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Fluids Barriers CNS. 2018 Aug 1;15(1):21. doi: 10.1186/s12987-018-0106-5.

Characteristics of the cerebrospinal fluid pressure waveform and craniospinal compliance in idiopathic intracranial hypertension subjects.

Author information

1
Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH, 43210, USA.
2
Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH, 43210, USA. roberts.8@osu.edu.
3
Department of Ophthalmology & Visual Science, The Ohio State University, 915 Olentangy River Rd, Columbus, OH, 43212, USA. roberts.8@osu.edu.
4
Department of Ophthalmology & Visual Science, The Ohio State University, 915 Olentangy River Rd, Columbus, OH, 43212, USA.
5
Department of Anesthesiology, The Ohio State University, 410W. 10th Avenue, Columbus, OH, 43210, USA.
6
Department of Neurosurgery, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA.
7
Ohio Neuro-Ophthalmology, Orbital Disease & Oculoplastics, 3545 Olentangy River Rd, Suite 200, Columbus, OH, 43214, USA.

Abstract

BACKGROUND:

Idiopathic intracranial hypertension (IIH) is a condition of abnormally high intracranial pressure with an unknown etiology. The objective of this study is to characterize craniospinal compliance and measure the cerebrospinal fluid (CSF) pressure waveform as CSF is passively drained during a diagnostic and therapeutic lumbar puncture (LP) in IIH.

METHODS:

Eighteen subjects who met the Modified Dandy Criteria, including papilledema and visual field loss, received an ultrasound guided LP where CSF pressure (CSFP) was recorded at each increment of CSF removal. Joinpoint regression models were used to calculate compliance from CSF pressure and the corresponding volume removed at each increment for each subject. Twelve subjects had their CSFP waveform recorded with an electronic transducer. Body mass index, mean CSFP, and cerebral perfusion pressure (CPP) were also calculated. T-tests were used to compare measurements, and correlations were performed between parameters.

RESULTS:

Cerebrospinal fluid pressure, CSFP pulse amplitude (CPA), and CPP were found to be significantly different (p < 0.05) before and after the LP. CSFP and CPA decreased after the LP, while CPP increased. The craniospinal compliance significantly increased (p < 0.05) post-LP. CPA and CSFP were significantly positively correlated.

CONCLUSIONS:

Both low craniospinal compliance (at high CSFP) and high craniospinal compliance (at low CSFP) regions were determined. The CSFP waveform morphology in IIH was characterized and CPA was found to be positively correlated to the magnitude of CSFP. Future studies will investigate how craniospinal compliance may correlate to symptoms and/or response to therapy in IIH subjects.

KEYWORDS:

Cerebrospinal fluid pressure; Cerebrospinal fluid pressure pulse amplitude; Cerebrospinal fluid pressure waveform; Compliance; Craniospinal compliance; Idiopathic intracranial hypertension; Pressure–volume curves

PMID:
30064442
PMCID:
PMC6069551
DOI:
10.1186/s12987-018-0106-5
[Indexed for MEDLINE]
Free PMC Article

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