The Cerebrospinal Fluid

  • John L. Fox


Examination of the cerebrospinal fluid (CSF) for diseases of the nervous system began with Quincke with his reports in 1872 (34a) and 1891 (34) (see Chapter 1). He popularized the use of spinal puncture (spinal tap) in the lumbar region (lumbar puncture; LP) mainly for the diagnosis and treatment of hydrocephalus. However, one of his cases did have an intracranial bleed. He measured the opening and closing CSF pressures, the amount removed, the specific gravity, and the protein concentration. This set the stage for confirmation of subarachnoid hemorrhage, a diagnosis presently made by visual CSF examination and, more recently, computerized tomography.


Cerebrospinal Fluid Lumbar Puncture Intracranial Aneurysm Subarachnoid Hemor Salmon Color 
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  1. 1.
    Adams JE, Prawirohardjo S: Fate of red blood cells injected into cerebrospinal fluid pathways. Neurology 9: 561–564, 1959Google Scholar
  2. 2.
    Barrows LJ, Hunter FT, Banker BQ: The nature and clinical significance of pigments in the cerebrospinal fluid. Brain 78: 59–80, 1955PubMedCrossRefGoogle Scholar
  3. 3.
    Buckell M: Biochemical aspects of ruptured aneurysms. J Neurol Neurosurg Psychiat 30: 586, 1967PubMedCrossRefGoogle Scholar
  4. 4.
    Chavany G-A, Guiot G, Poloukhine P: Sur certaines formes mortelles d’hémorragie ménigée de cause anévrysmale. La forme hypothalamique. Le rôle du spasme carotidien artériographiquement décelable et l’utilité diagnostique de la ponction lombaire tardive. Presse Med 60: 1803–1805, 1952Google Scholar
  5. 5.
    Collier J, Adie WJ: Cerebral vascular lesions. In Price FW (ed.): A Textbook of the Practice of Medicine. London, Henry Frowde and Hodder & Stoughton, 1922, pp. 1348–1365Google Scholar
  6. 6.
    Davis L, Davis RA: Intracranial aneurysms. In Davis L, Davis RA (eds.): Principles of Neurological Surgery. Philadelphia, Saunders, 1963, pp. 184–192Google Scholar
  7. 7.
    Dekaban A, McEachem D: Subarachnoid hemorrhage, intracerebral hemorrhage, and intracranial aneurysms. Arch Neurol Psychiat 67: 641–649, 1952Google Scholar
  8. 8.
    Dorland’s Illustrated Medical Dictionary, 25th ed. Philadelphia, Saunders, 1974Google Scholar
  9. 9.
    Dupont J-R, Van Wart CA, Kraintz L: The clearance of major components of whole blood from cerebrospinal fluid following simulated subarachnoid hemorrhage. J Neuropathol Exp Neurol 20: 450–455, 1961PubMedCrossRefGoogle Scholar
  10. 10.
    Fishman RA: Cerebrospinal fluid. In Baker AB (ed.): Clinical Neurology, Vol. 1, 2nd ed. New York, Harper & Row, 1962, pp. 350–388Google Scholar
  11. 11.
    Fox JL, Albin MS, Bader DCH, et al.: Microsurgical treatment of neurovascular disease. Neurosurgery 3: 285–337, 1978PubMedCrossRefGoogle Scholar
  12. 12.
    Froin G: Les Hémorragies Sous-Arachnoidiennes et le Mécanisme de PHématolyse en général. Paris, Steinheil, 1904Google Scholar
  13. 13.
    Froman C, Smith AC: Hyperventilation associated with low pH of cerebrospinal fluid after intracranial haemorrhage. Lancet 1: 780–782, 1966PubMedCrossRefGoogle Scholar
  14. 14.
    Froman C, Smith AC: Metabolic acidosis of the cerebrospinal fluid associated with subarachnoid haemorrhage. Lancet 1: 965–967, 1967PubMedCrossRefGoogle Scholar
  15. 15.
    Fujishima M, Sugi T, Choki J, et al.: Cerebrospinal fluid and arterial lactate, pyruvate and acid- base balance in patients with intracranial hemorrhages. Stroke 6: 707–714, 1975PubMedCrossRefGoogle Scholar
