Objective of the study: The determination of the CSF’s real role in the cranial cavity! The determination of the relationship between CSF and various neurological problems!

Material and method: 200 patients had examined neurologically for different neurological problems related to the brain: headaches 124 patients (pts) (62%), instability in standing position and walking 152 pts (76%), Dizziness 165 pts (82,75%), Disturbances of vision 200 pts (100%), strabismus 15 pts (7,5%), double vision, diplopia 12 pts (6%), weakness in walking, slow motion 159 (125,78%), disturbances of memory 97 (48,5%), disturbances of behavior and communication 124 (62%), disturbances of function of pelvic organs 103 pts (51,5%). All patients passed examination with MRI of brain and spinal cord, MRV of brain, ophthalmology examination. 145 pts underwent Lumbar puncture. Age of the pts 5492 years, 59 female and 86 male. With LP we measured the ICP and remove 30 ml of CSF. After the procedure we asked the pts to stand and walk and give information about the previous symptoms and after the LP. All pts had improvement. Therefore only 110 pts agreed to the further treatment for surgery and placement LP shunting. All 110 pts had undergone an operation for placement LP programmable valve, from different manufacture companies. Results: 125 patients had improvement immediately after the LP. The intracranial pressure was higher than 160 mm/H2O in 15 pts, all with disturbances of vision. From 110 pts that operated In 10 pts the shunt was blocked and we re-operated for replace the valve. 4 patients had infection and we removed the device. After treatment with antibiotics we placed again back the shunt. All the patients are satisfy with this kind of operation. The patients previously taking medication for their problems, either stopped taking, stopped increasing the doses, or reduced their doses.

Conclusions: All patients with neurological problems related to the brain, should have LP to measure the intracranial pressure and remove 20-30 ml of CSF. The way to check the ICP is LP. So the corresponding treatment for these problems is the LP Shunt. The programmable LP Shunt is the best device today to drainage the CSF, where isn’t obstructed hydrocephalus. The disadvantage of the LP Shunt is the difficulties in regulate, due to soft tissue under the shunt.