Diagnostic Dilemma

Is lumbar puncture indicated?


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Question
A 4½-year-old girl presented with headache, fever for 20 days, and vomiting, and left focal convulsion for 1 day. There was no altered sensorium or focal neurological deficit. There was no contact with TB. On examination, she had bradycardia with hypertension and was drowsy. Reflexes were normal. There were no meningeal signs. Other systems were normal. A CT brain showed a ring-enhancing lesion in the right frontotemporal region (high cortical) with perilesional edema. She was treated with steroids, mannitol, and albendazole.

Is a lumbar puncture indicated?
Answer Discussion :
P
Prakash Nagar
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No, not indicated . Its always risky to perform LP with increased ICT. Even guarded Lp\has risk. In this case CT report is very clear and better to treat depending on CT report and clinical picture.
7 hours ago
Z
Zainul Abedin
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THIS CHIAL HAS RAISED ICT AND CT SCAN AHS ALREADY CONFIRMED DIGNOSIS OF NCC.
SO WE SHOULD SATRT ANTI ICT MEASURE RATHER THAN DOING LP

3 Days ago

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