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From the Departments of Neurosurgery (Drs. Heit, Huhn, Chang, and T. Saul), Anesthesia (Dr. Jaffe), Neurology and Neurological Science (Dr. Bronte–Stewart), and Medicine (Dr. Rubenstein), Stanford University School of Medicine, CA; and SRI International (K. Possin), Menlo Park, CA.
Address correspondence and reprint requests to Dr. G.D. Silverberg, Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305-5327; e-mail: geralds{at}stanford.edu
Objective:— To evaluate the production rate of CSF in patients with differing disease states.
Methods:— The authors measured the production rate of CSF in three groups of patients: five patients with PD below age 60 (aged 51 ± 4 years, mean ± SD), nine with PD over age 60 (aged 69 ± 6 years, mean ± SD), and seven with dementia of the Alzheimer’s type (AD) (aged 72 ± 9 years, mean ± SD). This method, based on the Masserman technique, employs ventricular rather than a lumbar access to the CSF space. Furthermore, the volume of CSF removed during the procedure is only 3 mL rather than 10 mL.
Results:— These measurements indicate that the mean rate of CSF production in patients with PD under age 60 was 0.47 ± 0.13 mL/minute, in patients with PD aged 60 or older the mean rate was 0.40 ± 0.12 mL/minute, and in patients with AD the mean rate was 0.20 ± 0.06 mL/minute.
Conclusion:— These results indicate that the rate of CSF production in patients with PD is normal, and that the rate of CSF production in patients with AD is markedly reduced.
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