Cerebrospinal fluid opening pressure in clinical practice - a prospective study

Area of Science:

• Neurology
• Clinical Physiology

Background:

• Cerebrospinal fluid opening pressure (CSFOP) measurement is crucial for diagnosing neurological conditions.
• Existing reference values for CSFOP lack consensus and may be influenced by demographic factors.
• Previous studies indicated potential differences in CSFOP based on gender and age.

Purpose of the Study:

• To determine the normal distribution of CSFOP in an outpatient neurological sample.
• To investigate the influence of age, gender, and body mass index (BMI) on CSFOP.
• To establish updated reference ranges for CSFOP considering these variables.

Main Methods:

• CSFOP was measured via lumbar puncture using a standardized procedure in an outpatient setting.
• Data on patient age, gender, and BMI were collected concurrently.
• Descriptive statistics and multivariable linear regression analyses were employed.

Main Results:

• A cohort of 339 patients with normal age and BMI distribution was analyzed.
• The mean CSFOP was 17.5 cm H2O (range: 4.0-30.0).
• Multivariable regression revealed that male gender, younger age, and higher BMI were independently associated with increased CSFOP.

Conclusions:

• The study proposes adjusted CSFOP reference limits based on gender, age, and BMI.
• It suggests that current cut-offs for intracranial hypertension may need to be raised.
• Recommended "rule-of-thumb" cut-offs are provided for males and females, considering age and BMI thresholds.