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Out of Pressure!

Topic: Physiology

Created on Monday, October 27 2008 by rednucleus

Last modified on Monday, October 27 2008.

A 32-year-old man presents with headache. His brain CT scan is normal-looking but his lumbar puncture reveals opening pressure of 3 cm H2O. Which one of the following can not be a cause of this man's abnormal opening pressure?

 
        A) Schaltenbrand syndrome
 
        B) Recent lumbar puncture
 
        C) Spinal subarachnoid block
 
        D) Technical error
 
        E) Hypothyroidism
 

 


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This question was created on October 27, 2008 by rednucleus.
This question was last modified on October 27, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Schaltenbrand syndrome

This answer is incorrect.


This is a spontaneous intracranial hypotension, which might be due to a cryptic CSF leak. The condition is usually self-limited.  (See References)

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B) Recent lumbar puncture

This answer is incorrect.


CSF fistulae rank second on the list of causes of low CSF pressure. Previous lumbar puncture, head trauma, and neurosurgery are the commonest causes of persistent CSF fistulae.  (See References)

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C) Spinal subarachnoid block

This answer is incorrect.


Due to tumors, arachnoiditis, disc prolapse,...etc.  (See References)

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D) Technical error

This answer is incorrect.


This accounts for the majority of causes of low CSF pressure in clinical practice.  (See References)

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E) Hypothyroidism

This answer is correct.


Hypothyroidism results in a multitude of central and peripheral nervous system complications, but a low CSF pressure is not seen. Note that the normal range for CSF pressure is 5-18 cm H2O.  (See References)

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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York. (ISBN:0070674973)Advertising:
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physiology
Out of Pressure!
Question ID: 102708088
Question written by rednucleus. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 10/27/2008
Modified: 10/27/2008
Estimated Permutations: 120

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