Physical properties of cerebrospinal fluid of relevance to shunt function. 1: The effect of protein upon CSF viscosity.

Viscosity is the resistance to flow of a fluid and it is the only property of a fluid that will affect its flow through a system of valveless tubing (surface tension will affect the opening and closing of valves that are included in the system). The effect that an elevated protein concentration has upon CSF viscosity has received little study, yet many neurosurgeons believe that CSF with an elevated protein content is too viscous to flow satisfactorily through shunts. The total protein content and viscosity of 126 specimens of CSF from hydrocephalic patients were measured and analysed with reference to the aetiology of the hydrocephalus. The results indicate that high protein concentrations do not greatly affect the viscosity of CSF, and that the aetiology is also of little consequence. These findings were highly significant on linear regression analysis (p < 0.001). The flow of the most viscous CSF that is likely to be encountered would be reduced by only 7% through a given catheter, compared with that of the least viscous CSF.