Cerebrospinal fluid pressure

After the puncture, the pressure should be measured by the physician. The normal person's cerebrospinal fluid pressure lying position is 0.78~1.76kPa (80~180mmH2O), and the child is 0.4~1.0kPa (40~100mmH2O). Cerebrospinal fluid pressure can be increased when any lesion increases the volume of brain tissue or cerebrospinal fluid. Basic Information Specialist classification: examination classification: cerebrospinal fluid examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: 1 cerebrospinal fluid circulation blocked occipital area obstruction, spinal cord compression, spinal subarachnoid adhesions, subdural hematoma. 2 Cerebrospinal fluid loss caused by cranial fluid damage caused by cerebrospinal fluid leakage, continuous ventricular drainage, cerebrospinal fluid was released several times in a short period of time. 3 cerebrospinal fluid secretion decreased. 4 chronic consumption or failure of prostration, severe dehydration, chronic failure, schizophrenia, paralytic dementia, toxic dyspepsia in children. 5 benign low intracranial pressure syndrome. 6 The needle has not fully entered the spinal canal. Normal value: Cerebrospinal fluid pressure (newborn): 0.29-0.78kPa Cerebrospinal fluid pressure (child): 0.69-1.96kPa Cerebrospinal fluid pressure (adult #?.69-1.76kPa Above normal: 1 intracranial inflammatory suppurative meningitis, tuberculous meningitis, fungal meningitis, viral meningitis, epidemic encephalitis, poliomyelitis, otitis meningitis, brain abscess (unrupted )Wait. 2 intracranial non-inflammatory brain tumors, cerebral hemorrhage, subarachnoid hemorrhage, subdural hematoma, epidural hematoma, intracranial venous sinus thrombosis, hydrocephalus, brain injury, cysticercosis (cerebral cysticercosis) , cerebral echinococcosis, hydrocephalus (brain edema), paralytic dementia, meningeal vascular syphilis, epileptic seizures, etc. 3 extracranial disease hypertension, uremia, cerebral arteriosclerosis, lead poisoning, liver failure (typhoid hepatitis), certain eye diseases, partial blood stasis in the head or systemic blood stasis. 4 other large doses of progesterone, vitamin A, tetracycline drugs, increased chest and abdomen pressure, brain pressure can also be slightly elevated. negative: Positive: Tips: early detection, early diagnosis, early treatment. Normal value Newborns 0.29 ~ 0.78kPa; Children 0.69 ~ 1.96kPa; Adults are 0.69 to 1.76 kPa. Clinical significance (1) rise 1 intracranial inflammatory suppurative meningitis, tuberculous meningitis, fungal meningitis, viral meningitis, epidemic encephalitis, poliomyelitis, otitis meningitis, brain abscess (unrupted )Wait. 2 intracranial non-inflammatory brain tumors, cerebral hemorrhage, subarachnoid hemorrhage, subdural hematoma, epidural hematoma, intracranial venous sinus thrombosis, hydrocephalus, brain injury, cysticercosis (cerebral cysticercosis) , cerebral echinococcosis, hydrocephalus (brain edema), paralytic dementia, meningeal vascular syphilis, epileptic seizures, etc. 3 extracranial disease hypertension, uremia, cerebral arteriosclerosis, lead poisoning, liver failure (typhoid hepatitis), certain eye diseases, partial blood stasis in the head or systemic blood stasis. 4 other large doses of progesterone, vitamin A, tetracycline drugs, increased chest and abdomen pressure, brain pressure can also be slightly elevated. (2) lower 1 cerebrospinal fluid circulation blocked occipital area obstruction, spinal cord compression, spinal subarachnoid adhesions, subdural hematoma. 2 Cerebrospinal fluid loss caused by cranial fluid damage caused by cerebrospinal fluid leakage, continuous ventricular drainage, cerebrospinal fluid was released several times in a short period of time. 3 cerebrospinal fluid secretion decreased. 4 chronic consumption or failure of prostration, severe dehydration, chronic failure, schizophrenia, paralytic dementia, toxic dyspepsia in children. 5 benign low intracranial pressure syndrome. 