Lumbar Puncture 

Pro Tip: When performing a lumbar puncture, always measure the opening pressure.

The opening pressure may be the only parameter that suggests encephalitis that would otherwise go unnoticed. But remember the patient must be lying down! Otherwise the upright spinal column with the reservoir of fluid at the top in the brain will ensure their pressure will be artificially high – often ridiculously so. It is not unheard of for a patient to be admitted and treated for a possible CNS infection, just because they had an artificially raised opening pressure.

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