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Lumbar puncture

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https://www.readbyqxmd.com/read/29690727/-clinical-experience-and-next-generation-sequencing-analysis-of-encephalitis-caused-by-pseudorabies-virus
#1
W L Zhao, Y H Wu, H F Li, S Y Li, S Y Fan, H L Wu, Y J Li, Y L Lü, J Han, W C Zhang, Y Zhao, G L Li, X D Qiao, H T Ren, Y C Zhu, B Peng, L Y Cui, H Z Guan
Objective: To detect potential pathogens including pseudorabies virus in patients with encephalitis of unknown etiology in China and describe novel encephalitic entities. Methods: Patients with clinically suspected infectious encephalitis were enrolled in a multicenter study to identify the pathogens in PUMCH Encephalitis Program.Next-generation sequencing(NGS) of cerebrospinal fluid (CSF) was used in patients with encephalitis of unknown etiology enrolled from 2016 to 2017.The patients diagnosed as PRV encephalitis were studied to describe this novel entity...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29676357/is-a-diagnostic-lumbar-puncture-indicated-in-intraocular-retinoblastoma
#2
Sidharth Totadri, Vinay Munikoty, Usha Singh, Radhika Srinivasan, Amita Trehan, Richa Jain, Nandita Kakkar, Akshay Kumar Saxena, Arvind Rajwanshi, Deepak Bansal
Background: Lumbar puncture (LP) is frequently performed in patients with advanced intraocular retinoblastoma. However, this may not be necessary in a significant proportion of patients. Materials and Methods: A file review of patients who were diagnosed with retinoblastoma over a 13-year-period was performed. Patients who underwent LP as part of staging were included in the study. Results: The study included 223 patients. One-third had bilateral retinoblastoma...
April 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29675080/mycotic-cerebral-aneurysm-in-a-premature-infant
#3
John T Meadows, Don Hayes, Luis Rafael Moscote-Salazar, Willem Guillermo Calderon-Miranda
Mycotic cerebral aneurysms in neonates are extremely rare and can be difficult to diagnose without a high index of suspicion. We describe a 33-week gestation preterm neonate who developed a mycotic cerebral aneurysm leading to death before repair could be performed. We believe this to be the first literature reported case of a mycotic cerebral aneurysm in a preterm infant. This case revives the ongoing question of when to perform a lumbar puncture in a potentially septic or meningitic infant, while also casting light on maintaining a high index of suspicion for rare intracranial diagnoses that require cranial imaging...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29672450/downregulation-of-adenosine-and-adenosine-1-receptor-contributes-to-neuropathic-pain-in-resiniferatoxin-neuropathy
#4
Hung-Wei Kan, Chin-Hong Chang, Chih-Lung Lin, Yi-Chen Lee, Sung-Tsang Hsieh, Yu-Lin Hsieh
The neurochemical effects of adenosine signaling in small-fiber neuropathy leading to neuropathic pain are yet to be explored in a direct manner. This study examined this system at the level of ligand (via the ectonucleotidase activity of prostatic acid phosphatase, PAP) and adenosine A1 receptors (A1Rs) in resiniferatoxin (RTX) neuropathy, a peripheral neurodegenerative disorder which specifically affects nociceptive nerves expressing transient receptor potential vanilloid type 1 (TRPV1). We conducted immunohistochemistry on dorsal root ganglion neurons (DRG), high-performance liquid chromatography (HPLC) for functional assays, and pharmacological interventions to alter PAP and A1Rs in mice with RTX neuropathy...
April 16, 2018: Pain
https://www.readbyqxmd.com/read/29669791/retrospective-evaluation-of-infants-aged-1-60-days-with-residual-csf-tested-using-the-filmarray%C3%A2-meningitis-encephalitis-me-panel
#5
Anne J Blaschke, Kristen M Holmberg, Judy A Daly, Amy L Leber, Jennifer Dien Bard, Ernest K Korgenski, Kevin M Bourzac, Kristen J Kanack
In pediatric practice it is common for infants under 2 months of age to undergo evaluation for sepsis when they are ill, often including lumbar puncture (LP) to assess for central nervous system (CNS) infection. The FilmArray® Meningitis/Encephalitis (ME) Panel is a newly approved test for rapid identification of CNS pathogens. Our objective was to study the epidemiology of CNS infection in young infants and the potential impact of rapid multiplex PCR on their care.A performance evaluation of the FilmArray ME Panel was conducted from 2/2014-9/2014 at 11 sites...