  16. 16.
    Granholm L: The effect of blood in the CSF on the CSF lactate, pyruvate and bicarbonate concentrations. Scand J Clin Lab Invest 23: 361–366, 1969PubMedCrossRefGoogle Scholar
  17. 17.
    Greenblatt SH: Cerebrospinal fluid creatine phosphokinase in acute subarachnoid hemorrhage. J Neurosurg 44: 50–54, 1976PubMedCrossRefGoogle Scholar
  18. 18.
    Greenfield JG, Carmichael EA: The Cerebrospinal Fluid in Clinical Diagnosis. London, Macmillan & Co, 1925, pp. 50–52Google Scholar
  19. 19.
    Grubb RL, Raichle ME, Eichling JO, et al.: Effects of subarachnoid hemorrhage on cerebral blood volume, blood flow, and oxygen utilization in humans. J Neurosurg 46: 446–453, 1977PubMedCrossRefGoogle Scholar
  20. 20.
    Hamby WB: Intracranial Aneurysms. Springfield, 111., Charles C Thomas, 1952Google Scholar
  21. 21.
    Hamby WB: Remarks concerning intracranial aneurysm surgery. Clin Neurosurg 17: 1–17, 1970PubMedGoogle Scholar
  22. 22.
    Heidrich R: Subarachnoid haemorrhage. In Vinken PJ, Bruyn GW: Handbook of Clinical Neurology, Vol 12. Vascular Diseases of the Nervous System, Part II. Amsterdam, North Holland, 1972, pp. 68–204Google Scholar
  23. 22a.
    Inaba Y, Umeo I: Cerebrospinal fluid cytology after subarachnoid hemorrhage. J Neurosurg 51: 352–354, 1979PubMedCrossRefGoogle Scholar
  24. 23.
    Jackson IJ: Aseptic hemogenic meningitis. An experimental study of aseptic meningeal reactions due to blood and its breakdown products. Arch Neurol Psychiat 62: 572–589, 1949PubMedGoogle Scholar
  25. 24.
    Kennady JC: Investigations of the early fate and removal of subarachnoid blood. Pacif Med Surg 75: 163–168, 1967Google Scholar
  26. 25.
    Kronholm V, Lintrup J: Spectropho tome trie investigations of the cerebrospinal fluid in near-ultraviolet region. A possible diagnostic aid in diseases of the central nervous system. Acta Psychiat Scand 35: 314–329, 1960PubMedCrossRefGoogle Scholar
  27. 26.
    Lindsay JSB: Some observations on spontaneous subarachnoid haemorrhage. NZ Med J 49: 722–731, 1950Google Scholar
  28. 27.
    Madonick MJ, Savitsky N: Spinal fluid sugar in subarachnoid hemorrhage. J Nerv Ment Dis 108: 45–53, 1948PubMedCrossRefGoogle Scholar
  29. 28.
    Matthews WF, Frommeyer WB Jr. The in vitro behavior of erythrocytes in human cerebrospinal fluid. J Lab Clin Med 45: 508–515, 1955PubMedGoogle Scholar
  30. 29.
    McMenemey WH: The significance of subarachnoid bleeding. Proc Roy Soc Med 47: 701–704, 1954PubMedGoogle Scholar
  31. 30.
    Merritt HH, Fremont-Smith F: The Cerebrospinal Fluid. Philadelphia, Saunders, 1937, pp. 197–208Google Scholar
  32. 31.
    Milian G, Chiray: Méningite à pneumocoques. Xanthochromic du liquide céphalo-rachidien. Bull Soc Anat Paris 4: 550–552, 1902Google Scholar
  33. 32.
    Ohler WR, Hurwitz D: Spontaneous subarachnoid hemorrhage. JAMA 98: 1856–1861, 1932CrossRefGoogle Scholar
  34. 33.
    Patten BM: How much blood makes the cerebrospinal fluid bloody? JAMA 206: 378, 1968PubMedCrossRefGoogle Scholar
  35. 34.
    Quincke H: Die Lumbalpunction des Hydrocephalus. Berl Klin Wochenschr 28: 929–933, 1891Google Scholar
  36. 34a.
    Quincke H: Zur Physiologie der Cerebrospinalfliissigkeit. Arch Anat Physiol pp. 153–177, 1872Google Scholar
  37. 35.
    Richardson JC, Hyland HH: Intracranial aneurysms. A clinical and pathological study of subarachnoid and intracerebral hemorrhage caused by berry aneurysms. Medicine 20: 1–83, 1941CrossRefGoogle Scholar
  38. 36.
