MRI Magnetic Resonance Imaging

MRI (Magnetic Resonance Imaging) MRI plays an important role in the diagnosis of a stroke because:

1. MRI can sometimes show the existence of cerebral ischemia at an early stage, before it can be seen on CT-scan and often when the CT-scan remained negative.

2. MRI can often show the existence of infarction in the brain stem, cerebellum, or temporal lobes are not visible on CT-scan.

3. The ability of MRI in the search for deep-vein thrombosis as a cause of infarction is better than CT-scan.

4. MRI is more sensitive in finding small infarction (lakuner). CT-scan is still better dihanding MRI in the acute phase of stroke when the main goal to find the bleeding and there is a problem in terms of cooperation with the patient.

5. Penyengatan contrast in MRI is useful in determining the possibility of an infarct age and look for a tumor or AVM as a cause of stroke.

Note: SPECT (single photon emission computed tomography) can localize ischemia within a few hours after a stroke.

Arteriography

Arteriography, both worked with conventional and digital techniques, is intended to (a) identifying a lesion that can be corrected with surgery such as intracranial aneurysms and AVM, carotid artery stenosis, and carotid artery plaque is ulcerated, (b) help confirm the diagnosis, and (c) confirm the diagnosis before giving antikoagulansia done. In planning an arteriography, is clinically important to determine which systems are involved in stroke, carotid system or the system vertebrobasiler. Where possible, angiography is done with catheterization technique by an experienced radiologist.

Electroencephalography (EEG)

Electroencephalography (EEG) can help determine the localization of cortical dysfunction, and occasionally in the thalamus lesions. EEG can be abnormal in the first hours after a stroke, although the CT-scan was normal. EEG will usually be normal in the area of stroke in the posterior circulation or lacunar stroke and abnormal in the anterior circulation stroke or embolism region.

EEG is usually abnormal in stroke large blood vessels or embolism.

EEG is an important thing to do when a suspected epileptic activity. Weakness after a stroke may be a part of the post-attack epilesi (Todd paralysis).

Lumbar puncture

When the cerebrospinal fluid (CSF) containing blood (erythrocytes) 1000) and the pressure increased (200 mmH2O), lumbar puncture support the existence of a hemorrhage. Please note that normal CSF pressure and is not found in CSF cells can occur in 10% of intracerebral hemorrhage. All subarachnoid hemorrhage showed significant bleeding in CSS, usually containing erythrocytes 25,000.

Lumbar puncture with the content of erythrocytes 50-500 in the CSS to direct suspicion on cerebral embolism, and appeared to CSS clear in most of embolism.

In cerebral thrombosis and lacunar stroke was not found in CSS cells. Sometimes it seems the leucocytes in the CSF after the attacks of thrombosis or bleeding. Erythrocytes in large numbers (10000-20000) is sometimes seen in myocardial blood after an attack of cerebral embolism. After further development in the presence of CT, lumbar puncture is rarely done anymore in order to evaluate stroke patients lumbar puncture is done when:

• Suspicion of central nervous system infection.

• The possibility of enforcement of the diagnosis of sub-arachnoid haemorrhage. CT scans can produce false negative in 50-10% of patients with subarachnoid hemorrhage,

• The possibility of enforcement of the diagnosis of intra-cerebral hemorrhage, but did not allow performed CT-scan, and found no signs of increased intracranial pressure.

• Before you start 'giving antikoagulansia, in order to rule out any bleeding if it is not possible to do CT scan.

• suspicion of arteritis.

• Diagnosis of patients is unclear.

How MRI clinical applications?
MRI examination aims to identify the characteristics morpologik (location, size, shape, expansion and others of pathological conditions. These objectives can be obtained by assessing any one or combination of cross-sectional images of the body akial, sagittal, coronal or oblique depending on the location of organs and the possibility of pathology. The type of MRI examination in accordance with the organ that will be seen, for example: 1. Check to see abnormalities in the head: the pituitary gland, inner ear holes, eye socket, sinus, 2. Examination of the brain to detect: stroke / infarction, picture of brain function, bleeding, infection, tumor, congenital abnormalities, vascular abnormalities such as aneurysm, angioma, the process of degeneration, atrophy; 3. Examination of the spine to see the process of degeneration (HNP), tumor, infection, trauma, congenital abnormalities. 4. Musculo-skeletal examination for organ : knee, shoulder, elbow, wrist, ankle, foot, to detect tear cartilage, tendons, ligaments, tumors, infection / abscess, and others; 5. Examination Abdomen to see the heart, kidneys, bags and bile duct, pakreas , spleen, gynecological organs, prostate, bladder 6. Inspection Thorax to view: the lungs, heart.

