Studies Utilizing Current Estimated CSF Pressure Equations Should Not Be Conducted and Published [Letter]

Abstract Introduction Idiopathic Intracranial Hypertension (IIH) is a significant cause of preventable blindness. Patients also suffer from debilitating headaches, pulsatile tinnitus, nausea, vomiting, photophobia, and radicular pain. If IIH continues to rise as predicted, treatment cost will increase to 462.7 million GBP annually by 2030. Weight loss is the only proven disease-modifying therapy for reversal of IIH. Bariatric surgery is an attractive treatment option due to superlative weight loss and reversal of related comorbidities. The case series aims to raise awareness of bariatric surgery as a safe and effective treatment modality for IIH. Method The case series consists of a retrospective analysis of four patients with a pre-operative diagnosis of IIH. They were referred to our department for bariatric surgery between January to December 2018. They were followed up for a total of two years. Results In our case series, all four patients were females with a mean age of 34 years. Mean BMI reduced from 47.3 kg/m2 before surgery to 30 kg/m2 with an EWL of 76.4% at the end of two years after surgery. They all showed significant improvement or resolution in their symptoms related to IIH, and none of them required further CSF pressure reducing procedures afterwards. Conclusions Bariatric surgery is a safe and effective method of treating IIH. It is superior compared to medical management and CSF pressure reducing procedures which have high rates of recurrence.

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Venous and CSF pressure in cerebral infarction with a hemorrhagic component

Kazan medical journal ◽

10.17816/kazmj62190 ◽

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.

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Digital manometry to measure cerebrospinal fluid pressure during lumbar puncture

The Neuroradiology Journal ◽

10.1177/19714009211055190 ◽

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.

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Lumbar Cerebrospinal Fluid Opening Pressure Measured in a Flexed Lateral Decubitus Position in Children

PEDIATRICS ◽

10.1542/peds.93.4.622 ◽

1994 ◽

Vol 93 (4) ◽

pp. 622-623

Author(s):

Robert Ellis

Keyword(s):

Cerebrospinal Fluid ◽

Intrathecal Chemotherapy ◽

Lateral Decubitus Position ◽

Normal Range ◽

Opening Pressure ◽

Csf Pressure ◽

Normal Ranges ◽

Extended Position ◽

Lateral Decubitus ◽

Lumbar Cerebrospinal Fluid

Objective. Lumbar punctures in children are generally performed in a flexed position. Published normal ranges for cerebrospinal fluid (CSF) opening pressure require measurement in an extended position, and flexion is known to increase lumbar CSF pressure. This study sought to determine a normal range (mean ± 2 SD) for lumbar CSF opening pressure measured in a flexed lateral decubitus position in children. Methods. Opening pressure was measured in 33 children receiving diagnostic lumbar punctures or prophylactic intrathecal chemotherapy. Measurements were performed in a flexed lateral decubitus position. Patients with medical conditions affecting CSF pressure were excluded. Results. Opening pressure (mean ± SD) was 19.0 ± 4.4 cm H2O. Opening pressure was not significantly affected by patient age or sex. Intrathecal chemotherapy and sedation also did not affect CSF pressure. Conclusions. The normal range for lumbar CSF opening pressure measured in a flexed lateral decubitus position in children is 10 to 28 cm H2O.

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Relationship between Cerebral Blood Volume and CSF Pressure during Anesthesia with Isoflurane or Fentanyl in Dogs

Anesthesiology ◽

10.1097/00000542-198406000-00010 ◽

1984 ◽

Vol 60 (6) ◽

pp. 575-579 ◽

Cited By ~ 28

Author(s):

Alan A. Artru

Keyword(s):

Blood Volume ◽

Cerebral Blood Volume ◽

Csf Pressure

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Józef Brudziński (1874–1917)

European Neurology ◽

10.1159/000492127 ◽

2018 ◽

Vol 80 (1-2) ◽

pp. 14-16

Author(s):

Krzysztof Pietrzak

Keyword(s):

Nerve Root ◽

Research Activity ◽

Csf Pressure

Józef Brudziński’s (1874–1917) contribution to the field of neurology is noteworthy and undeniable. His organizational efforts and research activity have earned him the name of the “father of the Polish paediatrics”. He described the Brudzinski reflex and Brudzinski neck sign. He proved that the symptoms of these conditions were caused by nerve root irritation and elevated CSF pressure. He also described cheek phenomenon and symphyseal sign.

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