    Roost KT, Pimstone NR, Diamond I, et al.: Formation of cerebrospinal fluid xanthochromia after subarachnoid hemorrhage. Enzymatic conversion of hemoglobin to bilirubin by the arachnoid and choroid plexus. Neurology 22: 973–977, 1972PubMedGoogle Scholar
  39. 37.
    Rothenberg SF, Penka EJ, Garrity RW: A new isotope method for detecting continued or recurrent bleeding after subarachnoid hemorrhage. J Neurosurg 5: 215–222, 1958Google Scholar
  40. 38.
    Sambrook MA, Hutchinson EC, Aber GM: Metabolic studies in subarachnoid haemorrhage and strokes. II. Serial changes in cerebrospinal fluid and plasma area electrolytes and osmolality. Brain 96: 191–202, 1973PubMedCrossRefGoogle Scholar
  41. 39.
    Shannon DC, Shone N, Kazemi H: Acid-base balance in hemorrhagic cerebrospinal fluid. Neurology 22: 585–589, 1972PubMedGoogle Scholar
  42. 40.
    Sicard J-A: Chromodiagnostic du liquide céphalo-rachidien dans les hémorragies du névraxe. Valeur de la teinte jaunatre. CR Soc Biol 53: 1050–1053, 1901Google Scholar
  43. 41.
    Simmonds WJ: The absorption of blood from cerebrospinal fluid in animals. Aust J Exp Biol Med Sci 30: 261–270, 1952PubMedCrossRefGoogle Scholar
  44. 42.
    Simmonds WJ: The absorption of labelled erythrocytes from the subarachnoid space in rabbits. Aust J Exp Biol Med Sci 31: 77–83, 1953PubMedCrossRefGoogle Scholar
  45. 43.
    Simmonds WJ: The subarachnoid space: some experimental approaches to its pathology. Med J Aust 2: 452–456, 1953PubMedGoogle Scholar
  46. 44.
    Stehbens WH: Pathology of the Cerebral Blood Vessels. St. Louis, Mosby, 1972Google Scholar
  47. 45.
    Sugi T, Fujishima M, Omae T: Lactate and pyruvate concentrations, and acid-base balance of cerebrospinal fluid in experimentally induced intracerebral and subarachnoid hemorrhage in dogs. Stroke 6: 715–719, 1975PubMedCrossRefGoogle Scholar
  48. 46.
    Symonds CP: Spontaneous subarachnoid haemorrhage. Q J Med 18: 93–122, 1924–1925Google Scholar
  49. 47.
    Toole JF, Patel AN: Cerebrovascular Disorders, 2nd ed. New York, McGraw-Hill, 1974, pp. 280–313Google Scholar
  50. 48.
    Tourtellotte WW, Metz LN, Bryan ER, et al.: Spontaneous subarachnoid hemorrhage. Factors affecting the cerebrospinal fluid. Neurology 14: 301–306, 1964PubMedGoogle Scholar
  51. 49.
    Tourtellotte WW, Simpson JF, Metz LN, et al.: Intracranial hemorrhage and cerebrospinal fluid. In Fields WS, Sahs Al (eds.): Intracranial Aneurysms and Subarachnoid Hemorrhage. Springfield, 111., Charles C Thomas, 1965, pp. 85–93Google Scholar
  52. 50.
    Tourtellotte WW, Somers JF, Parker JA, et al.: A study on traumatic lumbar punctures. Neurology 8: 129–134, 1958PubMedGoogle Scholar
  53. 51.
    Troost BT, Walker JE, Cherington M: Hypoglycorrhachia associated with subarachnoid hemorrhage. Arch Neurol 19: 438–442, 1968PubMedCrossRefGoogle Scholar
  54. 52.
    Van Der Meulen JP: Cerebrospinal fluid xanthochromia: an objective index. Neurology 16: 170–178, 1966Google Scholar
  55. 53.
    Walton JN: Subarachnoid Haemorrhage. Edinburgh, Livingstone, 1956Google Scholar
  56. 54.
    Wolintz AH, Jacobs LD, Christoff N: Serum and cerebrospinal fluid enzymes in cerebrovascular disease. Creatine Phosphokinase, aldolase, and lactic dehydrogenase. Arch Neurol 20: 54–61, 1969PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1983

Authors and Affiliations

  • John L. Fox
    • 1
  1. 1.Medical Center School of MedicineWest Virginia UniversityMorgantownUSA

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