大槽穿刺

WordNet

pierce with a pointed object; make a hole into; "puncture a tire"
be pierced or punctured; "The tire punctured"
cause to lose air pressure or collapse by piercing; "puncture an air balloon"
a small hole made by a sharp object
the act of puncturing or perforating
loss of air pressure in a tire when a hole is made by some sharp object
make by piercing; "puncture a hole"
a tank that holds the water used to flush a toilet (同)water tank
an artificial reservoir for storing liquids; especially an underground tank for storing rainwater
a sac or cavity containing fluid especially lymph or cerebrospinal fluid (同)cistern

PrepTutorEJDIC

(とがったもので)…‘に'穴をあける,‘を'パンクさせる《+『名』+『with』+『名』》 / 〈穴など〉‘を'あける / …‘を'パチンと壊す / (とがったものでできた)穴 / (とがったもので)穴をあけること;(タイヤの)パンク
(雨水の)貯水槽(そう);(自然の)ため池;(一般に)貯水タンク,(水洗便所の)タンク

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/13 09:13:14」(JST)

wiki en

A suboccipital puncture or cisternal puncture is a diagnostic procedure that can be performed in order to collect a sample of cerebrospinal fluid (CSF) for biochemical, microbiological, and cytological analysis, or rarely to relieve increased intracranial pressure. It is done by inserting a needle through the skin below the external occipital protuberance into the cisterna magna and is an alternative to lumbar puncture. Indications for its use are limited. Subarachnoid hemorrhage and direct puncture of brain tissue are the most common major complications. Fluoroscopic guidance decreases the risk for complications. The use of this procedure in humans was first described by Ayer in 1920.

This is an exceedingly rare procedure. When CSF cannot be obtained from the lumbar space (and when its analysis is considered critical to treatment), a cisternal tap may be required. The needle is placed in the midline, passing just under the occipital bone, into the (usually large) cisterna magna (Fig. 23-2). This is technically fairly easy; however, if the needle is advanced too far it can enter the medulla, sometimes causing sudden respiratory arrest and death. The test should therefore be carried out only by experienced physicians (usually neurosurgeons or neurologists). An alternative route that may be used by neurosurgeons and neuroradiologists is lateral to C-1 with penetration through the large C-1 intervertebral hiatus.

The cisternal tap may be used in myelography when the upper margin of a spinal block needs to be defined, however, magnetic resonance imaging (MRI), has become the procedure of choice for defining the upper and lower limits of spinal cord or spinal cord compressing lesions. It is necessary at times in the intrathecal administration of irritating medications, such as amphotericin B. Medications are diluted more rapidly in the larger and more rapidly circulating volume of cisterna magna than in the smaller lumbar sac

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1. 刺創の概要 overview of puncture wounds
2. 腰椎穿刺：小児における適応、禁忌、手技、および合併症 lumbar puncture indications contraindications technique and complications in children
3. コクシジオイデス性髄膜炎 coccidioidal meningitis
4. 自発性頭蓋内圧低下症による頭痛：病態生理、臨床的特徴、および診断 headache attributed to spontaneous intracranial hypotension pathophysiology clinical features and diagnosis
5. 非HIV感染患者における播種性ヒストプラスマ症の診断および治療 diagnosis and treatment of disseminated histoplasmosis in non hiv infected patients

English Journal

Developments in ultrasound-guided thecal puncture in horses.

Mackay RJ.Author information University of Florida, Gainesville FL 32610, USA.AbstractSINCE the 1970s, needle puncture into the subarachnoid space in horses (thecal puncture) has been used more or less routinely to collect cerebrospinal fluid (CSF), for intrathecal medication and, more recently, as a portal for introduction of an endoscope (Mayhew 1975, Johnson and Constantinescu 2000, Steinman and others 2000, Prange and others 2011). Originally, there were two accepted techniques: upper cervical puncture via the atlanto-occipital (AO) space in recumbent horses under general anaesthesia; and lumbosacral cisternal puncture in conscious (usually standing) horses. Each of these techniques has advantages and drawbacks. AO cervical puncture is technically straightforward, safe for the operator, can be performed under brief intravenous anaesthesia, and usually yields clean limpid samples uncontaminated by blood. However, recovery from anaesthesia in neurologically compromised horses can be difficult and, occasionally, disastrous. By contrast, the lumbosacral approach is technically challenging even for the experienced operator, carries a small but real risk of explosive reaction by the horse, and significant blood contamination of the aspirated CSF sample is relatively common. At both sites, puncture-associated sepsis is a possibility but apparently very rare. Severe headache after dural puncture is a frequent problem in people (Bezov and others 2010), but signs consistent with headache are not seen in horses following the procedure.
The Veterinary record.Vet Rec.2014 Jan 11;174(2):43. doi: 10.1136/vr.g9.
SINCE the 1970s, needle puncture into the subarachnoid space in horses (thecal puncture) has been used more or less routinely to collect cerebrospinal fluid (CSF), for intrathecal medication and, more recently, as a portal for introduction of an endoscope (Mayhew 1975, Johnson and Constantinescu 200
PMID 24413298

Adult-onset migraine-related ophthalmoplegia and omolateral fetal-type posterior cerebral artery.

