Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Punctures”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,099 records · Page 61Linked to original sources
PubMed2001

PET-CT-guided percutaneous puncture of an infected cyst in autosomal dominant polycystic kidney disease: case report.

An infected cyst in autosomal dominant polycystic kidney disease was identified with a combined positron emission tomographic (PET) and computed tomographic (CT) system, an experimental setup mimicking an integrated CT-PET scanner. Image fusion of fluorine 18 fluorodeoxyglucose PET and CT images allowed exact localization of the infected cyst among many cysts identified on previous CT and magnetic resonance images. Confirmation was obtained instantly, followed by CT-guided percutaneous puncture. Integrated imaging systems hold promise for direct PET-guided puncture of areas of increased fluorodeoxyglucose uptake by using the anatomic accuracy of CT.

Escherichia coli Infections↗
PubMed1980

Ultrasonically guided punctures. A modified technique.

Punctures guided by ultrasound were performed in 59 patients with the aid of a modern dynamic sector scanner and a needle-guide unit fitted on the transducer head. The passage of the needle through the tissues could be observed on the monitor during puncture of both cysts and solid tissues. Consequently, the direction or position of the needle can be corrected if necessary.

Biopsy, Needle↗
PubMed1985

Pseudoaneurysm: a complication of faulty technique in femoral arterial puncture.

Pseudoaneurysm is a well-documented but rare complication of retrograde femoral arterial puncture. We present six patients in whom pseudoaneurysm complicated this procedure. The pseudoaneurysm arose from the superficial femoral artery in five patients and from the profunda femoris artery in one. An arteriovenous fistula also arose from the superficial femoral artery in one patient. In no patient did the pseudoaneurysm arise from the common femoral artery. Two mechanisms are postulated as to why pseudoaneurysms rarely complicate puncture of the common femoral artery.

Aneurysm↗
PubMed1991

Diagnostic fine-needle puncture of the gallbladder with US guidance.

From February 1988 to January 1990, 118 fine-needle diagnostic punctures of the gallbladder (DPG) were performed under continuous ultrasound (US) guidance on symptomatic patients with gallstones. The first attempt at gallbladder puncture and aspiration was successful in every patient with use of a 22-gauge needle and continuous US visualization of the needle tip. The aspirated volume varied between 3 and 88 mL (average +/- standard deviation, 25.0 mL +/- 15.3). Biliary analysis revealed an elevation of the cholesterol saturation index in patients with cholesterol gallstones (attenuation at computed tomographic examination of 50 HU or less) relative to that in patients with pigment stones (attenuation more than 50 HU) (1.3 +/- 0.2 vs 1.0 +/- 0.1, P less than .05). The nucleation time was prolonged in patients with pigment stones (19.3 days +/- 3.5 vs 1.8 days +/- 0.8 for patients with cholesterol stones, P less than .001). All patients remained hospitalized for 24 hours after DPG and were reexamined on an outpatient basis at 1 and 3 months thereafter. No complications were detected during either short-term observation or long-term follow-up. The authors conclude that DPG is a safe and valuable technique in the diagnostic work-up of gallstone patients to establish their suitability for nonoperative treatment.

Adolescent↗
PubMed1991

New device for CT-targeted percutaneous punctures.

A device for computed tomography (CT)-guided percutaneous punctures that is not affixed to the patient and can be used even when the gantry is tilted was developed and tested. In initial patient examinations, the device was accurate within 1.0 mm of the predetermined target point. Experience so far has involved retrobulbar anesthesia and puncture of intervertebral disk space.

Anesthesia, Local↗
PubMed1999

Craniofacial arteriovenous malformation: preoperative embolization with direct puncture and injection of n-butyl cyanoacrylate.

