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Cerebrospinal fluid sampling – (a) cerebellomedullary cistern

image of Cerebrospinal fluid sampling – (a) cerebellomedullary cistern
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Abstract

Cerebrospinal fluid (CSF) samples are used in cases of suspected meningitis, infectious or inflammatory central nervous system disease, pyrexia of unknown origin, and suspected central nervous system (CNS) lymphoma, or when imaging and other diagnostic tests are inconclusive.

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Figures

Image of Figure C.8:
Figure C.8: The patient should be placed in lateral recumbency with an assistant holding the head in position to obtain a cerebrospinal fluid sample from the cerebellomedullary cistern.
Image of Figure C.9:
Figure C.9: Needle insertion site (X). = atlas; = occipital protuberance. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission
Image of Figure C.10:
Figure C.10: The needle should be inserted parallel to the table surface and perpendicular to the skin. The needle should be advanced slowly into the subarachnoid space. Collection tubes for samples. Cerebrospinal fluid should be allowed to drip passively from the needle hub into a collection tube.

Supplements

Procedure video: Cerebrospinal fluid sampling - cerebellomedullary cistern

This video shows how to sample cerebrospinal fluid at the cerebellomedullary cistern. Please note that, for filming purposes, this procedure was performed on a cadaver. Appropriate aseptic techniques should be employed when performing this procedure.

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