Tocco P, Fenzi F, Cerini R, Monaco S.Author information Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy. pietocco@hotmail.comAbstractA 33-year-old woman with a long history of typical migraine without aura developed a pupillary-involving right third nerve palsy, after a typical migraine attack. The right pupil was 5 mm and showed delayed direct and consensual photomotor responses; the left pupil was 3 mm and reactive. Pupillary reaction to convergence was slow on the right eye. Ptosis, impaired elevation of the eye and weakened adduction were noted in the right eye. CT scan of the brain showed no abnormalities, whereas a CT digital cerebral angiography revealed a fetal-type right posterior cerebral artery (PCA). MRI disclosed thickening and contrast-enhancement of the cisternal portion of the right oculomotor nerve. A lumbar puncture, performed 5 days after the onset of ocular symptoms, yielded acellular cerebrospinal fluid (CSF) with normal protein and glucose levels. Ptosis and diplopia recovered within a week, whereas blurred vision, anisocoria and accommodation deficit subsided after 10 weeks.
BMJ case reports.BMJ Case Rep.2011 Nov 15;2011. pii: bcr1020114930. doi: 10.1136/bcr.10.2011.4930.
A 33-year-old woman with a long history of typical migraine without aura developed a pupillary-involving right third nerve palsy, after a typical migraine attack. The right pupil was 5 mm and showed delayed direct and consensual photomotor responses; the left pupil was 3 mm and reactive. Pupillary r
PMID 22674608

Rostrocaudal dynamics of CSF biomarkers.

Tarnaris A, Toma AK, Chapman MD, Petzold A, Keir G, Kitchen ND, Watkins LD.Author information The Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Box 32, Queen Square, London, WC, 1N 3BG, UK. andrewtarnaris@gmail.comErratum inNeurochem Res. 2012 Jan;37(1):232. AbstractThe rostrocaudal gradient (RCG) of markers present in cerebrospinal fluid (CSF) has not been studied adequately due to lack of appropriate control populations and ethical restrictions. The aim of this study is to understand the rostrocaudal gradient of CSF biomarkers. We contacted a study comparing CSF levels of seven biomarkers from cisternal (rostral) and lumbar (caudal) CSF obtained from patients with trigeminal neuralgia and tension-type headache. The RCGs of CSF/serum albumin ratio, 8-isoprostane. GFAP, total tau and beta amyloid protein were higher than one. The RCGs of lactate, VEGF and the heavy chain of neurofilament protein were lower than one. The study provides new values for several commonly examined markers of cisternal CSF. Knowledge of the RCG gradient of different CSF markers is important in interpreting studies reporting ventricular CSF values.
Neurochemical research.Neurochem Res.2011 Mar;36(3):528-32. doi: 10.1007/s11064-010-0374-1. Epub 2010 Dec 30.
The rostrocaudal gradient (RCG) of markers present in cerebrospinal fluid (CSF) has not been studied adequately due to lack of appropriate control populations and ethical restrictions. The aim of this study is to understand the rostrocaudal gradient of CSF biomarkers. We contacted a study comparing
PMID 21191652

Japanese Journal

Transcutaneous Cisternal Puncture for Sampling of Cerebrospinal Fluid in Awake Rat

TAKASUGI Yoshihiro,SHIRAI Toru,FUTAGAWA Koichi,KOGA Yoshihisa,EGAWA Kentaro,WATANABE Shinsuke,UMEDA Takashi
Experimental animals 54(2), 193-196, 2005-04-01
… Reported cisternal puncture methods require the anesthetization and fixation of an animal within a stereotaxic frame. … To determine the effect of anesthesia and animal fixation on the central nervous system (CNS), amino acid concentrations of cerebrospinal fluid (CSF) sampled by transcutaneous cisternal puncture were compared among awake rats, pentobarbital-anesthetized rats and pentobarbital-anesthetized rats fixed in a stereotaxic frame. …
NAID 10015525986