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CSF pressure: what is it?

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Cerebrospinal fluid (CSF) opening pressure is measured during a lumbar puncture and can provide important information about a patient’s health. Changes in CSF pressure can be a sign of illness or an improperly performed test. The measurement is noted in millimeters of water and can be affected by a patient’s age, size, and health conditions. High pressure can be caused by injury, improper drainage of cerebrospinal fluid, hemorrhage, and other problems. The CSF sample collected during the measurement can also be evaluated for signs of disease.

Cerebrospinal fluid (CSF) opening pressure is a measurement of the pressure taken within the spinal canal when a doctor initially penetrates it to collect a fluid sample for analysis. Doctors routinely note the opening pressure of the cerebrospinal fluid because it can provide important information about a patient’s health. Tests aren’t usually done just to measure pressure; if a patient’s pressure is a cause for concern and a doctor recommends monitoring, the patient’s skull may be fitted with a device to measure pressure within the brain case. Changes in CSF opening pressure can be a sign of illness or an improperly performed test.

To measure the opening pressure of the cerebrospinal fluid, a doctor carefully inserts a needle into the spinal canal in a procedure known as a lumbar puncture or lumbar puncture. The patient should lie down in a slightly bent position and remain still during this procedure. An anesthetic makes it more comfortable. Once the needle is in place, the healthcare provider can attach a gauge and allow CSF to flow into the gauge until it levels out. The healthcare provider bases the CSF opening pressure measurement on the amount of fluid collected.

This information is noted in millimeters of water (mmH2O); while CSF does indeed contain a mixture of compounds, not just water, this is the standardized measurement used. In very young children, it can be as low as 10 mmH2O, while obese adults can have pressure as high as 250 mmH2O. The doctor may consider the patient’s age and size when comparing the blood pressure measurement to a graph of normal values ​​to determine if the patient’s blood pressure is abnormal.

Patients in shock or coma tend to have low CSF opening pressure, as do patients who have just passed out and those with low blood pressure. High pressure is usually the result of high pressure within the skull, which can be caused by injury, improper drainage of cerebrospinal fluid, hemorrhage, and other problems. The healthcare provider may also evaluate the CSF sample collected during blood pressure measurement to check for signs of disease such as white blood cell clots that indicate inflammation.

The healthcare professional can note the CSF opening pressure on the patient record and can also note the collection technique used during the procedure. This ensures that anyone looking at the graph understands the circumstances of the measurement. If a measurement appears to be incorrect, healthcare professionals may consider that an error may have been made during the measurement. In this case, the patient’s blood pressure may not actually be abnormal or the doctor may need another test to check.

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