Abstract
Standardization of the block investigation procedure, using a simple, fine-needle recording system, is described. This undertaking was prompted by the uniform cisternal cerebrospinal fluid pressure response to jugular compression obtained in a previous series of combined cisternolumbar recordings. To establish normal limits, 14 volunteers were investigated with digital jugular compression by one examiner and 10 also with jugular compression brought about by an inflatable neck cuff. It was found that the jugular compression response in all instances had a characteristic square-wave appearance at a chart speed of 10 mm per second. The pressure rise and fall phases always took place within 0.5 second. After withdrawal of 15 ml. of cerebrospinal fluid, they occurred within 0.6 second. To establish technical conformity of different examiners, patients without evidence of spinal block were subjected to digital jugular compression by 10 examiners. After brief instruction, all were able to produce squarewave responses within the time limits given. A prerequisite was that the jugular compression was bilateral, briskly initiated, and forceful. The responses in each instance were similar to those obtained by the author for the same case. The uniformity in response could be ascribed partly to the dynamic properties of the spinal canal and those of the recording system. Recordings obtained with this technique permit easy and precise quantitative interpretation, enhancing block diagnostic sensitivity. Results obtained by different examiners and at different clinics should be directly comparable.