Document Detail

Chance of aneurysm in patients suspected of SAH who have a 'negative' CT scan but a 'positive' lumbar puncture.
MedLine Citation:
PMID:  21901483     Owner:  NLM     Status:  MEDLINE    
In patients with sudden severe headache and a negative computed tomography (CT) scan, a lumbar puncture (LP) is performed to rule in or out a subarachnoid haemorrhage (SAH), but this procedure is under debate. In a hospital-based series of 30 patients with sudden headache, a negative CT scan but a positive LP (defined as detection of bilirubin >0.05 at wavelength 458 nm), we studied the chance of harbouring an aneurysm and the clinical outcome. Aneurysms were found in none of both patients who presented within 3 days, in 8 of the 18 (44%) who presented within 4-7 days and in 5 of the 10 (50%) who presented within 8-14 days. Of the 13 patients with an aneurysm, 3 (23%) had poor outcome. In patients who present late after sudden headache, the yield in terms of aneurysms is high in those who have a positive lumbar puncture. In patients with an aneurysm as cause of the positive lumbar puncture, outcome is in the same range as in SAH patients admitted in good clinical condition.
P Horstman; F H H Linn; H A M Voorbij; G J E Rinkel
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Publication Detail:
Type:  Journal Article     Date:  2011-09-08
Journal Detail:
Title:  Journal of neurology     Volume:  259     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-05     Completed Date:  2012-08-03     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  649-52     Citation Subset:  IM    
The Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands.
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MeSH Terms
Bilirubin / cerebrospinal fluid
Headache Disorders, Primary / etiology
Intracranial Aneurysm / cerebrospinal fluid,  complications,  radiography
Middle Aged
Spinal Puncture
Subarachnoid Hemorrhage / cerebrospinal fluid*,  complications,  etiology,  radiography*
Time Factors
Tomography, X-Ray Computed
Reg. No./Substance:

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