Body position and cerebrospinal fluid pressure

Changes in body position cause pressure changes in the fluid spaces of the body. The postural pressure changes in the cerebrospinal fluid (CSF) space have been the subject of numerous clinical investigations from the beginning of this century. An important early finding was that in any position of the body, the level of CSF in manometers connected to lumbar, cisternal, and ventricular needles was the same (for references, see Masserman25). This means that when there is no block in the course of the CSF pathways, the craniospinal system acts as a continuous fluid medium (Fig. 1). This is also the case in patients with medium-pressure CSF shunts,23 so apparently the drainage of CSF in such patients does not cause collapse and block of any part of the CSF space. Thus, in the craniospinal system, the pressure is equal at all points in a horizontal plane, and the difference in pressure between two different horizontal planes equals the weight of the corresponding vertical column of CSF. If the pressure is measured at one level in the system, the pressure at all other horizontal planes can be calculated. In other words, Pascal’s laws are valid for the craniospinal system.

[1]  H. Nornes,et al.  Long‐Term Clinical Recording of Static and Dynamic Intra‐Arterial Blood Pressure , 1974, Acta anaesthesiologica Scandinavica.

[2]  E. Carmichael,et al.  FACTORS PRODUCING LUMBAR CEREBROSPINAL FLUID PRESSURE IN MAN IN THE ERECT POSTURE , 1937 .

[3]  A. Yamaura,et al.  Neurological deficits in the presence of the sinking skin flap following decompressive craniectomy. , 1977, Neurologia medico-chirurgica.

[4]  J. Lamorgese,et al.  Complication of a large cranial defect. Case report. , 1976, Journal of neurosurgery.

[5]  D. Potts,et al.  Effect of positional changes and jugular vein compression on the pressure gradient across the arachnoid villi and granulations of the dog. , 1973, Journal of neurosurgery.

[6]  J. Usubiaga,et al.  AND ITS RELATION TO SPREAD OF ANESTHETIC SOLUTIONS IN EPIDURAL SPACE , 1967, Anesthesia and analgesia.

[7]  N. Kassell,et al.  TRANSMISSION OF INCREASED INTRACRANIAL PRESSURE. I. WITHIN THE CRANIOSPINAL AXIS. , 1964, Journal of neurosurgery.

[8]  F. Giron,et al.  Gravitational effects of blood flow to the atherosclerotic lower extremity. , 1977, Journal of Surgical Research.

[9]  M. Critchley,et al.  Scientific foundations of neurology , 1972 .

[10]  J. E. Webster,et al.  Cinephotomicrography of the pial circulation; a study of factors influencing vascular caliber; preliminary report. , 1958, A.M.A. archives of neurology and psychiatry.

[11]  P. Stevens,et al.  Cardiovascular dynamics during orthostasis and the influence of intravascular instrumentation. , 1966, The American journal of cardiology.

[12]  N. Lundberg,et al.  Continuous recording and control of ventricular fluid pressure in neurosurgical practice. , 1962, Acta psychiatrica Scandinavica. Supplementum.

[13]  D. Briggs,et al.  Handbook of Physiology, Section 2, Circulation , 1964 .

[14]  E. Frost.  Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients. , 1977, Journal of neurosurgery.

[15]  H. Cserr.  Physiology of the choroid plexus. , 1971, Physiological reviews.

[16]  T. Langfitt,et al.  Cerebral vasomotor paralysis produced by intracranial hypertension , 1965, Neurology.

[17]  Observations in Intracranial Pressure Plateau Waves , 1975 .

[18]  M. Brock,et al.  Intracranial Pressure II , 1975, Springer Berlin Heidelberg.

[19]  H. P. Pieper,et al.  Dynamic pressure-flow relationships of brain blood flow in the monkey. , 1974, Journal of neurosurgery.

[20]  B Williams,et al.  Cerebrospinal fluid pressure changes in response to coughing. , 1976, Brain : a journal of neurology.