Source: fkunhas

Laboratory tests in stroke patients

Laboratory tests in stroke patients Laboratory tests in patients with stroke include:

• Calculate the complete peripheral blood: blood dyscrasias, polycythemia, thrombocytopenia or thrombocytosis or infection as a risk factor for stroke.

• prothrombin time, partial prothrombin time: addressed to patients with antiphospholipid antibodies (lengthwise partial prothrombin time).

• Analysis of urine: hematuria occurred in subacute bacterial endocarditis (SBE) with ischemic stroke due to embolism.

• sedimentation rate (ESR) LEDs indicate a possible increase in vasculitis, hiperviskositas or (SBE) as a cause of stroke.

• blood chemistry: elevated levels of glucose, cholesterol or triglycerides in the blood.

• chest X-rays: widening the size of the heart as a source of emboli in a stroke or hypertension due to long; to find an unexpected ferocity.

• Electrocardiogram: to indicate a cardiac arrhythmia, new myocardial infarction, or dilation of the left atrium.

• Computed Tomography (CT scan).

Computed Tomography (CT scan) is useful in distinguishing haemorrhagic stroke (intracerebral or subarachnoid) with stroke without hemorrhage / ischemia (thrombosis or embolism). The presence of blood on the new bleeding resulting in a region with increased density; otherwise an infarct resulting in a region with reduced density. In addition, CT-scan can help determine the location and size abnormalities, such as the vascularization, superficial or deep, small or large.

1. CT-scan was positive in intracerebral hemorrhage (with increased density) and often showed inter-hemisphere blood or bleeding in the brain to the bleeding subarakhnoidea parenkhim. These changes seen in the first hours after the onset of stroke symptoms. With more advanced CT again, some patients with clinical diagnosis of thrombosis can be found in the bleeding intraparenkhimal.

2. CT-scan is positive in most cases of cerebral infarction (decreased density), but peruhahan these changes can only be seen in 24-48 hours after the onset of stroke symptoms. By penyengatan of contrast, infarct can mimic a tumor but penyengatan against the contrast of the cerebral infarction is generally not associated with significant mass effect as happened in tumors. In a few instances. maybe there is mass effect with infarction, which raises the question of whether not a tumor, in which case it is with MRI, CT scan and serial clinical observations may clarify the diagnosis.

3. A common herdarah infarction secondary to embolism are great. In this case an increase in density on CT-scan. Provision of anticoagulants should be delayed if there is bleeding associated with embolic infarction.

4. Bleeding in the brain stem may be seen on CT scans, but brain stem infarction is usually not.

5. CT-scan to identify intracranial mass shift that requires medical treatment and operative aggressively to control the cerebral edema that occurs.

Delicia Medica - Stroke is the number one cause of disability in patients. For those who survived the attack of stroke, often suffered paralysis in some members of the body and as a result of brain injury. Therefore, stroke patients should undergo a variety of therapies and medical rehabilitation for recovery of body functions.

Intensive therapy and post-stroke begins as early as possible is highly recommended to maximize the recovery limb. In the United States, is now being developed use of robots to help the paralyzed arm movements, which often suffered a stroke patient.

A number of scientists from Brown University, USA, introduced the use of a tool called the MIT-Manus, which are specifically designed to train the upper arm. Patients stay seated at a table by putting his arm in the MIT-Manus and then ordered the tools to perform various tasks.

Scientists describe such a tool such as "power-steering" for the arms. Robot will recognize each movement and help make a move if necessary.

To test the ability of these robots, the researchers conducted a trial of 127 patients who had a stroke within the last five years. They were divided into three groups. The first is that menerita robot therapy for three months, then the group receiving physiotherapy, and the last is a group that received usual care without intensive therapy.

In the first and second groups, obtained significant results in the recovery movement of the upper arm as measured from the patient's ability in performing everyday movements, like holding a spoon, open the bottle, or considering shoelaces.

"The results of this research shows, with appropriate therapy, patient motion capability can be improved and can improve quality of life. This will give new hope to patients," said Dr.Albert Lo, chairman of the researcher.

Use of this robot is not yet widely used and is still in development stage. However, stroke patients can still obtain comparable results when handling rehabilitation as early as possible and conducted in accordance intensive phase of stroke.

