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Clinical Aspects and Evaluation of Cerebrospinal Fluid Dynamics

Jay M. Coblentz, MD; Steven Mattis, PhD; Lawrence H. Zingesser, MD; Samuel S. Kasoff, MD; Henryk M. Winiewski, MD, PhD; Robert Katzman, MD

Arch Neurol. 1973;29(5):299-308.

Abstract
Data from 30 patients with presenile dementia are reported regarding history, clinical findings with special assessment of mental status; electroencephalography; and cerebral blood flow for ten patients with histological Alzheimer disease, five patients with other histological findings, ten patients with clinically suspected Alzheimer disease, and five patients with communicating hydrocephalus following meningeal irritation. Cerebrospinal fluid (CSF) dynamics were evaluated by pneumoencephalography, iodinated serum albumin (RISA) cisternography, and CSF infusion. Pneumoencephalography and cisternography were misleading. The CSF infusion test with fewer false positives was also not diagnostic by itself, thus emphasizing that diagnosis ultimately depends on histology. Ventriculosystemic shunting was beneficial chiefly in patients with communicating hydrocephalus consequent to postmeningeal irritation.

Author Affiliations
Bronx, NY

From the departments of neurology (Drs. Coblentz, Mattis, and Katzman), radiology (Dr. Zingesser), neurosurgery (Dr. Kasoff), and pathology (Dr. Winiewski), Albert Einstein College of Medicine of Yeshiva University, Bronx, NY.

Footnotes
Accepted for publication May 22, 1973.

Reprint requests to Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461 (Dr. Katzman).

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