[21]  R. Cooper,et al.  The Effects of Head Position and Jugular Vein Compression (JVC) on Intracranial Pressure (ICP). A Clinical Study , 1976 .

[22]  J. Löfgren,et al.  CRANIAL AND SPINAL COMPONENTS OF THE CEREBROSPINAL FLUID PRESSURE‐VOLUME CURVE , 1973, Acta neurologica Scandinavica.

[23]  J. Masserman.  CEREBROSPINAL HYDRODYNAMICS: IV. CLINICAL EXPERIMENTAL STUDIES , 1934 .

[24]  K C Bradley,et al.  Cerebrospinal fluid pressure1 , 1970, Journal of neurology, neurosurgery, and psychiatry.

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

[26]  A. Myerson,et al.  EFFECTS OF ALTERATIONS IN POSTURE ON THE CEREBROSPINAL FLUID PRESSURE , 1935 .

[27]  T. Langfitt.  Increased intracranial pressure. , 1969, Clinical neurosurgery.

[28]  A. Sances,et al.  Herniated cerebellar tonsils and cough syncope. , 1974, Journal of neurosurgery.

[29]  B. Rn.  Part 1: Clinical studies on the effect of rapid postural changes , 1976 .

[30]  Rapela Ce,et al.  AUTOREGULATION OF CANINE CEREBRAL BLOOD FLOW. , 1964 .

[31]  L. B. Flexner,et al.  THE EFFECT OF DISLOCATION OF CEREBROSPINAL FLUID UPON ITS PRESSURE , 1932 .

[32]  H. Lidvall,et al.  ELECTROMANOMETRIC RECORDING OF CEREBRO‐SPINAL FLUID BLOCKS IN THE CERVICAL REGION , 1965, Acta neurologica Scandinavica. Supplementum.

[33]  R. Green,et al.  Effect of cerebrospinal fluid shunts on intracranial pressure and on cerebrospinal fluid dynamics , 1973, Journal of neurology, neurosurgery, and psychiatry.

[34]  L. H. Weed,et al.  THE HYDROSTATIC FACTOR IN VENOUS PRESSURE MEASUREMENTS , 1934 .

[35]  Pawl Rp.  Headache, cervical spondylosis, and anterior cervical fusion. , 1977 .

[36]  P. Perot,et al.  Dynamic changes of cerebrospinal fluid in upright and recumbent shunted experimental animals. , 1975, Child's brain.

[37]  B Magnaes,et al.  Body position and cerebrospinal fluid pressure. Part 2: clinical studies on orthostatic pressure and the hydrostatic indifferent point. , 1976, Journal of neurosurgery.

[38]  M. Brock,et al.  Intracranial Pressure III , 1976, Springer Berlin Heidelberg.

[39]  W. Hunt,et al.  Surgical risk as related to time of intervention in the repair of intracranial aneurysms. , 1968, Journal of neurosurgery.

[40]  S. Sherriff,et al.  The Effects of Position, State of Consciousness and Drugs on Cerebrospinal Fluid Absorption, Estimated by I125 Hippuran Resorption , 1972, Developmental medicine and child neurology. Supplement.

[41]  H. Portnoy,et al.  Anti-siphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematomas. , 1973, Journal of neurosurgery.

[42]  D. Ingvar,et al.  Regional cerebral blood volume during acute transient rises of the intracranial pressure (plateau waves). , 1969, Journal of neurosurgery.

[43]  H. Nornes,et al.  Supratentorial epidural pressure recorded during posterior fossa surgery. , 1971, Journal of neurosurgery.

[44]  M. Fog.  CEREBRAL CIRCULATION: THE REACTION OF THE PIAL ARTERIES TO A FALL IN BLOOD PRESSURE , 1937 .

[45]  S. Mullan,et al.  Respiratory hazards of the surgical treatment of the Arnold-Chiari malformation. , 1962, Journal of neurosurgery.

[46]  B Magnaes,et al.  Body position and cerebrospinal fluid pressure. Part 1: clinical studies on the effect of rapid postural changes. , 1976, Journal of neurosurgery.