22/02/2023
𝐀𝐭𝐥𝐚𝐧𝐭𝐨-𝐨𝐜𝐜𝐢𝐩𝐢𝐭𝐚𝐥 𝐂𝐞𝐫𝐞𝐛𝐫𝐨𝐬𝐩𝐢𝐧𝐚𝐥 𝐟𝐥𝐮𝐢𝐝 𝐜𝐨𝐥𝐥𝐞𝐜𝐭𝐢𝐨𝐧💉🤍🐴
Cerebrospinal fluid (CSF) is a clear, colorless liquid that circulates around the brain and spinal cord, providing cushioning and protection to the central nervous system. In some cases, it may be necessary to obtain a sample of CSF from an equine patient for diagnostic purposes (such as diagnosing EPM, EDM, etc.). There are different techniques for collecting CSF, including the atlanto-occipital route, which involves accessing the subarachnoid space through the space between the atlanto-occipital joint.
This procedure is usually performed under general anesthesia contrary to the lumbosacral route, which is usually under standing sedation. The volume of CSF that can be obtained through the atlanto-occipital route is often larger than that obtained through other techniques, which can be beneficial for diagnostic purposes. Additionally, the CSF obtained through this route is less likely to be contaminated with blood or other fluids from the surrounding tissues. This route allows for better visualization of the needle and the surrounding tissues, which can facilitate the placement of the needle in the correct location (last image is a graphic provided for better visualization). This can be especially important in cases where the anatomy is abnormal or where previous surgeries or injuries have altered the normal anatomy.
Overall, the atlanto-occipital route can be a useful technique for obtaining CSF in equine patients, especially in cases where a myelogram is going to follow, like in this particular case. For a myelogram the contrast is administered through the same needle after obtaining the sample.