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Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review.

Published version
Peer-reviewed

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Authors

Norager, Nicolas Hernandez  ORCID logo  https://orcid.org/0000-0003-1896-7749
Olsen, Markus Harboe 
Pedersen, Sarah Hornshoej 
Riedel, Casper Schwartz 
Czosnyka, Marek 

Abstract

BACKGROUND: Although widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remain sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to the body position of the patient. Despite this, the current reference values do not distinguish between intracranial and lumbar cerebrospinal fluid pressures, and body position-dependent reference values do not exist. In this study, we aim to establish these reference values. METHOD: A systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals. RESULTS: Thirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -  5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in the supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. CONCLUSIONS: This systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure were established, and are in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarcity of normal pressure measures, and highlights the need for further research on the matter.

Description

Funder: Rigshospitalet; doi: http://dx.doi.org/10.13039/501100005111


Funder: The DMSK Foundation

Keywords

CSF, Cerebrospinal fluid pressure, ICP, Intracranial pressure, Reference intervals, Reference values, Central Nervous System Diseases, Cerebrospinal Fluid Pressure, Humans, Intracranial Pressure, Reference Values

Journal Title

Fluids Barriers CNS

Conference Name

Journal ISSN

2045-8118
2045-8118

Volume Title

18

Publisher

Springer Science and Business Media LLC
Sponsorship
Novo Nordisk Fonden (NNF17OC0024718)