The Queckenstedt test is a clinical maneuver performed while measuring the CSF pressure at lumbar puncture. The CSF pressure normally rises when one or both jugular veins are compressed.



(1) Perform a lumbar puncture and measure the CSF pressure.

(2) Remeasure the pressure while compressing one or both jugular veins.

(3) A final pressure reading is taken after the pressure on the veins is released.


Normally there is a prompt rise as long as jugular vein compressed and a prompt return to normal after the pressure is stopped. Compression of both jugular veins causes a higher pressure than if only one is compressed


The presence of a blockage between the jugular vein and the CSF results in no change in pressure or else a delay in the pressure rise and fall.


Differential diagnosis of an abnormal test:

(1) If the response is abnormal when one jugular vein is compressed but not the other, then suspect a sinus thrombosis on the same side.

(2) If the response is abnormal when both jugular veins are compressed, then there is a block in CSF flow.

(3) A block of the needle point by a nerve root.


The "Reverse Test" involves compressing the abdomen while measuring the CSF pressure. In the event of a true block in CSF flow, the pressure will increase when the abdomen is pressed, due to congestion of the intraspinal veins below the level of the block. If there is a prompt rise in the pressure on abdominal compression, then the needle is not blocked.


Contraindications for performing the Queckenstedt test:

(1) intracranial bleeding

(2) intracranial tumor


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