CSF and EEG in Neurological Emergency

  • Mamta Bhushan Singh
  • Rohit Bhatia
  • Deepti Vibha


Performing a lumbar puncture and examining the cerebrospinal fluid (CSF) provide a unique opportunity to explore the internal milieu in which the brain and spinal cord are bathed. Analysis of the CSF is the cornerstone of diagnosis and management of many neurological emergencies. It also plays an important role in the diagnosis and sometimes prognostication of non-infectious diseases. Evaluation of the CSF is critical in establishing a diagnosis of infectious meningitis and in guiding antimicrobial therapy. Less commonly, a lumbar puncture (LP) is used as a part of the diagnostic workup of patients with suspected subarachnoid haemorrhage, demyelinating disease and leptomeningeal metastasis (LM) [1], all of which may present as neurological emergencies. The two major issues that may interfere with appropriate and timely CSF analysis (either by LP or shunt tap) are concerns about uncal or cerebellar tonsillar herniation and the need to initiate empirical antibiotics emergently [2]. Once the clinical indication for CSF analysis is understood, the amount to be tapped, investigations to be sent and an algorithm of action to be taken should be clearly drawn by the clinician. Doing an LP without a clear-cut question in mind is likely to cause a delay in sending samples for the most appropriate investigations.


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Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Mamta Bhushan Singh
    • 1
  • Rohit Bhatia
    • 1
  • Deepti Vibha
    • 1
  1. 1.Department of NeurologyAll India Institute of Medical SciencesNew DelhiIndia

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