Source: fkunhas-kompas

Diagnose of brain death

Diagnose of brain death Criteria for diagnosing brain death prior to termination and possible life-saving donor organ transplants. Criteria and actions outlined below are generally accepted by the medical profession and the law in England, although some practitioners still have objections. It is noteworthy that the tests are mainly for the death of "brain stem" and

some residual activity electroencephalographic abnormalities are not

all covered here.

Preconditions

1. Diagnosis of brain death should not be made ​​before at least 6 hours after onset of coma, or in case of coma after cardiac arrest, at least 24 hours after circulation improvements.

2. The diagnosis of brain death must be made by two senior doctors (usually two konsulen or a konsulen and Senior Registrar in the UK), either separately or jointly on at least two events at an interval of at least two hours between the first examination and second.

3. There should be no doubt about the situation or circumstances caused by the coma.

4. A reversible cause of coma must be removed; the levels of certain organ-suppressing drugs, the influence of muscle relaxants, hypothermia is less than 35 ° C, and metabolic or endocrine disorders.

Test function of the brain stem stops:

The answer to all these questions must be no. 

1. Are pupils react to light?

2. Is there a corneal reflex?

3. Is eye bergerakselama or after the test calories? This test involves first checking to see if there's ear wax, wax and remove it if needed, and stream water ice with a syringe into it.

4. Is there a reaction to motor along the cranial nerve region in

response to pain stimuli in the face, extremities, and body?

5. Is there a reflex refused if the catheter is inserted through the nose or mouth into the pharynx?

6. Is there a cough reflex when the catheter is inserted into the lower respiratory tract through the tube?

7. Does the patient have a complete apnea, when the pressure is increased arterial carbon dioxide exceed 7 kPa? Arterial blood samples to be taken, and if necessary carbon dioxide is incorporated into the branching airway through the catheter until PaCO2 reached the limit that is expected.

Definition

The electroencephalogram (EEG) is a noninvasive test used to evaluate brain function or disorders or to confirm brain death. Parts of the Body Involved

Scalp Reasons for Procedure

An EEG may be done for the following reasons:

To diagnose seizures

To assess conditions and diseases that affect the brain, such as trauma , coma , encephalitis , cognitive impairment, brain tumors , or certain psychological disorders

Risk Factors for Complications During the Procedure

There are very few risks associated with this procedure. If you are prone to seizures and need to discontinue medication for the test, you may be more likely to have a seizure.

What to Expect

Prior to Procedure

Depending on the reason for your EEG, you may be given some of the following instructions:

Stop taking medications, such as antidepressants, stimulants, or seizure medicines, at least 1-2 days before the test.

Avoid caffeine the day before and the day of the test.

Shampoo hair and do not use hairspray or gel the day of the test.

If you are having a sleep-deprived EEG, you may need to stay awake the night before the test. You should also arrange for a ride to and from the test.

If you are prone to seizures, arrange for a ride to and from the test.

Anesthesia

None

Description of the Procedure

You sit or lie in a chair or cot. Electrodes are attached to your scalp with a special gel or paste. These electrodes record the brain's electrical activity and transmit impulses to an electroencephalograph, which magnifies them and records them as brain waves on moving strips of paper. You will be asked to close your eyes and be still for most of the test. However, depending on the reason for the test, you may also be asked to breathe deeply and rapidly for three minutes. A strobe light may also used for a portion of the test.

After Procedure

The technician removes the electrodes. You will be advised about restarting any medications you may have stopped.

How Long Will It Take?

A standard EEG takes about one hour.

Will It Hurt?

No, an EEG is painless.

Possible Complications

None

Average Hospital Stay

None

Postoperative Care

None

Outcome

Your test results will be interpreted by a neurologist and forwarded to your doctor. Within one to two weeks of your test, your doctor will discuss the results with you.

Source: fkunhas

Subdural hematoma: factors causing neurological disorders

Subdural hematoma factors causing neurological disorders Subdural hematoma is one of the factors that could cause neurological disorders:
 

1. Geriatric patients appear drowsy with a new personality changes occur. Headache is a picture of subdural hematoma is an important and almost always occurs.

2. Mental changes usually occur within several days to several weeks, sometimes several months.
3. Not always there is a history of head trauma (1 / 3 patients with subdural hematoma without head trauma).

4. Check the existence of subdural hematoma by CT-scan and EEG. Sometimes not seen any incidence of lesions on CT scan. So if clinically very suspicious of subdural hematoma, although the MRI did not have abnormalities on CT-scan.

