Abstract
BackgroundAlthough widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.MethodA systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals.ResultsThirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. ConclusionsThis systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.
The Effect of Oral Clonidine Premedication on Lumbar Cerebrospinal Fluid Pressure in Humans
