Tuesday, December 8, 2015

Ask the Doctor: Intracranial Pressure

CCA posts a monthly blog series called, "Ask the Doctor." You can submit your questions to Annie Reeves (areeves@ccakids.com) and we will ask Dr. Earl Gage of Kids' Plastic Surgery in St. Louis to answer them. Thanks Dr. Gage for helping spread information and resources for our cranio families! Today's question is about intracranial pressure.

Ask the Doctor


Question: How accurate are spinal taps when it comes to checking intracranial pressures? My son's elevates pressures do not show up on any of the standard tests. The only way was an ICP bolt when numbers topped out at 62. Will a spinal tap give compatible numbers? 

Answer: Spinal taps are not a good or reliable measure of intracranial pressure. Although the opening pressure (or the pressure that is generated when a spinal tap is performed and the dura is first punctured) can give an estimate of intracranial pressure, the pressure that is measured can be skewed by a number of factors, including physician’s procedural technique, patient positioning, and whether the patient is calm or upset.  Probably the best, most reliable way to measure intracranial pressure is a 24-hour monitoring of the pressure by ICP bolt.

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