With 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  Go to ALiEM (PV) Cards for more resources.
- 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]