When should CT scan be performed before LP in meningitis?

  • CT imaging is important when raised ICP suspected:
    • Lumbar puncture may precipitate cerebral herniation
  • Should be performed if in all patients presenting with:
    • Focal neurologic deficits (excluding cranial nerve palsies)
    • New-onset seizures
    • Severely altered mental status (Glasgow Coma Scale score <10)
    • Severely immunocompromised state
  • In patients lacking these characteristics, CT imaging is not recommended before lumbar puncture