I like to know if someone can help clear up this question that's been bothering me for a long time. Both the brain and spinal cord are exquisitely sensitive to pressure and compression as what happens with a tumor or mass lesion. Also serious neurological deficit can occur with raised intracranial pressure (ICP) due to compression of brain tissue and decreased cerebral perfusion. unless there is an obstruction in the csf pathways, there will also be increased intraspinal pressure in the setting of raised ICP. We know this is the case because when we do a lumbar puncture in these situations, the opening pressure is raised. My question is why do we then not see neurological deficit (quadraparesis etc.) specifically secondary to pressure on spinal cord in the setting of raised ICP? Would greatly appreciate any of your thoughts on this.