Significance of the So-Called Absorptive Reserve in Communicating Hydrocephalus

Neurosurgery ◽  
1981 ◽  
Vol 8 (5) ◽  
pp. 525-530 ◽  
Author(s):  
Frederick H. Sklar ◽  
Chester W. Beyer ◽  
Jan T. Diehl ◽  
Kemp W. Clark
Keyword(s):  
Cerebrospinal Fluid ◽  
Absorptive Capacity ◽  
Communicating Hydrocephalus ◽  
Physiological Range ◽  
Resting Pressure ◽  
Pressure Parameter ◽  
Infusion Technique ◽  
Csf Absorption

Abstract Twelve patients with communicating hydrocephalus were studied with a servocontrolled lumbar infusion technique to measure net cerebrospinal fluid (CSF) absorptive capacity and resting pressure. Each patient showed a significant absorptive reserve; the rate of CSF absorption exceeded the rate of formation over a physiological range of pressure. The size of the ventricles did not correlate with either the absorptive capacity or the resting pressure parameter, or both. The data suggest that communicating hydrocephalus does not reflect a simple imbalance between the rates of CSF formation and absorption. Other factors must be of etiological importance and are considered in the discussion.

Resistance to Outflow of Cerebrospinal Fluid Determined by Bolus Injection Technique and Constant Rate Steady State Infusion in Humans

Neurosurgery ◽  
1985 ◽  
Vol 16 (3) ◽  
pp. 336-340 ◽  
Author(s):  
Michael Kosteljanetz
Keyword(s):  
Cerebrospinal Fluid ◽  
Steady State ◽  
Bolus Injection ◽  
Point Of View ◽  
Injection Technique ◽  
Communicating Hydrocephalus ◽  
Constant Rate ◽  
High Degree ◽  
Infusion Technique

Abstract Two methods for the determination of resistance to the outflow of cerebrospinal fluid, the bolus injection technique and the constant rate steady state infusion technique, were compared. Thirty-two patients with a variety of intracranial diseases (usually communicating hydrocephalus) were studied. There was a high degree of correlation between the resistance values obtained with the two methods, but values based on the bolus injection technique were systematically and statistically significantly lower than those obtained with the constant rate infusion test. From a practical point of view. both methods were found to be applicable in a clinical setting.

Cerebrospinal Fluid

2021 ◽  
pp. 274-276
Author(s):  
Ruple S. Laughlin
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Right Atrial ◽  
Common Cause ◽  
Resting Pressure ◽  
Cause Of Error ◽  
Lateral Decubitus ◽  
The Right ◽  
Is Failure ◽  
Csf Absorption

The total volume of cerebrospinal fluid (CSF) within the ventricles and subarachnoid space is about 150 mL. The absorption of CSF is directly linked to intracranial pressure. In steady states, the rate of CSF absorption equals CSF formation, and the normal resting pressure of CSF is typically between 150 and 180 mm H2O (reference range, 65-200 mm H2O [5-15 mm Hg]). The most common cause of error in measurement of CSF pressure is failure to position the patient properly (the correct position is lateral decubitus; the right atrial pressure serves as the reference [0 mm H2O]).

Servo-controlled Lumbar Infusions

Neurosurgery ◽  
1978 ◽  
Vol 3 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Frederick H. Sklar ◽  
Chester W. Beyer ◽  
Murugappan Ramanathan ◽  
Ilya Elashvili ◽  
Paul R. Cooper ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Statistical Significance ◽  
Variable Rate ◽  
Controlled System ◽  
Computer Data ◽  
Time Period ◽  
On Line ◽  
The Difference ◽  
Infusion Technique ◽  
Csf Absorption

Abstract The variable rate lumbar subarachnoid infusion technique allows rapid quantitative study of the cerebrospinal fluid (CSF) compartment. Numerous pressure plateaus are studied in a brief time period with a servo-controlled system. The test determines the difference between rates of CSF absorption and formation as a function of pressure. On-line computer data analysis increases experimental efficiency to guarantee statistical significance. Animal and patient data are presented in the report.

