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November 9, 1929

Die Technik und Anwendung der Suboccipital-oder Zisternenpunktion.

JAMA. 1929;93(19):1497. doi:10.1001/jama.1929.02710190069034

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The summary of the development of the method of cistern puncture in man gives less credit to the American Ayer and more to Eskuchen than is deserved. A detailed account of the topographic anatomy of the region punctured is clearly given as well as a discussion of the type of instruments and operative technic. The German method of first touching the occipital bone, then sliding down into the cisterna, and the American method of direct puncture are compared. The author faithfully discusses the dangers and pitfalls and the necessary precaution to prevent all untoward effects from the procedure. The various dangerous possibilities seem to be overrated by previous authors, as even puncturing the medulla is a matter that causes symptoms for only a few hours. No contraindication is found by Memmesheimer in increased intracranial pressure such as caused by an intracranial tumor, for the cisternal puncture supposedly removes ventricular fluid.

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