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Headache and Other Factors Modifying Cerebrospinal Fluid Opening Pressure in Pediatric Patients

Oscar M Espitia Segura1,2,3, Ana M Bedoya Morales1,2,4, Cristina L Ramírez-Sierra1,4,5

  • 1Qualitative and Quantitative Research Network in Child Neurology (RICCNeP), Bogotá, Colombia.

Journal of Child Neurology
|May 15, 2024
PubMed

Insights

Pediatric cerebrospinal fluid opening pressure is influenced by age, BMI, male gender, remifentanil, propofol, and corticosteroid withdrawal. Understanding these factors is crucial for accurate neurologic assessments in children.

Area of Science:

  • Neurology
  • Pediatrics
  • Clinical Measurement

Background:

  • Cerebrospinal fluid opening pressure (CSOP) is a critical diagnostic parameter in pediatric neurology.
  • Numerous factors can influence CSOP measurements, complicating interpretation.
  • Standardized methods are essential for reliable CSOP assessment in children.

Purpose of the Study:

  • To identify and describe factors associated with modifications in CSOP measurements in pediatric patients.
  • To establish a clearer understanding of normal CSOP ranges in children by accounting for influencing variables.

Main Methods:

  • Retrospective analysis of lumbar puncture data from pediatric patients.
  • Institutional standardization of procedures was applied.
  • Bivariate and linear regression analyses were used to assess associations between CSOP and various factors.

Main Results:

  • Analysis of 544 lumbar punctures revealed a median age of 107 months and median CSOP of 19.7 cm H2O.
  • Age, BMI, male gender, and remifentanil/propofol anesthesia were positively correlated with increased CSOP.
  • Corticosteroid withdrawal showed a negative correlation with CSOP; an age-headache interaction increased CSOP up to 140 months.

Conclusions:

  • Age, anesthetic agents (remifentanil, propofol), BMI, male gender, and corticosteroid withdrawal significantly impact pediatric CSOP.
  • The interaction between age and headache influences CSOP, particularly in younger children.
  • These findings are vital for accurately estimating normal CSOP values and interpreting results in pediatric neurologic evaluations.

Keywords:
headacheintracranial hypertensionlumbar punctureopening pressurepediatrics

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