If we get a patient of SAH L.P is the most sensitive test.If we do lumbar puncture and the intracranial pressure is raised ,wont it lead to cerebellar herniation, .So how do we proceed in daignosis of SAH.(CT scan is 90 -95% sensitive)i.e will L.P still be our best choice for daignosis.
prathapdoctor Forum Elite
Topics: 12 Posts: 406
06/12/07 - 12:00 PM
#2
if you suspect SAH, CT is the first test of choice then only you will go for LP.
doyoudig Forum Guru
Topics: 144 Posts: 613
06/12/07 - 12:13 PM
#3
if the Pt has no Signs of Papilledema than u can initially do LP, if there are signs then CT is ur best next option
asmaali_h Forum Newbie
Topics: 4 Posts: 11
06/13/07 - 08:38 AM
#4
thanks guys
DrVirgo Forum Hero
Topics: 1096 Posts: 3,515
06/13/07 - 10:48 AM
#5
For SAH, 1. First diagnostic test: Head CT w/o contrast to look for bleed.
if no bleed and no mass effect..... (remember that CT is only 90-95 % sensitive), and you still suspect SAH...
2. LP to show RBCs
if bleed consistent in amount in consecutive tubes (if not its a bloody/traumatic tap)
3. Angiography to guide the neurosurgeons to find where the aneurysm is so they can clip it. ___________________ Our greatest glory is not in never falling, but in rising every time we fall.
khorshid Forum Guru
Topics: 32 Posts: 591
06/13/07 - 05:56 PM
#6
That's right first CT, then LP.
DrVirgo Forum Hero
Topics: 1096 Posts: 3,515
06/13/07 - 06:19 PM
#7
The three situations in which you would ALWAYS do CT BEFORE LP.
