LIQUORODYNAMIC TESTS

From Big Medical Encyclopedia

LIQUORODYNAMIC TESTS — the physical or chemical and pharmacological impacts applied to diagnosis of defeats back and a brain during the carrying out a puncture of the spaces filled with cerebrospinal liquid (ventrikulyarny, suboktsipitalny, spinal, floor-by-floor punctures), with measurement or registration of pressure, and also visual or chemical definition of the dyes entered with the diagnostic purpose at these manipulations. For identification of disturbance of passability of subarachnoid space at pathology of a spinal cord during punctures the greatest distribution was found by Kvekkenshtedt and Stukey's tests.

Kvekkenshtedt's test: squeeze a neck a hand or the cuff imposed on a neck, in to-ruyu the pressured air of 60 — 100 mm of mercury is forced.

Stukey's test: press on a wall of a stomach a fist against the stop in a backbone.

Increase intracranial pressure (see) at a prelum of a neck or stomach is result of the vascular and reflex act consisting of two phases — venous and arterial. Venous stagnation, expansion of mass of small vessels of a brain at simultaneous increase in the ABP leads to increase in a krovenapolneniye of a brain and increase in intracranial pressure. A releaser of reaction at Kvekkenshtedt's test is direct stagnation of a venous blood in a head cavity, at Stukey's test — the remote stagnation in veins of a skull and epidural cellulose of the vertebral channel.

Kvekkenshtedt's test is considered negative and indicates lack of disturbance of ways of circulation of cerebrospinal liquid, its pressure increases; positive — if build-up of pressure is absent and testifies to the block of these ways.

At Stukey's test at the patients having or not having the block various pressure ratio of cerebrospinal liquid therefore in itself it has small diagnostic value is noted, but the role it raises at a combination to Kvekkenshtedt's test.

T. M. Sergienko, V. S. Mikhaylovsky (1955) revealed considerably big reliability of tests during the carrying out graphic registration on the recorder of change of pressure of cerebrospinal liquid. At use of such technique depending on a ratio of build-up of pressure at Kvekkenshtedt and Stukey's test before extraction of cerebrospinal liquid several types of the curves allowing to judge extent of disturbance of a likvorodinamika are allocated.

Arendt's test and colourful test of the Dandy most often are applied to recognition of the opened and closed form of hydrocephaly.

Arendt's test it is based on the principle of communicating vessels. In position of the patient it is on one side made ventriculopuncture (see) and spinal puncture (see). After connection to needles of glass tubes and tonometries serially lower the foot and head end of a table. In the absence of the block both in horizontal position, and at tests cerebrospinal liquid in tubes is established at one level. Incomplete or spasmodic alignment of level indicates the partial block.

For conducting colourful test of the Dandy enter 1,0% into a cerebral cavity solution dropped, methylene blue, indigo carmine or other indifferent dye. At open hydrocephaly the first portions of paint during a spinal puncture appear in 3 — 5 min.; at the closed hydrocephaly paint in cerebrospinal liquid does not appear. In the absence of the block with urine 35 — 60% of paint are removed, at partial — less than 30%, at full — less than 10%

In diagnosis patol, the processes limiting a head cavity (tumors of a brain, abscesses, intracraneal hemorrhages) apply graphic registration of the dosed Kvekkenshtedt and Stukey's tests and the dosed inhalation of carbonic acid.

Depending on expressiveness of intracranial hypertensia, a condition of a brain hemodynamics, expressiveness dislocations of a brain (see) various types of curves are registered: the perverted type of a curve — rise in pressure at Kvekkenshtedt's test is less, than at Stukey's test; a curve of «double rise» — with the expressed secondary spontaneous build-up of pressure at Stukey's test; curves with various ratio of size of build-up of pressure at L. the item and with various expressiveness of double rise in pressure.

The dosed tests with inhalation of carbonic acid are carried out at registration of spinal or intracranial pressure. After registration of initial sizes of pressure within 1 min. to the patient allow to inhale 3 — 6 — 9% carbonic acid in mix with air or oxygen. At a normal tone and reactivity of vessels of a brain build-up of pressure at test small (does not exceed 80 — 100 mm of a water column). In the presence of the center limiting a head cavity in a stage of compensation, subcompensation and the beginning of a stage of a decompensation pressure at test increases much more — by 300 — 500 mm of a water column. At the end of a stage of a decompensation, and also at a low tone of brain vessels, napr, after an oncotomy, rise in pressure decreases (does not exceed 40 — 50 mm of a water column).


Bibliography: Arendt A. A. Liquorodynamic test in diagnosis of diseases of a brain, Vopr, neyrokhir., t. 10, No. 5, page 55, 1946; Romodanov A. P., Dunayevsky A. E. and About r l about in Yu. A., the Tumour of a spinal cord, Kiev, 1976, bibliogr.; Sergienko T. M. and Mikhaylovsky V. S. Technology of kimogra-fichesky registration of liquorodynamic researches, Vopr, neyrokhir., t. 19, No. 4, page 18, 1955; Intracranial pressure, ed. by J. W. F. Beks, v. 3, p. 354, B., 1976; Queckenstedt, Zur Diagnose der Ruckenmarkskompression, Dtsch. Z.Nerven-heilk., Bd 55, S. 325, 1916; StookeyB., Merwarth H. ti. Frantz A.M. A manometria study of the cerebrospinal fluid in suspected spinal cord tumors, Surg. Gynec. Obstet., v. 41, p. 429, 1925.


T. M. Sergienko.

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