Anaesthesia 53(5):431–434Įide PK, Brean A (2006) Lumbar cerebrospinal fluid pressure waves versus intracranial pressure waves in idiopathic normal pressure hydrocephalus. Neurology 59(10):1641–1643ĭinsmore J, Bacon RC, Hollway TE (1998) The effect of increasing degrees of spinal flexion on cerebrospinal fluid pressure. J Neurol 267(12):3696–3701īono F, Lupo MR, Serra P, Cantafio C, Lucisano A, Lavano A, Fera F, Pardatscher K, Quattrone A (2002) Obesity does not induce abnormal CSF pressure in subjects with normal cerebral MR venography. Investig Opthalmol Vis Sci 53(3):1422īø SH, Lundqvist C (2020) Cerebrospinal fluid opening pressure in clinical practice – a prospective study. ![]() Acta Neurochir 157(1):109–113īerdahl JP, Fleischman D, Zaydlarova J, Stinnett S, Allingham RR, Fautsch MP (2012) Body mass index has a linear relationship with cerebrospinal fluid pressure. J Neuro-Ophthalmol 34(3):218–222Īndresen M, Hadi A, Petersen LG, Juhler M (2015) Effect of postural changes on ICP in healthy and ill subjects. Consensus on guidelines for body position including neck and hip flexion measuring CSF op may be needed.Ībel AS, Brace JR, McKinney AM, Friedman DI, Smith SD, Westesson PL, Nascene D, Ott F, Lee MS (2014) Effect of patient positioning on cerebrospinal fluid opening pressure. This may cause patients to shift from a normal ICP range to a pathological ICP range, which will potentially affect treatment decisions. Neck flexion alone, and neck flexion and hip flexion in combination, has significant confounding influence on ICP. However, when straightening the hip and neck simultaneously ICP decreased by 6.4 mmHg ( n = 6, IQR − 9.5 to − 4.4). Straightening the hips alone decreased ICP with 0.2 mmHg ( n = 15, IQR − 0.5 to 2.0), while straightening the neck alone decreased ICP by 4.0 mmHg ( n = 15, IQR − 5.9 to − 1.7). In the horizontal examination, ICP increased in all but one patient when changing from supine position to lateral recumbent position ( n = 15, median increase of 6.9 mmHg, IQR 3.1 to 9.9). The vertical examination showed that ICP decreased by 15.2 mmHg when straightening the neck in a sitting lumbar puncture position ( n = 24, IQR − 20.1 to − 9.7). The patients underwent either a vertical postural examination ( n = 24) or a horizontal postural examination ( n = 15) to examine a varying degree of spine flexion. ![]() Thirty-nine patients, undergoing invasive ICP monitoring as part of diagnostic work-up, were included. ![]() This study investigated if flexion of hip and neck both separately and simultaneously influence intracranial pressure (ICP) to a clinically relevant extent. The cerebrospinal fluid opening pressure (CSF op) is measured in a horizontal position. The standard lumbar puncture position involves maximum flexion of both lumbar and cervical spine.
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