Editor's Correspondence |

Cranial Computed Tomography Before Lumbar Puncture—Reply

Ajay K. Gopal, MD
Arch Intern Med. 2000;160(18):2868-2870. doi:.
Text Size: A A A
Published online


In reply

We thank Dr Linden and colleagues for their interest in our article1 and are pleased that our initial study generated discussion regarding the controversial issue of screening CT before LP. We agree that limiting our study to only those patients with suspected meningitis may have led to findings that were more directly applicable to this group of patients. We designed our study to look for clinical predictors of abnormal radiographic findings in all patients who underwent CT screening. This design may closely reflect the true clinical scenarios, in which multiple diagnoses are often considered. Though clinicians were asked to choose the primary reason for performing LP, this did not preclude other potential diagnoses. This was, in part, reflected by the fact that the vast majority of cerebrospinal fluid samples from patients with "suspected subarachnoid hemorrhage" were also sent for bacterial culture. However, as mentioned in our article, we do recognize the utility of CT in the diagnosis of subarachnoid hemorrhage.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles