Levin B E
Arch Neurol. 1978 Jan;35(1):37-40. doi: 10.1001/archneur.1978.00500250041009.
A search for spontaneous retinal venous pulsations was carried out in 218 subjects. Spontaneous venous pulsations were present in 87.6% of 146 unselected subjects 20 to 90 years of age and absent in 100% of 33 patients with raised intracranial pressure without papilledema and ten patients with papilledema. Lumbar puncture in nine patients with raised intracranial pressure established the upper level at which spontaneous pulsations disappear as 190 mm H2O, and no pressure above 180 mm H2O was found in 29 patients with venous pulsations present prior to lumbar puncture. There was no correlation between the presence or absence of venous pulsations and blood pressure. Some normal subjects with absent pulsations showed definite pulsations on subsequent examinations. These findings confirm that the presence of spontaneous venous pulsations is a reliable indicator of an intracranial pressure below 180 to 190 mm H2O, while the absence of pulsations may be found with normal intracranial pressure and is therefore not a reliable guide to raised intracranial pressure.
对218名受试者进行了自发性视网膜静脉搏动的检查。在146名年龄在20至90岁的未经过挑选的受试者中，87.6%存在自发性静脉搏动；在33例无视乳头水肿的颅内压升高患者和10例视乳头水肿患者中，100%不存在自发性静脉搏动。对9例颅内压升高患者进行腰椎穿刺，确定自发性搏动消失时的颅内压上限为190mmH₂O，在腰椎穿刺前存在静脉搏动的29例患者中，未发现颅内压高于180mmH₂O。静脉搏动的有无与血压之间无相关性。一些原本无搏动的正常受试者在后续检查中出现了明确的搏动。这些发现证实，自发性静脉搏动的存在是颅内压低于180至190mmH₂O的可靠指标，而搏动的缺失在颅内压正常时也可能出现，因此不是颅内压升高的可靠指征。
