Effects of the cervical collar on cerebrospinal fluid pressure.
We investigated the hypothesis that cervical collars might compress the internal jugular veins and raise intracranial pressure in head-injured patients. In a randomised, single-blind, crossover study of nine patients scheduled for elective spinal anaesthesia the cerebrospinal fluid pressure in the lumbar subarachnoid space was measured with and without a 'Stifneck' cervical collar applied. There was a significant elevation of cerebrospinal fluid pressure in seven of the patients studied when the cervical collar was applied (p < 0.01). This preliminary study raises the possibility that immobilisation of the cervical spine with the 'Stifneck' cervical collar may, by raising the intracranial pressure, contribute to secondary neurological injury in head-injured patients in whom intracranial compliance is already reduced.
Raphael
J H
JH
Department of Anaesthetics, Pilgrim Hospital, Boston, Lincolnshire.
Chotai
R
R
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015170:Cerebrospinal Fluid Pressure; D002574:Cervical Vertebrae / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D008875:Middle Aged; D011559:Pseudotumor Cerebri / Q000209:etiology*; D016037:Single-Blind Method; D013997:Time Factors