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Cerebrospinal Fluid Pressure Measurements in
Patients Experiencing Severe, Benign
Khandhar S.M., Friedman D.I.
Posted August 2003
Presented at: 45th Annual Scientific Meeting
American Headache Society

June 19-22, 2003; Chicago, Illinois

Objectives: To determine the range of opening pressures in patients being evaluated in the Emergency Department for headache, whose discharge diagnosis was a benign headache disorder.

Conclusions: Cerebrospinal fluid pressure may be elevated in patients with benign headache disorders and is not necessarily indicative of idiopathic intracranial hypertension. Possible reasons for elevated pressure include valsalva maneuver associated with crying during a severe headache, improper positioning, faulty examination technique, or an unrecognized effect of severe head pain or its treatment on cerebrospinal fluid pressure. Because of its retrospective, our study is limited by the quality of documentation available. A prospective study using a standardized technique, a uniform reporting form for the LP, and final diagnosis based in IHS diagnostic criteria would be useful. However, in the “real world”, diagnoses are often made based on LP data that are collected in the ED setting. We conclude that cerebrospinal fluid pressure measurements may be elevated in the setting of an acute headache, and a high opening pressure does not always signal a worrisome intracranial process.