Abstract
Intracranial pressure (ICP) monitoring at our department includes a standardized postural change examination to evaluate its effects on ICP. During these procedures we observed that neck flexion caused an increase in ICP in one patient. To clarify if the observation was a random occurrence or if it could be reproduced, we added neck flexion and extension to the standard examination.
Highlights
Intracranial pressure (ICP) monitoring at our department includes a standardized postural change examination to evaluate its effects on ICP
We examined the effect on ICP with the patient sitting upright with a straight back and 1) a straight neck or 2) maximal neck flexion, and the patient sitting bent in “lumbar puncture position” with 3) neck flexion or 4) a straight neck
The results indicate that the position of the neck has a more important influence on ICP than previously presumed
Summary
Intracranial pressure (ICP) monitoring at our department includes a standardized postural change examination to evaluate its effects on ICP. During these procedures we observed that neck flexion caused an increase in ICP in one patient. To clarify if the observation was a random occurrence or if it could be reproduced, we added neck flexion and extension to the standard examination. The neck was 8.5 mmHg (range 2.4 to 18 mmHg). The increase was highly significant (p < 0.001). The median increase was 15.89 mmHg (range 8 to 25.7 mmHg). This increase in ICP was likewise highly significant (p < 0.001)
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