PURPOSE: To evaluate the use of n-butyl cyanoacrylate (NBCA) for preoperative embolization of craniofacial arteriovenous malformation. MATERIALS AND METHODS: Fourteen patients with craniofacial arteriovenous malformation (forehead [n = 9], deep facial [n = 3], occipital [n = 1], or lip [n = 1] lesion) were treated with injection of NBCA. Forehead lesions were supplied by ophthalmic (n = 6) and/or superficial temporal arteries (n = 7); and facial and scalp lesions, by bilateral internal maxillary (n = 4), facial (n = 2), and/or occipital arteries (n = 1). Lesions were percutaneously punctured with a 20-gauge needle in the area of arteriovenous connection. Direct angiography was performed before and after compression of venous drainage, and NBCA diluted 30%-50% with iodized oil was injected during venous compression. RESULTS: Postembolization arteriograms showed that six lesions were completely devascularized after single or multiple (one to nine) injections, and five were effectively devascularized (> or = 90%). Although three lesions were 60%-70% devascularized after injection, two of these were successfully extirpated with no notable blood loss. In nine patients, the ophthalmic arterial supply had disappeared after embolization. There were no procedure-related complications. CONCLUSION: Direct-puncture embolization with NBCA is an effective and safe technique for preoperative devascularization of craniofacial arteriovenous malformation. For safe and effective devascularization, compression of draining venous channels is thought to be important.

Adolescent↗
PubMedDate not supplied

Cerebral thrombophlebitis in three patients with probable multiple sclerosis. Role of lumbar puncture or intravenous corticosteroid treatment.

We report 3 cases of young patients, 2 women and 1 man, who presented a cerebral venous thrombosis following intravenous treatment with high doses of corticosteroids. All of them presented a probable multiple sclerosis according to clinical, biological (CSF) and MRI criteria and were treated for the first time by a bolus of 1,000 mg of methylprednisolone OD during 5 days. All the usual causes of cerebral venous thrombosis were systematically excluded in all of them. The role of corticosteroid treatment in cerebral thrombophlebitis is discussed. All of them underwent a lumbar puncture a few days before corticosteroid treatment and the relationship between lumbar puncture and cerebral thrombophlebitis is also discussed. Cerebral venous thrombosis associated with corticosteroid treatment has rarely been reported. The relationship between corticosteroids and venous thrombosis has already been suggested but has never been clearly understood.

Adult↗
PubMed1999

Low-pressure shunt 'malfunction' following lumbar puncture in children with shunted obstructive hydrocephalus.

Most shunt malfunctions present with signs and symptoms of high intracranial pressure, and computed tomography scans demonstrate ventricular enlargement. However, several authors have described a rare 'low-pressure' hydrocephalic state in which ventricular enlargement can occur in the face of low, or even negative, intracranial pressures. We report 2 children with obstructive hydrocephalus in whom this 'low-pressure state' followed a lumbar puncture; in both children, the shunts were functioning properly despite increased ventricular size on computed tomography scans, and all symptoms resolved (and the ventricles returned to baseline) following a period of enforced recumbency without shunt revision. We hypothesize that subarachnoid cerebrospinal fluid leakage through the puncture site in the lumbar theca decreases the intracranial pressures globally to a point below the opening pressures of the shunt valves. The ventricular cerebrospinal fluid, unable to be drained through either the subarachnoid space or the shunt, accumulates within the ventricular system under low pressure. One consistent feature in our 2 patients has been the postural nature of the headaches. We recommend enforced recumbency and, if necessary, a blood patch to seal the lumbar leakage. Shunt revision or prolonged external ventricular drainage appears to be unnecessary in these patients. Finally, neurosurgeons should be aware of this potential complication.

Cerebral Ventricles↗
PubMed2001

Monoamine compounds in cerebrospinal fluid of healthy subjects punctured without preceding strict bed rest: a pilot study.

The interpretation of data on compounds in the lumbar cerebrospinal fluid (CSF) is limited by several confounding factors, e.g. motor activity for which strict bed rest prior to lumbar puncture is recommended for standardisation. Now we report data from 14 healthy males employing the standardised procedure except for the requirement of strict bed rest. The levels of serotonin, noradrenaline, 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid and 4-hydroxy-3-methoxyphenylglycol in the second CSF fraction (7-12 ml) were significantly higher than those in the first fraction (0-6 ml), indicating the presence of concentration gradients. 5-HIAA was negatively influenced by age and the neuraxis distance in the lying position and positively by atmospheric pressure. Storage time and atmospheric pressure contributed to the variance in dopamine. Both tyrosine, tryptophan and dopamine were linearly correlated with storage time. We also found a significant curvilinear correlation between tapping time and atmospheric pressure. On comparing with previous studies, the results support the notion that the issue of strict bed rest or not prior to lumbar puncture might have to be taken into consideration when interpreting lumbar monoamine CSF data.

