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CSF opening pressure in children with optic nerve head edema
R A Avery1, D J Licht, S S Shah
1Department of Neurology, Children's National Medical Center, Washington, DC 20010, USA. RAvery@cnmc.org
Neurology
|May 11, 2011
Summary
Children with optic nerve head edema (ONHE) not caused by infection, inflammation, or ischemia typically have elevated cerebrospinal fluid opening pressure (OP) above 28 cm H2O. This pressure is significantly higher than in healthy children.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neurosurgery
Background:
- Elevated intracranial pressure can lead to optic nerve head edema (ONHE).
- Previous research indicated abnormal cerebrospinal fluid opening pressure (OP) in children exceeds 28 cm H2O.
- The relationship between ONHE and OP in children warrants further investigation.
Purpose of the Study:
- To determine the typical range of OP in children presenting with ONHE.
- To compare OP in children with ONHE to age-matched controls without ONHE.
- To assess if ONHE in children is consistently associated with OP greater than 28 cm H2O.
Main Methods:
- A prospective study enrolled children aged 1-18 years with ONHE that later resolved.
- Exclusion criteria included ONHE secondary to infectious, inflammatory, or ischemic conditions.
- Control subjects without ONHE were matched to case subjects based on age.
Main Results:
- Forty-one OP measurements from 33 children with ONHE were analyzed and compared to 41 matched controls.
- Children with ONHE exhibited significantly higher OP (mean 41.4 cm H2O) than controls (mean 18.9 cm H2O).
- 97.6% of children with ONHE had OP >28 cm H2O, compared to 4.8% of controls.
Conclusions:
- Children with ONHE, excluding infectious, inflammatory, or ischemic causes, typically present with OP >28 cm H2O.
- This finding supports the established threshold for abnormal OP in pediatric patients.
- Elevated OP is a significant characteristic of ONHE in children when not attributed to specific secondary causes.
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