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November 1962

Blood Cerebrospinal Fluid Barrier in Tuberculous Meningitis: Studies During the Acute and Recovery Phase

Author Affiliations

Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, N.Y.

Arch Neurol. 1962;7(5):427-431. doi:10.1001/archneur.1962.04210050063007

Introduction  An intravenous injection of glucose normally causes the glucose content of the cerebrospinal fluid to rise, and there is a consistent pattern of change of concentration in the cisternal and lumbar spinal fluid. We have previously reported studies describing the normal pattern for glucose diffusion in patients1,2 and have obtained comparable findings on dogs.3 Similar diffusion patterns have been observed using a variety of different diffusible substances.4,5,6 Glucose diffusion in patients results in a normal maximum rise of both lumbar and cisternal curves greater than 30 mg/100 ml. above the initial values.1,2,7 Figure 1 shows a typical set of such normal curves which were obtained in a small infant with cerebral palsy, the cisternal curve showing higher values than the lumbar curve.Studies on glucose diffusion in acute tuberculous meningitis have sometimes previously shown a reversal of the normal pattern for the lumbar and cisternal

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