Abstract
Complications Reported in an Elective “2-Day Lumbar Tap Trial (LTT)” for a Single Adult Hydrocephalus Center
Neurosurgery, v 67(Supplement_1)
01 Dec 2020
Abstract
INTRODUCTION Permanent cerebrospinal fluid diversion is the best treatment modality in appropriate normal pressure hydrocephalus (NPH) patients who are found to be shunt responsive. In order to determine shunt responsiveness, neurosurgeons often perform adjunct tests such as the LTT. This is the largest study of complications reported during a 2 day LTT at a single Adult Hydrocephalus Center. METHODS We retrospectively reviewed the electronic medical records of 97 patients that were managed in our Adult Hydrocephalus Center by a single neurosurgeon. As part of our NPH work-up, patients diagnosed with probable NPH underwent a high volume lumbar tap by the interventional radiology team under fluoroscopy. RESULTS 103 attempted LTT were performed in 97 patients between 2016 - 2020. 1 patient was unable to complete the LTT due to extreme anxiety before the procedure. Inadequate CSF was obtained (8 cc and 12 cc) in 2 patients. MRI lumbar spine was performed, which did not show any anatomical features precluding a successful repeat tap. Repeat taps again yielded inadequate drainage of 5 and 2ccs for the respective patients. There were no major complications in the 103 completed taps, such as death, infection, cranial/spinal hemorrhage, or nerve-root injury. In terms of minor complications, 2 patients experienced transient nerve root irritation resolving prior to completion of their procedures. 5 patients suffered from headaches. 1 occurred during the tap resulting in early termination of the procedure; the other 4 patients experienced the headaches post-tap. Of the post-procedure headaches, 3 had symptomatic resolution either spontaneously (1) or with tylenol (2). The other patient received a migraine cocktail in the ER resulting in headache resolution. CONCLUSION High volume LTTs have a safe complication profile and are useful in determining shunt responsiveness without requiring hospital admission and its associated costs and morbidity.
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Details
- Title
- Complications Reported in an Elective “2-Day Lumbar Tap Trial (LTT)” for a Single Adult Hydrocephalus Center
- Creators
- Mohamed ElnokalyBrandon KujawskiAlfredo MunozJody Leonardo
- Publication Details
- Neurosurgery, v 67(Supplement_1)
- Publisher
- Wolters Kluwer Health, Inc
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Surgery
- Other Identifier
- 991022059808504721