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Alteration of the intra cranial pressure volume relationship following the bolus cerebro spinal fluid manipulation test by various basic intra cranial pressure levels



Alteration of the intra cranial pressure volume relationship following the bolus cerebro spinal fluid manipulation test by various basic intra cranial pressure levels



Nichidai Igaku Zasshi 41(6): 617-636



The pressure-volume index (PVI), compliance (Co), CSF outflow resistance (Ro), formation rate of CSF (Iform) and T1/2 [half-life] value were measured in [dogs in] states of various grades of induced intracranial hypertension, in order to assess the interrelationshp between the cranial cavity and its contents consisting of brain tissue, cerebral blood volume and CSF. To check the physiological significance of these indices, simliar experiments were performed in non-treated, intrinsic monoamine nerve denervated, and cardiac arrest animals. The Co by the bolus manipulation test was equal to the real intracranial compliance. The elastance (E) calculated from PVI did not always indicate the real intracranial compliance. The PVI was directly reflected in the cerebral blood circulation and indicated a critical point at 60 mmHg of basic intracranial pressure when autoregulation of the intracranial vessels could be detected with increased PVI. In the low elastic phase, the values of Ro and Iform reflected the real condition of the CSF circulation system, but in the high elastic phase with increased PVI, the values of Ro and Iform did not reflect the real CSF circulation system. The T1/2 value which was constant at various levels of intracranial pressure formed a useful index representing such factors of the total intracranial environment as indicate the relationship with V/P. Results calculated from the injection method and the withdrawal method did not always have the same value because of the different bolus CSF manipulation method. Information yielded by the bolus CSF manipulation test provides very hopeful indices for the clinical application, but the limits in the high elastic phase must be borne in mind.

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