Observational studyActa neurochirurgica2023
Cerebrospinal fluid production rate in various pathological conditions: a preliminary study.
Observational study in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Evaluation of a Novel Automated Cerebral Ventricular Drainage System for Intracranial Pressure Monitoring and Cerebrospinal Fluid Drainage in Neurocritical Care Patients: A Prospective, Randomized Clinical Study.Neurocritical care · 2026Trial
- Arrested hydrocephalus and beyond: advances in the pathophysiology, diagnosis, and management of various forms of chronic hydrocephalus: a comprehensive narrative review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- TRPV4 inhibition as a pharmacotherapy for post-hemorrhagic hydrocephalus.Fluids and barriers of the CNS · 2026Article
- Integrating brain organoids, meningeal immunity, and glymphatic dynamics: toward modeling neuroimmune clearance and crosstalk in disease.Frontiers in immunology · 2026Review
- Variability in the circulation of cerebrospinal fluid: causes and clinical implications for intraventricular drug delivery.Frontiers in drug delivery · 2026Review
- CSF protein clearance impairment revealed using stable isotope kinetics in normal pressure hydrocephalus.Brain communications · 2026Article
- A Lumped Parameter Modelling Study of Idiopathic Intracranial Hypertension Suggests the CSF Formation Rate Varies with the Capillary Transmural Pressure.Brain sciences · 2025Article
- CSF production rate, resistance to reabsorption, and intracranial pressure: a systematic review and meta-analysis.Brain communications · 2025Review
- A Lumped Parameter Model Suggests That Infusion Studies Overestimate the Cerebrospinal Fluid Outflow Resistance in Normal Pressure Hydrocephalus.Brain sciences · 2024Article
- Significant individual variation in cardiac-cycle-linked cerebrospinal fluid production following subarachnoid hemorrhage.Fluids and barriers of the CNS · 2024Article
- CSF formation rate-a potential glymphatic flow parameter in hydrocephalus?Fluids and barriers of the CNS · 2024Article
- Idiopathic intracranial hypertension: a step change in understanding the disease mechanisms.Nature reviews. Neurology · 2023Review
- Pathogenesis and management of idiopathic intracranial hypertension: A narrative review.Brain circulationReview
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe cerebrospinal fluid (CSF) production rate in humans is not clearly defined but is estimated to be 18-24 ml/h (Trevisi et al Croat Med J 55(4):377-387 (24); Casey and Vries Childs Nerv Syst 5(5):332-334 (8)). A frequent clinical observation is that patients often drain higher volumes of CSF than can be explained by the assumed 'normal' CSF production rate (PRcsf). In the National Hospital for Neurology and Neurosurgery PRcsf was recorded in a variety of common neurosurgical pathologies using LiquoGuard7, an automated peristaltic pump that accurately controls CSF drainage and maintains a pre-set CSF pressure.
methodsA prospective observational study was performed from September 2021 onwards, on all patients in the National Hospital for Neurology and Neurosurgery who required CSF drainage as part of their ongoing treatment. The external drain was connected to a LiquoGuard7 pump (Möller Medical GmbH, Fulda, Germany), and the internal software of LiquoGuard7 was used to measure PRcsf. Statistical analysis used SPSS (version 25.0, IBM) by paired t test, comparing measured rates to hypothetical 'normal' CSF production rates calculated and published by Ekstedt (16-34ml/h) (Ekstedt J Neurol Neurosurg Psychiatry 41(4):345-353 (14)), assuming a similar distribution.
resultsPRcsf was calculated in 164 patients. Suspected normal pressure hydrocephalus (n=41): PRcsf of 79ml/h±20SD (p<0.0001). Post-surgical CSF leak (n=26): PRcsf of 90ml/h±20SD (p<0.0001). Subarachnoid haemorrhage (n=34): PRcsf of 143ml/h±9SD (p<0.0001). Intracerebral haemorrhage (n=22): PRcsf of 137ml/h±20SD (p<0.0001). Spinal lesions (n=7): PRcsf of 130ml/h±20SD (p<0.0032). Pituitary adenomas (n=10): PRcsf of 29 ml/h±9SD (p<0.049). Idiopathic intracranial hypertension (n=15): PRcsf of 86ml/h±10SD (p<0.0001). Decompensated long-standing overt ventriculomegaly (n=4): PRcsf of 65ml/h±10SD (p<0.0001). Cerebral infection (n=5): PRcsf of 90ml/h±20SD (p<0.0001).
conclusionNet CSF production rate may be higher than expected in many conditions, as measured with new device LiquoGuard7 through the study of net flow rate, which may have implications for clinical decisions on CSF diversion. The conventional understanding of CSF production and circulation does not explain the findings of this study. More extensive studies are needed to validate this technique.
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