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Article
August 4, 1923

PUNCTURE OF THE CISTERNA MAGNA: REPORT ON ONE THOUSAND, NINE HUNDRED AND EIGHTY-FIVE PUNCTURES

JAMA. 1923;81(5):358-360. doi:10.1001/jama.1923.02650050012004
Abstract

Puncture of the cisterna cerebellomedullaris (cisterna magna) is undoubtedly potentially a dangerous procedure. Nevertheless, a method of approach to the cerebral meninges without operation is at times of such obvious advantage that I have in three papers advocated this procedure.1

After somewhat more than three years of clinical use, it seems wise to publish certain data concerning the safety, the technic and the value of cistern puncture. To make this report of greater value, a number of physicians in different cities have kindly cooperated. While most of the punctures have been made by eight men, it is estimated that at least fifty have contributed to the total number.

THE SAFETY OF CISTERN PUNCTURE  In this series of punctures in 450 patients, no death is known to have occurred directly or indirectly from puncture. In only one case has hemorrhage been demonstrated. It was stated in the report that "one

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