The Influence of Pulse and Respiration on Spinal Cerebrospinal Fluid Pulsation

Rationale and Objectives:The aim of the study is to elucidate the location and amount of spinal cerebrospinal fluid pulsations and to differentiate and quantify the cardiac and the respiratory influence. Materials and Methods:An echo planar imaging sequence was applied to 5 different levels of the spinal canal of 7 healthy volunteers. The amount of maximal flow and respiratory signal variation were determined by a time and frequency domain analysis, respectively. Results:CSF pulsation was high in the anterior cervical and in the thoracolumbar spine. Respiratory influence rose by 19% at C1 and by 28% at T12. The systolic flow was elevated during late expiration and the diastolic upward movement was pronounced by early expiration. Conclusion:The pulsation in the lower spine seems to be related to a second motor of CSF movement because there is a rising respiratory influence and a reappearance of pulsation waves. Physiological spinal CSF pulsation contains a relevant respiratory component.

[1]  U Klose,et al.  Improvement of the acquisition of a large amount of MR images on a conventional whole body system. , 1999, Magnetic resonance imaging.

[2]  K. Urayama,et al.  Origin of lumbar cerebrospinal fluid pulse wave. , 1994, Spine.

[3]  J. O'connell,et al.  THE VASCULAR FACTOR TN INTRACRANIAL PRESSURE AND THE MAINTENANCE OF THE CEREBROSPINAL FLUID CIRCULATION , 1943 .

[4]  I. Idy-Peretti,et al.  Cerebrospinal Fluid Dynamics and Relation with Blood Flow: A Magnetic Resonance Study with Semiautomated Cerebrospinal Fluid Segmentation , 2001, Investigative radiology.

[5]  A. Blamire,et al.  Observation of cerebrospinal fluid flow with echo-planar magnetic resonance imaging. , 1991, The British journal of radiology.

[6]  A I Katz,et al.  Mechanics of Distension of Dog Veins and Other Very Thin‐Walled Tubular Structures , 1970, Circulation research.

[7]  W. Weyland,et al.  The influence of airway pressure changes on intracranial pressure (ICP) and the blood flow velocity in the middle cerebral artery (VMCA). , 2000, Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS.

[8]  J Bittoun,et al.  Origin of subarachnoid cerebrospinal fluid pulsations: a phase-contrast MR analysis. , 2000, Magnetic resonance imaging.

[9]  L. M. Levy MR imaging of cerebrospinal fluid flow and spinal cord motion in neurologic disorders of the spine. , 1999, Magnetic resonance imaging clinics of North America.

[10]  J. Shah Positive lumbar extradural space pressure. , 1994, British journal of anaesthesia.

[11]  D N Levin,et al.  Hemodynamically independent analysis of cerebrospinal fluid and brain motion observed with dynamic phase contrast MRI , 1996, Magnetic resonance in medicine.

[12]  G. Zannoli,et al.  Temporal and spatial assessment of normal cerebrospinal fluid dynamics with MR imaging. , 1993, Magnetic resonance imaging.

[13]  U. Klose,et al.  II. Physiology of respiration-related pulsations , 1992 .

[14]  G. H. du Boulay,et al.  Pulsatile movements in the CSF pathways. , 1966 .

[15]  I. Kricheff,et al.  Cerebrospinal fluid pulsations at myelography: a videodensitometric study. , 1974, Radiology.

[16]  G. du Boulay,et al.  Pulsatile movements in the CSF pathways. , 1966, The British journal of radiology.

[17]  Michael Erb,et al.  Intracranial oscillations of cerebrospinal fluid and blood flows: Analysis with magnetic resonance imaging , 2002, Journal of magnetic resonance imaging : JMRI.

[18]  Levy Lm MR imaging of cerebrospinal fluid flow and spinal cord motion in neurologic disorders of the spine. , 1999 .

[19]  D. Feinberg,et al.  Human brain motion and cerebrospinal fluid circulation demonstrated with MR velocity imaging. , 1987, Radiology.

[20]  N J Pelc,et al.  Cerebrospinal fluid flow measured by phase-contrast cine MR. , 1993, AJNR. American journal of neuroradiology.

[21]  D. Greitz,et al.  On the Pulsatile Nature of Intracranial and Spinal CSF-Circulation Demonstrated by MR Imaging , 1993, Acta radiologica.

[22]  U. Klose,et al.  Cerebrospinal fluid flow , 2004, Neuroradiology.

[23]  U Klose,et al.  Detection of a relation between respiration and CSF pulsation with an echoplanar technique , 2000, Journal of magnetic resonance imaging : JMRI.

[24]  J. Sackier,et al.  Decreased cerebrospinal fluid absorption during abdominal insufflation , 1999, Surgical Endoscopy.

[25]  S. Seyfert,et al.  Conditions of iodine contrast transfer from lumbosacral CSF to blood , 2003, Journal of the Neurological Sciences.

[26]  R. R. Lee,et al.  Dynamic Physiologic Changes in Lumbar CSF Volume Quantitatively Measured By Three-Dimensional Fast Spin-Echo MRI , 2001, Spine.

[27]  L Timmermann,et al.  Spontaneous oscillations of arterial blood pressure, cerebral and peripheral blood flow in healthy and comatose subjects. , 1999, Neurological research.