Downregulation of cerebrospinal fluid production in patients with chronic hydrocephalus

2002 ◽  
Vol 97 (6) ◽  
pp. 1271-1275 ◽  
Author(s):  
Gerald D. Silverberg ◽  
Stephen Huhn ◽  
Richard A. Jaffe ◽  
Steven D. Chang ◽  
Thomas Saul ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Production Rate ◽  
Ventricular Catheter ◽  
Chronic Hydrocephalus ◽  
Production Rates ◽  
Normal Range ◽  
Content Type ◽  
Fluid Production ◽  
Csf Production ◽  
Fine Print

Object. The goal of this study was to determine the effect of hydrocephalus on cerebrospinal fluid (CSF) production rates in patients with acute and chronic hydrocephalus. Methods. The authors studied CSF production both in patients presenting with acute and chronic hydrocephalus, and patients with Parkinson disease (PD) of a similar mean age, whose CSF production was known to be normal. A modification of the Masserman method was used to measure CSF production through a ventricular catheter. The CSF production rates (means ± standard deviations) in the three groups were then compared. The patients with PD had a mean CSF production rate of 0.42 ± 0.13 ml/minute; this value lies within the normal range measured using this technique. Patients with acute hydrocephalus had a similar CSF production rate of 0.4 ± 0.13 ml/minute, whereas patients with chronic hydrocephalus had a significantly decreased mean CSF production rate of 0.25 ± 0.08 ml/minute. Conclusions. The authors postulate that chronic increased intracranial pressure causes downregulation of CSF production.

The effect of dexamethasone phosphate on the production rate of cerebrospinal fluid in the spinal subarachnoid space of dogs

1973 ◽  
Vol 39 (4) ◽  
pp. 480-484 ◽  
Author(s):  
Osamu Sato ◽  
Makoto Hara ◽  
Takehiko Asai ◽  
Ryuichi Tsugane ◽  
Naoki Kageyama
Keyword(s):  
Cerebrospinal Fluid ◽  
Production Rate ◽  
Subarachnoid Space ◽  
Content Type ◽  
Spinal Subarachnoid Space ◽  
Dexamethasone Phosphate ◽  
Maximal Reduction ◽  
Csf Production ◽  
Fine Print

✓ The effect of intravenous dexamethasone on cerebrospinal fluid (CSF) production was studied in dogs by a method of caudocephalad perfusion of the spinal subarachnoid space with an inulin-containing buffer. The CSF production rate began to reduce immediately after the injection of 0.15 mg/kg and attained a maximal reduction of 50% in 50 minutes.

Effect of certain drugs on cerebrospinal fluid production in the dog

1964 ◽  
Vol 206 (2) ◽  
pp. 247-250 ◽  
Author(s):  
W. W. Oppelt ◽  
C. S. Patlak ◽  
D. P. Rall
Keyword(s):  
Cerebrospinal Fluid ◽  
Carbonic Anhydrase ◽  
Production Rate ◽  
Cardiac Glycoside ◽  
Intrathecal Administration ◽  
Production Rates ◽  
Ventriculocisternal Perfusion ◽  
Fluid Production ◽  
Significant Change ◽  
Csf Production

Cerebrospinal fluid (CSF) production rates were measured in the dog by ventriculocisternal perfusion with inulin containing buffer. Normal CSF production rate was found to be about 0.05 ml/min which represents a turnover of 0.4%/min. After intravenous administration of the carbonic anhydrase inhibitors, acetazolamide and methazolamide, a 40–50% decrease in CSF production occurred. An increase in plasma pCO2, by allowing the animals to inhale 95% oxygen, 5% CO2, did not result in any significant change in CSF production. Both intravenous and intrathecal administration of varying doses of the cardiac glycoside, ouabain, did not cause any significant change in CSF production rates. It is concluded that CSF production, in part, is controlled by a carbonic anhydrase system.

Surgical removal of bilateral papillomas of the choroid plexus of the lateral ventricles with resolution of hydrocephalus

1979 ◽  
Vol 50 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Steven K. Gudeman ◽  
Humbert G. Sullivan ◽  
Michael J. Rosner ◽  
Donald P. Becker
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Large Volume ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Content Type ◽  
Lateral Ventricles ◽  
Csf Diversion ◽  
Csf Production ◽  
Fine Print

✓ The authors report a patient with bilateral papillomas of the choroid plexus of the lateral ventricles with documentation of cerebrospinal fluid (CSF) hypersecretion causing hydrocephalus. Special attention is given to the large volume of CSF produced by these tumors (removal of one tumor reduced CSF outflow by one-half) and to the fact that CSF diversion was not required after both tumors were removed. Since tumor removal alone was sufficient to stop the progression of hydrocephalus, we feel that this case supports the concept that elevated CSF production by itself is sufficient to cause hydrocephalus in patients with papillomas of the choroid plexus.

