Elevated lumbar puncture opening pressure in aseptic meningitis. 2022

Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. Electronic address: maytalore@gmail.com.

OBJECTIVE Elevated lumbar puncture opening pressure (ELPOP) is a reported but understudied phenomenon in aseptic meningitis. This study aimed to characterize the features of ELPOP in aseptic meningitis patients. METHODS An observational, retrospective, single-center study was conducted. We included all adult patients diagnosed with aseptic meningitis or meningoencephalitis from October 2015 to May 2017, for whom lumbar puncture opening pressure (LP OP) was measured. OP > 25 cm H2O was documented as ELPOP. Patients' demographic characteristics, clinical data, laboratory and cerebrospinal fluid (CSF) results, as well as optic disc appearance were analyzed. RESULTS Among 116 patients (61 males) included, 16 patients (14 %) had ELPOP (11 males). The average age of those patients was 32.4 years (SD = 9.8), and the mean OP was 31.7 cm H2O (SD = 6.02) as opposed to the mean normal LPOP (NLPOP) of16.13 cm H2O (SD = 4.15). Body mass index (BMI) was significantly higher in the ELPOP group (p = 0.0081). Funduscopic examination was documented in 15/16 patients in the ELPOP group and revealed swollen optic discs in 6 (40 %) patients. Fundus examination was performed in 62 patients in the NLPOP group, of whom 2 (3.2 %) had a swollen disc. There was no difference in CSF content between groups. CONCLUSIONS This study fills the void of information lacking on the frequency of ELPOP in aseptic meningitis. Its association with increased BMI may be related to the pathogenesis. LP OP should be measured in all patients with aseptic meningitis. Additional research is needed to determine the threshold of tolerated intracranial pressure (ICP).

UI MeSH Term Description Entries
D007427 Intracranial Pressure Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D008297 Male Males
D008582 Meningitis, Aseptic A syndrome characterized by headache, neck stiffness, low grade fever, and CSF lymphocytic pleocytosis in the absence of an acute bacterial pathogen. Viral meningitis is the most frequent cause although MYCOPLASMA INFECTIONS; RICKETTSIA INFECTIONS; diagnostic or therapeutic procedures; NEOPLASTIC PROCESSES; septic perimeningeal foci; and other conditions may result in this syndrome. (From Adams et al., Principles of Neurology, 6th ed, p745) Aseptic Meningitis
D010211 Papilledema Swelling of the OPTIC DISK, usually in association with increased intracranial pressure, characterized by hyperemia, blurring of the disk margins, microhemorrhages, blind spot enlargement, and engorgement of retinal veins. Chronic papilledema may cause OPTIC ATROPHY and visual loss. (Miller et al., Clinical Neuro-Ophthalmology, 4th ed, p175) Choked Disk,Edema of the Optic Disc,Edema of the Optic Disk,Optic Disc Edema,Optic Disk Edema,Optic Papilla Edema,Papillitis, Optic,Decreased Intraocular Pressure-Associated Papilledema,Increased Intracranial Pressure-Associated Papilledema,Optic Nerve Papillitis,Papilledema Associated with Decreased Intraocular Pressure,Papilledema Associated with Increased Intracranial Pressure,Papillitis,Retinal Edema,Choked Disks,Decreased Intraocular Pressure Associated Papilledema,Disk, Choked,Edema, Optic Disc,Edema, Optic Disk,Edema, Optic Papilla,Edema, Retinal,Edemas, Optic Disc,Edemas, Optic Disk,Edemas, Retinal,Increased Intracranial Pressure Associated Papilledema,Optic Papillitis,Papillitis, Optic Nerve,Retinal Edemas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013129 Spinal Puncture Tapping fluid from the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae. Lumbar Puncture,Spinal Tap,Lumbar Punctures,Puncture, Lumbar,Puncture, Spinal,Punctures, Lumbar,Punctures, Spinal,Spinal Punctures,Spinal Taps,Tap, Spinal,Taps, Spinal
D015170 Cerebrospinal Fluid Pressure Manometric pressure of the CEREBROSPINAL FLUID as measured by lumbar, cerebroventricular, or cisternal puncture. Within the cranial cavity it is called INTRACRANIAL PRESSURE. Spinal Fluid Pressure,Cerebrospinal Fluid Pressures,Pressure, Cerebrospinal Fluid,Pressures, Cerebrospinal Fluid,Fluid Pressure, Cerebrospinal,Fluid Pressure, Spinal,Fluid Pressures, Cerebrospinal,Fluid Pressures, Spinal,Pressure, Spinal Fluid,Pressures, Spinal Fluid,Spinal Fluid Pressures

Related Publications

Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
June 1980, Archives of neurology,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
December 2014, The American journal of emergency medicine,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
April 2003, Biomedizinische Technik. Biomedical engineering,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
September 2014, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
January 2020, Neurologia i neurochirurgia polska,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
January 1986, The Medical journal of Australia,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
July 1996, Pediatrics,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
July 1996, Pediatrics,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
June 2021, Neuropediatrics,
Meital Ben-Dov, and Avi Fellner, and Ophir Keret, and Itay Lotan, and Lilach Goldstein, and Daphna Mezad-Koursh, and Israel Steiner, and Ainat Klein
June 2006, Journal of child neurology,
Copied contents to your clipboard!