April 18, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29668546/induction-dosage-of-propofol-for-repeated-sedations-in-children-with-hematological-disorders
#6
Alessandra Moretto, Alberto Zanella, Valentina Ciceri, Matteo Rota, Vittorio Scaravilli, Virginia Beltrama, Mariagrazia Bosatra, Antonio Pesenti
Pediatric patients with hematologic malignancies require several procedural sedations by means of propofol infusion. We retrospectively analyzed the medical records of leukemic pediatric patients who had undergone procedural sedations at an Italian tertiary referral center (San Gerardo Hospital, Monza) from January 2011 to November 2013. We retrieved the following: demographics; diagnosis; chemotherapy phase; use of corticosteroids; induction dosage of propofol, fentanyl and/or ketamine; and the type of procedure...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29664192/cerebrospinal-fluid-markers-of-extracellular-matrix-remodeling-synaptic-plasticity-and-neuroinflammation-before-and-after-cranial-radiotherapy
#7
E Fernström, K Minta, U Andreasson, Å Sandelius, P Wasling, A Brinkmalm, K Höglund, K Blennow, J Nyman, H Zetterberg, M Kalm
BACKGROUND: Advances in the treatment of brain tumors have increased the number of long-term survivors, but at the cost of side effects following cranial radiotherapy ranging from neurocognitive deficits to outright tissue necrosis. At present, there are no tools reflecting the molecular mechanisms underlying such side effects, and thus no means to evaluate interventional effects after cranial radiotherapy. Therefore, fluid biomarkers is of great clinical interest. OBJECTIVE: Cerebrospinal fluid (CSF) levels of proteins involved in inflammatory signaling, synaptic plasticity and extracellular matrix (ECM) integrity were investigated following radiotherapy to the brain...
April 17, 2018: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29663721/alveolar-rhabdomyosarcoma-in-the-cerebrospinal-fluid
#8
Janice S Ahn, Melina Flanagan
Alveolar rhabdomyosarcoma (RMS) is an aggressive soft tissue mass demonstrating rapid growth, dissemination, and leptomeningeal spread. Primary diagnosis is usually established by core biopsy. In rare cases, cytopathologic evaluation is indicated to identify recurrent or metastatic disease. We present a case of a 24-year-old man with a previously diagnosed alveolar RMS of the foot who presented to our institution with back pain. A lumbar puncture was performed and the cerebrospinal fluid (CSF) showed atypical cells demonstrating nuclear enlargement, eccentricity, binucleation, and frequent karyorrhexis...
April 16, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29663539/cryptococcal-infections-over-a-15-year-period-at-a-tertiary-facility-impact-of-guideline-management
#9
Ian Gassiep, Joel Douglas, Theophilus I Emeto, Katherine Crawley, Elliott G Playford
BACKGROUND: Cryptococcosis is an invasive fungal infection caused primarily by Cryptococcus neoformans and Cryptococcus gattii species, presenting predominantly as meningoencephalitis. The aim of this study is to assess all cryptococcal infections managed at our facility from 2001-2015 to determine incidence, risk factors, and comparison of outcomes prior to and following introduction of the 2010 Infectious Disease Society of America (IDSA) guidelines. METHODS: Retrospective analysis of all patients diagnosed and treated for cryptococcal infection occurring between January 2001 and December 2015...
April 17, 2018: Mycoses
https://www.readbyqxmd.com/read/29663282/the-frozen-brain-state-of-cryptococcus-gattii-a-globe-trotting-tropical-neurotropic-fungus
#10
Paul T Akins, Brian Jian
Initially reported in tropical regions, Cryptococcus gattii infection is now diagnosed globally. METHODS: case report; Literature review. Although initial reports described outbreaks of pulmonary and central nervous system (CNS) disease in tropical regions such as Australia and New Guinea, it is now clear that Cryptococcus gattii is a global, neurotropic pathogen. In contrast with C. neoformans, C. gattii patients are more likely to present with cryptococcomas in the brain and lungs and are often HIV negative...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29660553/a-novel-targeted-foraminoplasty-device-improves-the-efficacy-and-safety-of-foraminoplasty-in-percutaneous-endoscopic-lumbar-discectomy-preliminary-clinical-application-of-70-cases
#11
Shengxiang Ao, Junlong Wu, Wenjie Zheng, Yue Zhou
OBJECTIVES: Percutaneous endoscopic lumbar discectomy (PELD) has become a mature and mainstream surgical technique for treating lumbar disc herniation (LDH); however, there is a steep learning curve with PELD, especially for puncture and foraminoplasty. In this study, we assessed the outcome and safety of a novel quantificational and targeted foraminoplasty device named ZESSYS for LDH. METHODS: From September to December of 2016, 70 patients with symptomatic LDH were enrolled in the study...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29651451/toward-dynamic-lumbar-puncture-guidance-using-needle-based-single-element-ultrasound-imaging
#12
Haichong K Zhang, Younsu Kim, Melissa Lin, Mateo Paredes, Karun Kannan, Abhay Moghekar, Nicholas J Durr, Emad M Boctor
Lumbar punctures (LPs) are interventional procedures that are used to collect cerebrospinal fluid. Since the target window is small, physicians have limited success conducting the procedure. The procedure is especially difficult for obese patients due to the increased distance between bone and skin surface. We propose a simple and direct needle insertion platform, enabling image formation by sweeping a needle with a single ultrasound element at the tip. The needle-shaped ultrasound transducer can not only sense the distance between the tip and a potential obstacle, such as bone, but also visually locate the structures by combining transducer location tracking and synthetic aperture focusing...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29651369/unusual-relapse-of-chronic-lymphocytic-leukemia-after-remission
#13
Wajeeha Rizvi, Quoc Truong
Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia with over 20,000 estimated cases in 2017. Leukemic involvement of the nervous system from CLL causing neurologic symptoms is reported in only about one percent of patients. Unfortunately, there is no current standard therapy for the treatment of CLL leptomeningeal disease. In this case, we discuss an unusual presentation of CLL leptomeningeal disease misdiagnosed as chronic rebound headache. A 61-year-old female was diagnosed with Rai stage I CLL in 2002...