6 The needle has not fully entered the spinal canal. High results may be diseases: Hughes-Stovin syndrome, cough syncope syndrome, herpes simplex encephalitis in the elderly, brain stem injury, central pontine myelinolysis, high altitude cerebral edema, spinal arachnoiditis, intracranial hypertension Zheng, children with acute toxic encephalopathy, pediatric nerve white syndrome syndrome (1) Patients with significant increase in intracranial pressure (expressed with headache, vomiting, optic nerve head edema, etc.) In order to avoid the formation of cerebral palsy, it is generally prudent to do or prohibit the waist from taking cerebrospinal fluid. Do not put too much cerebrospinal fluid, too fast. (2) The cerebrospinal fluid specimen is collected by a doctor for lumbar puncture and is required to be sent within 1 hour. Inspection process 1. The patient lies on the hard board bed, the back is perpendicular to the table top, the head is bent as far as possible to the chest, the knees are tightly attached to the abdomen with both hands, so that the trunk is as arched as possible; or the assistant is used to hold the patient's head opposite the surgeon. The other hand pulls the lower limbs of the armpits and holds them tightly, so that the spine is as convex as possible to widen the intervertebral space, which is convenient for needle insertion. 2, determine the puncture point, usually the junction point of the highest point of the bilateral iliac spine and the posterior median line as the puncture point, here is equivalent to the third to fourth lumbar spine process, sometimes in the upper or lower lumbar spine The gap is carried out. 3, routine disinfection of the skin after wearing sterile gloves, cover the hole towel, with 2% lidocaine from the skin to the interspinous ligament for layer-by-layer local anesthesia. 4, the surgeon uses the left hand to fix the puncture point skin, the right hand holding puncture needle to the vertical back, the needle tip slightly obliquely to the direction of the head, the adult needle depth is about 4 ~ 6cm, children about 2 ~ 4cm. When the needle passes through the ligament and the dura mater, there is a sudden loss of resistance. At this point, the needle core can be slowly withdrawn (to prevent the cerebrospinal fluid from flowing out quickly, causing cerebral palsy), and the cerebrospinal fluid can be seen to flow out. 5. Connect the pressure measuring tube to measure the pressure before draining. The cerebrospinal fluid pressure in the normal lateral position is 70-180 mmH2O (0.098 Kpa=10 mmH2O) or 40-50 d/min. If you continue to do the queckstedt test, you can see if there is any obstruction in the subarachnoid space. That is, after the initial pressure is measured, the assistant first compresses one side of the carotid artery for about 10 s, then presses the other side, and finally presses both sides of the carotid artery. When the carotid artery is compressed at normal time, the pressure of the cerebrospinal fluid immediately increases by about one time, and after 10 to 20 seconds after the pressure is released, it rapidly drops to the original level, which is called negative in the obstruction test, indicating that the subarachnoid space is unobstructed; if the carotid artery is compressed, it cannot be When the pressure of the cerebrospinal fluid is raised, the obstruction test is positive, indicating that the subarachnoid space is completely blocked. If it rises slowly after applying pressure, it will slowly fall after relaxation, indicating incomplete obstruction. but. Those with increased intracranial pressure are forbidden to do this test. 6. Remove the pressure measuring tube and collect 2~5ml of cerebrospinal fluid for examination. If it is needed for cultivation, use sterile tube to keep the specimen. 7. After the operation, insert the needle core and pull out the puncture needle together, cover the sterile gauze, and fix it with tape. 8, go to the pillow for 4 to 6 hours, so as not to cause postoperative low intracranial pressure headache. The same science test. Not suitable for the crowd 1. If there is obvious papilledema or cerebral palsy, contraindications are contraindicated. 2. Patients who are in shock, exhaustion or endangered state and local skin inflammation, and lesions in the posterior cranial fossa are contraindicated. Adverse reactions and risks If the patient has symptoms such as breathing, pulse, or abnormal color during puncture, stop the operation immediately and deal with it accordingly.