Neck pressure test

After compression of the jugular vein, the pressure of the cerebrospinal fluid immediately rises and reaches 1.5 to 2.9 kPa in 10 to 20 s. Immediately after the pressure is released, it is reduced to the initial pressure level. After pressing, the pressure rises slowly and reaches the highest level > 20s. After the neck is released, the pressure drops rapidly, suggesting that the spinal arachnoid cavity is not completely blocked. There was no change in cerebrospinal fluid pressure during neck compression, or the initial pressure was normal, but the pressure decreased by more than 0.5 kPa after releasing 4 to 5 ml of cerebrospinal fluid, suggesting that the subarachnoid space of the spinal cord was completely blocked. Basic Information Specialist classification: examination classification: cerebrospinal fluid examination Applicable gender: whether men and women apply fasting: fasting Tips: Check with your doctor. Normal value Index = [final pressure × release cerebrospinal fluid volume (ml) / initial pressure] = 5 to 7. Clinical significance Before the neck test, the abdominal test should be performed first. The examiner presses the patient's abdomen for 10-20s with the palm of the hand. The pressure of the cerebrospinal fluid rises rapidly, and the initial pressure level is restored within 20 seconds after the hand is released. If there is no such reaction, the puncture position is improper or puncture. The needle is not smooth. After the compression, the pressure rises slowly, reaching the highest level for >20s, and the pressure drops rapidly after the neck is released, suggesting that the spinal arachnoid cavity is not completely blocked. There was no change in cerebrospinal fluid pressure during neck compression, or the initial pressure was normal, but the pressure decreased by more than 0.5 kPa after releasing 4 to 5 ml of cerebrospinal fluid, suggesting that the subarachnoid space of the spinal cord was completely blocked. After releasing 4 to 5 ml of cerebrospinal fluid, the pressure drops little, and the initial pressure level is quickly restored, suggesting that there is traffic hydrocephalus or intracranial hypertension. One side of the neck test was normal, and there was no response on the contralateral side, suggesting that there may be lateral sinus embolism or jugular vein thrombosis on the side, or other lateral sinus or jugular vein compression lesions. An index of <5 suggests a spinal canal obstruction or intracranial tumor, >7 suggests hydrocephalus, brain atrophy, and serous meningitis. Precautions No special precautions, check with your doctor. Inspection process Pulse pressure belt compression method, after the patient's neck is tied with the pulse pressure band of the blood pressure meter, after reading the initial pressure of the lumbar puncture, the pulse pressure band is inflated to 2.7 kPa (20 mmHg), and the pressure rise is observed every 5 s to the pressure. No longer rise; quickly deflated, also observed every 5s, recording the pressure drop until the pressure no longer drops. Repeat the inflating to 5.3, 8.0, 10.7 kPa (40, 60, 80 mmHg), test separately, record the pressure rise and fall, for judgment. 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.