Management of proximal shunt obstruction

1988 ◽  
Vol 68 (5) ◽  
pp. 817-819 ◽  
Author(s):  
Charles C. Duncan
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Intracranial Pressure ◽  
Signs And Symptoms ◽  
Ventricular Catheter ◽  
Shunt Failure ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Shunt Obstruction ◽  
Fine Print

✓ Proximal shunt obstruction or obstruction of the ventricular catheter may present with signs and symptoms of shunt failure with either no cerebrospinal fluid flow or a falsely low intracranial pressure (ICP) upon shunt tap. The author reports a technique for lowering the ICP and for measuring the pressure in patients with such obstruction by cannulation of the reservoir and ventricular catheter to penetrate into the ventricle with a 3½-in. No. 22 spinal needle. The findings in 20 cases in which this approach was utilized are summarized.

Cerebrospinal fluid edema: a rare complication of shunt operations for hydrocephalus

1982 ◽  
Vol 57 (5) ◽  
pp. 697-700 ◽  
Author(s):  
Yasuhiro Chiba ◽  
Hiroshi Takagi ◽  
Fumoto Nakajima ◽  
Satoshi Fujii ◽  
Takao Kitahara ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
Rare Complication ◽  
Shunt Revision ◽  
Ventricular Catheter ◽  
Shunt Operation ◽  
Low Density ◽  
Content Type ◽  
Low Density Area ◽  
Fine Print

✓ Three cases are presented in which a rare complication occurred after a shunt operation for hydrocephalus. On postoperative computerized tomography (CT) scans, extensive low-density areas appeared in the white matter along the ventricular catheter. After shunt revision, gradual resolution or disappearance of the low-density area was clearly demonstrated on CT. In one patient, a collection of cerebrospinal fluid (CSF) was confirmed at operation and appeared to lie in the extracellular spaces of the white matter. The phenomenon is considered to be localized CSF edema, different from porencephaly.

Acute effect of glycerol on net cerebrospinal fluid production in dogs

1985 ◽  
Vol 63 (5) ◽  
pp. 759-762 ◽  
Author(s):  
Huda Y. Zoghbi ◽  
Sada Okumura ◽  
John P. Laurent ◽  
Marvin A. Fishman
Keyword(s):  
Cerebrospinal Fluid ◽  
Acute Effect ◽  
Serum Osmolality ◽  
Percentage Change ◽  
Perfusion Technique ◽  
Content Type ◽  
Ventriculocisternal Perfusion ◽  
Fluid Production ◽  
The Mean ◽  
Csf Production

✓ The effect of glycerol administration on cerebrospinal fluid (CSF) formation in dogs was studied by means of a ventriculocisternal perfusion technique. Net CSF production rate decreased after oral administration of glycerol (3 gm/kg) from a baseline level of 42.33 ± 6.68 µl/min (mean ± standard error) to a trough of 10.33 ± 4.88 µl/min at 90 minutes after administration (p < 0.025). Serum osmolality concomitantly increased from a baseline value of 296 ± 2.83 to 309 ± 4.7 mOsm/kg H2O at 90 minutes. The mean percentage change in CSF production inversely correlated to the mean percentage change in serum osmolality, r = −0.85. Thus, glycerol administration decreases net CSF formation, and this effect may be related in part to the rise in serum osmolality.

Effect of systemic arterial hypotension on the rate of cerebrospinal fluid formation in dogs

1974 ◽  
Vol 41 (3) ◽  
pp. 350-355 ◽  
Author(s):  
Michael E. Carey ◽  
A. Richard Vela
Keyword(s):  
Blood Pressure ◽  
Cerebrospinal Fluid ◽  
Mean Arterial Blood Pressure ◽  
Content Type ◽  
Arterial Blood ◽  
Ventriculocisternal Perfusion ◽  
Fluid Formation ◽  
The Mean ◽  
Csf Production ◽  
Fine Print

✓The rate of cerebrospinal fluid (CSF) production in dogs was measured by ventriculocisternal perfusion with artificial CSF containing inulin. In normotensive animals, the average CSF production was 36 ± 6 µl/min. When the mean arterial blood pressure was reduced to 62 ± 1 mm Hg, the CSF production fell to 22 ± 5 µl/min, a 39% reduction in fluid formation. The authors briefly discuss various hypotheses to explain this reduction.

