The Journal of Emergency Medicine
Volume 23, Issue 1 , Pages 67-74 , July 2002

Distinguishing traumatic lumbar puncture from true subarachnoid hemorrhage

  • Kaushal H Shah, MD

      Affiliations

    • Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
    • ,
  • Jonathan A Edlow, MD (FACEP)

      Affiliations

    • Corresponding Author InformationReprint Address: Jonathan A. Edlow, MD, FACEP, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Clinical Center 2, 330 Brookline Avenue, Boston, MA 02215, USA
    • Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

Received 25 May 2001 ,Revised 17 December 2001 ,Accepted 28 January 2002.

References 

  1. Marton KI, Gean AD. The spinal tap (a new look at an old test). Ann Intern Med. 1986;104:840–848
  2. Eskey CJ, Ogilvy CS. Fluoroscopy-guided lumbar puncture (decreased frequency of traumatic tap and implications for the assessment of ct-negative acute subarachnoid hemorrhage). Am J Neuroradiol. 2001;22:571–576
  3. Schievink WI. Intracranial aneurysms. N Engl J Med. 1997;336:28–40
  4. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28:14–20
  5. Beetham R, Fahie-Wilson M, Park D. What is the role of CSF spectrophotometry in the diagnosis of subarachnoid hemorrhage?. Ann Clin Biochem. 1998;35:1–4
  6. Edlow JA, Wyer PC. How good is a negative cranial computed tomographic scan result in excluding subarachnoid hemorrhage?. Ann Emerg Med. 2000;36:507–516
  7. Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. [see comments] N Engl J Med. 2000;342:29–36
  8. Page KB, Howell SJ, Smith CML, et al.  Bilirubin, ferritin, D-dimers and erythrophages in the cerebrospinal fluid of patients with suspected subarachnoid haemorrhage but negative computed tomography scans. J Clin Path. 1994;47:986–989
  9. Tsementzis SA, Hitchcock ER, DeCothi A, Gill JS. Comparative studies of the diagnostic value of cerebrospinal fluid spectrophotometry and computed tomographic scanning in subarachnoid hemorrhage. Neurosurgery. 1985;17:908–912
  10. Vermeulen M, Hasan D, Blijenberg BG, Hijdra A, Van Gijn J. Xanthochromia after subarachnoid haemorrhage needs no revisitation. J Neurol Neurosurg Psychiatry. 1989;52:826–828
  11. Schull M. Lumbar puncture first (an alternative model for the investigation of lone acute sudden headache). Acad Emerg Med. 1999;6:131–136
  12. Weir B. Diagnostic aspects of subarachnoid hemorrhage. In:  Weir B editors. Subarachnoid hemorrhage (causes and cures). New York: Oxford University Press; 1998;p. 144–176
  13. Abbrescia KL, Brabson TA, Dalsey WC, et al.  The effect of lower-extremity position on cerebrospinal fluid pressures. Acad Emerg Med. 2001;8:8–12
  14. Walton J. In: Subarachnoid hemorrhage. Edinburgh: E & S Livingstone, Ltd; 1956;p. 118–127
  15. Buruma O, Janson H, Den Bergh F, Bots G. Blood-stained cerebrospinal fluid (traumatic puncture or haemorrhage). J Neurol Neurosurg Psychiatry. 1981;44:144–147
  16. Tourtellotte WW, Somers JF, Parker JA, Itabashi HH, de Jong RN. A study of traumatic lumbar punctures. Neurology. 1958;8:129–134
  17. Fishman R. In: Chapter 8 (composition of the cerebrospinal fluid, 2nd ed. Cerebrospinal fluid in diseases of the central nervous system). Philadelphia: WB Saunders; 1992;p. 183–252
  18. Barrows L, Hunter F, Banker B. The nature and clinical significance of pigments in the cerebrospinal fluid. Brain. 1955;78:59–79
  19. Morgenstern LB, Luna-Gonzalez H, Huber JC, et al.  Worst headache and subarachnoid hemorrhage (prospective computed tomography and spinal fluid analysis). Ann Emerg Med. 1998;32(Part 1):297–304
  20. Judge B. Laboratory analysis of xanthochromia in patients with suspected subarachnoid hemorrhage (a national survey). Philadelphia, PA: Scientific Assembly, American College of Emergency Physicians; 2000;
  21. Edlow J, Bruner K, Horowitz G. Xanthochromia. Archives of Clinical Pathology and Laboratory Medicine. 2002;126:413–415
  22. Mendelow AD, Cartlidge N. Xanthochromia in subarachroid haemorrhage. J Neurol Neurosurg Psychiatry. 1990;53:270–271
  23. Lang DT, Berberian LB, Lee S, Ault M. Rapid differentiation of subarachnoid hemorrhage from traumatic lumbar puncture using the D-dimer assay. Am J Clin Pathol. 1990;93:403–405
  24. Matthews WF, Frommeyer WB. The in vitro behavior of erythrocytes in human cerebrospinal fluid. J Lab Clin Med. 1955;45:508–515

PII: S0736-4679(02)00464-X

The Journal of Emergency Medicine
Volume 23, Issue 1 , Pages 67-74 , July 2002

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