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By Karen L. Roos, Allan R. Tunkel

This quantity offers a complete accounting of the profound developments made within the figuring out, and remedy of, bacterial infections of the valuable fearful method. As these kinds of infections proceed to reason morbidity and mortality, a better realizing in their prognosis and administration is important to extend the chance of fine neurological final result in affected sufferers.

This instruction manual highlights developments in quite a few parts, together with new neuroimaging details on thoughts like computed tomography and magnetic resonance imaging. furthermore, clinicians will locate worthwhile facts on Nucleic acid amplification checks, reminiscent of polymerase chain response (PCR), that experience aided within the identity of infectious brokers no longer typically remoted utilizing traditional tradition suggestions.   different themes lined contain cerebrospinal fluid research, the pathogenesis and pathophysiology of bacterial vital fearful approach infections, the foundations of antimicrobial remedy, and chapters on particular disorder entities, together with meningitis and HIV.

* helpful insights into the pathophysiological mechanism of bacterial CNS infections * A multidisciplinary achieve that offers serious details for neurologists, neurosurgeons, and experts in infectious illness * enormous info and emphasis on new diagnostic suggestions and laboratory testing

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1150–1161. Tunkel AR, Hartman BJ, Kaplan SL, et al. (2004). Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39: 1267–1284. 29 Zhanel GG, Karlowsky JA, Davidson RJ, et al. (1992). Effect of pooled human cerebrospinal fluid on the postantibiotic effects of cefotaxime, ciprofloxacin, and gentamicin against Escherichia coli. Antimicrob Agents Chemother 36: 1136–1139. Handbook of Clinical Neurology, Vol. L. R. V. All rights reserved Chapter 3 Lumbar puncture and cerebrospinal fluid analysis HENRY WELCH AND RODRIGO HASBUN * Department of Medicine, Section of Infectious Diseases, University of Texas Medical School, Houston, TX, USA The lumbar puncture (LP), a century-old procedure, is the enduring procedure for the evaluation of suspected central nervous system (CNS) disorders.

The largest and most important of the cisterns is the cisterna magna, which surrounds the brainstem and cerebellum at the base of the skull. The cistern magna may be used to obtain CSF (Greenlee and Carroll, 1997). The choroid plexus located in the ventricular system produces approximately 500 ml of CSF/day, with Correspondence to: Dr. Rodrigo Hasbun, Department of Medicine, Section of Infectious Diseases, University of Texas Medical School, 6431 Fannin St. 112 MSB Houston, TX 77030, USA. edu, Tel: þ1-713-500-7140, Fax: þ1-713-500-5495.

Edu, Tel: þ1-713-500-7140, Fax: þ1-713-500-5495. 32 H. WELCH AND R. , 2001). , 2001; Cinque and Linde, 2003). CSF flows from the lateral ventricles into the third ventricle via the foramina of Monroe, and then through the cerebral aqueduct into the fourth ventricle. The CSF circulates through apertures in the fourth ventricle, the lateral foramina of Luschka and the medial foramen of Magendie, to the subarachnoid space. , 2001). The subarachnoid space is normally a closed system, and head trauma increases the risk of bacterial meningitis (Tunkel, 2001).

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