Lumbar Puncture/CSF Testing

[Al321]

I'm a 47 yr old male in good shape. I've had chronic forehead pressure/mental fog for many years (+20). I've been somewhat fortunate in that I hadn't had many headaches; only the chronic pressure and out of it feeling.  I've had some sinus issues in the past but sinuses have been all clear since a 2002 surgery. Recently went to a neurologist and he did a brain MRI w/contrast. Didn't see any problems with scan and recommended a Lumbar to rule out intercranial hypertension.  

The Lumbar puncture procedure went ok with no pain. Dr. indicated that pressure was slightly elevated (in the 180's mm). The doctor lowered pressure to 150 mm. I asked why CSF fluid wasn't being tested and the only answer was that my neuologist didn't write it on the Lumbar order. After the procedure, I was required to lay flat for 1 hr before leaving hospital (+ the rest of the day at home). Went to eat with a friend and at the end of meal, I started sweating profusely with some nausea and temporarily lost my vision (say 20-30 seconds). Could still see light but couldn't make anything out and was seeing spots.

Have a few questions:

1. What is the normal pressure range for a 47 yr old male in good shape? (I've seen the high side anywhere from 150
    to 250 mm from searching the internet).
2. How much variance can be seen from one Lumbar puncture to the next?
3. Could the reaction I experienced as noted above have been due to the local anesthesia the Dr. shot in my back or
    could it be related to the change in CSF pressure?  
4. Is it not standard procedure to analyze the CSF fluid when doing a Lumbar Puncture for pressure? Isn't it possible
    that the other diagnostic test of the CSF fluid could reveal some deficiency/disease that might be causing my
    symptoms?

Any help greatly appreciated with the above questions.

alan

[DrNoopurMD]

Hi,

I forgot to mention that normal CSF pressure in the lower back is 80-200 mm water. So if you’re lower back CSF pressure is 150 it is well within the normal range.
Hydrocephalus is not a hereditary disease.
I would suggest you to make sure you do not have sinusitis. Since your MRI and LP are within normal limits the possibility of any neurological disease is very slim.

[Al321]

Thanks for the info.

I assume my slightly elevated pressure in the 180's could conceiveably be causing some of my symptoms?? Also note that my dad had normal pressure hydrocephalus. He passed away a few years ago but not due to the hydrocephalus; complications in surgery when installing shunt led to a stroke.

I assume my slightly elevated pressure is probably just a coincidence and there's no evidence that hydrocephalus is hereditary?

Thanks again.

alan

[DrNoopurMD]

Hi,

How are you?
The normal ICP (intracranial pressure) is 0-10 mm Hg. At 20-25 mmHg treatment to reduce ICP is needed.
The main causes of raised ICP are brain tumors, ischemia-anoxia, infections like meningitis and encephalitis and hydrocephalus.
Variations can be seen in lumbar puncture examination, if there is a neurological condition since the last LP.
The symptoms of profuse sweating, temporary loss of vision and nausea were most likely due to the change in ICP.
Usually a csf examination is done after LP to rule out infections and inflammations in the brain. Especially so since it is an invasive procedure and cannot be done repeatedly.
Hope this helps!