded. Participants comprised symptomatic and asymptomatic patients. The latter ones could be further divided into 3 groups: late syphilis, early syphilis with anti-syphilis treatment failure, and early syphilis with serum toludine re...
Source: Medicine - November 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The zebra sign
A 65 year old female was transferred to the Hyperacute Stroke Unit after a routine L5/S1 laminectomy. She suffered a small dural tear. 3 hours post procedure, her GCS dropped to 3. CT scan showed a bi-cerebellar haemorrhage and MRI brain the next day revealed a convexity subarachoid haemorrhage. Imaging was reviewed with neuroradiologists and neurosurgeons. They recognised this as a typical case of post-dural puncture remote cerebellar haemorrhage. In surgical literature there are many cases reported since 1981 of "the Zebra sign". Patients can become obtunded up to 72 hours after the injury. The mechanism of the haemorrha...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Patel, B., Nagendran, A., Khan, U. Tags: Brain stem / cerebellum, Stroke, Radiology, Radiology (diagnostics) Thur 21, Parallel session 5: Therapeutics Source Type: research

Multiple intracranial arteritis and hypothyroidism secondary to Streptococcus anginosus infection
A 50-year-old Chinese woman reported a sharp paroxysmal headache and abrupt paralysis of the left leg. She then developed ptosis, blurred vision, diplopia and fever. On admission, a neurological examination revealed right III, IV, VI and left V1 cranial nerve palsy, bilateral upper eyelid oedema and left leg monoplegia (Medical Research Council grade 2/5). In addition, a left Babinski sign and nuchal rigidity were observed. Blood tests revealed elevated white cell count (WCC) and a majority of the cells were neutrophils. Lumbar puncture revealed that the WCC (120x106/μL) and protein level (0.79 g/L) of the cerebros...
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 13, 2015 Category: Neurosurgery Authors: Zhang, C., Xie, B., Shi, F.-D., Hao, J. Tags: Open access, Immunology (including allergy), Meningitis, Brain stem / cerebellum, Cranial nerves, Drugs: CNS (not psychiatric), Headache (including migraine), Infection (neurology), Pain (neurology), Stroke, Hypertension, Ophthalmology, Radiology, Musculo Source Type: research

E-075 neurosarcoidosis presenting as aneurysmal subarachnoid hemorrhage: an interesting case and novel treatment
Neurosarcoidosis, the term used for sarcoidosis involving the central nervous system, represents an uncommon form of sarcoidosis, found in a 5% of patients with systemic sarcoidosis. Clinically evident cerebrovascular involvement in neurosarcoidosis has been reported but appears to be an extremely rare manifestation of neurosarcoidosis. The literature describes these cerebral vasculopathic changes as areas of stenosis and/or vascular irregularity, with clinical manifestations including headache, ischemic stroke, and parenchymal hemorrhage. Neurosarcoidosis has even been described as the etiology for a case of moyamoya synd...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Gaughen, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

De novo status epilepticus with isolated aphasia
Conclusions Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled “Status Epilepticus”.
Source: Epilepsy and Behavior - June 12, 2015 Category: Neurology Source Type: research

Paradoxical herniation after decompressive craniectomy provoked by lumbar puncture or ventriculoperitoneal shunting.
CONCLUSIONS Lumbar puncture and ventriculoperitoneal shunting carry substantial risk when performed in a patient after decompressive craniectomy and before cranioplasty. When the condition that prompts decompression (such as brain swelling associated with stroke or trauma) requires time to resolve, risk is associated with lumbar puncture performed ≥ 1 month after decompressive craniectomy. PMID: 26067613 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - June 12, 2015 Category: Neurosurgery Authors: Creutzfeldt CJ, Vilela MD, Longstreth WT Tags: J Neurosurg Source Type: research

De novo status epilepticus with isolated aphasia.
CONCLUSIONS: Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled "Status Epilepticus". PMID: 26044094 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - June 1, 2015 Category: Neurology Authors: Flügel D, Kim OC, Felbecker A, Tettenborn B Tags: Epilepsy Behav Source Type: research

CT within 6 hours of headache onset to rule out subarachnoid hemorrhage in nonacademic hospitals
Conclusions: Our results support a change of practice wherein a lumbar puncture can be withheld in patients with a head CT scan performed <6 hours after headache onset and reported negative for the presence of SAH by a staff radiologist in the described nonacademic setting.
Source: Neurology - May 11, 2015 Category: Neurology Authors: Blok, K. M., Rinkel, G. J. E., Majoie, C. B. L. M., Hendrikse, J., Braaksma, M., Tijssen, C. C., Wong, Y. Y., Hofmeijer, J., Extercatte, J., Kerklaan, B., Schreuder, T. H. C. M. L., ten Holter, S., Verheul, F., Harlaar, L., Pruissen, D. M. O., Kwa, V. I. Tags: All Headache, Diagnostic test assessment, CT, Subarachnoid hemorrhage ARTICLE Source Type: research

Myriad Manifestations of a Global Infectious Disease (I7-5A)
CONCLUSIONS: This case exhibits the myriad manifestations of tuberculosis in one patient; including meningitis, vasculitis, and tuberculomas. It also highlights that insular stroke in the non-dominant hemisphere could affect the cardiovascular-autonomic system.Disclosure: Dr. Prabhu has nothing to disclose. Dr. Raghupathi has nothing to disclose. Dr. Dissin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Prabhu, A., Raghupathi, R., Dissin, J. Tags: The Global Burden of Neurological Infections: Epidemiology, Treatment, and Prevention Poster Presentations Source Type: research