Abstract
Post-lumbar puncture (LP) headache may be due to "low CSF pressure", leading to stretching of pain sensitive intracranial structures. The low intracranial pressure is secondary to net loss of intracranial CSF. It has, however, not been possible to measure intracranial CSF volume accurately during life until recently. Intracranial CSF volume can now be measured non-invasively by a MRI technique. The changes in intracranial CSF volume were studied in 20 patients who had LP. Total intracranial CSF volume was reduced in 19 of the 20 patients 24 hours after LP (range -1.8 mls to -158.6 mls). Most of the CSF was lost from the cortical sulci. Very large reductions in intracranial CSF volume were frequently related to post-LP headache but some patients developed headache with relatively little alteration in the intracranial CSF volume. There was not a measurable change in position of the intracranial structures following LP.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Condon B., Patterson J., Wyper D., Hadley D., Grant R., Teasdale G., Rowan J. Use of magnetic resonance imaging to measure intracranial cerebrospinal fluid volume. Lancet. 1986 Jun 14;1(8494):1355–1357. doi: 10.1016/s0140-6736(86)91666-1. [DOI] [PubMed] [Google Scholar]
- Grant R., Condon B., Patterson J., Wyper D. J., Hadley M. D., Teasdale G. M. Changes in cranial CSF volume during hypercapnia and hypocapnia. J Neurol Neurosurg Psychiatry. 1989 Feb;52(2):218–222. doi: 10.1136/jnnp.52.2.218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marton K. I., Gean A. D. The spinal tap: a new look at an old test. Ann Intern Med. 1986 Jun;104(6):840–848. doi: 10.7326/0003-4819-104-6-840. [DOI] [PubMed] [Google Scholar]
- VANDAM L. D., DRIPPS R. D. Long-term follow-up of patients who received 10,098 spinal anesthetics; syndrome of decreased intracranial pressure (headache and ocular and auditory difficulties). J Am Med Assoc. 1956 Jun 16;161(7):586–591. doi: 10.1001/jama.1956.02970070018005. [DOI] [PubMed] [Google Scholar]