Pressure curves from the cerebrospinal fluid

Antoni, Nils

doi:10.1111/j.0954-6820.1946.tb19257.x

Cited by 20 publications

(4 citation statements)

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“…This patient also showed a delayed return to CSFP baseline following release of Queckenstedt’s test, so called “valvular effect” according to previous reports. 20 …”

Section: Resultsmentioning

confidence: 99%

“…In addition to other abnormalities of the Queckenstedt’s test, there was a persistent CSFP rise in 2 patients after the release of the neck compression ( Figures 3 and 5 ), that is not found in spine-healthy patients, previously called the valvular effect. 20 This might be another signature of the dissociation between the cerebral and lumbar compartment related to the stenosis. Alternatively, the altered vessel tone, for example, of the epidural veins, might contribute to this finding.…”

Section: Discussionmentioning

confidence: 99%

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Cerebrospinal Fluid Pressure Dynamics as a Bedside Test in Traumatic Spinal Cord Injury to Assess Surgical Spinal Cord Decompression: Safety, Feasibility, and Proof-of-Concept

Kheram

Boraschi

Pfender

et al. 2023

Neurorehabil Neural Repair

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Background Sufficient and timely spinal cord decompression is a critical surgical objective for neurological recovery in spinal cord injury (SCI). Residual cord compression may be associated with disturbed cerebrospinal fluid pressure (CSFP) dynamics. Objectives This study aims to assess whether intrathecal CSFP dynamics in SCI following surgical decompression are feasible and safe, and to explore the diagnostic utility. Methods Prospective cohort study. Bedside lumbar CSFP dynamics and cervical MRI were obtained following surgical decompression in N = 9 with mostly cervical acute-subacute SCI and N = 2 patients with non-traumatic SCI. CSFP measurements included mean CSFP, cardiac-driven CSFP peak-to-valley amplitudes (CSFPp), Valsalva maneuver, and Queckenstedt’s test (firm pressure on jugular veins, QT). From QT, proxies for cerebrospinal fluid pulsatility curve were calculated (ie, relative pulse pressure coefficient; RPPC-Q). CSFP metrics were compared to spine-healthy patients. computer tomography (CT)-myelography was done in 3/8 simultaneous to CSFP measurements. Results Mean age was 45 ± 9 years (range 17-67; 3F), SCI was complete (AIS A, N = 5) or incomplete (AIS B-D, N = 6). No adverse events related to CSFP assessments. CSFP rise during QT was induced in all patients [range 9.6-26.6 mmHg]. However, CSFPp was reduced in 3/11 (0.1-0.3 mmHg), and in 3/11 RPPC-Q was abnormal (0.01-0.05). Valsalva response was reduced in 8/11 (2.6-23.4 mmHg). CSFP dynamics corresponded to CT-myelography. Conclusions Comprehensive bedside lumbar CSFP dynamics in SCI following decompression are safe, feasible, and can reveal distinct patterns of residual spinal cord compression. Longitudinal studies are required to define critical thresholds of impaired CSFP dynamics that may impact neurological recovery and requiring surgical revisions.

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“…This patient also showed a delayed return to CSFP baseline following release of Queckenstedt’s test, so called “valvular effect” according to previous reports. 20 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Pressure Dynamics as a Bedside Test in Traumatic Spinal Cord Injury to Assess Surgical Spinal Cord Decompression: Safety, Feasibility, and Proof-of-Concept

Kheram

Boraschi

Pfender

et al. 2023

Neurorehabil Neural Repair

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“…Or the variations may be caused by pulsations of the small vessels of the optic nerve head. A direct transmission of the pulsations of the cerebrospinal fluid through the optic nerve tissue may also possibly occur (1,2,6). The next step in the investigation, logically following the establishment of the pulse-synchronous variations, would be the study of a protrusion variation curve plotted during a period related to the ECG.…”

Section: Resultsmentioning

confidence: 99%

Rapid Variations of the Prominent Optic Disc

Bynke

Krakau

1961

Acta Ophthalmologica

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“…Hence, it reduces intracranial compliance and thereby increases CSFPp. Comprehensive monographies have been written on QT morphology and physiology, for instance by Lakke [ 30 ] and Antoni [ 2 ], but information on the range for mean CSFP rise during QT are sparse (between 7 and 40 mmHg [ 2 , 20 , 41 ]), and the evolution of CSFPp from resting state to the plateau phase of QT has not systematically been described yet in spine-healthy patients. To our knowledge, only Gilland et al [ 21 ] reported the CSFPp (6 mmHg) during the plateau phase of QT (i.e., at a mean CSFP of 29 mmHg), as observed in 31 healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Queckenstedt’s test repurposed for the quantitative assessment of the cerebrospinal fluid pulsatility curve

et al. 2023

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Purpose Before the era of spinal imaging, presence of a spinal canal block was tested through gross changes in cerebrospinal fluid pressure (CSFP) provoked by manual compression of the jugular veins (referred to as Queckenstedt's test; QT). Beyond these provoked gross changes, cardiac-driven CSFP peak-to-valley amplitudes (CSFPp) can be recorded during CSFP registration. This is the first study to assess whether the QT can be repurposed to derive descriptors of the CSF pulsatility curve, focusing on feasibility and repeatability. Method Lumbar puncture was performed in lateral recumbent position in fourteen elderly patients (59.7±9.3 years, 6F) (NCT02170155) without stenosis of the spinal canal. CSFP was recorded during resting state and QT. A surrogate for the relative pulse pressure coefficient was computed from repeated QTs (i.e., RPPC-Q). Results Resting state mean CSFP was 12.3 mmHg (IQR 3.2) and CSFPp was 1.0 mmHg (0.5). Mean CSFP rise during QT was 12.5 mmHg (7.3). CSFPp showed an average 3-fold increase at peak QT compared to the resting state. Median RPPC-Q was 0.18 (0.04). There was no systematic error in the computed metrics between the first and second QT. Conclusion This technical note describes a method to reliably derive, beyond gross CSFP increments, metrics related to cardiac-driven amplitudes during QT (i.e., RPPC-Q). A study comparing these metrics as obtained by established procedures (i.e., infusion testing) and by QT is warranted.

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Pressure curves from the cerebrospinal fluid

Cited by 20 publications

References 0 publications

Cerebrospinal Fluid Pressure Dynamics as a Bedside Test in Traumatic Spinal Cord Injury to Assess Surgical Spinal Cord Decompression: Safety, Feasibility, and Proof-of-Concept

Cerebrospinal Fluid Pressure Dynamics as a Bedside Test in Traumatic Spinal Cord Injury to Assess Surgical Spinal Cord Decompression: Safety, Feasibility, and Proof-of-Concept

Rapid Variations of the Prominent Optic Disc

Queckenstedt’s test repurposed for the quantitative assessment of the cerebrospinal fluid pulsatility curve

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