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Neurology and Neurosurgery

Facial Nerve Palsy

In this video, one can appreciate that the patient has a lower motor neuron type of weakness affecting the right facial nerve. On asking the patient to look upwards (stimulation of the frontalis muscles), one can appreciate the lack of wrinkles over the forehead on ...

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Indications of a Lumbar Puncture

A lumbar puncture (LP, also known as a spinal tap) is a diagnostic and at times, therapeutic medical procedure. Diagnostic indications The main diagnostic indications of performing a LP is for collection and evaluation of cerebrospinal fluid (CSF) for diagnosis and exclusion of infectious, inflammatory ...

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Contraindications of a Lumbar Puncture

A lumbar puncture (LP) is contraindicated in the following scenarios: Patients with bleeding diathesis, e.g. severe coagulopathy (INR >1.4) and thrombocytopenia (platelet <50 x 109/L). If coagulopathy or thrombocytopenia is not corrected prior to the procedure, spinal hematomas resulting in spinal cord compromise may result. ...

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Preparation of a Lumbar Puncture

Patient Position A lumbar puncture (LP) can be performed with the patient in the lateral recumbent position or sitting upright. The lateral recumbent position is preferred because it allows accurate measurement of the opening pressure. The patient shown in the photo here is in the ...

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Performing the Lumbar Puncture (Part 1)

In the video shown here, the patient is in the left lateral recumbent position. The lumbosacral region of the patient is clearly exposed. The doctor has put on sterile gloves and is applying disinfectant over the lumbar region. Sterile draping is then applied as shown ...

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