Analysis of cerebrospinal fluid dynamics in hydrocephalus

在家兔脑积水基础研究的基础上，进行了临床研究。对11例患有交通性脑积水的成人进行了脑脊液（CSF）流量研究。通过分流的CSF流量，用作者开发的分流CSF流量计测量，放射性同位素（RI）脑池造影，鞘内给药的染料清除率（PSP），单光子发射计算机断层扫描（SPECT），经颅多普勒超声（TCD），诱发电位和颅内压（ICP）与神经症状和体征的改善和CT结果的变化进行比较。在吸收紊乱的病例中，24小时内染料清除率为50%或更低，通过分流管的每日CSF总流量往往超过115 ml。CSF峰值流量为0.25 ml/min的病例，平均120 ml/天也显示了分流后神经学发现的改善。在分流管未成为主要CSF通路的病例中，可预期神经功能改善。换句话说，这可能意味着分流术后脑脊液在脑脊髓间隙吸收的阻力降低，并且生理学脑脊液吸收途径已经恢复。

Based upon the basic reserch of hydrocephalus using the rabbits, Clinical studies were performed. Cerebrospinal fluid (CSF) flow studies were evaluated in eleven adults with communicating hydrocephalus. CSF flow through a shunt, measured with an inshunt CSF flowmeter developed by the authors, radioisotope (RI) cisternography, clearance of dye (PSP) administered intrathecally, single photon emission computed tomography (SPECT), Transcranial Doppler Sonsgram (TCD), evoked potential and intracranial pressure (ICP) were compared with improvements in neurological symptoms and signs and changes in CT findings. In cases having disturbed absorption, with 50% or less dye clearance within 24 houes, the daily total volume of CSF flowing through a shunt tended to exceed 115 ml. Cases with peak CSF flow of 0.25 ml/min., for an average 120 ml/day also showed improvements in neurological findings after shunting. The neurological improvements can be expected in the cases which the shunt tube do not become the majour CSF pathway. In other words, this could mean that resistance to CSF absorption in the cerero- spinal space has decreased after the shunt operation and there has been recovery of the phisiological CSF absorption pathways.