Cerebrospinal fluid collection

Re: Cerebrospinal fluid collection

Nick Shackleton — Thu, 24 Jun 2010 06:43:18 GMT

Any other info feel free to ask

Re: Cerebrospinal fluid collection

Honeybadger — Wed, 23 Jun 2010 09:43:03 GMT

Thats really interesting, thanks (Much better than my book!)

Re: Cerebrospinal fluid collection

Maisy — Tue, 22 Jun 2010 22:05:41 GMT

I've seen cisternal sample collection being carried out in general practice whilst locuming. The dog had ?meningitis and the vet advised referral/MRI etc which the owner declined. Not sure of the overall outcome but the dog certainly recovered well with no complications. It isn't the kind of procedure that would be ideal for someone with no knowledge/guidance to carry out-the vet had done a number of them from working in referral practices but still found them daunting.

Re: Cerebrospinal fluid collection

Nick Shackleton — Tue, 22 Jun 2010 22:01:58 GMT

Cisterna puncture produces a better sample as there is more CSF in the area of the cervical vertebrae compared to lumber region.

Can't recall seeing any complications. One problem that I have seen occur is contamination of the sample with blood, therefore a fresh needle must be used to collect a new sample, this may increase the risk of a break down in asepsis.

If a surgical aseptic technique is not adhered to therefore the possibility of introducing bacteria into the spinal canal, which could in theory lead to meningitis.

Sub arachnoid bleeds and direct puncture of the brain are also complications (not seen either of these) that could be seen in puncturing the cisterna magna. Fluoroscopic guidance could be used to reduce the risk of the above complications.

The main reason for using a lumber puncture would be so that a myelogram could be performed afterwards as this a far safer point to inject contrast media as there is less risk of it flowing onto the patients' brain, which can be irritant and cause seizures and death in worse case scenario.

Re: Cerebrospinal fluid collection

Honeybadger — Tue, 22 Jun 2010 21:42:01 GMT

Did they use Cisternal or Lumbar puncture? Or a mixture of both? Have you ever seen anything go wrong?

Re: Cerebrospinal fluid collection

Kim Buckley — Tue, 22 Jun 2010 21:32:16 GMT

I've only seen it in referral. Bit too scary for someone who doesn't know what they were doing if you ask me!

Re: Cerebrospinal fluid collection

Nick Shackleton — Tue, 22 Jun 2010 21:31:12 GMT

I would personally say it a rather specialist procedure to do. At the end of the day you are putting a needle into the patient's spinal canal.

I have not seen it performed in general practice. we used to do it on a regular basis in my previous practice (100% referral) and previous to this in 50% referral practice.