5. Bilateral subdural hematoma on CT-scan can be seen only as a leveling sulcus-sulcus cerebral cortex; narrowing of the ventricles can not be seen. Diagnosis with MRI or arteriography.

6. If clinical suspicion of subdural hematoma, do not do a lumbar puncture. A lumbar puncture is not a diagnostic tool and can even make things worse. (cerebrospinal fluid of patients with subdural hematoma can be seen xantokrom with increased protein, but 50% of the normal case).

Risks that occur due to head injury

1. Epidural hematoma

an operation case which is often obtained. where the damage occurred between the internal and duramater tabula (duramater firmly attached to the sutura, except in young children and the elderly). picture obtained bikonveks and 80% with a fracture in Os temporal artery that causes rupture Meningea Media (this artery through in Os.temporalis). The existence of Lucid Interval in which patients have fainted (but not because of bleeding), but fainted because Comotio (sensation of the brain). For the prognosis is good (can not have neurological abnormalities), if handled quickly. if treated late can be fatal.

2. Subdural hematoma

The main cause for venous dikorteks.didapatkan picture rips mid line switch &> 5 mm (it is advisable for the operation), although hematomnya thin. poor prognosis because of the damage in the area of ​​the cortex and there is bleeding.

3. Intracerebral hemorrhage
4. CONTUSIO / hematoma
5. CONCUSSION

aja yahh .. until this hour notes, very simple and small. instead i miss catetnya, but the purpose of this catatanq, disconnected where ... run anywhere ... But that is quite obvious kan.moga useful!

Source: fkunhas

How to block pain?

How to block pain? Intended to block pain and reduce or eliminate pain. Many ways can be done to block pain, based on understanding the mechanisms of pain:

1. Blocking the formation of pain mediators, particularly PG, namely by providing analgesic steroids (prednisone, dexamethasone), or nonsteroidal (aspirin, paracetamol, ibuprofen, etc.). Steroidal analgesic (NSAID) is the more prominent is the nature antiinflamasinya (inflammatory), while most other nonsteroidal antipyretic analgesics are also some anti-inflammatory properties. (NSAID = Non Steroid Anti Inflammatory Drugs.)

2. Block the delivery of pain by the nerve fibers can be made through anesthesia (drug), both locally (in place of pain stimuli occurred only) or systemic (whole body's nervous.) Lidocaine spray / injection (in a tooth extraction, circumcision) is an example of local anesthesia. There are also a variety of anesthesia given via intravenous injection (into veins), and even now many are given through the spinal cord, especially if the desired effects of the drug very quickly as in the operation Cesaria section (cesarean delivery).

3. Central block pain / pain receptors in the brain, ie, with narcotic analgesics (morphine, pethidin). Only the form of a narcotic analgesic that is able to penetrate the barrier between blood and brain (blood brain barrier) that can block pain very much. Steroidal analgesics, anesthetics, and narcotic analgesics may only be given by a physician (on prescription), while non-steroidal analgesics can be bought freely by consumers.

Jakarta-Scientists discover enzyme in the brain that affect the meaning of pain. This could be a new target in the fight against chronic pain in humans with cancer.

In a study published in Science magazine, scientists from Canada and South Korea say they managed to set the level of pain by blocking certain enzymes in the brain.

It gives a basic understanding of brain mechanisms related to chronic pain involves, write the study's lead author Min Zhuo, professor of physiology at the University of Toronto.

Such information not only provides new possibilities about the design of painkillers, but also helps people understand why many drugs fail to control chronic pain.

Painkillers is already there in the long term. However, chronic pain management in hospital and the treatment of cancer and other diseases is still far enough in many places.

Zhuo and his colleagues found elevated levels of protein kinase M zeta emzim in the area of the brain called the anterior cingulate cortex in injured rats.

To confirm the function of this enzyme, they get rid of the rat gene in the group that is believed responsible for the increased production of the enzyme. Scientists later found that the mice had felt little or no pain after being given drugs that block these enzymes.

"A lot of painkillers that do not work for chronic pain, particularly neuropathic pain. There is great need for effective new drugs to control chronic pain," wrote Zhuo.

Source: fkunhas-m.inilah.com

What all back pain can be massaged?

What all back pain can be massaged? Not all massage reduce back pain complaints, much less able to heal. If hip pain because bone loss, or pinching the nerve, or damage to the vertebral column due to the spread of cancer, with massage may actually worsen the damage to the bones so that the weight increase of complaints and symptoms. 

