For centuries the great minds of medical science puzzled over the importance of the cerebrospinal fluid. As far back as Hippocrates, it was thought that this "phlegm" that flooded the intracranial contents had pathological significance. However, not until the late 1800s, when Quincke introduced and popularized lumbar puncture, did physicians take an interest in the study of this fluid in relation to clinical illness. Since then a variety of techniques for obtaining cerebrospinal fluid from various sites have developed, and the relationship of cerebrospinal fluid to a variety of disease processes has received considerable study. In this volume, we have attempted to assemble reviews of some of these important developments during the past century. Chapter 1 contains a historical review of key investigations that helped shape our concepts of cerebrospinal fluid from the earliest recorded description by the author of the Edwin Smith Surgical Papyrus in the seventeenth century B. C. to contemporaries such as Kabat, Glusman, and Knaub, who introduced quantitative determinations of cerebrospinal fluid gamma globulin levels. In Chapter 2 there is a description of our current understanding of the anatomical compartment for the cerebrospinal fluid and the physiology of its formation, circulation, and absorption. Dr. Richard Leech in Chapter 3 contributes a comprehensive description of the disorders associated with excessive quanti ties of cerebrospinal fluid-commonly referred to as hydrocephalus. A variety of techniques for properly collecting and evaluating cerebrospinal fluid are detailed in Chapter 4.

For centuries the great minds of medical science puzzled over the importance of the cerebrospinal fluid. As far back as Hippocrates, it was thought that this "phlegm" that flooded the intracranial contents had pathological significance. However, not until the late 1800s, when Quincke introduced and popularized lumbar puncture, did physicians take an interest in the study of this fluid in relation to clinical illness. Since then a variety of techniques for obtaining cerebrospinal fluid from various sites have developed, and the relationship of cerebrospinal fluid to a variety of disease processes has received considerable study. In this volume, we have attempted to assemble reviews of some of these important developments during the past century. Chapter 1 contains a historical review of key investigations that helped shape our concepts of cerebrospinal fluid from the earliest recorded description by the author of the Edwin Smith Surgical Papyrus in the seventeenth century B. C. to contemporaries such as Kabat, Glusman, and Knaub, who introduced quantitative determinations of cerebrospinal fluid gamma globulin levels. In Chapter 2 there is a description of our current understanding of the anatomical compartment for the cerebrospinal fluid and the physiology of its formation, circulation, and absorption. Dr. Richard Leech in Chapter 3 contributes a comprehensive description of the disorders associated with excessive quanti ties of cerebrospinal fluid-commonly referred to as hydrocephalus. A variety of techniques for properly collecting and evaluating cerebrospinal fluid are detailed in Chapter 4."

The United States Congress designated the 1990's as the "Decade of the Brain" in recognition of the importance of neuroscience to the health and well-being of Americans. It has been suggested that as many as 20% of all patients seeking medical treatment have neurologic problems, either as the presenting complaint or as an associated condition complicating the primary illness. To this end, it is important that physicians understand basic neuroscience principles and nervous system diseases. Of course, this text is not encyclopedic but instead is an outline of the knowledge required of all medical students. Interested students can consult numerous texts that provide comprehensive coverage of the field, including Greenfield's Neuropathology and the exhaustive 60 ] volume Handbook of Clinical Neurology. The information selected for inclusion in this volume of the Oklahoma Notes series remains true to the goal of the whole series-incorporating only that material vital in both the general clinical practice of medicine and to answer questions on the all-important United States Medical Licensing Examination. Roger A. Brumback Richard W. Leech Acknowledgments This text would not have been possible without a great deal of help and support from a number of individuals. We want to thank all those who assisted in our education in neuroscience and neuropathology including: William M. Landau and Philip R. Dodge of the Washington University School of Medicine, Lowell W. Lapham of the University of Rochester Medical Center, and Ellsworth C.