My purpose in this paper is to emphasize the value of a technical procedure in neurology which I do not feel has had the general clinical application it deserves. Since Wegeforth, Ayer and Essick1 in 1919 demonstrated the clinical usefulness of cisternal puncture, this procedure has not received sufficient clinical application, particularly in the hands of general practitioners, pediatricians and others who may be called on to use it in a therapeutic or diagnostic way.
Ayer2 described the following technic for puncture of the cisterna magna: The patient is placed on the side as for lumbar puncture. The cervical vertebrae are placed on the same alinement as the spinal canal by supporting the head on a pillow; the chin is well flexed, as shown in the accompanying illustration, so that one can get as much separation between the occiput and atlas as possible. The neck is shaved and
BENNETT AE. DIAGNOSTIC AND THERAPEUTIC INDICATIONS FOR CISTERNAL PUNCTURE: RESULTS IN TEN CASES OF MENINGOCOCCIC MENINGITIS. JAMA. 1929;93(14):1060–1062. doi:10.1001/jama.1929.02710140026008
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