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Opening Pressure at Lumbar Puncture

MedGen UID:
1792904
•Concept ID:
C5556463
•
Finding
Synonym: Opening Pressure

Definition

The initial pressure of cerebrospinal fluid when sampled via lumbar puncture. It is a surrogate measurement of intracranial pressure. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVOpening Pressure at Lumbar Puncture

Professional guidelines

PubMed

Papilledema: A review of etiology, pathophysiology, diagnosis, and management.
Xie JS, Donaldson L, Margolin E
Surv Ophthalmol 2022 Jul-Aug;67(4):1135-1159. Epub 2021 Nov 20 doi: 10.1016/j.survophthal.2021.11.007. PMID: 34813854
Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome: A Systematic Review and Meta-analysis.
D'Antona L, Jaime Merchan MA, Vassiliou A, Watkins LD, Davagnanam I, Toma AK, Matharu MS
JAMA Neurol 2021 Mar 1;78(3):329-337. doi: 10.1001/jamaneurol.2020.4799. PMID: 33393980Free PMC Article
Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children.
Friedman DI, Liu GT, Digre KB
Neurology 2013 Sep 24;81(13):1159-65. Epub 2013 Aug 21 doi: 10.1212/WNL.0b013e3182a55f17. PMID: 23966248

Recent clinical studies

Etiology

Case 334.
Brun-Vergara ML, Zakhari N, Torres CH
Radiology 2024 Oct;313(1):e240620. doi: 10.1148/radiol.240620. PMID: 39470428
Elevated lumbar puncture opening pressure in aseptic meningitis.
Ben-Dov M, Fellner A, Keret O, Lotan I, Goldstein L, Mezad-Koursh D, Steiner I, Klein A
J Clin Neurosci 2022 Dec;106:55-60. Epub 2022 Oct 18 doi: 10.1016/j.jocn.2022.10.001. PMID: 36265366
Papilledema: A review of etiology, pathophysiology, diagnosis, and management.
Xie JS, Donaldson L, Margolin E
Surv Ophthalmol 2022 Jul-Aug;67(4):1135-1159. Epub 2021 Nov 20 doi: 10.1016/j.survophthal.2021.11.007. PMID: 34813854
Spontaneous Intracranial Hypotension.
Wang SJ
Continuum (Minneap Minn) 2021 Jun 1;27(3):746-766. doi: 10.1212/CON.0000000000000979. PMID: 34048402
Pseudotumor Cerebri Syndrome in Children.
Barmherzig R, Szperka CL
Curr Pain Headache Rep 2019 Jul 10;23(8):58. doi: 10.1007/s11916-019-0795-8. PMID: 31292773Free PMC Article

Diagnosis

Spontaneous intracranial hypotension: searching for the CSF leak.
Dobrocky T, Nicholson P, Häni L, Mordasini P, Krings T, Brinjikji W, Cutsforth-Gregory JK, Schär R, Schankin C, Gralla J, Pereira VM, Raabe A, Farb R, Beck J, Piechowiak EI
Lancet Neurol 2022 Apr;21(4):369-380. Epub 2022 Feb 25 doi: 10.1016/S1474-4422(21)00423-3. PMID: 35227413
Papilledema: A review of etiology, pathophysiology, diagnosis, and management.
Xie JS, Donaldson L, Margolin E
Surv Ophthalmol 2022 Jul-Aug;67(4):1135-1159. Epub 2021 Nov 20 doi: 10.1016/j.survophthal.2021.11.007. PMID: 34813854
Cryptococcosis in solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.
Baddley JW, Forrest GN; AST Infectious Diseases Community of Practice
Clin Transplant 2019 Sep;33(9):e13543. Epub 2019 Apr 14 doi: 10.1111/ctr.13543. PMID: 30900315
Diagnostic Lumbar Puncture.
Doherty CM, Forbes RB
Ulster Med J 2014 May;83(2):93-102. PMID: 25075138Free PMC Article
Cerebrospinal fluid analysis.
Seehusen DA, Reeves MM, Fomin DA
Am Fam Physician 2003 Sep 15;68(6):1103-8. PMID: 14524396

Therapy

Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome: A Systematic Review and Meta-analysis.
D'Antona L, Jaime Merchan MA, Vassiliou A, Watkins LD, Davagnanam I, Toma AK, Matharu MS
JAMA Neurol 2021 Mar 1;78(3):329-337. doi: 10.1001/jamaneurol.2020.4799. PMID: 33393980Free PMC Article
Cryptococcosis.
Zavala S, Baddley JW
Semin Respir Crit Care Med 2020 Feb;41(1):69-79. Epub 2020 Jan 30 doi: 10.1055/s-0039-3400280. PMID: 32000285
Pseudotumor Cerebri Syndrome in Children.
Barmherzig R, Szperka CL
Curr Pain Headache Rep 2019 Jul 10;23(8):58. doi: 10.1007/s11916-019-0795-8. PMID: 31292773Free PMC Article
Cryptococcosis in solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.
Baddley JW, Forrest GN; AST Infectious Diseases Community of Practice
Clin Transplant 2019 Sep;33(9):e13543. Epub 2019 Apr 14 doi: 10.1111/ctr.13543. PMID: 30900315
Cryptococcal meningitis.
Bicanic T, Harrison TS
Br Med Bull 2004;72:99-118. Epub 2005 Apr 18 doi: 10.1093/bmb/ldh043. PMID: 15838017

