The Necessity of Lumbar Puncture in Children with Presumed Pseudotumor Cerbri: Infectious Mimickers

Despite the primary diagnostic criterion of elevated cerebrospinal fluid (CSF) pressure with normal constituents, many practitioners question the need for lumbar puncture in 'classic' presentations of pediatric pseudotumor cerebri. This is predicated on the unique challenges of performing lumbar puncture in children: sedation is often required; accurate measurement of the opening pressure may be complicated by crying or difficulties with positioning; and there is currently no clear consensus on the normal opening pressure in children at various ages. However, other important causes of elevated intracranial pressure with a normal MRI must be recognized, and may be overlooked without careful CSF analysis.