Only back pain causes muscle tension, one seated, one bed, one standing, and one walk, or resulting from the use of high heeled footwear, which usually become more comfortable with the massage.

Back pain is not eased by massage, or even worse, need to be wary of. Maybe not the usual back pain, and needs to be addressed so as not to be worse medical complications.

Damage to the spine due to the spread of cancer, at a certain level, can result in sudden paralysis of the body. Even though only by a small sontekan, paralysis can occur suddenly.

 
What's for back pain can still exercise? HNP back pain becomes a relapse after excessive physical activity, including exercise. However, the talented osteoporosis and hip muscles rigid because lack of movement actually need to exercise for the muscles, joints, and spine segment is more weak and thinning bones do not grow worse. Loin pain at the pubic bone joint damage is not allowed to perform heavy physical activity, including the type of vigorous exercise such as badminton, volleyball, basketball, and football. Swimming and bathing in the pool runs a more appropriate choice.

What about back pain therapy?

What about back pain therapy?Back pain treated according to the cause. Start with oral medications, injections at the site of pain, until the special treatment at the hospital.

 

Classified as the most severe back pain that may require surgery HNP. Pain relief medication (analgeticum and antirheumatic drugs) to relieve pain only for a moment alone. If the cause is not removed, the pain will still be there and hold her waist. 

Types of back pain because of the attitude and position of the body so that there is a strained hip muscle (spasm), which usually goes away with a massage. Moderate pain on mental disorders is only lost if the tension loosened his soul.

What are the true causes of back pain?

What are the true causes of back pain? True lumbago centered on the spine or lumbar waist disturbed. (1) Most often because the wrong attitude and body position is not ergonomic. Pain is not good in the waist, usually forgotten when it is busy, the body quickly tired and unfit.

Usually experienced by those with less motion (se-dentary); improper sitting posture, overweight, lazy, and suffered mental tension, (2) There might be changes in spinal cord tissue fibrosis or called lumbago. Complaints can not be turned away when lying down, (3) Suffering from a young hip bone disorders (20 years) or ankylosing ankylopoetic; (4) False tendons in the muscles of the hip or pelvis fracture segments commonly occur in obese people, (5) Spondyloarthrosis deformans pubic bone. This part of the aging process. Often at the age of 50 years; (6) Arthritis sacroiliaca arthritis hip bone segment for TB disease; (7) HNP (hernia Nucleous Pulposes) or the process of softening and destruction of bone segments bearing waist.

Laboratory tests in stroke patients

Laboratory tests in stroke patients Laboratory tests in patients with stroke include: • Calculate the complete peripheral blood: blood dyscrasias, polycythemia, thrombocytopenia or thrombocytosis or infection as a risk factor for stroke.

• prothrombin time, partial prothrombin time: addressed to patients with antiphospholipid antibodies (lengthwise partial prothrombin time).

• Analysis of urine: hematuria occurred in subacute bacterial endocarditis (SBE) with ischemic stroke due to embolism.

• sedimentation rate (ESR) LEDs indicate a possible increase in vasculitis, hiperviskositas or (SBE) as a cause of stroke.

• blood chemistry: elevated levels of glucose, cholesterol or triglycerides in the blood.

• chest X-rays: widening the size of the heart as a source of emboli in a stroke or hypertension due to long; to find an unexpected ferocity.

• Electrocardiogram: to indicate a cardiac arrhythmia, new myocardial infarction, or dilation of the left atrium.

• Computed Tomography (CT scan).

Computed Tomography (CT scan) is useful in distinguishing haemorrhagic stroke (intracerebral or subarachnoid) with stroke without hemorrhage / ischemia (thrombosis or embolism). The presence of blood on the new bleeding resulting in a region with increased density; otherwise an infarct resulting in a region with reduced density. In addition, CT-scan can help determine the location and size abnormalities, such as the vascularization, superficial or deep, small or large.

1. CT-scan was positive in intracerebral hemorrhage (with increased density) and often showed inter-hemisphere blood or bleeding in the brain to the bleeding subarakhnoidea parenkhim. These changes seen in the first hours after the onset of stroke symptoms. With more advanced CT again, some patients with clinical diagnosis of thrombosis can be found in the bleeding intraparenkhimal.

2. CT-scan is positive in most cases of cerebral infarction (decreased density), but peruhahan these changes can only be seen in 24-48 hours after the onset of stroke symptoms. By penyengatan of contrast, infarct can mimic a tumor but penyengatan against the contrast of the cerebral infarction is generally not associated with significant mass effect as happened in tumors. In a few instances. maybe there is mass effect with infarction, which raises the question of whether not a tumor, in which case it is with MRI, CT scan and serial clinical observations may clarify the diagnosis.