3,4-Dihydroxyphenylacetic Acid↗
PubMed2001

CSF collection time at lumbar puncture is influenced by plasma cholesterol and triglycerides.

It is a fairly well-known fact that the CSF collection time (tapping time) at lumbar puncture may influence CSF levels of monoamine compounds (e.g. the serotonin metabolite 5-hydroxyindoleacetic acid, 5-HIAA) and some neuropeptides. Since serum levels of cholesterol and triglycerides and low CSF levels of 5-HIAA have been linked to violent behaviour and impulsivity, we investigated retrospectively whether serum cholesterol and triglycerides affect CSF collection time. The series consists of 14 healthy males lumbar punctured at the L(4-5) level. We found that both serum cholesterol and serum triglycerides influenced the CSF collection time for 12 ml of CSF (R = 0.77; p = 0.0067). There was no correlation between cholesterol in serum and CSF, nor between cholesterol in the CSF and collection time. However, we accidentally found a correlation between cholesterol in the CSF and age. The proposed hypothesis tries to explain why cholesterol- and triglyceride-rich lipoprotein particles modify the CSF collection time and influence endothelial function with a subsequent effect on CSF production and/or intraspinal pressure. Thus, it may be of interest to pay attention to serum cholesterol and triglycerides, their effect on CSF collection time and, in the next step, their putative impact on levels of various compounds in the CSF.

Adult↗
PubMed1979

Puncture of avascular renal 'tumour' as a necessary complement of angiography.

12 cases of 'avascular tumour' of the kidney are discussed. Percutaneous renal puncture revealed: 7 cases of malignant tumour; 3 cases of hydronephrosis of the upper segment of a duplicated kidney; 1 case of abscess of the kidney, and 1 case of renal tuberculosis. 10 out of 12 patients were operated on and the histological examination confirmed the diagnosis established by puncture.

Angiography↗
PubMed1997

Use of a collagen plug versus manual compression for sealing arterial puncture site after cardiac catheterization.

The aim of the study was to investigate (1) the safety and efficacy of the application of a collagen plug (Vasoseal) at arterial puncture sites, (2) the hemostasis time, and (3) the comfort for the patient of a collagen plug (Vasoseal) when compared with manual compression. Sixty-two patients were randomized either for application of a collagen plug (Vasoseal, group A, n = 33) or manual compression (group B, n = 29) after cardiac catheterization. All patients were evaluated for subjective pain score ranging from 1 to 5 (1 = no pain up to 5 = very strong pain). In addition the authors measured the time until hemostasis could be achieved. The patients were evaluated by duplex sonography for complications at days 1 and 7 after the procedure. The pain score demonstrated a significantly lower score in group A when compared with group B (P = 0.01). The mean time for hemostasis was significantly lower in group A (mean 9.6 minutes) when compared with group B (mean 23.6 minutes) (P = 0.0001). Regarding the complication rate there was no significant difference between the groups (group A vs group B, P = 0.82). The authors conclude that the application of a collagen plug at the arterial puncture site is a safe and time-saving method. In addition it is less painful and therefore better tolerated than manual compression.

Aged↗
PubMed1992

Hearing loss as a sequel of lumbar puncture.

Only a few case reports have been published about hearing impairment following lumbar puncture, and not all were thoroughly documented by audiograms. We present nine cases of hearing loss following myelography, lumbar puncture, and spinal anesthesia. We speculate that this rare complication arises only in persons with a wholly or partially patent cochlear aqueduct, and occurs via the release of perilymphatic fluid in the cerebrospinal space. Hearing loss was seen in eight of the nine patients in the lower frequencies, and in six of the nine patients on both sides. Recovery to normal hearing was noticed in six of the nine patients. Transient hearing loss may occur more often than it is generally assumed, and the symptom can remain unnoticed. Since not all of these hearing losses proved to be fully reversible, we suggest informing patients about this complication for medicolegal reasons.

Adult↗
PubMed1989

Paraplegia after lumbar puncture. In an infant with previously undiagnosed hemophilia A. Treatment and peri-operative considerations.

