What is the role of lumbar puncture (LP) in the workup of cerebral aneurysms?

Updated: Dec 06, 2018
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

LP may help to establish the diagnosis of SAH in the absence of focal signs of mass effects. Aneurysmal SAH demonstrates hemorrhagic CSF with a xanthochromic supernatant, although these findings may be absent within the first few hours following aneurysmal rupture.

The opening pressure may be elevated.

WBC count may increase after a delay, reflecting a meningeal inflammatory reaction.

The protein may be elevated with normal or decreased glucose.

Cultures may reveal an infectious etiology.

Ventriculostomy: External drainage of CSF may assist in the management of hydrocephalus and cases with poor clinical grades.


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