University Magna Graecia, Italy.
Cephalalgia. 2010 Dec;30(12):1419-25. doi: 10.1177/0333102410370877. Epub 2010 May 12.
Bilateral transverse sinus stenosis (BTSS) has been reported to be associated with idiopathic intracranial hypertension without papilloedema in headache sufferers.
To test the accuracy of short-term cerebrospinal fluid (CSF) pressure monitoring through a lumbar needle for detection of elevated intracranial pressure in headache sufferers with BTSS, we prospectively performed lumbar puncture in order to measure lumbar CSF opening pressures and to monitor, for 1 h, the CSF pressure in 48 consecutive headache sufferers with BTSS and in 50 consecutive headache sufferers with normal appearance of transverse sinuses or stenosis of one transverse sinus.
Of the 48 headache sufferers with BTSS, 18 (37.5%) had elevated CSF opening pressure and abnormal pressure waveforms, but short-term CSF pressure monitoring revealed abnormal pressure waves associated with elevated mean CSF pressure also in 26 (86.6%) out of 30 patients who had normal opening pressures. None of the 50 headache sufferers with normal appearance of transverse sinuses or stenosis of one transverse sinus had abnormal pressure waves and elevated CSF pressures.
In this study, short-term CSF pressure monitoring through a lumbar needle revealed abnormal pressure waves and elevated mean CSF pressures in the majority of headache sufferers with BTSS who had normal CSF opening pressures. These findings demonstrate the accuracy of short-term CSF pressure monitoring through a lumbar needle in estimating CSF pressure; they also highlight that a single-spot opening pressure measurement has a low accuracy for recognition of increased intracranial pressure in headache sufferers with BTSS.
双侧横窦狭窄（BTSS）与无视乳头水肿的特发性颅内高压相关，在头痛患者中也有报道。
为了测试通过腰椎针进行短期脑脊髓液（CSF）压力监测以检测 BTSS 头痛患者颅内压升高的准确性，我们前瞻性地进行了腰椎穿刺，以测量腰椎 CSF 开放压力，并监测 48 例连续 BTSS 头痛患者和 50 例连续横窦正常或单侧横窦狭窄的头痛患者的 CSF 压力 1 小时。
48 例 BTSS 头痛患者中，18 例（37.5%）CSF 开放压力升高且压力波形异常，但短期 CSF 压力监测显示，在 30 例开放压力正常的患者中，26 例（86.6%）也存在与平均 CSF 压力升高相关的异常压力波。50 例横窦正常或单侧横窦狭窄的头痛患者无一例出现异常压力波和升高的 CSF 压力。
在这项研究中，通过腰椎针进行的短期 CSF 压力监测显示，大多数 CSF 开放压力正常的 BTSS 头痛患者存在异常压力波和升高的平均 CSF 压力。这些发现表明通过腰椎针进行短期 CSF 压力监测可以准确估计 CSF 压力；它们还强调单次 CSF 开放压力测量对于识别 BTSS 头痛患者颅内压升高的准确性较低。
