Is lumbar puncture still needed in suspected subarachnoid hemorrhage after a negative head computed tomographic scan?

摘要

Headache is a frequent complaint encountered inemergency medicine. Although most headaches arebenign, subarachnoid hemorrhage is of particularconcern. Missing a sentinel hemorrhage delays diagnosis and carries a worse prognosis.1 The currentstandard is to perform a lumbar puncture after anegative computed tomographic (CT) scan.2 Lumbarpuncture may be uncomfortable and can be associatedwith postdural puncture headaches.3 As for CT,sensitivity declines over time.