Changes in cerebrospinal fluid pressure in daily life.

The purpose of the present study was to measure changes in cerebrospinal fluid pressure (CSF-P) during actions of daily life. A spinal tap was performed on 23 inpatients. During the procedure, the patients were requested to perform the following four actions: nose blowing with one side closed, nose blowing with both sides closed, breath holding, and sniffing. The CSF-P was recorded before and during these actions. Of these, nose blowing with both sides closed resulted in the greatest elevation of pressure. Three patients with perilymph fistula showed larger changes than the other 20 patients. Conversely, sniffing lowered the CSF-P in all cases. The present study suggests that daily physical actions cause significant elevations of CSF-P. Such changes may be responsible for the development of perilymph fistula.