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jueves, 27 de abril de 2017

Is Head CT Needed Before LP

emDocs - April 24, 2017 - Authors: April M and Long B - Edited by: Koyfman A
"Key Takeaways:
  • The best available evidence suggests some association between LP and brainstem herniation in patients with intracranial mass effect lesions.
  • However, this risk is small, and there is no evidence that deferring LP prevents herniation in patients with these lesions.
  • Decision rules that attempt to identify patients most likely to have intracranial lesions with risk for post-LP herniation have several limitations and have not been validated.
  • Patients with significant pre-test probability for intracranial mass effect lesion or bacterial meningitis based on clinical assessment should receive head CT.
  • Antimicrobials are required if meningitis is suspected.
  • Concern for meningitis warrants antibiotics before CT if imaging will be obtained."