J Child Neurol. 2016 Nov 30. pii: 0883073816681936. [Epub ahead of print]
Comparison of Cerebrospinal Fluid Opening Pressure in Children With Demyelinating Disease to Children With Primary Intracranial Hypertension.
Morgan-Followell B1, Aylward SC2.
The authors aimed to compare the opening pressures of children with demyelinating disease to children with primary intracranial hypertension. Medical records were reviewed for a primary diagnosis of demyelinating disease, or primary intracranial hypertension. Diagnosis of demyelinating disease was made according to either the 2007 or 2012 International Pediatric Multiple Sclerosis Study Group criteria. Primary intracranial hypertension diagnosis was confirmed by presence of elevated opening pressure, normal cerebrospinal fluid composition and neuroimaging. The authors compared 14 children with demyelinating disease to children with primary intracranial hypertension in 1:1 and 1:2 fashions. There was a statistically significant higher BMI in the primary intracranial hypertension group compared to the demyelinating group (P = .0203). The mean cerebrospinal fluid white blood cell count was higher in the demyelinating disease group compared to primary intracranial hypertension (P = .0002). Among both comparisons, the cerebrospinal fluid opening pressure, glucose, protein and red blood cell counts in children with demyelinating disease were comparable to age- and sex-matched controls with primary intracranial hypertension.
The normal range for CSF is reported differently in various sources, with most reporting a normal range of 7-18 cmH2O in adults,1 though some consider the normal range 5-25 cmH2O.2 However, a pressure >25 cmH2O or <5 cmH2O should certainly prompt you to look for a source.
Although this study was limited by its retrospective nature and limited sample size, our data confirm that elevated cerebrospinal fluid opening pressure does occur in pediatric patients with acute demyelinating disease; investigations for additional causes of elevated opening pressure in these patients may be unnecessary. As clinical and visible radiologic variables do not explain this finding in our pediatric demyelinating cohort, further understanding may require assessment of cerebrospinal fluid flow dynamics.
Users browsing this forum: No registered users