Contraindications to lumbar puncture as defined by computed cranial tomography. 1987

D J Gower, and A L Baker, and W O Bell, and M R Ball
Department of Surgery, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.

Papilloedema is not always an adequate predictor of potential complications from lumbar puncture, and many clinicians are using computed tomography (CT) before lumbar puncture in an effort to identify more accurately the "at risk" patient. This paper identifies the following anatomical criteria defined by CT scanning that correlate with unequal pressures between intracranial compartments and predispose a patient to herniation following decompression of the spinal compartment: lateral shift of midline structures, loss of the suprachiasmatic and basilar cisterns, obliteration of the fourth ventricle, or obliteration of the superior cerebellar and quadrigeminal plate cisterns with sparing of the ambient cisterns. These criteria should be considered to be contraindications to lumbar puncture.

UI MeSH Term Description Entries
D007427 Intracranial Pressure Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D008297 Male Males
D004677 Encephalocele Brain tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. Frontal Encephalocele,Hernia, Cerebral,Occipital Encephalocele,Acquired Encephalocele,Bifid Cranium,Cephalocele,Cerebellar Hernia,Cerebellar Herniation,Cranial Meningoencephalocele,Craniocele,Cranium Bifidum,Encephalocele, Acquired,Encephalocele, Frontal,Encephalocele, Occipital,Encephalocele, Sincipital,Notoencephalocele,Sincipital Encephalocele,Tonsillar Hernia,Tonsillar Herniation,Acquired Encephaloceles,Bifid Craniums,Bifidum, Cranium,Bifidums, Cranium,Cephaloceles,Cerebellar Hernias,Cerebellar Herniations,Cerebral Hernia,Cerebral Hernias,Cranial Meningoencephaloceles,Cranioceles,Cranium Bifidums,Cranium, Bifid,Craniums, Bifid,Encephaloceles,Encephaloceles, Acquired,Encephaloceles, Frontal,Encephaloceles, Occipital,Encephaloceles, Sincipital,Frontal Encephaloceles,Hernia, Cerebellar,Hernia, Tonsillar,Hernias, Cerebellar,Hernias, Cerebral,Hernias, Tonsillar,Herniation, Cerebellar,Herniation, Tonsillar,Herniations, Cerebellar,Herniations, Tonsillar,Meningoencephalocele, Cranial,Meningoencephaloceles, Cranial,Notoencephaloceles,Occipital Encephaloceles,Sincipital Encephaloceles,Tonsillar Hernias,Tonsillar Herniations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013129 Spinal Puncture Tapping fluid from the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae. Lumbar Puncture,Spinal Tap,Lumbar Punctures,Puncture, Lumbar,Puncture, Spinal,Punctures, Lumbar,Punctures, Spinal,Spinal Punctures,Spinal Taps,Tap, Spinal,Taps, Spinal
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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