# Cerebrospinal Fluid Pressure Abnormalities DUKE study

**URL:** <https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601>\
**Category:** VM/MAV\
**Created:** [December 20, 2011, 10:55pm UTC](https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601 "2011-12-20T22:55:36Z")\
**Posts on this page:** 4\
**Page:** 1

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**Author:** ![elishat27](https://mvertigo.org/user_avatar/mvertigo.org/elishat27/32/43_2.png) [@elishat27](https://mvertigo.org/u/elishat27)\
**Post date:** [December 20, 2011, 10:55pm UTC](https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601/1 "2011-12-20T22:55:36Z")

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**THE FOLLOWING POST WAS ORIGINALLY POSTED BY JAMES. I JUST COPIED IT AND PASTED IT AS A NEW TOPIC BC I WANTED TO MAKE SURE EVERYONE COULD SEE IT. THANK YOU SO MUCH FOR POSTING THIS JAMES!**

Wendy posted this at [m.org](http://m.org) thought I would cut and paste it here.

As an update, the results of the DUKE research project are being presented in April, 2012, at the Spring meeting of the American Neurotology Society.  
Below is the abstract:

Cerebrospinal Fluid Pressure Abnormalities as a Cause of  
Chronic Subjective Vertigo with Migraine or Head Pressure  
H. Wolfgang Beumer, MD; David M. Kaylie, MD  
Linda Gray, MD; Peter Kranz, MD  
Objective: The normal range of CSF pressure is poorly defined. Abnormal pressure for some may be  
normal for others. The objective is to determine if altering the CSF pressure in patients within “normal”  
range can relieve symptoms of chronic subjective vertigo with migraine headache or head pressure, with  
or without other otologic complaints  
Study Design: Prospective, IRB approved study  
Setting: Tertiary center  
Patients: Patients with chronic subjective vertigo, migraine or head pressure, with or without other  
otologic  
complaints and clouded mentation  
Intervention: Diagnostic lumbar puncture with opening pressure measurement and addition or removal  
of CSF  
Outcome measure: Self-reported symptom score immediately after lumbar puncture  
Results: 46 patients met entrance criteria. Average opening pressure was 270 mmH20 ranging from 110  
to 265mmH20. 27 patients had immediate symptom improvement with removal of CSF - opening  
pressure for this group averaged 217mmH20. Eight had complete resolution of symptoms, 14 had  
significant improvement and 5 had mild improvement. Eleven patients had improvement with addition of  
CSF, 3 with complete resolution of symptoms, 4 with significant improvement and 3 with mild  
improvement with CSF pressure averaging 157mmH20. The opening pressure was significantly higher in  
group that improved with CSF removal. Eight patients had no improvement with addition or removal of  
CSF. 7 reported no change, one reported significant worsening.  
Conclusion: Chronic subjective vertigo with migraine or head pressure, clouded mentation with or  
without other otologic complaints is often caused by abnormal CSF pressure. Removing or adding CSF in  
many of these patients provided immediate relief of their symptoms. Lumbar puncture should be  
considered in these patients.  
Define Professional Practice Gap & Educational Need: Lack of contemporary knowledge of treatment  
for chronic subjective vertigo and migraine headache leads to many patients receiving suboptimal care  
Learning Objective: To learn about potential causes of chronic subjective vertigo with migraine and how  
to treat it  
Desired Result: Attendees will be able to apply the knowledge they gain in the treatment of patients with  
chronic subjective vertigo  
IRB or IACUC Approval: yes

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**Author:** ![ilovesalem](https://mvertigo.org/letter_avatar_proxy/v4/letter/i/ac8455/32.png) [@ilovesalem](https://mvertigo.org/u/ilovesalem)\
**Post date:** [December 21, 2011, 6:58am UTC](https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601/2 "2011-12-21T06:58:18Z")

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Thank you for sharing. Will they still be performing this although the study is now finished? I was really hoping to make it out there…

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**Author:** ![opus2828](https://mvertigo.org/letter_avatar_proxy/v4/letter/o/eb9ed0/32.png) [@opus2828](https://mvertigo.org/u/opus2828)\
**Post date:** [December 21, 2011, 1:26pm UTC](https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601/3 "2011-12-21T13:26:47Z")

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I think even though the study may be done you could still go see Dr. Gray for treatment. If I don’t respond to meds I will be doing just that in the Spring.

Julie

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**Author:** ![elishat27](https://mvertigo.org/user_avatar/mvertigo.org/elishat27/32/43_2.png) [@elishat27](https://mvertigo.org/u/elishat27)\
**Post date:** [December 21, 2011, 3:48pm UTC](https://mvertigo.org/t/cerebrospinal-fluid-pressure-abnormalities-duke-study/3601/4 "2011-12-21T15:48:09Z")

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Absolutely you can, I have an appt. with Dr. Gray on Jan. 4th for the spinal tap. If you are interested in this you need to call ASAP as her schedule is super busy.  
Good luck!  
Elisha