During lumbar puncture in a patient with suspected lateral sinus thrombosis, manual compression of the jugular vein on the healthy side produces a prompt rise in cerebrospinal fluid pressure, while compression on the affected side produces no rise. This finding is known as:

• A Queckenstedt's test, positive for lateral sinus thrombosis
• B Fistula test, positive for perilymph fistula
• C Stookey's test, indicating communicating hydrocephalus
• D Tobey-Ayer test, positive for lateral sinus thrombosis ✓

Explanation

The Tobey-Ayer test exploits the fact that jugular compression normally increases intracranial venous pressure and hence lumbar CSF pressure. When one lateral sinus is thrombosed, compressing the ipsilateral jugular does not raise intracranial venous pressure because that drainage pathway is blocked, so the CSF manometer stays flat on that side while rising briskly on the healthy side. Queckenstedt's test refers to bilateral compression and is used in spinal block assessment.

Reference: Dhingra, Diseases of Ear, Nose and Throat, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.