3. A common herdarah infarction secondary to embolism are great. In this case an increase in density on CT-scan. Provision of anticoagulants should be delayed if there is bleeding associated with embolic infarction.

4. Bleeding in the brain stem may be seen on CT scans, but brain stem infarction is usually not.

5. CT-scan to identify intracranial mass shift that requires medical treatment and operative aggressively to control the cerebral edema that occurs.

6. A subdural hematoma can be recognized on CT-scan with the shift of intracranial mass, partial disappearance of the lateral ventricles or sulcus-sulcus, and changes in density (depending on age of lesion) on perrnukaan brain.

7. Brain tumors can be identified on CT-scan with a typical density patterns, penyengatan of contrast, and mass effect. In a small percentage of brain tumors is clinically resemble a stroke.

MRI (Magnetic Resonance Imaging)
MRI plays an important role in the diagnosis of a stroke because:
1. MRI can sometimes show the existence of cerebral ischemia at an early stage, before it can be seen on CT-scan and often when the CT-scan remained negative.
2. MRI can often show the existence of infarction in the brain stem, cerebellum, or temporal lobes are not visible on CT-scan.
3. The ability of MRI in the search for deep-vein thrombosis as a cause of infarction is better than CT-scan.
4. MRI is more sensitive in finding small infarction (lakuner). CT-scan is still better dihanding MRI in the acute phase of stroke when the main goal to find the bleeding and there is a problem in terms of cooperation with the patient.
5. Penyengatan contrast in MRI is useful in determining the possibility of an infarct age and look for a tumor or AVM as a cause of stroke.

Note: SPECT (single photon emission computed tomography) can localize ischemia within a few hours after a stroke.

Arteriography
Arteriography, both worked with conventional and digital techniques, is intended to (a) identifying a lesion that can be corrected with surgery such as intracranial aneurysms and AVM, carotid artery stenosis, and carotid artery plaque is ulcerated, (b) help confirm the diagnosis, and (c) confirm the diagnosis before giving antikoagulansia done. In planning an arteriography, is clinically important to determine which systems are involved in stroke, carotid system or the system vertebrobasiler. Where possible, angiography is done with catheterization technique by an experienced radiologist.

Electroencephalography (EEG)
Electroencephalography (EEG) can help determine the localization of cortical dysfunction, and occasionally in the thalamus lesions. EEG can be abnormal in the first hours after a stroke, although the CT-scan was normal. EEG will usually be normal in the area of stroke in the posterior circulation or lacunar stroke and abnormal in the anterior circulation stroke or embolism region.
EEG is usually abnormal in stroke large blood vessels or embolism.

EEG is an important thing to do when a suspected epileptic activity. Weakness after a stroke may be a part of the post-attack epilesi (Todd paralysis).

Lumbar puncture
When the cerebrospinal fluid (CSF) containing blood (erythrocytes) 1000) and the pressure increased (200 mmH2O), lumbar puncture support the existence of a hemorrhage. Please note that normal CSF pressure and is not found in CSF cells can occur in 10% of intracerebral hemorrhage. All subarachnoid hemorrhage showed significant bleeding in CSS, usually containing erythrocytes 25,000.
Lumbar puncture with the content of erythrocytes 50-500 in the CSS to direct suspicion on cerebral embolism, and appeared to CSS clear in most of embolism.

In cerebral thrombosis and lacunar stroke was not found in CSS cells. Sometimes it seems the leucocytes in the CSF after the attacks of thrombosis or bleeding. Erythrocytes in large numbers (10000-20000) is sometimes seen in myocardial blood after an attack of cerebral embolism. After further development in the presence of CT, lumbar puncture is rarely done anymore in order to evaluate stroke patients lumbar puncture is done when:
• Suspicion of central nervous system infection.
• The possibility of enforcement of the diagnosis of sub-arachnoid haemorrhage. CT scans can produce false negative in 50-10% of patients with subarachnoid hemorrhage,
• The possibility of enforcement of the diagnosis of intra-cerebral hemorrhage, but did not allow performed CT-scan, and found no signs of increased intracranial pressure.
• Before you start 'giving antikoagulansia, in order to rule out any bleeding if it is not possible to do CT scan.
• suspicion of arteritis.
• Diagnosis of patients is unclear.

Source: fkunhas