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학습 자료 둘러보기 →The priority assessment is identifying signs of increased intracranial pressure (ICP). The most critical bedside finding is papilledema on fundoscopic exam, which indicates a high risk of cerebral herniation if CSF is drained.
A CT scan should be performed before the procedure if papilledema or other focal neurological signs are present. The procedure must be deferred until imaging rules out a mass effect or obstructive hydrocephalus.
Do not proceed with the lumbar puncture if papilledema is found. Removing CSF creates a pressure gradient that can force the brainstem through the foramen magnum, a rapidly fatal complication.
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