New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer. Part 4: A unifying criterion of the development of hydrocephalic syndrome. Its dynamic basis.

In the final part of this series we present all of the clinical material, and the patients are classified by different cisternographic syndromes on the dynamic basis offered for our method: dynamic disconnection between ventricular system and basal cisterns, brain atrophy, initial dynamic decompensation or prehydrocephalus, communicating hydrocephalus with and without epicortical fluid circulation. A nomogram method for clinical estimation of CSF production based on the mathematical properties of our analysis of the ventricular reflux is proposed. The different normal and pathological characteristics of fluid movements in the spinal canal are given, and their importance as signs of turbulence in the posterior fossa are emphasized. Different aspects of the dynamics of CSF production are shown and discussed, and an evolving conception of hydrocephalus development is presented.