Effects of the cervical collar on cerebrospinal fluid pressure

Abstract

We investigated the hypothesis that cervical collars might compress the internal jugular veins and raise intracranial pressure in head‐injured patients. In a randomised, single‐blind, crossover study of nine patients scheduled for elective spinal anaesthesia the cerebrospinal fluid pressure in the lumbar subarachnoid space was measured with and without a ‘Stifneck’cervical collar applied. There was a significant elevation of cerebrospinal fluid pressure in seven of the patients studied when the cervical collar was applied (p < 0.01). This preliminary study raises the possibility that immobilisation of the cervical spine with the 'Stifneck’cervical collar may, by raising the intracranial pressure, contribute to secondary neurological injury in head‐injured patients in whom intracranial compliance is already reduced. Copyright © 1994, Wiley Blackwell. All rights reserved