Impaired lymphatic cerebrospinal fluid absorption in a rat model of kaolin-induced communicating hydrocephalus

2008 ◽  
Vol 294 (5) ◽  
pp. R1752-R1759 ◽  
Author(s):  
G. Nagra ◽  
J. Li ◽  
J. P. McAllister ◽  
J. Miller ◽  
M. Wagshul ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Communicating Hydrocephalus ◽  
Sprague Dawley ◽  
Halothane Anesthesia ◽  
Sprague Dawley Rats ◽  
Cerebrospinal Fluid Absorption ◽  
Almost All ◽  
Nasal Lymphatics ◽  
Csf Absorption ◽  
Tracer Enrichment

It has been assumed that the pathogenesis of hydrocephalus includes a cerebrospinal fluid (CSF) absorption deficit. Because a significant portion of CSF absorption occurs into extracranial lymphatics located in the olfactory turbinates, the purpose of this study was to determine whether CSF transport was compromised at this location in a kaolin-induced communicating (extraventricular) hydrocephalus model in rats. Under 1–3% halothane anesthesia, kaolin ( n = 10) or saline ( n = 9) was introduced into the basal cisterns of Sprague-Dawley rats, and the development of hydrocephalus was assessed 1 wk later using MRI. After injection of human serum albumin (125I-HSA) into a lateral ventricle, the tracer enrichment in the olfactory turbinates 30 min postinjection provided an estimate of CSF transport through the cribriform plate into nasal lymphatics. Lateral ventricular volumes in the kaolin group (0.073 ± 0.014 ml) were significantly greater than those in the saline-injected animals (0.016 ± 0.001 ml; P = 0.0014). The CSF tracer enrichment in the olfactory turbinates (expressed as percent injected/g tissue) in the kaolin rats averaged 0.99 ± 0.39 and was significantly lower than that measured in the saline controls (5.86 ± 0.32; P < 0.00001). The largest degree of ventriculomegaly was associated with the lowest levels of lymphatic CSF uptake with lateral ventricular expansion occurring only when almost all of the lymphatic CSF transport capacity had been compromised. We conclude that lymphatic CSF absorption is impaired in a kaolin-communicating hydrocephalus model and that the degree of this impediment may contribute to the severity of the induced disease.

HYDROCEPHALUS IN ACHONDROPLASIA STUDIED BY CISTERNOGRAPHY

PEDIATRICS ◽  
1972 ◽  
Vol 49 (1) ◽  
pp. 46-49
Author(s):  
A. Everette James ◽  
John P. Dorst ◽  
Ernest S. Mathews ◽  
Victor A. McKusick
Keyword(s):  
Cerebrospinal Fluid ◽  
Communicating Hydrocephalus ◽  
Diagnostic Study

Cerebrospinal fluid (CSF) images were obtained in two patients with achondroplasia. Communicating hydrocephalus was present without ventricular stasis of the radiopharmaceutical. CSF diversionary shunts may not be indicated in the usual patient with achondroplasia and hydrocephalus. This diagnostic study offers future promise in predicting those patients who may benefit from a CSF diversionary shunt.

Evaluation of the central canal of the spinal cord in experimentally induced hydrocephalus

1978 ◽  
Vol 48 (6) ◽  
pp. 970-974 ◽  
Author(s):  
A. Everette James ◽  
William J. Flor ◽  
Gary R. Novak ◽  
Ernst-Peter Strecker ◽  
Barry Burns
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Experimental Model ◽  
Alternative Pathway ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Content Type ◽  
Histological Appearance ◽  
Fine Print

✓ The central canal of the spinal cord has been proposed as a significant compensatory alternative pathway of cerebrospinal fluid (CSF) flow in hydrocephalus. Ten dogs were made hydrocephalic by a relatively atraumatic experimental model that simulates the human circumstance of chronic communicating hydrocephalus. The central canal was studied by histopathology and compared with 10 normal control dogs. In both groups the central canal of the spinal cord was normal in size, configuration, and histological appearance. In this experimental model dilatation of the canal and increased movement of CSF does not appear to be a compensatory alternative pathway.

