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Cerebral Herniation During Bacterial Meningitis in Children
BMJ 306:953-955, Rennick,G.,et al, 1993
See this aricle in Pubmed

Article Abstract
Cerebral herniation was detected in 19(4-3%)of the 445 children(21 episodes;herniation occurred twice in two children).Herniation occurred in 14(45%)of the 31 children who died.Nineteen episodes of herniation occurred in the 17 children who had a lumbar puncture;12 of the episodes occurred in the first 12 hours after the lumbar puncture and seven over six other 12 hour periods(odds ratio 32:6(95%confidence interval 8.5 to 117.3);p<0.001).The results of cranial computed tomography were normal in five(36%)of the 14 episodes of herniation in which scanning was performed at about the time of herniation.The temporal relation between lumbar puncture and herniation strongly suggests that a lumbar puncture may cause herniation in some patients,and normal results on computed tomography do not mean that it is safe to do a lumbar puncture in a child with bacterial meningitis.
 
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CAT scan
contraindications
herniation syndromes,intracranial
intracranial pressure,increased
lumbar puncture
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meningitis,bacterial
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uncal herniation

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