CSF DYNAMIC DIAGNOSIS OF SPINAL BLOCK VI: Reliability of combined cisterno-lumbar electromanometrics

Gilland, Olof

doi:10.1111/j.1600-0404.1966.tb05409.x

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…In this study, compression of jugular veins produced a square wave increase in extradural pressure for the duration of compression. This increase is almost identical to the increase in spinal CSF pressure produced by jugular venous compression [8,9].…”

Section: Discussionsupporting

confidence: 53%

“…As the spinal CSF imparts its pressure to the potential lumbar extradural space, changes in spinal CSF pressure should be reflected in extradural space pressure. Compression of jugular veins increases spinal CSF pressure [7][8][9] and extradural pressure [10][11][12]. In this study, compression of jugular veins produced a square wave increase in extradural pressure for the duration of compression.…”

Section: Discussionmentioning

confidence: 86%

“…The amplitude of the pulse wave varies directly with intracranial pressure [6]. The amplitude increases when the intracranial pressure is increased by jugular venous compression [8,9], induced hypercapnia [14] or by injection of fluid into the CSF [15].…”

Section: Discussionmentioning

confidence: 99%

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Positive lumbar extradural space pressure

Shah

1994

British Journal of Anaesthesia

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Specially selected soft Macintosh balloon indicators were attached to needles during five extradural and five spinal punctures. When the needle point entered the extradural space, the mean balloon pressure decreased suddenly from 24.9 (range 14-37) to 12.3 (10-16) mm Hg in the five extradural punctures and from 22.3 (17-28) to 13.7 (10-17) mm Hg in the five spinal punctures. In the five spinal punctures, the balloon pressure did not alter when the needle was advanced from the extradural to the subarachnoid space. Contrary to expectation, none of the balloons deflated when the needle point entered the extradural or subarachnoid spaces. The balloon pressure varied rhythmically in synchrony with respiration and cardiac pulsations. The final balloon pressure, extradural space pressure and subarachnoid pressure were equal. The results suggest that the extradural pressure is positive and of the same magnitude as the prevailing lumbar cerebrospinal fluid pressure. Jugular venous compression, ventilation with carbon dioxide and positive end-expiratory pressure (PEEP) produce a rapid increase in cerebrospinal fluid (CSF) pressure. These stimuli also produced a measurable increase in the lumbar extradural pressure. Jugular venous compression increased the mean lumbar extradural pressure by 6.8 (3-10) mm Hg and ventilation with carbon dioxide increased it by 10 (5-12.5) mm Hg. PEEP values of 5, 10, 15 and 20 cm H2O produced an immediate increase in extradural pressure of 1-2 mm Hg for every 5 cm H2O of PEEP. The lumbar extradural pressure increased rapidly with stimuli known to increase CSF pressure. Changes in spinal CSF pressure may be detected by measuring extradural pressure.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 86%

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Positive lumbar extradural space pressure

Shah

1994

British Journal of Anaesthesia

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“…One must also expect that the length of the spinal block, which could not be evaluated in this study, will influence the values recorded. 2 The spinal block infusion test must therefore be regarded as a semiquantitative test.…”

Section: Validity and Limitations Of Spinal Block Infusion Testmentioning

confidence: 99%

Clinical recording of pressure on the spinal cord and cauda equina

Magnæs¹

1982

Journal of Neurosurgery

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When an intraspinal expanding lesion causes a spinal block, a segment of the spinal cord or cauda equina will be subjected to general pressure from the surrounding tissue. This spinal block pressure, the spinal equivalent to intracranial pressure, was measured by lumbar infusion of fluid and simultaneous recording of the volume-pressure curve caudal to the block. The point of deviation from or breakthrough of the exponential volume-pressure curve indicated the spinal block pressure. Spinal block pressure of about 500 mm H2O and more could be determined by this method, and, when it was combined with Queckenstedt's test, lower pressures could be assessed as well. In the static (thoracic) part of the spine, spinal block pressure up to the level of arterial blood pressure was recorded. In the dynamic part of the spine, however, spinal block pressure could exceed arterial blood pressure due to external compressive forces during extension of the spine. There was a general tendency for more severe neurological deficits in patients with high spinal block pressure; but the duration of the pressure, additional focal pressure, and spinal cord compared with nerve root compression seemed equally important factors. The recording has implications for diagnosis, positioning of patients for myelography and surgery, selection of high-risk patients for the most appropriate surgical procedure, and detection of postoperative hematoma. There were no complications associated with the recordings.

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“…The use of electromanometric equipment for registration of CSF-pressure variations increased the sensitivity of Queckenstedt's test, but still the degree of obstruction has to be considerable to become manifest (GILLAND 1965).…”

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confidence: 99%