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Cerebrospinal fluid opening pressure in children: experience in a controlled setting
Marcus W Lee1, Vettakikoru V Vedanarayanan
1Department of Pediatric Neurology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. mwlee@umc.edu
Pediatric Neurology
|September 13, 2011
Summary
Cerebrospinal fluid opening pressure in children may be higher than previously thought. This study found pediatric opening pressures were poorly correlated with age and BMI, suggesting adult ranges may be more applicable.
Area of Science:
- Neurology
- Pediatrics
- Clinical Measurement
Background:
- Limited data exists on cerebrospinal fluid (CSF) opening pressures in pediatric populations.
- Establishing accurate reference ranges is crucial for diagnosing neurological conditions in children.
Purpose of the Study:
- To retrospectively analyze measured CSF opening pressures in pediatric patients.
- To investigate correlations between CSF opening pressure, age, and body mass index (BMI) percentile in children.
Main Methods:
- Retrospective review of lumbar puncture procedures performed in an outpatient surgery setting under anesthesia.
- Standardized measurement of opening pressures in the left lateral decubitus position with controlled end-tidal carbon dioxide levels (40-45 mm Hg).
- Analysis of data from 44 pediatric patients, excluding those with specific neurological or CSF abnormalities.
Main Results:
- The mean CSF opening pressure was 20.3 cm H(2)O (median 21 cm H(2)O).
- A weak correlation was observed between opening pressure and patient age (r=0.09).
- A weak correlation was observed between opening pressure and BMI percentile (r=0.14).
Conclusions:
- Pediatric CSF opening pressures may approximate adult reference ranges more closely than previously assumed.
- Values exceeding 20 cm H(2)O in children should not automatically be considered abnormal, warranting a re-evaluation of pediatric reference ranges.
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