American Journal of Neuroradiology 23:175-176, January 2002
© 2002 American Society of Neuroradiology
Letter
Atraumatic Lumbar Puncture
a Santa Fe, NM 87501
Eskey and Ogilvey (1) conclude that the use of fluoroscopically guided lumbar punctures in patients with suspected subarachnoid hemorrhage should reduce the incidence of false-positive diagnoses of acute hemorrhage and therefore the number of unnecessary angiographic procedures. The authors may wish to consider another method of obtaining a lumbar puncture based on the experience of those of us who carried out pneumoencephalography before the days of CT. With the patient sitting erect and bending forward over a pillow on his or her lap, the interspinous distances are increased. An accurate midsagittal approach is easily ascertained and access to the subarachoid space is atraumatic and simple. I would submit that this method leads to fewer false-positive results than those of the usual bedside lateral decubitus approach and is less time-consuming and costly than the biplane fluoroscopic approach, which the authors advocate.
References
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Eskey CJ, Ogilvey CS. Fluroscopically guided lumbar puncture: decreased frequency of traumatic tap and implications for the assessment of CT-negative acute subarachnoid hemorrhage.
AJNR Am J Neuroradiol2001; 22
:571
–576
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