In every diagnostic lumbar puncture, a manometer should be used. This is not only my opinion, but must be that of any one seeking all the information that can be gained from spinal fluid examination. It is true that great variations occur within what we call normal pressure, and that normal pressure varies greatly with different conditions; but it is also true that we can recognize definitely pathologic pressures. Therefore I reiterate that any analysis of spinal fluid findings is inadequate if the pressure findings have been neglected.
In advocating pressure studies in diagnostic punctures I refer not only to the reading of the initial pressure, but also to subsequent Pressure readings following certain procedures which give us a conception of the amount of fluid present in the cerebrospinal reservoirs, and also evidence of block in the fluid pathways. Moreover, while much may be learned from pressure studies of the
AYER JB. CEREBROSPINAL FLUID PRESSURE FROM THE CLINICAL POINT OF VIEW. Arch NeurPsych. 1925;14(4):440-448. doi:10.1001/archneurpsyc.1925.02200160007002