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Acid-Base Balance in Cerebrospinal Fluid
JEROME B. POSNER, MD;
AUGUST G. SWANSON, MD;
FRED PLUM, MD
Arch Neurol. 1965;12(5):479-496.
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Introduction
ALTHOUGH delirium, reduced consciousness, and abnormal motor function frequently accompany systemic acid-base disorders, the mechanisms producing these symptoms are unknown. Blood pH and other serum acid-base variables usually correlate poorly with the neurological symptoms. Therefore, several laboratories, including our own, have recently investigated the cerebrospinal fluid (CSF) acidbase balance in systemic disorders. Since these data have not previously been discussed in the neurological literature and since no previous report has attempted to correlate CSF acid-base balance with neurological function, the entire field is reviewed here in some detail. Preliminary reports of some of our material have appeared in abstract form.1,2
The CSF pH depends almost entirely on its carbon dioxide-bicarbonate ratio (CO2/HCO-3) and contains so little protein that its buffering capacity resembles a 20 millimolar (mM) bicarbonate solution. Foa,3 in 1906, first measured the CSF pH electrometrically and obtained in dog a value of
. . . [Full Text PDF of this Article]
Author Affiliations
NEW YORK; SEATTLE; NEW YORK
From the Department of Neurology, The New York Hospital-Cornell Medical Center and the Division of Neurology, University of Washington School of Medicine, Seattle.
Footnotes
Submitted for publication Jan 1, 1965; accepted Jan 22.
Reprint requests to New York Hospital-Cornell Medical Center, New York, NY 10021 (Dr. Posner).
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