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Positive lumbar extradural space pressure

J L Shah1

  • 1Department of Anaesthesia, Dudley Road Hospital, Birmingham.

British Journal of Anaesthesia
|September 1, 1994
PubMed
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Measuring extradural pressure offers a reliable method to detect changes in cerebrospinal fluid (CSF) pressure. This study demonstrates that extradural pressure mirrors lumbar CSF pressure and responds to stimuli that affect CSF pressure.

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Neurology

Background:

  • Accurate measurement of extradural and cerebrospinal fluid (CSF) pressures is crucial for understanding spinal fluid dynamics.
  • Previous methods for assessing extradural pressure have limitations in real-time monitoring.

Purpose of the Study:

  • To investigate the relationship between extradural pressure and lumbar cerebrospinal fluid (CSF) pressure.
  • To determine if extradural pressure can serve as a surrogate for measuring CSF pressure changes.
  • To assess the impact of physiological stimuli on extradural pressure.

Main Methods:

  • Soft Macintosh balloon indicators were attached to needles during extradural and spinal punctures.
  • Balloon pressure was monitored upon entering the extradural and subarachnoid spaces.

Related Experiment Videos

  • The effects of jugular venous compression, CO2 ventilation, and positive end-expiratory pressure (PEEP) on extradural pressure were recorded.

    • Main Results:

    • A sudden decrease in balloon pressure was observed upon entering the extradural space in both extradural and spinal punctures.
    • Balloon pressure did not change significantly when advancing from the extradural to the subarachnoid space.
    • Extradural pressure was found to be equal to the prevailing lumbar CSF pressure and varied rhythmically with respiration and cardiac pulsations.
    • Stimuli known to increase CSF pressure, such as jugular venous compression, CO2 ventilation, and PEEP, caused a rapid and measurable increase in extradural pressure.

    Conclusions:

    • Lumbar extradural pressure is positive and equivalent in magnitude to the concurrent lumbar CSF pressure.
    • Extradural pressure monitoring can effectively detect rapid changes induced by stimuli that also elevate CSF pressure.
    • Measuring extradural pressure represents a viable method for detecting alterations in spinal CSF pressure.