World Library  
Flag as Inappropriate
Email this Article

Suboccipital puncture

Article Id: WHEBN0008065995
Reproduction Date:

Title: Suboccipital puncture  
Author: World Heritage Encyclopedia
Language: English
Subject: Intervertebral disc annuloplasty, Meningeal biopsy, Brain biopsy, Intracranial pressure monitoring, Ganglionectomy
Collection: Neurological Disorders
Publisher: World Heritage Encyclopedia

Suboccipital puncture

Suboccipital puncture
ICD-9-CM 01.0

A suboccipital puncture or cisternal puncture is a diagnostic procedure that can be performed in order to collect a sample of cerebrospinal fluid (CSF) for biochemical, microbiological, and cytological analysis, or rarely to relieve increased intracranial pressure. It is done by inserting a needle through the skin below the external occipital protuberance into the cisterna magna and is an alternative to lumbar puncture. Indications for its use are limited. Subarachnoid hemorrhage and direct puncture of brain tissue are the most common major complications. Fluoroscopic guidance decreases the risk for complications. The use of this procedure in humans was first described by Ayer in 1920.

This is an exceedingly rare procedure. When CSF cannot be obtained from the lumbar space (and when its analysis is considered critical to treatment), a cisternal tap may be required. The needle is placed in the midline, passing just under the occipital bone, into the (usually large) cisterna magna (Fig. 23-2). This is technically fairly easy; however, if the needle is advanced too far it can enter the medulla, sometimes causing sudden respiratory arrest and death. The test should therefore be carried out only by experienced physicians (usually neurosurgeons or neurologists). An alternative route that may be used by neurosurgeons and neuroradiologists is lateral to C-1 with penetration through the large C-1 intervertebral hiatus.

The cisternal tap may be used in myelography when the upper margin of a spinal block needs to be defined, however, magnetic resonance imaging (MRI), has become the procedure of choice for defining the upper and lower limits of spinal cord or spinal cord compressing lesions. It is necessary at times in the intrathecal administration of irritating medications, such as amphotericin B. Medications are diluted more rapidly in the larger and more rapidly circulating volume of cisterna magna than in the smaller lumbar sac

This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.