LumbarPunctureWith increasing awareness of CT’s irradiation risk, I thought I would review a classic 2001 article from the New England Journal of Medicine. Head CT’s previously were commonly performed prior to all lumbar punctures (LP) to rule-out meningitis. When can you safely go straight to an LP without imaging?

Caveat: This review only applies to those patients in whom you suspect meningitis. This does not apply to those being worked up for subarachnoid hemorrhage.

PV Card: When To Skip Head CT Before LP for Meningitis


Adapted from [1] Go to ALiEM (PV) Cards for more resources.

Reference

  1. Hasbun R, Abrahams J, Jekel J, Quagliarello V. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001;345(24):1727-1733. [PubMed]
Michelle Lin, MD

Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD