Measurement errors during lumbar puncture/cerebrospinal fluid pressure
I (f/52) had a lumbar puncture performed about 2 weeks ago (I had been having pain problems for months due to a herniated cervical disc and inexplicable pressure/headache). There was blood in the liquor. Since I had no signs of infection and nothing else indicated meningitis or something similar, the doctors assumed that the blood in the liquor was a “random product”.
I have to say that this puncture was very painful for me, the doctor had to puncture twice before he could get to the liquor, and nerves were irritated in the process. I.e. it makes perfect sense to me that the blood in the cerebrospinal fluid can be explained by this.
The puncture revealed a low CSF pressure of 7. A blood patch was then placed. During a second puncture 5 days later, the value was measured again, this time it was 20. The second puncture was painless. Blood was found in the CSF again, the doctors attributed this to the previous blood patch, this explanation also makes sense to me.
I would now be interested to know whether a low CSF pressure reading can also be a “measurement error” just like blood in the CSF?
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My experience as a nurse says maybe. When they perform this test they use a spinal manometer that the doc holds up during the puncture to see the pressure. Similar to the tube inside of a BP machine of old. For serial spinal pressure measurement a catheter can be placed in the spine over days and it’s attached to a monitoring device. It’s a visual determination made by the performing doc and a pretty common procedure.