Analysis of cerebrospinal fluid dynamics in hydrocephalus

在利用兔进行脑积水基础研究的基础上，进行了临床研究。对11例成人交通性脑积水患者进行了脑脊液(CSF)血流检查。采用自行研制的分流式脑脊液流量计测量脑脊液流量、放射性核素脑池造影术、鞘内注射染料清除量(PSP)、单光子发射计算机体层摄影(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及CT表现的变化进行比较。在24周内染料清除率在50%或以下的吸收障碍患者，每天流经分流管的脑脊液总量往往超过115ml，而峰值脑脊液流量为0.25ml/min，平均每天120ml的患者，分流术后的神经症状也有改善。在分流管未成为主要的脑脊液通路的情况下，神经功能的改善是可以预期的。换句话说，这可能意味着分流手术后脑脊液吸收的阻力减少，生理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.