Cerebrospinal fluid

Cerebrospinal fluid (synonym cerebrospinal fluid) - liquid medium nervous system, circulating in the subarachnoid space of the brain and spinal cord and in the brain ventricles. In education spinal fluid participate mainly vascular plexus brain (see). The cerebrospinal fluid is continually produced and absorbed, update it happens in a matter of one or several days. A large part of the cerebrospinal fluid circulates in the side, third and fourth ventricles of the brain, and minority in the subarachnoid space. The normal circulation of cerebrospinal fluid is provided by the movements of the head, body, legs, breathing exercises, brain activity.
Cerebrospinal fluid of the lateral ventricles comes through interventricular (monrovi) holes in the third ventricle, through which the brain (selview) water supply is reported with the fourth ventricle. From last through the middle hole (Magandi) and hole (Luchki) cerebrospinal fluid takes place in the rear tank, where is distributed for tanks bases and convex surface of the brain, and subarachnoid space of the spinal cord.
Normal cerebrospinal fluid colorless and transparent. The number ranges from 15 to 20 ml in neonates and 100 - 150 ml in adults. The share of the cerebrospinal fluid is 1006-1012, the reaction alkalescent (pH equal to 7.4 and 7.6). Cerebrospinal fluid consists of water part and dry residue, which includes organic and inorganic substances. The amount of protein in the cerebrospinal fluid ranges from 12 to 43 mg%. Protein is composed of albumins and globulins. Total nitrogen 16-22 mg%, residual nitrogen 12-28 mg%; in children, 17 - 26 mg%. Sugar is 40-70 mg%. Chlorides 680-720 mg%. Detected small amounts of lipids, amino acids, microelements and other substances. In the cerebrospinal fluid in a small number contains cells (lymphocytes, there are plasma cells, monocytes). In adults, 1 mm3 cerebrospinal fluid has 1-5 cells; newborns - 20-25 cells in 1 mm3, to one year the number of cells is reduced to 12-15 cells in 1 mm3.
The pressure of the spinal fluid of a person in norm at a lumbar puncture (see) in the horizontal position is 100-150 mm waters. Art. and increases in a vertical position, up to 200-250 mm waters. Art. the Pressure in the cavity of the skull cerebrospinal fluid and brain determines intracranial pressure. Increased intracranial pressure, occurring due to the increased production of cerebrospinal fluid or violation of its outflow, leads to hypertensive syndrome, the main signs of which are headache, vomiting, dizziness, congestive nipples optic nerves, change craniogram.
In various pathological processes (tumors, inflammatory foci) may be a violation of patency of the subarachnoid space. To study the patency of the subarachnoid space used liquorodynamics samples of Queckenstedt and Stokey. When the sample of Queckenstedt during the puncture for a few seconds jam on the jugular vein, the pressure of the cerebrospinal fluid is noticeable - test negative. When violation of the cross above the place puncture pressure does not rise - test positive. Trial of Stockea: during the puncture squeeze in a few seconds the abdominal veins - the pressure of the cerebrospinal fluid is increased approximately in 2 times - test negative. If there is a blockade of the subarachnoid space in nizhnegorodsky, lumbar regions of the spinal cord, the pressure increases - test positive.
Intracranial pressure is increased in inflammatory diseases of the brain and spinal cord and its membranes, and at volume processes. At various diseases of the nervous system changes the composition and properties of spinal fluid. In some cases, may feel a predominant increase in the number of cells or proteins. Cell protein dissociation is a considerable increase in the number of cells with the same or moderately elevated levels of the protein occurs in introducing and serous meningitis; for purulent meningitis is characterized neutrophilic Placitas, for sero - lymphocytic or mixed with a predominance of the number of lymphocytes. Protein cellular dissociation - more protein at normal or slightly increased the number of cells occurs by tumors of the brain abscesses, cystic arachnoiditis.
As cerebrospinal fluid are used qualitative reaction on globulins, they will judge the increased content of protein substances: reaction Nonna - apelt reaction and the reaction Pandi. Reaction Nonna - apelt reaction carried out as follows: 0.5 ml of cerebrospinal fluid is mixed with 0.5 ml Polynesians solution of ammonium sulfate and depending on the content in the spinal fluid globulin change the transparency of a liquid. If the reaction Pandi on a watch glass pour 10% solution of carbolic acid from it receives one or a few drops of cerebrospinal fluid. As a result, the liquid becomes cloudy. Depending on the dimness these reactions are evaluated as subprograma (+)positive (+ + )clearly positive (+ + + ) and strongly positive (+ + + + ). In some infectious diseases in the spinal fluid antibodies are determined using the specific reactions, for example reactions Wasserman and Kahn (syphilis), reaction Wright (brucellosis) and other essential bacteriological and virologic testing of cerebrospinal fluid to identify various microbes, the tubercle Bacillus, viruses.