It is generally assumed that cerebrospinal fluid (CSF) is secreted in the brain ventricles, and so that after an acute blockage of the aqueduct of Sylvius an increase in the ventricular CSF pressure and dilatation of isolated ventricles may be expected. We have tested this hypothesis in cats after blocking the acqueduct, we measured the CSF pressure in both isolated ventricles and the cisterna magna and performed radiographic monitoring of the cross-sectional area of the lateral ventricle. The complete acqueductal blockage was achieved by implanting a plastic cannula into the aqueduct of Sylvius through a small tunnel in the vermis of the cerebellum in the chloralose anesthetized cats. After the reconstitution of the occipital bone, the CSF pressure was measured in the isolated ventricles via a plastic cannula implanted in the aqueduct of Sylvius and in the cisterna magna via a stainless steel cannula. During the following two hours the CSF pressures in the isolated ventricles and cisterna magna were identical to those in control conditions. We also monitored the ventricular cross-sectional are by means of radiography for two hours after the acqueductal blockage and failed to observe any significant changes. When mock CSF was infused into isolated ventricles to imitate the CSF secretion, the gradient of pressure between the ventricle and cisterna magna developed and disappeared as soon as the infusion was terminated. However, when mock CSF was infused into the cisterna magna at various rates, the resulting increased subarachnoid CSF pressure was accurately transmitted across the brain parenchyma into the CSF of isolated ventricles. The absence of an increase in the CSF pressure and ventricular dilatation during the two hours of aqueductal blockage suggest that a new reconsideration of the CSF physiology as well as of the development of acute hydrocephalus is required.

Temeljne medicinske znanosti,Kliničke medicinske znanosti