Digital manometry to measure cerebrospinal fluid pressure during lumbar puncture

2021 ◽  
pp. 197140092110551
Author(s):  
Robert Heider ◽  
Peter G Kranz ◽  
Erin Hope Weant ◽  
Linda Gray ◽  
Timothy J Amrhein
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Puncture ◽  
Pressure Measurement ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Pressure Measurements ◽  
Csf Pressure ◽  
Left Lateral Decubitus Position ◽  
Significant Difference ◽  
Time Savings

Rationale and Objectives Accurate cerebrospinal fluid (CSF) pressure measurements are critical for diagnosis and treatment of pathologic processes involving the central nervous system. Measuring opening CSF pressure using an analog device takes several minutes, which can be burdensome in a busy practice. The purpose of this study was to compare accuracy of a digital pressure measurement device with analog manometry, the reference gold standard. Secondary purpose included an assessment of possible time savings. Materials and Methods This study was a retrospective, cross-sectional investigation of 71 patients who underwent image-guided lumbar puncture (LP) with opening CSF pressure measurement at a single institution from June 2019 to September 2019. Exclusion criteria were examinations without complete data for both the digital and analog measurements or without recorded needle gauge. All included LPs and CSF pressures were measured with the patient in the left lateral decubitus position, legs extended. Acquired data included (1) digital and analog CSF pressures and (2) time required to measure CSF pressure. Results A total of 56 procedures were analyzed in 55 patients. There was no significant difference in mean CSF pressures between devices: 22.5 cm H2O digitally vs 23.1 analog ( p = .7). Use of the digital manometer resulted in a time savings of 6 min (438 s analog vs 78 s digital, p < .001). Conclusion Cerebrospinal fluid pressure measurements obtained with digital manometry demonstrate comparable accuracy to the reference standard of analog manometry, with an average time savings of approximately 6 min per case.

Venous and CSF pressure in cerebral infarction with a hemorrhagic component

1985 ◽  
Vol 66 (6) ◽  
pp. 419-421
Author(s):  
A. A. Ashman
Keyword(s):  
Cerebrospinal Fluid ◽  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Csf Pressure

Literature data on the value of cerebrospinal fluid pressure in certain forms of ischemic stroke are few and contradictory.

A simplified method for obtaining cerebrospinal fluid pressure measurements in the dog

1963 ◽  
Vol 18 (4) ◽  
pp. 837-837 ◽  
Author(s):  
Javier Verdura ◽  
Robert J. White ◽  
Henry Kretchmer
Keyword(s):  
Cerebrospinal Fluid ◽  
Continuous Monitoring ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Cerebrospinal Fluid Leakage ◽  
Pressure Measurements ◽  
Fluid System ◽  
Polyethylene Tube ◽  
Simplified Method ◽  
Direct Inspection

A simplified method for recording the cerebrospinal fluid pressure in the dog is presented. It consists of introducing the polyethylene tube of a Rochester needle into the sub-arachnoid space at the level of the ventral atlanto-occipital joint. The advantages of this technique are: the dura mater is punctured under direct vision; a completely sealed fluid system results which permits direct inspection for cerebrospinal fluid leakage; and the animal may be placed in any anatomical position during the continuous monitoring of cerebrospinal fluid pressure. This method of measuring the cerebrospinal fluid pressure has been utilized in 30 canine experiments and has proven equally effective in recording cerebrospinal fluid pressures in monkeys. Submitted on December 21, 1962

Cerebrospinal fluid pressure measurements and radioisotope cisternography in dogs

1974 ◽  
Vol 8 (1) ◽  
pp. 85-91 ◽  
Author(s):  
G. Novak ◽  
Carole Digel ◽  
B. Burns ◽  
A. Everette James
Keyword(s):  
Animal Model ◽  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Communicating Hydrocephalus ◽  
Pressure Measurements ◽  
Cerebrospinal Fluid Flow ◽  
The Mean ◽  
Made In