An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis

2004 ◽  
Vol 100 (3) ◽  
pp. 534-540 ◽  
Author(s):  
Spyros Sgouros ◽  
Susan J. Dipple
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Cerebrospinal Fluid ◽  
Energy Dispersive ◽  
Ventricular Catheter ◽  
Content Type ◽  
X Ray ◽  
Programmable Valve ◽  
Fine Print ◽  
Scanning Electron

Object. Surveys of cerebrospinal fluid (CSF) shunts that have been removed from patients have shown that even when the ventricular catheter is the cause of the obstruction, the valve may be obstructed or underperforming. The aim of this pilot study was to investigate the degradation of shunt valve structure over time due to the deposition of debris. The findings were compared with findings in unused valves. Methods. Scanning electron microscopy was used to visualize the structures of the valves. The items that were examined included two unused and nine explanted cylindrical medium pressure valves, one unused and six explanted Delta 1.5 valves (PS Medical, Goleta, CA), and one explanted Medos Programmable valve (Codman Johnson & Johnson, LeLocle, Switzerland). The valves were cut open, disassembled, and coated in gold. The areas that were analyzed included the main valve chamber, the diaphragm unit, and the antisiphon device. For areas with abnormal deposits, energy-dispersive x-ray microanalysis was performed to establish the chemical composition of the deposits. The reference unused valves had smooth surfaces with no deposits in any areas. All explanted valves had extensive deposits in all surveyed areas. The deposits varied from small clusters of crystals to large areas that displayed a cobblestone appearance. In diaphragm valves the deposits extensively affected the surface of the diaphragm and the gap between the diaphragm and the surrounding case, where normally CSF flows; in the Medos valve the deposits affected in the spring and “staircase” unit. Deposits were present as early as 2 weeks after implantation. On some valves there was a complete film covering the entire outlet of the valve, which formed a cast inside the valve stretching from wall to wall. The deposits consisted mostly of sodium and chloride, but occasionally contained calcium. In all infected and some noninfected valves there was a significant peak of carbon, indicating the presence of protein deposits. Conclusions. It appears that the continuous flow of CSF through shunt valves causes surface deposits of sodium chloride and other crystals on all aspects of the valve, including the outlet pathways. The formation of deposits may be encouraged by the adhesive properties of the materials that constitute the valve parts.

Hydrocephalus secondary to diffuse villous hyperplasia of the choroid plexus

1996 ◽  
Vol 85 (4) ◽  
pp. 689-691 ◽  
Author(s):  
Gavin W. Britz ◽  
D. Kyle Kim ◽  
John D. Loeser
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Resonance Imaging ◽  
Ventriculoatrial Shunt ◽  
Content Type ◽  
Tomography Scanning ◽  
Csf Production ◽  
Choroid Plexus Papillomas ◽  
Fine Print

✓ Diffuse villous hyperplasia of the choroid plexus, which is distinct from bilateral choroid plexus papillomas, is extremely rare and is often associated with hydrocephalus due to the overproduction of cerebrospinal fluid (CSF). The authors describe an infant with hydrocephalus, diagnosed by computerized tomography scanning, who developed ascites following placement of a ventriculoperitoneal shunt and, subsequently, demonstrated excessive CSF production when the shunt was externalized. The patient was later successfully treated by placement of a ventriculoatrial shunt. Magnetic resonance imaging demonstrated diffuse villous hyperplasia of the choroid plexus as the cause of the patient's hydrocephalus. The literature on diffuse villous hyperplasia of the choroid plexus is reviewed.

Parenchymal cerebrospinal fluid extravasation as a complication of computerized tomography

1980 ◽  
Vol 52 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Harold L. Rekate
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Right Hemisphere ◽  
Neurological Dysfunction ◽  
Ventricular Catheter ◽  
Content Type ◽  
Fluid Extravasation ◽  
Computerized Tomographic Study ◽  
The Right ◽  
Fine Print

✓ A case is presented in which neurological deterioration occurred during a computerized tomographic study. Total hemispheric dysfunction was seen in a patient with a postoperative suboccipital pseudomeningocele, whose head was wrapped in a compressive water bag. Cerebrospinal fluid was forced under pressure into the parenchyma of the right hemisphere, around a ventricular catheter. The neurological dysfunction resolved promptly with shunting.

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