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Factors affecting cerebrospinal fluid opening pressure in patients with spontaneous intracranial hypotension

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Abstract

Objectives

Spontaneous intracranial hypotension (SIH) is recognized far more commonly than ever before. Though usually characterized by low cerebrospinal fluid (CSF) pressure, some patients with SIH are observed to have normal pressure values. In this study, we aimed to confirm the proportion of patients with normal CSF opening pressure (CSF OP) and explore the factors affecting CSF OP in SIH patients.

Methods

We retrospectively reviewed 206 consecutive SIH patients and analyzed their clinical and imaging variables (including demographic data, body mass index (BMI), duration of symptoms, and brain imaging findings). Univariate and multivariate analyses were performed to identify the potential factors affecting CSF OP.

Results

In a total of 114 (55.3%) cases the CSF OP was ≤60 mmH2O (1 mmH2O=9.806 65 Pa), in 90 (43.7%) cases it was between 60 and 200 mmH2O, and in 2 (1.0%) cases it was >200 mmH2O. Univariate analysis showed that the duration of symptoms (P<0.001), BMI (P<0.001), and age (P=0.024) were positively correlated with CSF OP. However, multivariate analysis suggested that only the duration of symptoms (P<0.001) and BMI (P<0.001) were strongly correlated with CSF OP. A relatively high R 2 of 0.681 was obtained for the multivariate model.

Conclusion

Our study indicated that in patients without a low CSF OP, a diagnosis of SIH should not be excluded. BMI and the duration of symptoms can influence CSF OP in SIH patients, and other potential factors need further investigation.

中文概要

题目

影响自发性颅内低压患者的脑脊液开放压的潜在因素

目的

评估正常脑脊液开放压在自发性颅内低压(SIH) 患者中所占的比例,并初步探讨SIH 患者的脑脊 液开放压的影响因素。

创新点

通过大样本容量的病例证实了正常脑脊液开放压 在SIH 患者中占较高比例,并进一步得出体重指 数和症状持续时间与脑脊液开放压存在显著相 关性。

方法

回顾了206 例在我院确诊的SIH 患者,收集其人 口学信息、体重指数、症状持续时间、影像检查 结果等资料。通过单变量分析和多变量分析识别 影响脑脊液开放压的潜在因素。

结论

本研究进一步证实正常脑脊液开放压在SIH 患者 中并不少见,特别是那些肥胖和症状持续时间长 的患者。除了体重指数和症状持续时间,仍然存 在其他未识别的因素影响SIH 患者的脑脊液开 放压大小

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Acknowledgments

The authors would like to thank Dr. Qiao-wei ZHANG and Dr. Yi YANG at our hospital (Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China) for image re-evaluation and critical review of the manuscript.

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Authors and Affiliations

  1. Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China

    Ling-ling Yao & Xing-yue Hu

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  1. Ling-ling Yao
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Correspondence to Xing-yue Hu.

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ORCID: Ling-ling YAO, http://orcid.org/0000-0002-1326-5097

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Yao, Ll., Hu, Xy. Factors affecting cerebrospinal fluid opening pressure in patients with spontaneous intracranial hypotension. J. Zhejiang Univ. Sci. B 18, 577–585 (2017). https://doi.org/10.1631/jzus.B1600343

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  • DOI: https://doi.org/10.1631/jzus.B1600343

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