We report a 3-month-old infant who became paraplegic from an epidural hematoma caused by a diagnostic lumbar puncture for work-up of sepsis. The differential diagnosis of the cause of paraplegia was epidural hematoma formation versus spinal abscess. Hemophilia A was diagnosed when coagulation studies were discovered to be abnormal, and non-contrast CT scan revealed an epidural mass with spinal cord displacement. The coagulopathy was rapidly corrected preoperatively with an infusion of cryoprecipitate. A medially limited bilateral T8-L4 laminectomy allowed complete evacuation of the hematoma with maximum preservation of normal bone tissue, but no clinical improvement resulted. Coagulopathy should be highly suspect in an infant who becomes paraplegic after lumbar puncture. The coagulopathy may be rapidly corrected with deficient factor replacement, allowing major spinal surgery to be performed safely.

Epidural Space↗
PubMed1990

Diseases that mimic meningitis. Analysis of 650 lumbar punctures.

A retrospective review of charts for 650 children who had lumbar puncture for suspected meningitis was undertaken to determine the characteristics of patients with and without meningitis, identify other conditions suggesting meningitis, and evaluate the predictive value of signs and symptoms of meningitis. The incidence of positive lumbar punctures increased with patient age. Younger infants did not present with classical features of meningitis. Bulging fontanel, lethargy, and irritability were nonspecific symptoms. Vomiting and headache, although not specific, proved to be more sensitive indicators of meningeal infection. Most patients with meningitis (75%) had at least one sign of meningeal irritation, but so did 25% of patients without meningitis. Brudzinski's sign was not specific. In contrast, nuchal rigidity and Kernig's sign had high predictive value. Up to age five, the diseases most often suggesting meningitis were right-sided pneumonia, gastroenteritis, otitis, tonsillitis, exanthema subitum, and urinary tract infections. Of 171 patients with febrile convulsion, one (0.5%) had bacterial meningitis and four had aseptic meningitis.

Bacterial Infections↗
PubMed1998

Postdural puncture headache in pediatric oncology patients.

This prospective cohort study determined the incidence and risk factors for development of postdural puncture headache (PDPH) in children after lumbar puncture (LP). Eighty-six children were enrolled. LPs were performed with use of 22-gauge spinal needles with the bevel oriented parallel to the long axis of the spine. Follow-up telephone interviews and patients' diary of symptoms were collected. Headache brought on by sitting up and relieved by lying down was defined as PDPH. Of the 80 who completed the study, six (8%) developed PDPH. Two (3%) were less than 6 years old and four (5%) were 6 to 12 years of age. Children with a history of headache following a previous LP were nine times as likely to experience PDPH. PDPH occurs not infrequently in children. A prior history of headache is a predisposing factor.

Age Factors↗
PubMed2005

Acute headache and subarachnoid haemorrhage: a retrospective review of CT and lumbar puncture findings.

AIM: Assess and correlate the clinical presentation, cranial CT and lumbar puncture (LP) findings in patients presenting with acute headache, clinically suspicious of subarachnoid haemorrhage, from the Accident and Emergency (A/E) department of a main teaching hospital. METHOD: We retrospectively reviewed over a 1-year period all patients referred for cranial CT from the A/E department, with clinically suspected non-traumatic SAH. Patients with a negative CT, with a diagnosis of SAH on LP, had their initial CT examination reassessed in a double blind review. RESULTS: 116 consecutive patients were included in the study. Patients were divided into 3 groups post CT results: diagnostic of SAH (19), abnormal without evidence of SAH (16) and normal (81). The clinical management of the latter group was analysed with particular emphasis on the performance and results of lumbar puncture (LP). 81 patients, clinically suspicious of SAH in our study had a normal cranial CT and were eligible for LP 49% had an LP, which was positive in 15% and contributed 24% to the total number diagnosed with SAH. LP was not performed in 51% of eligible patients. CONCLUSION: This study reviews the varying clinical presentations of SAH and the difficulty in clinically diagnosing SAH where headache is the only symptom. We review the wide differential diagnosis on cranial CT and on discharge of patients presenting with symptoms clinically suspicious of SAH. In addition this study identfies a high proportion of patients without detailed clinical notes and discharged without a diagnosis. The study reaffirms that a significant proportion of patients are diagnosed on LP and stress the importance of performing a LP in all cases with clinically suspected SAH with a negative CT This latter point requires highlighting in the medical literature as over half of eligible patients did not have a LP performed despite this being accepted diagnostic protocol.

Humans↗