Question

Case Scenario: A patient was admitted to Barrow Neurological Center after a serious car accident. Upon assessment, it is found he has a contusion in the main brain stem area. Breathing is affected, and the doctor believes a ventilator will be necessary to allow the brain to heal.

1. Question: The doctor has asked you to set the patient up for a cerebrospinal fluid analysis. Explain to family what to expect during this test.

Answer 1

CSF test to be done by Lumber puncture .The risk of LP ..... we have to insert a long specialized needle inside the spinal canal to get the fluid sorrounding brain and spinal canal and ,collect it for examination The  needle is inserted in between the bones of the spine (vertebrae) into the spinal canal. (The needle is most commonly placed between the third and fourth lumbar vertebrae.) usually after local anaesthesia

the fluid, its pressure,,naked eye examination and microscopy, and biochemical findings are sought

We have to explain why we are going to perform this to the patients party

1.

A lumbar puncture may be done to:

• Collect cerebrospinal fluid for analysis and to measure its pressure
• Inject spinal anesthetics, or other medications
• Inject dye (myelography) or radioactive substances (cisternography) into cerebrospinal fluid to make diagnostic images of the fluid's flow

We need the information because Information gathered from a lumbar puncture can help diagnose:in this case

• Bleeding around the brain (subarachnoid hemorrhage) can be diagnosed.

Now we have to explain the risk first to the patient party

When spinal fluid is removed during an LP, the risks include headache from a persistent spinal fluid leak, brain herniation, bleeding, and in worst case infection.may happen Each of these complications are uncommon with the exception of headache, which can appear from hours to up to a day after a lumbar puncture. Up to 25% of patients may  get headaches after the procedure. Headaches occur less frequently when the patient maintains supine position several hours after the procedure.The headache typically starts several hours up to two days after the procedure and may be accompanied by nausea, vomiting and dizziness. So the patient party should be informed about the risks.Back discomfort or pain. may .be there. The pain might radiate down the back of your legs.These also to be explained to the patient partyExcept that b;leeding or possibility of Brainstem herniation.is also there, These are to be explained to the patients