NDLI: Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

Please wait, while we are loading the content...

Extensive basal ganglia edema caused by a traumatic carotid-cavernous fistula: a rare presentation related to a basal vein of Rosenthal anatomical variation.

Brain involvement by leprosy presenting as a frontal cystic lesion.

Early experience with stent retrievers and comparison with previous-generation mechanical thrombectomy devices for acute ischemic stroke.

Association of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study.

Hoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder.

Prognostic value of retinal nerve fiber layer thickness for postoperative peripheral visual field recovery in optic chiasm compression.

Neuroprotective effects of erythropoietin pretreatment in a rodent model of transient middle cerebral artery occlusion.

Deep brain stimulation for Huntington's disease: long-term results of a prospective open-label study.

Challenges in sciatic nerve repair: anatomical considerations.

Amelioration of oxidative stress and protection against early brain injury by astaxanthin after experimental subarachnoid hemorrhage.

Comparative inpatient resource utilization for patients undergoing endoscopic or microscopic transsphenoidal surgery for pituitary lesions.

Neuro-ophthalmic effects of stenting across the ophthalmic artery origin in the treatment of intracranial aneurysms.

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

A novel device for hands-free positioning and adjustment of the surgical microscope.

Twist-drill craniostomy with hollow screws for evacuation of chronic subdural hematoma.

Endoscopic endonasal transsphenoidal approach to large and giant pituitary adenomas: institutional experience and predictors of extent of resection.

The endoscopic endonasal approach for the management of craniopharyngiomas: a series of 103 patients.

Hemorrhage risks and functional outcomes of untreated brainstem cavernous malformations.

Brain shift during bur hole-based procedures using interventional MRI.

Endoscopic endonasal transcavernous posterior clinoidectomy with interdural pituitary transposition.

The effect of stem cells in bridging peripheral nerve defects: a meta-analysis.

Neuronavigation using susceptibility-weighted venography: application to deep brain stimulation and comparison with gadolinium contrast.

Analysis of 30-day readmissions among neurosurgical patients: surgical complication avoidance as key to quality improvement.

Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations.

Stent-assisted coil embolization of ruptured wide-necked aneurysms in the acute period: incidence of and risk factors for periprocedural complications.

Year: 2014 Volume: 121 Issue: Supplementary

Year: 2014 Volume: 120

Year: 2013 Volume: 119

Year: 2013 Volume: 118

Year: 2012 Volume: 117

Year: 2012 Volume: 116

Year: 2011 Volume: 115

Year: 2011 Volume: 114

Year: 2010 Volume: 113

Year: 2010 Volume: 112

Year: 2009 Volume: 111

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Thomas, Lisa E. Czuczman, Amanda D. Boulanger, Alyson B. Peak, David A. Miller, Emily S. Brown, David F. M. Marill, Keith A.
Description	Author Affiliation: Thomas LE ( Department of Emergency Medicine, University of Maryland Upper Chesapeake Medical Center, Bel Air, Maryland)
Abstract	UNLABELLED: OBJECT.: When patients present to the emergency department (ED) with acute headache concerning for subarachnoid hemorrhage (SAH) and a lumbar puncture (LP) shows blood in the CSF, it is difficult to distinguish the results of a traumatic LP from those of SAH. CT angiography (CTA) is often performed, but the long-term outcome for patients with a positive LP and normal neurovascular imaging remains uncertain. The primary objective of this study was to determine whether patients who presented to the ED with acute headache and had red blood cells (RBCs) in their CSF on LP but negative cerebrovascular imaging suffered subsequent SAH. METHODS: A case series study of consecutive adult ED patients who incurred charges for LP between 2001 and 2009 was performed from 2010 through 2011. Inclusion criteria were: headache, > 5 RBCs/mm(3) in CSF, noncontrast head CT with no evidence of hemorrhage, and cerebrovascular CTA or MRA without aneurysm or vascular lesion within 2 weeks of the ED visit. Patients with less than 6 months of available follow-up were excluded. The primary outcomes were 1) subsequent nontraumatic SAH and 2) new vascular lesion. Secondary outcomes were complications related to SAH, or LP or angiography. RESULTS: Of 4641 ED patients billed for an LP, 181 patients (mean age 42 years) were included in this study. Over a median follow-up of 53 months, 0 (0%) of 181 patients (95% CI 0%-2.0%) had a subsequent SAH or new vascular lesion identified. Although not the primary outcome, there was 1 patient who was ultimately diagnosed with vasculitis. Eighteen (9.9%) of 181 patients (95% CI 6.0%-15.3%) had an LP-related complication and 0 (0%) of 181 patients (95% CI 0%-2.0%) had an angiography-related complication. CONCLUSIONS: Patients who present to the ED with acute headache concerning for SAH and have a finding of bloody CSF on LP but negative findings on cerebrovascular imaging are at low risk for subsequent SAH and thus are likely to be safe for discharge. Replacement of the CT/LP with a CT/CTA diagnostic algorithm merits further investigation.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	1
Volume Number	121
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2014-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Cerebral Angiography Headache Etiology Subarachnoid Hemorrhage Diagnosis Emergency Service, Hospital Cerebrospinal Fluid Retrospective Studies Spinal Puncture Complications Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Detection of subarachnoid haemorrhage on early CT: is lumbar puncture still needed after a negative scan?

Gross xanthochromia on lumbar puncture may not represent an acute subarachnoid hemorrhage.

Risk-benefit analysis of lumbar puncture to evaluate for nontraumatic subarachnoid hemorrhage in adult ED patients.

Continuous cerebral spinal fluid drainage associated with complications in patients admitted with subarachnoid hemorrhage.

Subarachnoid haemorrhage: lumbar puncture for every negative scan?

Sensitivity of newer-generation computed tomography scanners for subarachnoid hemorrhage: a Bayesian analysis.

Headache Over Heels: CT Negative Subarachnoid Hemorrhage

Validation of cerebrospinal fluid findings in aneurysmal subarachnoid hemorrhage.

Evaluating the sensitivity of visual xanthochromia in patients with subarachnoid hemorrhage.

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

Similar Documents

Detection of subarachnoid haemorrhage on early CT: is lumbar puncture still needed after a negative scan?

Gross xanthochromia on lumbar puncture may not represent an acute subarachnoid hemorrhage.

Risk-benefit analysis of lumbar puncture to evaluate for nontraumatic subarachnoid hemorrhage in adult ED patients.

Continuous cerebral spinal fluid drainage associated with complications in patients admitted with subarachnoid hemorrhage.

Subarachnoid haemorrhage: lumbar puncture for every negative scan?

Sensitivity of newer-generation computed tomography scanners for subarachnoid hemorrhage: a Bayesian analysis.

Headache Over Heels: CT Negative Subarachnoid Hemorrhage

Validation of cerebrospinal fluid findings in aneurysmal subarachnoid hemorrhage.

Evaluating the sensitivity of visual xanthochromia in patients with subarachnoid hemorrhage.

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.