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Research
Nicolas Hernandez Norager
Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1896-7749
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Background
Although widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.
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 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 was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.
Keywords
Cerebrospinal fluid pressure, CSF, ICP, Intracranial pressure, Reference intervals, Reference values
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CURRENT STATUS: Published
View the published article at Fluids and Barriers of the CNS.
Version 1
Posted 13 Jan, 2021
No community comments so far
Editorial decision: Minor revision
On 17 Feb, 2021
Review #3 received
Received 16 Feb, 2021
Reviewer #3 agreed
On 02 Feb, 2021
Review #2 received
Received 01 Feb, 2021
Review #1 received
Received 18 Jan, 2021
Reviewer #2 agreed
On 17 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
First submitted
On 03 Jan, 2021
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Subject Areas
Neurosurgery
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Fluids and Barriers of the CNS.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Nicolas Hernandez Norager
Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1896-7749
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Fluids and Barriers of the CNS.
Version 1
Posted 13 Jan, 2021
No community comments so far
Editorial decision: Minor revision
On 17 Feb, 2021
Review #3 received
Received 16 Feb, 2021
Reviewer #3 agreed
On 02 Feb, 2021
Review #2 received
Received 01 Feb, 2021
Review #1 received
Received 18 Jan, 2021
Reviewer #2 agreed
On 17 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
First submitted
On 03 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurosurgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Fluids and Barriers of the CNS.
Background
Although widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.
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 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 was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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