The effect of whole body position on lumbar cerebrospinal fluid opening pressure

• Main Authors: Udommongkol Chesda, Tejavanija Sirakarn, Sithinamsuwan Nakorn, Sithinamsuwan Pasiri, Nidhinandana Samart
• Format: Article
• Language: English
• Published: BMC 2008-07-01
• Series: Cerebrospinal Fluid Research
• Online Access: http://www.cerebrospinalfluidresearch.com/content/5/1/11
• ISSN: 1743-8454

<p>Abstract</p> <p>We compared cerebrospinal fluid (CSF) opening pressure measurements in the lumbar subarachnoid space between the flexed position (F-OP) and relaxed position (R-OP) in recumbent patients. We devised an equation for using F-OP to determine the existence of raised intracranial pressure (ICP). Patients (n = 83) underwent lumbar puncture while in the flexed lateral decubitus position and then were moved to the relaxed position. F-OP and R-OP were measured with a water manometer. R-OP > 180 mmH₂O plus relevant clinical signs were taken as indicators of raised intracranial pressure. Mean pressures for F-OP and R-OP were 178.54 and 160.52 mmH₂O respectively, <it>p </it><0.001. When F-OP > 180, raised ICP could be significantly over diagnosed. The authors recommend an equation [R-OP_{(calculated, mmH2O)}= 0.885 × F-OP_{(measured, mmH2O)}] or using 200 mmH₂O as the threshold for increased ICP with flexed posture.</p>