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Archived Comments for: Cerebrospinal fluid leakage after radioisotope cisternography is not influenced by needle size at lumbar puncture in patients with intracranial hypotension

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  1. Spontaneous or Iatrogenic Intracranial Hypotension?

    Md.Gulam Mostafa, Uttara Adhunik Medical College, Bangladesh

    29 June 2009

    The authors did an excellent tedious and arrogantly expensive study without any destination. This study is just extrapolation of authors work to the existing fact in a bizarre way. Good news is a stimulus to recapitulate intracranial hypotension- SPONTANEOUS or IATROGENIC ?
    Spontaneous intracranial hypotension (spontaneous CSF leaking) often difficult to diagnose and treat rather than traumatic or iatrogenic CSF leaking. RI cisternography is used but not conclusive, 30% of spontaneous CSF leaking remain undiagnosed even with RI cisternography. Early bladder filling was observed before too, nothing hypothesize or discussed about the possibility of EBF. How about the tracer concentration around the micturition center in brain ? Lumbar puncture is routinely practiced procedures in the clinical wards and PLH is a common phenomenon, not a challenge for physician. What is the suggestions for the size of needle for LP ? if it is the iatrogenic intracranial hypotension ? Nothing indicating about the spontaneous CSF leaking, totally ignored the challenging condition ?

    Dr.Md.Gulam Mostafa
    Department of Anatomy, UAMC
    Dhaka, Bangladesh

    Competing interests

    None declared