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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Gopal et al¹ found that altered mentation, focal neurological examination, papilledema, and the overall clinical impression of the examiner predicted the presence of intracranial lesions and of findings that contraindicted lumbar puncture (LP) on cranial computed tomography (CT) in patients presenting to the emergency department. The goal of their study was to identify patients who can safely undergo LP without screening CT. We have several questions and comments regarding their methods and conclusions and would like to present some data of our own.

Why were patients with indications for LP other than meningitis included in the study? Although performing an LP before CT has recently been proposed as a cost-effective diagnostic strategy in low-risk patients with suspected subarachnoid hemorrhage,² with few exceptions, the only reason for doing an emergency LP without a prior CT is to exclude meningitis and encephalitis. Hence, the clinically relevant study population is those with suspected . . . [Full Text of this Article]

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Fatal Lumbar Puncture: Fact Versus Fiction--An Approach to a Clinical Dilemma
Oliver et al.
Pediatrics 2003;112:e174-176.
ABSTRACT | FULL TEXT