Summary
Cranial CSF volumes, for the first time including CSF in the subarachnoid space, can be measured by Magnetic Resonance Imaging (MRI). The MRI sequence causes signal from the grey matter and white matter to cancel producing a contrast of 200: 1 between a unit of CSF and a unit of brain. We have assessed the variations between normal individuals and investigated some of the physiological factors that might influence cranial CSF volumes.
Total CSF volumes were measured in 64 normal subjects, aged from 18–64 years (mean 38 years). Ventricular, cortical sulcal and posterior fossa volumes were also calculated separately. In 20 females with a normal menstrual cycle, CSF volumes were measured mid cycle and premenstrually; 10 post menopausal females and 10 males were rescanned after an interval of 2 weeks. Total cranial CSF volume were calculated before and during inhalation of 7% CO2 and before and during hyperventilation while breathing 60% O2, in 12 normal subjects.
Total intracranial CSF volume ranged from 57.1–286.5 ml. Total intracranial and cortical sulcal CSF volumes increased more steeply with age than ventricular or posterior fossa CSF volumes. Males had more cranial CSF than females. Total CSF volume increased premenstrually in 19 females. Males and post-menopausal females did not have a significant change in CSF volume, on repeat examination. CO2 inhalation produced a mean increase of paCO2 of 17.2mmHg and CSF volume decreased in all subjects (mean 9.4 ml). Cranial CSF volume increased in 11 subjects during O2 inhalation (range -0.5 to + 26.7 ml mean 10.9 ml).
These observations show that total cranial CSF volume increases with age mainly due to an increase in cortical CSF volume. Significant changes occur during the menstrual cycle. The changes with 7% CO2 and 60% O2 inhalation are in keeping with the modified MonroKellie hypothesis and probably reflect reciprocal changes in cerebral blood volume and cerebro-spinal fluid volume. MRI measurements of cranial CSF volume are likely to increase knowledge and advance management of many intracranial disorders.
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Teasdale, G.M. et al. (1988). Intracranial CSF Volumes: Natural Variations and Physiological Changes Measured by MRI. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_45
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DOI: https://doi.org/10.1007/978-3-7091-8975-7_45
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