Prognosis

Occam versus Hickam.
Cobbs L, Murchison AP, DeBusk A, Bilyk JR
Surv Ophthalmol 2022 Nov-Dec;67(6):1717-1722. Epub 2022 Jun 17 doi: 10.1016/j.survophthal.2022.06.001. PMID: 35718026
Idiopathic intracranial hypertension in atypical demographics.
Donaldson L, Jhaveri A, Micieli J, Margolin E
J Neurol Sci 2022 Jun 15;437:120271. Epub 2022 Apr 29 doi: 10.1016/j.jns.2022.120271. PMID: 35525063
Pseudotumor Cerebri Syndrome in Children.
Barmherzig R, Szperka CL
Curr Pain Headache Rep 2019 Jul 10;23(8):58. doi: 10.1007/s11916-019-0795-8. PMID: 31292773Free PMC Article
Cryptococcal meningitis.
Bicanic T, Harrison TS
Br Med Bull 2004;72:99-118. Epub 2005 Apr 18 doi: 10.1093/bmb/ldh043. PMID: 15838017
Cerebrospinal fluid analysis.
Seehusen DA, Reeves MM, Fomin DA
Am Fam Physician 2003 Sep 15;68(6):1103-8. PMID: 14524396

Clinical prediction guides

Elevated lumbar puncture opening pressure in aseptic meningitis.
Ben-Dov M, Fellner A, Keret O, Lotan I, Goldstein L, Mezad-Koursh D, Steiner I, Klein A
J Clin Neurosci 2022 Dec;106:55-60. Epub 2022 Oct 18 doi: 10.1016/j.jocn.2022.10.001. PMID: 36265366
Idiopathic intracranial hypertension in atypical demographics.
Donaldson L, Jhaveri A, Micieli J, Margolin E
J Neurol Sci 2022 Jun 15;437:120271. Epub 2022 Apr 29 doi: 10.1016/j.jns.2022.120271. PMID: 35525063
Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome: A Systematic Review and Meta-analysis.
D'Antona L, Jaime Merchan MA, Vassiliou A, Watkins LD, Davagnanam I, Toma AK, Matharu MS
JAMA Neurol 2021 Mar 1;78(3):329-337. doi: 10.1001/jamaneurol.2020.4799. PMID: 33393980Free PMC Article
H2O coma.
Stiefel D, Petzold A
Neurocrit Care 2007;6(1):67-71. doi: 10.1385/NCC:6:1:67. PMID: 17356195
Cerebrospinal fluid analysis.
Seehusen DA, Reeves MM, Fomin DA
Am Fam Physician 2003 Sep 15;68(6):1103-8. PMID: 14524396

Recent systematic reviews

Diagnostic approach, therapeutic strategies, and surgical indications in intradural thoracic disc herniation associated with CSF leak, intracranial hypotension, and CNS superficial siderosis.
Bonomo G, Cusin A, Rubiu E, Iess G, Bonomo R, Boncoraglio GB, Stanziano M, Ferroli P
Neurol Sci 2022 Jul;43(7):4167-4173. Epub 2022 Apr 8 doi: 10.1007/s10072-022-06059-y. PMID: 35396636Free PMC Article
Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome: A Systematic Review and Meta-analysis.
D'Antona L, Jaime Merchan MA, Vassiliou A, Watkins LD, Davagnanam I, Toma AK, Matharu MS
JAMA Neurol 2021 Mar 1;78(3):329-337. doi: 10.1001/jamaneurol.2020.4799. PMID: 33393980Free PMC Article
Idiopathic intracranial hypertension and bariatric surgery: a systematic review.
Sun WYL, Switzer NJ, Dang JT, Gill R, Shi X, de Gara C, Birch D, Nataraj A, Karmali S
Can J Surg 2020 Mar 20;63(2):E123-E128. doi: 10.1503/cjs.016616. PMID: 32195557Free PMC Article
CSF Pressure, Volume, and Post-Dural Puncture Headache: A Case-Control Study and Systematic Review.
Smith JH, Mac Grory B, Butterfield RJ, Khokhar B, Falk BL, Marks LA
Headache 2019 Sep;59(8):1324-1338. Epub 2019 Jul 24 doi: 10.1111/head.13602. PMID: 31342523
Bariatric surgery as a treatment for idiopathic intracranial hypertension: a systematic review.
Handley JD, Baruah BP, Williams DM, Horner M, Barry J, Stephens JW
Surg Obes Relat Dis 2015 Nov-Dec;11(6):1396-403. Epub 2015 Aug 12 doi: 10.1016/j.soard.2015.08.497. PMID: 26499350

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