C1-2 CSF tap in a 6-month-old infant: illustrative case

Area of Science:

• Neurosurgery
• Pediatric Neurology
• Diagnostic Procedures

Background:

• Cerebrospinal fluid (CSF) access is crucial for diagnosing conditions like meningitis.
• Lumbar puncture (LP) is the standard method but may be contraindicated or unfeasible in certain pediatric cases.
• C1-2 puncture presents an alternative route for CSF sampling.

Purpose of the Study:

• To describe the successful performance of a C1-2 puncture in a 6-month-old infant.
• To highlight the technical considerations and safety of this procedure in infancy.
• To evaluate C1-2 puncture as an alternative to LP when contraindicated.

Main Methods:

• A lateral C1-2 puncture was performed under general anesthesia with fluoroscopic guidance.
• Preprocedural imaging and real-time fluoroscopy were used to determine needle trajectory and safety.
• Cerebrospinal fluid was successfully aspirated for laboratory analysis.

Main Results:

• The C1-2 puncture was performed without technical difficulty or procedural complications.
• The infant tolerated the procedure well with no adverse postoperative events.
• This represents a rare instance of C1-2 CSF tap in an infant.

Conclusions:

• C1-2 puncture is a safe and feasible method for CSF sampling in infants when lumbar access is contraindicated or unsuccessful.
• This technique provides a viable option for diagnosing suspected meningitis in infants with specific contraindications.
• Further reports on this rarely utilized approach in infancy are warranted.