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Previous Volume 341:129-130 July 8, 1999 Number 2 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In the commentary of their Clinical Problem-Solving article "A Balancing Act" (Feb. 4 issue),¹ Saha and colleagues emphasize the importance of clinical examination in assessing the safety of lumbar puncture. In particular, the presence of papilledema and focal neurologic signs are mentioned as indicators of increased intracranial pressure. Another valuable clinical marker is an assessment for retinal venous pulsation. Its presence has been demonstrated to signify that intracranial pressure is normal. Levin² showed that although patients with normal intracranial pressure may not have venous pulsation, no patient with increased intracranial pressure had venous pulsation, despite the fact . . . [Full Text of this Article]

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