Correction for CSF protein in traumatic lumbar punctures

Traumatic lumbar puncture (LP) is fairly common and occurs when the needle causes bleeding into the subarachnoid space. Introduction of peripheral red blood cells (RBCs) in cerebrospinal fluid (CSF) increases CSF protein levels, thereby complicating diagnosis of bacterial meningitis.

This study examined the association between CSF RBC count and CSF protein level in a prospective cohort of 1298 children (median age, 3 months; age range, 0 days –23 years) who underwent LP in the emergency department at a children’s hospital in Boston and did not have evidence of meningitis. Most LPs were performed to evaluate for possible meningitis.

Overall, 189 patients (15%) had traumatic LPs (CSF RBC count >1000/mm3). CSF protein level increased by 1.1 mg/dL for every 1000-cell increase in CSF RBC count.

Nigrovic LE et al. Correction of cerebrospinal fluid protein for the presence of red blood cells in children with a traumatic lumbar puncture. J Pediatr 2011 Jul; 159:158.

Read all articles in Emergency Procedures, Lumbar Puncture, medical procedures, Neurological diseases, Traumatology
Tags: HPC updates, lumbar puncture, meningitis

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