Clinical implications of heterogeneity of lumbar and cisternal CSF acid-base balance in physiological states and in conditions of intracranial hypertension.

Considering the lack of complete agreement of viewpoints concerning the heterogeneity of ABB indices of CSF at various levels along the brain-spinal axis, an attempt was made to elucidate this problem. For this procedure 82 patients suffering from diseases causing increased intracranial pressure and spinal pain were examined. A total of 262 samples of CSF was taken from cisterna magna and from the lumbar region of the subarachnoid space. In accordance with the degree of severity of clinical symptoms resulting from increased intracranial pressure, the patients examined were divided into five groups. The results of examination show irregular differentiation of samples of CSF which is related to the clinical state of the patients examined. On the basis of the law of thermodynamics of irreversible processes and in particular of the law of increase in entropy, clinical implications following from the results of investigations are discussed. Treating the heterogeneity of the ABB of CSF as a sign of thermodynamic imbalance of the living system, the author seems a relationship between the results of examination of the investigated system, its thermodynamic state systematisation, probability, and informative function. The presented propositions are supported, in the opinion of the author, by results of investigations of ABB in CSF in 227 cases of cranio-cerebral trauma, vascular diseases and tumors of the brain.