Cerebrospinal Fluid In Neurologic Disorders

Cerebrospinal Fluid in Neurologic Disorders, Volume 146 provides a brief overview on the current use of CSF in clinical routine, the physiology of CSF, and its usefulness and potential as a biomarker. The second part addresses the main purpose of the volume, describing CSF from a research perspective in context with the most important diagnostic entities in neurology. The book's authors provide insight into the current understanding of CSF changes in these various conditions and what it tells us about the nature of neurological diseases. Furthermore, methodological aspects are discussed, as are shortcomings that need to be addressed. Finally, the book provides an outlook for potential directions that can be explored to improve the various aspects of CSF research with the ultimate goal of being incorporated in clinical practice. Provides a brief overview on the current use of CSF in clinical routine, the physiology of CSF, and its usefulness and potential as a biomarker Addresses relevant research in context with the most important diagnostic entities in neurology Edited by leading authors in CSF research from around the globe, presenting the broadest, most expert coverage available

The cerebrospinal fluid (CSF) is an invaluable diagnostic tool in clinical neurology, not only in the evaluation of inflammatory, degenerative, and malignant diseases of the nervous system, but also in the diagnosis of all forms of cerebral and subarachnoidal bleedings. The CSF can be easily obtained by lumbar puncture and a set of basic analyses can be conducted using relatively simple laboratory methods. By combining different CSF parameters, a wide range of diagnostic entities can be identified. However, properly interpreting the test results requires a high level of expertise and cannot be achieved by just reporting on individual analytic values. This book covers essential aspects of cerebrospinal fluid analysis and its use in the diagnosis of common neurological diseases. The first part addresses preclinical aspects such as the history of CSF, as well as the anatomical, physiological, and biological background of this valuable fluid. In addition, CSF collection, its preanalytical and methodological implications, and the increasing number of disease-specific markers in CSF are discussed in detail. Lastly, CSF analyses are put into context with clinical syndromes, demonstrating their diagnostic value in neurological clinical practice. Cerebrospinal Fluid in Clinical Neurology helps readers understand the preanalytical and analytical aspects of CSF diagnostics and offers a valuable reference guide for interpreting CSF results during the clinical work-up for neurological patients.

Scientists have speculated as to the nature of cerebrospinal fluid (CSF) - "the third circulation" or "vital spirit" for centuries. Just what is this mysterious bathing solution of the central nervous system? Is it a vehicle of transport for an "animal spirit" directing all our activities, as thought by Galen (Singer, 1956) or but a "modified tap water" (Halliburton, 1917)? With the advent of lumbar puncture, cerebrospinal fluid has become a readily available and important means of studying disease affecting the nervous system. In recent years, many sophisticated tools including com puter guided gas chromatography/mass spectrometry and high performance liquid chromatography have made it possible to identify and quantify many constituents of this fluid. The CSF has an enormous, though largely "untapped", potential in aiding diagnosis and evaluating treatment of many neurological, psychiatric and systemic disorders. As the ependyma is only a diffusional barrier between the CSF and extracellular fluid of the brain for many compounds, changes in the concentration of these compounds in the CSF may reflect disease processes in the brain.

For centuries the great minds of medical science puzzled over the importance of the cerebrospinal fluid. As far back as Hippocrates, it was thought that this "phlegm" that flooded the intracranial contents had pathological significance. However, not until the late 1800s, when Quincke introduced and popularized lumbar puncture, did physicians take an interest in the study of this fluid in relation to clinical illness. Since then a variety of techniques for obtaining cerebrospinal fluid from various sites have developed, and the relationship of cerebrospinal fluid to a variety of disease processes has received considerable study. In this volume, we have attempted to assemble reviews of some of these important developments during the past century. Chapter 1 contains a historical review of key investigations that helped shape our concepts of cerebrospinal fluid from the earliest recorded description by the author of the Edwin Smith Surgical Papyrus in the seventeenth century B. C. to contemporaries such as Kabat, Glusman, and Knaub, who introduced quantitative determinations of cerebrospinal fluid gamma globulin levels. In Chapter 2 there is a description of our current understanding of the anatomical compartment for the cerebrospinal fluid and the physiology of its formation, circulation, and absorption. Dr. Richard Leech in Chapter 3 contributes a comprehensive description of the disorders associated with excessive quanti ties of cerebrospinal fluid-commonly referred to as hydrocephalus. A variety of techniques for properly collecting and evaluating cerebrospinal fluid are detailed in Chapter 4.

