Cerebrospinal Fluid Pressure-Related Features in Chronic Headache: A Prospective Study and Potential Diagnostic Implications.

Front Neurol 2018 18;9:1090. Epub 2018 Dec 18.

Neurosciences Research Center, Magna Græcia University, Catanzaro, Italy.

To identify the pressure-related features of isolated cerebrospinal fluid hypertension (ICH) in order to differentiate headache sufferers with ICH from those with primary headache disorder. In this prospective study, patients with refractory chronic headaches and suspected of having cerebrospinal fluid-pressure elevation without papilledema or sixth nerve palsy, together with controls, underwent 1-h lumbar cerebrospinal fluid pressure monitoring via a spinal puncture needle. We recruited 148 consecutive headache patients and 16 controls. Lumbar cerebrospinal fluid pressure monitoring showed high pressure and abnormal pressure pulsations in 93 (63 %) patients with headache: 37 of these patients with the most abnormal pressure parameters (opening pressure above 250 mm HO, mean pressure 301 mm HO, mean peak pressure 398 mm HO, and severe abnormal pressure pulsations) had the most severe headaches and associated symptoms (nocturnal headache, postural headache, transient visual obscuration); 56 patients with the less abnormal pressure parameters (opening pressure between 200 and 250 mm HO, mean pressure 228 mm HO, mean peak pressure 316 mm HO, and abnormal pressure pulsations) had less severe headaches and associated symptoms. Nocturnal and postural headache, and abnormal pressure pulsations are the more common pressure-related features of ICH in patients with chronic headache. Abnormal pressure pulsations may be considered a marker of ICH in chronic headache.

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2018.01090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305580PMC
December 2018
3 Reads

Publication Analysis

Top Keywords

abnormal pressure
28
pressure pulsations
20
pressure
16
cerebrospinal fluid
16
pressure-related features
12
chronic headache
12
headache
10
opening pressure
8
headache patients
8
patients abnormal
8
pulsations severe
8
severe headaches
8
postural headache
8
symptoms nocturnal
8
headaches associated
8
peak pressure
8
headache abnormal
8
fluid pressure
8
associated symptoms
8
250 pressure
8

Similar Publications