Acta Neurochirurgica

, Volume 58, Issue 3–4, pp 167–185 | Cite as

Simultaneous cerebral and spinal fluid pressure recordings

I. Technique, physiology, and normal results
  • B. Williams


Cerebrospinal fluid pulsation is likely to be responsible for the progression of some diseases, and it is differences in pressure which are significant in causing the imposition of energy upon tissues. The normal range of such differences has not been extensively documented. A technique for measuring intracranial and intraspinal pressures simultaneously in erect conscious patients is described. Normally the pressures are in a continual state of pulsation in response to changes in pressure in the arteries and veins. The measurements of CSF pressure fluctuations in response to normal cardiac pulsation, respiratory changes, coughing, Queckenstedt's test, and a variation of Valsalva's manoeuvre have been recorded, and the physiology has been discussed.


Cerebrospinal fluid intracranial pressure Valsalva's manoeuvre Queckenstedt's test 


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  1. Bedford, T. H. B., The effects of increased intracranial venous pressure on the cerebrospinal fluid. Brain58 (1935), 427–447.Google Scholar
  2. Bering, E. A., Bering J. R., Choroid plexus as a CSF pump. Arch. Neurol. Psychiat. (Chic.)75 (1955), 165–172.Google Scholar
  3. Brock, M., Dietz, H., Intracranial pressure. Berlin-Heidelberg-New York: Springer. 1972.Google Scholar
  4. Dardenne, G., Dereymaeker, A., Lacheron, J. M., Cerebrospinal fluid pressure and pulsatility. Europ. Neurol.2 (1969), 193–216.PubMedGoogle Scholar
  5. Davis, P. R., Troup, J. D. G., Pressures in the trunk cavities when pulling, pushing and lifting. Ergonomics7 (1964), 465–474.Google Scholar
  6. Dereymaeker, A., Stevens, A., Rombouts, J. J., Lacheron, J. M., Pierquin, A., Study of the influence of the arterial pressure upon the morphology of cisternal CSF pulsation. Europ. Neurol.5 (1971), 107–114.PubMedGoogle Scholar
  7. Du Boulay, G., Pulsatile movements in the CSF pathways. Brit. J. Radiol.39 (1966), 255–262.PubMedGoogle Scholar
  8. —, Specialisation broadens the view. The significance of a CSF pulse. Second Glyn Evans Memorial Lecture. Clin. Radiol.23 (1972), 401–409.PubMedGoogle Scholar
  9. Dunbar, H. S., Guthrie, T. C., Karpell, B., A study of the cerebrospinal fluid pulse wave. Arch. Neurol. (Chic.)14 (1966), 624–630.Google Scholar
  10. Gardner, W. J., The Tobey-Queckenstedt test in the localisation of tumour of the cerebello-pontine angle. Arch. Neurol. Psychiat. (Chic.)20 (1928), 585–588.Google Scholar
  11. —, Cerebrospinal fluid dynamics. In: Medical physics (Glaser, O., ed.), pp. 148–152. Chicago: Year Book Co. 1945.Google Scholar
  12. —, The dysraphic states from syringomyelia to anencephaly. Amsterdam: Excerpta Medica. 1973.Google Scholar
  13. Gilland, O., CSF dynamic diagnosis of spinal block. Stockholm: Almqvist & Wiksell. 1966.Google Scholar
  14. Hamer, J., Alberti, E., Hoyer, S., Wiedemann, K., Influence of systemic and cerebral vascular factors on the cerebrospinal fluid pulse waves. J. Neurosurg.46 (1977), 36–45.PubMedGoogle Scholar
  15. Hamit, H. F., Beal, A. C., DeBakey, M. E., Haemodynamic influences upon brain and CSF pulsations and pressures. J. Trauma5 (1965), 174–184.Google Scholar
  16. Henriques, C. Q., The veins of the vertebral column and their role in the spread of cancer. Ann. roy. Coll. Surg. Engl.31 (1962), 1–22.Google Scholar
  17. Jackson, J. R., Williams, B., Errors in velocity measurement by the Pitot principle in fluids with slowly propagated pressure waves. J. Biomed. Eng.1 (1978), 50–54.Google Scholar
  18. Kaufmann, G. E., Clark, K., Emergency frontal twist drill ventriculostomy. J. Neurosurg.33 (1970), 226–227.PubMedGoogle Scholar
  19. Laitinen, L., Origin of the arterial pulsation of cerebrospinal fluid. Acta neurol. (scand.)44 (1968), 168–176.Google Scholar
  20. Lakke, J. P. W. F., Queckenstedt's test. Amsterdam: Excerpta Medica. 1969.Google Scholar
  21. Lockey, P., Poots, G., Williams, B., Theoretical aspects of the attenuation of pressure pulses within the CSF pathways. Med. biol. Eng.14 (1975), 861–869.Google Scholar
  22. Magnaes, B., Body position and cerebrospinal pressure. 2. Clinical studies on orthostatic pressure and the hydrostatic indifferent point. J. Neurosurg.44 (1976), 698–705.PubMedGoogle Scholar
  23. O'Connell, J. E. A., Cerebrospinal fluid mechanics. Proc. roy. Soc. Med.63 (1970), 507–518.PubMedGoogle Scholar
  24. Ponssen, H., Van den Bos, G., Influence of the circulation on the CSF pressure waves. J. Neurol. Neurosurg. Psychiat.34 (1971), 108.Google Scholar
  25. Prytherch, D. R., Smith, M. J. A., Williams, B., The measurement of cerebrospinal fluid flow. Phys. Med. Biol.24 (1979), 1196–1208.PubMedGoogle Scholar
  26. — — Thursfield, C. D., Williams, B., A flow probe for cerebrospinal fluid. In preparation (1981).Google Scholar
  27. Queckenstedt, H. H. G., Zur Diagnose der Rückenmarkscompression. Dtsch. Z. Nervenheilk.25 (1916), 325–333.Google Scholar
  28. Quincke, H., Die Lumbalpunction des Hydrocephalus. Berl. klin. Wschr.28 (1891), 929–965.Google Scholar
  29. Reitan, H., On movements of fluid inside the cerebrospinal space. Acta radiol. (Stockh.)22 (1941), 762–779.Google Scholar
  30. Sibayan, R. Q., Begeman, P. C., King, A. I., Gurdjian, E. S., Thomas, E. M., Experimental hydrocephalus. Ventricular cerebrospinal fluid pressure and waveform studies. Arch. Neurol. (Chic.)23 (1970), 165–172.Google Scholar
  31. Williams, B., Cerebrospinal fluid pressure changes in response to coughing. Brain99 (1976), 331–346.PubMedGoogle Scholar
  32. Wilson, C. B., Bertan, V., Interruption of the anterior choroidal artery in experimental hydrocephalus. Arch. Neurol. (Chic.)17 (1967), 614–619.Google Scholar
  33. Wynter, W. E., Four cases of tubercular meningitis in which paracentesis of the theca vertebralis was performed for the relief of fluid pressure. Lancet1 (1891), 981–982.Google Scholar
  34. Zierski, J., Personal communication (1975).Google Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • B. Williams
    • 1
  1. 1.Midland Centre for Neurosurgery and NeurologyWarleyEngland

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