This comprehensive and authoritative text covers the anatomical and physiological aspects of cerebrospinal fluid. Also includes material on differential diagnosis, AIDS, neuro-oncology, psychiatric disorders, and the composition and clinical examination of cerebrospinal fluid, including a detailed discussion on the treatment of complications of the lumbar puncture.

Hydrocephalus is one of the most common diseases of pediatric and adult neurosurgery. With the introduction of modern neurosurgical procedures, this disease has become a life-long problem. Even with optimal treatment, there is still significant morbidity and mortality along with a significant cost to the medical system. This has caused patients and their families to demand improvements in treatments and forced clinicians to evaluate their treatments in large consortiums while utilizing both genetics and technology to improve outcomes or avoid placement of shunt all together. This text is designed to present the current treatments for hydrocephalus across the lifespan. The foundation for understanding cerebral spinal fluid (CSF) abnormalities begins with the understanding of physiology and pathogenesis of disease. These chapters are written by published experts in the field and detail the significant advances in the detection of CSF abnormalities. This section will discuss the current advances in imaging and current research in biomarkers for both pediatric and adult patients. We will then systematically discuss the treatment of both pediatric and adult CSF disorders. These will be broken down by cause, since the physiology of each can be different. We will end the book with a discussion both of the technological advances and a discussion of consortiums and how they have advanced treatment of this chronic disease.

Addressing the gap in the literature between pediatric medicine and geriatric medicine, Cerebrospinal Fluid Disorders examines the disorders of the cerebrospinal fluid (CSF) pathways from birth to old age. Highlights of the book include: Comprehensive content detailing CSF disorders and their effects on the brain and spine at all developmental stages Key updates to recent developments that physicians can utilize in their practice Clear organization with each section divided into background information, disease discussion, surgical aspects, controversies, and social issues—giving readers quick access to the most important information needed to properly diagnose and manage patients with CSF disorders Multidisciplinary content written by clinicians representing a host of specialties, making the book useful for not only neurologists, but also those in related specialties involved in treating CSF disorders, including neurosurgery, pediatrics, general practice, ophthalmology, radiology, and emergency medicine Expert patient communication tips to help practitioners deliver information to patients and their caregivers on highly sensitive issues, such as alternative treatments, quality-of-life issues, and medico-legal aspects More than 400 illustrations to clarify content Exploring the management of the resultant effects of such disorders on both the brain and spine throughout the body’s changes in development, the book is written by more than 50 global experts in neurology and related disciplines. Their combined wisdom offers the most effective diagnostic and management guidelines for treating patients with CSF disorders.

Physiologic compartmentalization effectively isolates the central nervous system from the rest of the body. This isolation not only provides protection of its delicate function from aberrant peripheral influences but also impedes its diagnostic evaluation. Cerebro spinal fluid (CSF) bathes the brain and spinal cord, is in dynamic equilibrium with its extracellular fluid, and tends to reflect the state of health and activity of the central nervous system. CSF examination is the most direct and popular method of assessing the central chemical and cellular environment in the living patient or mammal. The purpose of this multidisciplined reference text is to provide the sophisticated knowledge of CSF physiology and pathology necessary for the meaningful interpretation of data obtained by various types of CSF analysis. The methodology for reliable CSF collection, storage, preparation, and analysis is discussed with respect to individual, somatotropic, chronologic, endorcinologic, pharmacologic, and possible artifactual var iations in CSF composition. These essential aspects, which ensure the validity of CSF data, are presented to aid the investigator in clinical and experimental protocol formu lation and in elimination of possible sources of error.