scholarly journals Levofloxacin Disposition in Cerebrospinal Fluid in Patients with External Ventriculostomy

2003 ◽  
Vol 47 (10) ◽  
pp. 3104-3108 ◽  
Author(s):  
Federico Pea ◽  
Federica Pavan ◽  
Ennio Nascimben ◽  
Claudio Benetton ◽  
Pier Giorgio Scotton ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Steady State ◽  
Bacterial Meningitis ◽  
Acute Bacterial Meningitis ◽  
Terminal Phase ◽  
Communicating Hydrocephalus ◽  
Synergistic Activity ◽  
Dosing Interval ◽  
Concentration Time ◽  
Meningeal Inflammation

ABSTRACT In vitro levofloxacin exhibits both potent or intermediate activity against most of the pathogens frequently responsible for acute bacterial meningitis and synergistic activity with some beta-lactams. Since levofloxacin was shown to penetrate the cerebrospinal fluid (CSF) during meningeal inflammation both in animals and in humans, the disposition of levofloxacin in CSF was studied in 10 inpatients with external ventriculostomy because of communicating hydrocephalus related to subarachnoid occlusion due to cerebral accidents who were treated with 500 mg of levofloxacin intravenously twice a day because of extracerebral infections. Plasma and CSF concentration-time profiles and pharmacokinetics were assessed at steady state. Plasma and CSF levofloxacin concentrations were analyzed by high-pressure liquid chromatography. The peak concentration of levofloxacin at steady state (C max ss)was 10.45 mg/liter in plasma and 4.06 mg/liter in CSF, respectively, with the ratio of the C max ss in CSF to the C max ss in plasma being 0.47. The areas under the concentration-time curves during the 12-h dosing interval (AUC0-τs) were 47.69 mg · h/liter for plasma and 33.42 mg · h/liter for CSF, with the ratio of the AUC0-τ for CSF to the AUC0-τ for plasma being 0.71. The terminal-phase half-life of levofloxacin in CSF was longer than that in plasma (7.02 ± 1.57 and 5.51 ± 1.36 h, respectively; P = 0.034). The ratio of the levofloxacin concentration in CSF to the concentration in plasma progressively increased with time, from 0.30 immediately after dosing to 0.99 at the end of the dosing interval. In the ventricular CSF of patients with uninflamed meninges, levofloxacin was shown to provide optimal exposure, which approximately corresponded to the level of exposure of the unbound drug in plasma. The findings provide support for trials of levofloxacin with twice-daily dosing in combination with a reference beta-lactam for the treatment of bacterial meningitis in adults. This cotreatment could be useful both for overcoming Streptococcus pneumoniae resistance and for enabling optimal exposure of the CSF to at least one antibacterial agent for the overall treatment period.

Potentiometric analysis for sodium and potassium in biological fluids.

1982 ◽  
Vol 28 (1) ◽  
pp. 170-172 ◽  
Author(s):  
E Langhoff ◽  
I Steiness
Keyword(s):  
Cerebrospinal Fluid ◽  
Biological Fluids ◽  
Flame Photometry ◽  
Aqueous Samples ◽  
Physiological Range ◽  
Relative Decrease ◽  
Potentiometric Analysis ◽  
Sample Water ◽  
Uremic Patients ◽  
Sodium And Potassium

Abstract Results obtained with a potentiometric analyzer, NOVA 1, specific for sodium and potassium, were compared with those by flame photometry. Both instruments showed linearity within a physiological range of sodium and potassium concentrations and had similar precisions. Volume displacements from addition of albumin or Intralipid to aqueous samples yielded the predicted lower flame-photometric results because of the relative decrease in sample water. There may be a small interaction between sodium and albumin. Physiological measurements on plasma from uremic patients showed no change after dialysis that could be ascribed to a decrease in interaction of these ions with creatinine and urea. Potentiometric values for sodium and potassium did not differ significantly, whether measured in cerebrospinal fluid or in the corresponding plasma. Results for urine were the same potentiometrically and by flame photometry.

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