Cerebrospinal fluid pressure measurements and radioisotope cisternograms were made in 16 mongrel random-source dogs (beagle breed excluded) as a screening technique in developing an experimental animal model for communicating hydrocephalus. Cerebrospinal fluid pressure measurements were made by puncturing the cisterna magna with a spinal needle through which the radiopharmaceutical was also subsequently injected. The mean cerebrospinal fluid pressure was 117 mm water, and the incidence of hydrocephalus was found to be rare. Cisternographic flow patterns also indicate that cerebrospinal fluid flow and absorption in dogs differs from that found in man.

scholarly journals Patients with pulse-synchronous tinnitus should be suspected to have elevated cerebrospinal fluid pressure

2019 ◽  
Vol 47 (9) ◽  
pp. 4104-4113 ◽  
Author(s):  
Ping Guo ◽  
Wenfang Sun ◽  
Suming Shi ◽  
Wuqing Wang
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Puncture ◽  
Fluid Pressure ◽  
Brain Magnetic Resonance Imaging ◽  
Clinical Importance ◽  
Fundus Examination ◽  
Resonance Imaging ◽  
Exact Test ◽  
Csf Pressure ◽  
The Mean

Objective This study was performed to evaluate the prevalence and clinical importance of elevated cerebrospinal fluid (CSF) pressure among patients with pulse-synchronous tinnitus. Methods Nineteen patients underwent height and weight measurements, routine otologic examinations, ear computed tomography, brain magnetic resonance imaging, fundus examination, and tinnitus score assessment. We analyzed the data with Fisher’s exact test, the t-test, and Pearson’s correlation. Results The mean age of the 19 patients was 39.2 ± 8.1 years (range, 27–54 years), and the mean body mass index was 22.2 ± 1.6 kg/m2 (range, 19.9–24.6 kg/m2). The proportion of patients with elevated CSF pressure was 68%. No significant correlation between the severity of tinnitus and CSF pressure was found. Lumbar puncture and oral administration of diuretics resulted in significant improvement in tinnitus. Conclusions If detailed physical and imaging examinations fail to detect the definite cause of pulse-synchronous tinnitus, a routine lumbar puncture should be performed to measure the CSF pressure. Elevated CSF pressure should be suspected in patients with pulse-synchronous tinnitus.

A Simple Method of Estimating Cerebrospinal Fluid Pressure During Lumbar Puncture

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 895-897
Author(s):  
Robert W. Ellis ◽  
Lewis C. Strauss ◽  
Joseph M. Wiley ◽  
Thomas M. Killmond ◽  
Robert W. Ellis
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Puncture ◽  
Fluid Pressure ◽  
Relative Viscosity ◽  
Csf Flow ◽  
Simple Method ◽  
Counting Period ◽  
Needle Size ◽  
Csf Pressure

It is often difficult to measure cerebrospinal fluid (CSF) pressure in children. CSF flow through a spinal needle is described by the equation: Flow = pressure/(needle constant x relative viscosity). Thus, CSF flow rate during lumbar puncture can be used to estimate CSF pressure. Because the viscosity of CSF is approximately the same as that of normal saline, 0.9% NaCl was used to model CSF flow in vitro. Flow of saline through various spinal needles was measured as pressure and temperature were varied to determine needle constants and variation in viscosity with temperature. Counting periods for which the number of drops counted equals the pressure (in centimeters of H2O) then were determined for each needle size. At patient temperatures less than 40°C, counting periods were calculated at 21, 39, and 12 seconds, for 22-gauge 1.5-inch, 22-gauge 3.5-inch, and 20-gauge 3.5-inch spinal needles, respectively. Viscosity decreased slightly above 40°C, and counting periods became 20, 37, and 11 seconds. Finally, the method was tested prospectively in 12 patients by comparing drop count (over the calculated counting period) to manometric pressure measurement. Drop counts were within 15% of manometric pressure in all patients. This method allows simple and rapid estimation of CSF pressure during lumbar puncture.

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