It is not an uncommon experience in neurologic practice to be presented with a patient having all the signs and symptoms of a compressing lesion of the spinal cord above the level of the second lumbar vertebra but with the complete absence of manometric block. Doubt will exist as to the etiologic explanation of the illness, but usually a neurosurgeon is eventually consulted and exploration is performed. Then one frequently finds a normal appearing spinal cord with no macroscopic evidence of neurologic disease.
Most authors who have written on this subject since Queckenstedt's original work in 1916 have referred to the diagnostic importance of spinal fluid block but have not indicated what should be done when this valuable sign is absent. Of 235 cases of this type reported by Stookey and Klenke1 in 1928, 125 showed normal dynamics of the spinal fluid, and 10 of the patients underwent urgical
FLEISS AN, INGHAM H. CORD COMPRESSING LESIONS WITH NORMAL QUECKENSTEDT SIGN. JAMA. 1943;123(12):759–761. doi:10.1001/jama.1943.02840470025007
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