Is cranial CSF volume under hormonal influence? An MR study.

We used magnetic resonance to investigate the hypothesis that premenstrual neurological symptoms are due to cerebral oedema and brain swelling. Total cranial and lateral ventricular CSF volumes were measured midcycle and premenstrually in 20 women with a normal menstrual cycle, and similar measurements were made 2 weeks apart in 10 postmenopausal women and 10 men. Total cranial CSF volume increased premenstrually in 19 women. The mean premenstrual increase was by 11.5 ml. There was not a significant difference between those women who were taking an oral contraceptive and those who were not. The CSF volume did not change significantly on repeat measurement in men and postmenopausal women. The CSF changes observed reflect a reduction in brain volume and do not support cerebral swelling as the cause of premenstrual neurological symptoms.