Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Department of Neurology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
J Clin Neurosci. 2022 Dec;106:55-60. doi: 10.1016/j.jocn.2022.10.001. Epub 2022 Oct 18.
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.
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 HO was documented as ELPOP. Patients' demographic characteristics, clinical data, laboratory and cerebrospinal fluid (CSF) results, as well as optic disc appearance were analyzed.
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 HO (SD = 6.02) as opposed to the mean normal LPOP (NLPOP) of16.13 cm HO (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.
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).
腰椎穿刺开放压力升高（ELPOP）是无菌性脑膜炎的一种已报道但研究较少的现象。本研究旨在描述无菌性脑膜炎患者中 ELPOP 的特征。
进行了一项观察性、回顾性、单中心研究。我们纳入了 2015 年 10 月至 2017 年 5 月期间所有被诊断为无菌性脑膜炎或脑膜脑炎的成年患者，这些患者的腰椎穿刺开放压力（LP OP）均已测量。记录 OP＞25cmH₂O 为 ELPOP。分析患者的人口统计学特征、临床数据、实验室和脑脊液（CSF）结果以及视盘外观。
共纳入 116 例患者（61 例男性），其中 16 例（14%）有 ELPOP（11 例男性）。这些患者的平均年龄为 32.4 岁（SD=9.8），平均 OP 为 31.7cmH₂O（SD=6.02），而平均正常 LPOP（NLPOP）为 16.13cmH₂O（SD=4.15）。ELPOP 组的体重指数（BMI）明显较高（p=0.0081）。15/16 例 ELPOP 患者进行了眼底检查，发现 6 例（40%）患者视盘肿胀。62 例 NLPOP 患者进行了眼底检查，其中 2 例（3.2%）视盘肿胀。两组 CSF 含量无差异。
本研究填补了无菌性脑膜炎中 ELPOP 频率信息缺乏的空白。它与 BMI 升高的相关性可能与发病机制有关。所有无菌性脑膜炎患者均应测量 LP OP。需要进一步研究以确定可耐受颅内压（ICP）的阈值。
