A Study of the Cerebrospinal Fluid Pulse Wave

Dunbar, Howard S.; Guthrie, Thomas C.; Karpell, Barbara

doi:10.1001/archneur.1966.00470120056009

Cited by 86 publications

(29 citation statements)

References 5 publications

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“…2 There are two concepts regarding the origin of the lumbar cerebrospinal¯uid pulse wave (L-CSFPW): that it arises from pulsation of the spinal cord. 3,4 and that it is due to pulsation of the brain which is transmitted through the subarachnoid space of the spine. 5,6 We recently demonstrated in dogs that L-CSFPW re¯ects pulsation of both the spinal cord and brain by analyzing the e ect on it of the occulusion of tha aorta and vena cava using system analysis; this showed the possibility that L-CSFPW could be an indicator of the spinal cord blood¯ow.…”

Section: Introductionmentioning

confidence: 99%

Lumbar cerebrospinal fluid pulse wave rising from pulsations of both the spinal cord and the brain in humans

1997

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There are two theories regarding the origin of the lumbar cerebrospinal¯uid pulse wave (L-CSFPW): that it arises from the arteries supplying the spinal cord, and that it is due to the pulsations of the brain transmitted through the subarachnoid space of the spine.We investigated L-CSFPW of 11 myelopathic patients with a complete (®ve patients, CBgroup) or an incomplete spinal block (six, ICB-group) on myelography to determine the origin of L-CSFPW. Since arterial pressure amplitude (APA), the energy source of L-CSFPW, is not the same between individuals or between before and after operation, not only L-CSFPW itself but also the transfer function between the arterial pressure wave and the L-CSFPW calculated by the system analysis method was analyzed to eliminate the in¯uence of hemodynamic uctuations. In the system analysis, the arterial pressure wave, L-CSFPW and transfer function were decomposed into ®ve harmonic waves (HW).In the CB group, L-CSFPW was observed to be 0.72 mmHg on average (range, 0.25 ± 1.00) in spite of blocking pulsations of the brain, showing that there was a contribution to L-CSFPW unrelated to the brain, that is, the spinal cord. In the CB group, however, the preoperative transfer function value of HW1 (mean, 0.056; range, 0.012 ± 0.170) was lower than that in the ICB group (mean, 0.137; range, 0.061 ± 0.236) (P50.05), indicating that the brain pulsation also contributed to L-CSFPW.In the ICB group, there was signi®cant reduction of HW1 (P50.01) and HW2 (P50.05) transfer function after posterior decompression surgery in spite of improvement in the subarachnoid space narrowing: preoperative HW1, mean, 0.137, range, 0.061 ± 0.236; postoperative HW1, mean, 0.065, range, 0.021 ± 0.153; preoperative HW2, mean, 0.092, range, 0.011 ± 0.148; postoperative HW2, mean, 0.044, range, 0.030 ± 0.066. It has been reported that the spinal cord blood¯ow is decreased 20% or more by laminectomy, therefore, L-CSFPW measurement may be sensitive enough to detect a 20% or higher decrease in this ow. This suggests that L-CSFPW could possibly be used clinically as a non-invasive method of monitoring the spinal cord blood¯ow. For broad clinical application of CSFPW, however, further studies are needed, especially on the direct relationship between CSFPW and spinal cord blood¯ow itself.

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Section: Introductionmentioning

confidence: 99%

Lumbar cerebrospinal fluid pulse wave rising from pulsations of both the spinal cord and the brain in humans

1997

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“…Most investigators believe that they originate from the arterial pulsation and are modified by respiration (Antoni 1946, Bering 1955, Dunbar et al 1966. Recently, however, it was demonstrated that CSF pulsations follow the contour of venous rather than the arterial pulsation and it was suggested, therefore, that the brain pulsations may also follow the venous rather than the arterial pattern (Hamit et al 1965).…”

Section: Discussionmentioning

confidence: 99%

The effect of decerebrate rigidity on the intracranial pressure

et al. 1979

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The mechanical effect of acute decerebrate rigidity upon the ICP and the mechanisms underlying the relationship between them have been investigated with experiments performed on 26 cats. It has been shown that: a) Extreme rigidity of the peripheral musculature with or without partial activation of the trunkal muscles produces no change in ICP, b) the simultaneous elevation of the intra-thoracic and intra-abdominal pressures is the factor primarily operative in raising and maintaining the elevated ICP, c) when cerebrovascular homeostasis is already defective a subsidiary but not unimportant role is played by the elevation of the systemic arterial pressure, d) under conditions of normal brain elastance mild and short-lasting spasms produce no effect on the ICP. In an animal, however, in which the brain elastance had been increased by inflating a small air-filled balloon, similar spasms produced a marked increase in ICP.

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“…The main site of transfer of the arterial pulsation is regarded by some as being the basal and spinal arteries (Antoni 1946, Dunbar et al 1966 and by others as the ventricular ehoroid plexuses (Bering 1955). The amplitude of the ventrienlar CSF wave form may be altered by variations in intracranial pressure (Ryder et al 1952).…”

Section: Discussionmentioning

confidence: 99%

Significance of the ventricular fluid pressure wave form in the diagnosis of cerebral circulatory arrest and brain death

Tsementzis

1978

Acta neurochir

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The fluctuations in the absolute value of the ventricular fluid pressure (VFP) with simultaneous changes in the amplitude and frequency of the oscillations of the ventricular fluid wave form are described in seven patients who developed brain death following either a head injury or a cerebrovascular accident, and are compared with those observed in nineteen patients who survived similar brain pathology. The findings in the two groups were significantly different. It is suggested that VFP monitoring does provide reliable evidence of brain death even while the patient is on artificial respiration.

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A Study of the Cerebrospinal Fluid Pulse Wave

Cited by 86 publications

References 5 publications

Lumbar cerebrospinal fluid pulse wave rising from pulsations of both the spinal cord and the brain in humans

Lumbar cerebrospinal fluid pulse wave rising from pulsations of both the spinal cord and the brain in humans

The effect of decerebrate rigidity on the intracranial pressure

Significance of the ventricular fluid pressure wave form in the diagnosis of cerebral circulatory arrest and brain death

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