By palpating onto the iliac crest and spinal processes of the back, the site of needle puncture for lumbar puncture (LP) is identified. As the spinal cord ends at the level of L2 in adults, the spinal needle can be inserted safely between the L3/4 or L4/5 levels. The highest point of the iliac crest…
Lumbar punctures (LPs) are relatively safe procedures. However, some of the complications include: Post-lumbar puncture headache This is one of the most common complications after LP and occurs in 10-30% of patients receiving a LP. This is due to leakage of cerebrospinal fluid from the dura and traction on pain-sensitive structures. Patients with post-LP headache…
Normal Cerebrospinal Fluid The photos shown here is that of normal cerebrospinal fluid after a lumbar puncture. Normal cerebrospinal fluid is colourless and odorless. Xanthochromia The cerebrospinal fluid here shows xanthochromia (Figure 1), meaning of yellow discolorization. Presence of xanthrochromia means that there is presence of red cells in the cerebrospinal fluid. With time, the red…
A. Clinical Manifestations The classic triad of fever, headache and meningeal irritation (neck stiffness) sometimes do not occur altogether. Occasionally, patients may also have altered sensorium. Meningitis can be classified into acute, subacute, and chronic meningitis. Acute meningitis is characterized by onset of symptoms over the course of hours to up to several days. Subacute…
A. Clinical manifestations The clinical manifestations of encephalitis may be similar to those of meningitis. However, altered level of consciousness is a predominant sign. It can range from mild lethargy to deep coma. Moreover, focal or generalized seizures occur in many patients with encephalitis, especially in severe disease. Virtually every possible type of focal neurological…