LUMBAR PUNCTURE 腰椎穿刺併發症CEREBRAL ... | Lumbar puncture brain herniation

CSF的判讀另寫一篇 https://blog.xuite.net/ymmcc/twblog/435889540 LUMBAR PUNCTURE 造成CEREBRAL HERNIATION 機率多高呢? uptodate 裡面提到.急診小醫師https://dictionary.cambridge.org/zht/日誌相簿影音好友名片200905071202LUMBARPUNCTURE腰椎穿刺併發症CEREBRALHERNIATION?腦神經科-中風-腦出血-腦膜炎CSF的判讀另寫一篇 https://blog.xuite.net/ymmcc/twblog/435889540LUMBARPUNCTURE造成CEREBRALHERNIATION機率多高呢?uptodate裡面提到.如果有IICP約12%會發生herniation. Cerebralherniation—ThemostseriouscomplicationofLPiscerebralherniation.Suspectedincreasedintracranialpressure(ICP)isarelativecontraindicationtoperformanceofanLPandalsorequiresindependentassessmentandtreatment.Incidence—Themagnitudeoftheriskwasevaluatedinareportof129patientswithincreasedICP:15patients(12percent)hadanunfavorableoutcomewithin48hoursofLP[61].Similarfindingswerenotedinaseriesof55patientswithSAH:sevenpatients(13percent)experiencedneurologicdeteriorationduringorsoonafteranLP,sixofwhomhadevidenceofcerebraldislocation[62].Cardiorespiratorycollapse,lossofconsciousness,anddeathmayfollow. 發生cerebralherniation約一半是立即發生.其他病患在穿刺後12小時內發生. A1969studyof30patientswithincreasedICPwhodeterioratedafterLPattemptedtoidentifytheclinicalfeaturesofpatientswhowereatgreatestriskforthiscomplication[63].Thefollowingfindingswerenoted:73percenthadfocalfindingsonneurologicexamination(includingdysphagia,hemiparesis,andcranialnervepalsies),30percenthaddocumentedpapilledemapriortotheLP,and30percenthadevidenceofincreasedICPonplainskullfilms(erosionoftheposteriorclinoidprocesses).Deteriorationoccurredimmediatelyinone-halfofthepatients,withtheremainderdecliningwithin12hours.https://www.uptodate.com/contents/lumbar-puncture-technique-indications-contraindications-and-complications-in-adults下面是腦膜炎死亡個案.20090500709123chiefcomplaint:dizzinessandnauseavitalsigns:BT35HR85RR20BP163/101CC:DIZZINESSANDVOMITINGTONIGHT,RIGHTEARPUSDISCHARGEDUETOCOMPH: ThepatientgotAOM(RIGHTEARBLEEDINGANDOTALGIA)6weeksago LABDATAGLU360  BUN10   AST11  NA134  K4.1  CRP1.24  WBC11770 SEG59.4HB15.4 thenext dayaftervisiting ER,thepatientdischargedat 18:10Duringt


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