https://wikem.org/w/index.php?action=history&feed=atom&title=Template%3ACT_before_LP%2Fen 2026-04-16T14:33:26Z Revision history for this page on the wiki MediaWiki 1.38.2 https://wikem.org/w/index.php?title=Template:CT_before_LP/en&diff=385014&oldid=prev 2026-01-26T08:27:22Z

<p>Updating to match new version of source page</p> <p><b>New page</b></p><div>&lt;noinclude&gt;&lt;languages/&gt;&lt;/noinclude&gt;<br /> '''LP without CT is likely safe if:&lt;ref&gt;Computed Tomography of the Head before Lumbar Puncture in Adults with Suspected Meningitis. NEJM 2001; 345; 1727-33&lt;/ref&gt;'''<br /> *History <br /> **Age &lt; 60<br /> **Not immunocompromised<br /> **No history of CNS disease<br /> **No [[Special:MyLanguage/seizure|seizure]] within 1 week of presentation<br /> *Physical Exam<br /> **No [[Special:MyLanguage/altered level of consciousness|altered level of consciousness]]<br /> ***Ability to answer two consecutive questions successfully<br /> ***Ability to follow two consecutive commands successfully<br /> **Normal [[Special:MyLanguage/neurologic exam|neurologic exam]]<br /> <br /> ''If none of the above, chance of normal ct is 97%; none of the patients herniated''<br /> <br /> '''CT findings that prohibit LP:&lt;ref&gt;Emergency Radiology: Case Studies Schwartz&lt;/ref&gt;'''<br /> *Midline shift<br /> **Unequal pressures between the 3 cerebral compartments (left/right supretentorial compartments, posterior fossa)<br /> **Intracerebral masses not causing midline shift<br /> *Obstructive [[Special:MyLanguage/Hydrocephalus|Hydrocephalus]]<br /> **Enlargement of ventricles prox to lesions and normal ventricles distal (especially 4th ventricle)<br /> *Basilar cisterns compressed<br /> **Lateral/3rd ventricles may be small due to diffuse cerebral edema or enlarged due to obstr. hydroceph. +/- shift<br /> *Posterior fossa mass<br /> **Displacement/compression of 4th ventricle</div>

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