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Safety of lumbar puncture in patients with cerebral venous thrombosis
Author(s) -
Canhão P.,
Abreu L. F.,
Ferro J. M.,
Stam J.,
Bousser M. G.,
Barinagarrementeria F.,
Fukujima M. M.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12136
Subject(s) - medicine , confidence interval , odds ratio , lumbar puncture , venous thrombosis , magnetic resonance imaging , prospective cohort study , thrombosis , cohort , lumbar , surgery , radiology , cerebrospinal fluid
Background and purpose Lumbar puncture ( LP ) may precipitate cerebral venous thrombosis ( CVT ), but it is unclear if LP is deleterious in patients with CVT . We aimed to assess the safety of LP in the I nternational S tudy on C erebral V eins and D ural S inus T hrombosis prospective cohort. Methods In 624 patients with CVT , we compared the prognosis of patients submitted or not to LP . The primary outcome was ‘death or dependency at 6 months’, as evaluated by the modified R ankin S cale ( mRS ; mRS  = 3–6, with adjustment for variables associated with poor prognosis); secondary outcomes were: ‘worsening after admission’; ‘acute death’; and ‘complete recovery at 6 months’ ( mRS  = 0–1). We analyzed the same outcomes in subgroups of patients with brain lesions on the admission computer tomography/magnetic resonance imaging. Results LP was performed in 224 patients (35.9%). There was no difference in frequency of ‘death or dependency at 6 months’ between patients with or without LP [13.4% vs. 14.4%; odds ratio ( OR ) = 0.9, 95% confidence interval ( CI ) 0.6–1.5; P  = 0.739]. LP was not associated with ‘worsening after hospitalization’ [21.5% vs. 23.5%; OR  = 0.9, 95% CI 0.6–1.3; P  = 0.577], ‘acute death’ [3.6% vs. 3.3%; OR  = 1.1, 95% CI 0.5–2.7; P  = 0.844] or ‘complete recovery’ [79.9% vs. 76.6%; OR  = 1.2, 95% CI 0.8–1.7; P  = 0.484]. In the subgroups of patients with brain lesions, the prognoses were not different between patients submitted or not to LP . Conclusion LP was not associated with the functional outcome of patients with CVT , suggesting that LP was not harmful in these patients. These results should not be generalized to patients with large brain lesions and risk of herniation where LP is contraindicated.

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