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The CSF tap test, sometimes lumbar tap test or Miller Fisher Test, is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be helpful in a patient with suspected normal pressure hydrocephalus (NPH). The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive ...
The tests have a positive predictive value over 90%, but a negative predictive value less than 50%. The LP should show normal or mildly elevated CSF pressure. CSF should have normal cell contents, glucose levels, and protein levels. [25] [26] [27]
Macewen's sign or Macewen sign (/ m ə ˈ k j uː ə n / mə-KEW-ən) is a sign used to help to diagnose hydrocephalus [1] (accumulation of excess cerebrospinal fluid) and brain abscesses. Tapping the skull near the junction of the frontal, temporal, and parietal bones will produce cracked pot sound. Positive test is indication of separated ...
Scarring and fibrosis of the subarachnoid space following infectious, inflammatory, or hemorrhagic events can also prevent reabsorption of CSF, causing hydrocephalus. [47] Normal pressure hydrocephalus (NPH) is a form of chronic communicating hydrocephalus, with enlarged cerebral ventricles and intermittently increased cerebrospinal fluid pressure.
It can cause headaches, made worse by standing, moving and coughing, [33] as the low CSF pressure causes the brain to "sag" downwards and put pressure on its lower structures. [33] If a leak is identified, a beta-2 transferrin test of the leaking fluid, when positive, is highly specific and sensitive for the detection for CSF leakage. [ 34 ]
Occasionally, the CSF pressure measurement may be normal despite very suggestive symptoms. This may be attributable to the fact that CSF pressure may fluctuate over the course of the normal day. If the suspicion of problems remains high, it may be necessary to perform more long-term monitoring of the ICP by a pressure catheter. [8]
Increased volume of the ventricles will result in higher pressure within the ventricles, and cause higher pressure in the cortex from it being pushed into the skull. A person may have aqueductal stenosis for years without any symptoms, and a head trauma , hemorrhage , or infection could suddenly invoke those symptoms and worsen the blockage.
Choroid plexus papilloma, also known as papilloma of the choroid plexus, is a rare benign neuroepithelial intraventricular WHO grade I lesion found in the choroid plexus. [1] It leads to increased cerebrospinal fluid production, thus causing increased intracranial pressure and hydrocephalus. [2]