TO TAP OR NOT TO TAP (Further Comments)

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Abstract
To my mind, the suspicion of a cerebral or cerebellar abscess is a contraindication to lumbar puncture until and unless technetium scan and electroencephalogram are both negative. In brain abscess, more than in any other lesion, severe and unpleasant lumbar puncture reactions have been particularly likely to occur. I suppose distortion of the brain rather than increased pressure alone may add to the risks. Two general situations seem to me also to contradicate lumbar puncture. One is the suspicion of lead poisoning with encephalopathy. We have here for several years absolutely interdicted lumbar punctures when this diagnosis is under suspicion, pending estimations of blood lead or x-ray examinations of the gastrointestinal tract for lead chips.

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