Queckenstedt's maneuver
Encyclopedia
Queckenstedt's maneuver is an outdated clinical test, formerly used for diagnosing spinal stenosis
. The test is performed by placing the patient in the lateral decubitus position, thereafter the clinician performs a lumbar puncture
. The opening pressure is measured. Then, the clinician's assistant compresses both jugular veins|(if increased intracranial pressure is not suspected then one may exert pressure on both external jugular veins but usually pressure is first exerted on the abdomen, this pressure causes an engorgement of spinal veins and in turn rapidly increases CSF pressure), which leads to a rise in the intracranial pressure
. Given normal anatomy, the intracranial pressure will be reflected as a rapidly rising pressure measured from the lumbar needle, within 10–12 seconds. If there is a stenosis in the spine, there will be a damped, delayed response in the lumbar pressure, thus a positive Queckenstedt's maneuver. Nowadays this test has been made mostly superfluous by superior imaging modalities like MRI and CAT
.
The test is named after Hans Heinrich Georg Queckenstedt
who described it in 1916.
Spinal stenosis
Lumbar spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves at the level of the lumbar vertebra. This is usually due to the common occurrence of spinal degeneration that occurs with aging. It can also sometimes be caused by spinal disc...
. The test is performed by placing the patient in the lateral decubitus position, thereafter the clinician performs a lumbar puncture
Lumbar puncture
A lumbar puncture is a diagnostic and at times therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis, or very rarely as a treatment to relieve increased intracranial pressure.-Indications:The...
. The opening pressure is measured. Then, the clinician's assistant compresses both jugular veins|(if increased intracranial pressure is not suspected then one may exert pressure on both external jugular veins but usually pressure is first exerted on the abdomen, this pressure causes an engorgement of spinal veins and in turn rapidly increases CSF pressure), which leads to a rise in the intracranial pressure
Intracranial pressure
Intracranial pressure is the pressure inside the skull and thus in the brain tissue and cerebrospinal fluid . The body has various mechanisms by which it keeps the ICP stable, with CSF pressures varying by about 1 mmHg in normal adults through shifts in production and absorption of CSF...
. Given normal anatomy, the intracranial pressure will be reflected as a rapidly rising pressure measured from the lumbar needle, within 10–12 seconds. If there is a stenosis in the spine, there will be a damped, delayed response in the lumbar pressure, thus a positive Queckenstedt's maneuver. Nowadays this test has been made mostly superfluous by superior imaging modalities like MRI and CAT
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
.
The test is named after Hans Heinrich Georg Queckenstedt
Hans Heinrich Georg Queckenstedt
Hans Heinrich Georg Queckenstedt was a German neurologist remembered for describing Queckenstedt's phenomenon. He graduated from the University of Leipzig in 1900, having studied under Emil Kraepelin. He worked under Sigbert Josef Maria Ganser, and gained his doctorate in 1904...
who described it in 1916.