February 9, 2018: Curēus
https://www.readbyqxmd.com/read/29645365/pre-procedural-ultrasound-for-infant-lumbar-puncture-a-randomized-clinical-trial
#14
David Kessler, Vartan Pahalyants, Joshua Kriger, Gerald Behr, Peter Dayan
BACKGROUND: Our purpose was to determine the potential effect of pre-procedural ultrasound to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized ultrasound protocol. METHODS: This prospective, two-arm, parallel group randomized trial was conducted in a single-center pediatric emergency department. We compared pre-procedural ultrasound vs. palpation method on success with infant LPs...
April 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29629045/iatrogenic-development-of-cerebrospinal-fluid-leakage-in-diagnosing-spontaneous-intracranial-hypotension
#15
Chang-Joon Lee, Sung-Min Shim, Sang-Hyeon Cho, Jae-Ho Park, Young Ki Kim
A 34-year-old woman came to the emergency room complaining of a severe orthostatic headache. Results of a cerebrospinal fluid tap and brain computed tomography were normal. Based on her history and symptoms, she was found to have spontaneous intracranial hypotension. She was hospitalized and her symptoms improved with conservative treatment. On the next day, her headache suddenly worsened. Cisternography was performed to confirm the diagnosis and determine the spinal level of her cerebrospinal fluid leak. It revealed multiple cerebrospinal fluid leaks in the lumbar and upper thoracic regions...
March 2018: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29627993/the-diagnostic-dilemma-of-traumatic-lumbar-puncture-current-standing-of-cerebrospinal-fluid-leukocyte-corrections-and-our-experience-with-cerebrospinal-fluid-biomarkers
#16
Mudasir Nazir, Wasim Ahmad Wani, Khalid Kawoosa, Sheeraz Ahmad Dar, Muzaffar Malik, Naseer Yousuf Mir, Ikhlas Ahmad, Rais Ahmad Bhat, Javeed Iqbal Bhat, Qazi Iqbal Ahmad, Bashir Ahmad Charoo, Syed Wajid Ali
OBJECTIVE: To assess the diagnostic efficiency of cerebrospinal fluid markers of procalcitonin, lactate, and cerebrospinal fluid/serum lactate ratio for detecting bacterial meningitis during traumatic lumbar puncture, and to compare these markers with routinely used uncorrected and corrected leukocyte measurements. METHODS: Infants aged ≤90 days with traumatic lumbar puncture were prospectively studied. The diagnostic characteristics of cerebrospinal fluid assays of uncorrected and corrected leukocyte count, procalcitonin, lactate, and lactate ratio were described and compared...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29626021/acute-encephalitis-diagnosis-and-management
#17
Mark Ellul, Tom Solomon
Encephalitis, inflammation of the brain, is most commonly caused by a viral infection (especially herpes simplex virus [HSV] type 1 in the UK) although autoimmune causes, such as N-methyl D-aspartate receptor (NMDAR) antibody encephalitis, are increasingly recognised. Most patients present with a change in consciousness level and may have fever, seizures, movement disorder or focal neurological deficits. Diagnosis hinges crucially on lumbar puncture and cerebrospinal fluid (CSF) examination, but imaging and electroencephalography (EEG) may also be helpful...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29622505/preoperative-lumbar-drainage-placement-for-surgical-cranioplasty
#18
Henrik Giese, Jennifer Meyer, Andreas Unterberg, Christopher Beynon
OBJECTIVE: Intraoperative reduction of cerebrospinal fluid may be required in patients undergoing cranioplasty (CP) surgery, especially in the presence of bulging cranial defects. Direct cannulation of the frontal horn of the lateral ventricle is associated with risks such as intracerebral haemorrhage or postoperative leakage of cerebrospinal fluid. Here we report our initial experiences with preoperative lumbar drain (LD) placement for cranioplasty surgery in patients with bulging cranial defects...
April 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29620662/good-outcomes-after-the-delayed-removal-of-an-epidural-hematoma-a-case-report
#19
Yong-Xing Yao, Ming-Xia Li, Lian-Juan Sun
RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29619550/perspectives-on-diagnosis-and-management-of-adult-idiopathic-intracranial-hypertension
#20
Irini Chatziralli, Panagiotis Theodossiadis, George Theodossiadis, Ioannis Asproudis
PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed...
April 4, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
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