CEREBROSPINAL FLUID DYNAMICS IN MAN

Abstract

Although Quincke¹ introduced the technic of lumbar puncture in 1891, it was not until 1916 that Queckenstedt² stressed the importance of cerebrospinal fluid dynamics. Queckenstedt pointed out that in the presence of obstructive lesions of the subarachnoid space the rise in cerebrospinal fluid pressure which normally follows compression of the veins of the neck (mainly the internal jugulars) does not take place. A further step in the interpretation of the abnormal dynamic responses of the cerebrospinal fluid which occur with blockage of the spinal subarachnoid space was made by Ayer³ in 1921, when he introduced the technic of combined cisternal and lumbar puncture. Attempts have been made to quantitate the dynamics of the cerebrospinal fluid. Stookey, Merwarth and Frantz⁴ and Stookey and Klenke⁵ described a modification of the Queckenstedt test. They suggested that the response of the cerebrospinal fluid pressure following manual bilateral jugular compression