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73-620: The Edwin Smith Papyrus is an ancient Egyptian medical text , named after Edwin Smith who bought it in 1862, and the oldest known surgical treatise on trauma . This document, which may have been a manual of military surgery, describes 48 cases of injuries, fractures, wounds, dislocations and tumors. It dates to Dynasties 16 – 17 of the Second Intermediate Period in ancient Egypt, c. 1600 BCE. The papyrus

146-509: A carbonic anhydrase inhibitor such as acetazolamide , repeated drainage via lumbar puncture, or the insertion of a shunt such as a ventriculo-peritoneal shunt. CSF can leak from the dura as a result of different causes such as physical trauma or a lumbar puncture, or from no known cause when it is termed a spontaneous cerebrospinal fluid leak . It is usually associated with intracranial hypotension : low CSF pressure. It can cause headaches, made worse by standing, moving and coughing, as

219-403: A CSF volume of 4 mL/kg, children have a CSF volume of 3 mL/kg, and adults have a CSF volume of 1.5–2 mL/kg. A high CSF volume is why a larger dose of local anesthetic, on a mL/kg basis, is needed in infants. Additionally, the larger CSF volume may be one reason as to why children have lower rates of postdural puncture headache. Most (about two-thirds to 80%) of CSF is produced by

292-409: A Swiss physician and physiologist, made note in his 1747 book on physiology that the "water" in the brain was secreted into the ventricles and absorbed in the veins, and when secreted in excess, could lead to hydrocephalus. François Magendie studied the properties of CSF by vivisection. He discovered the foramen Magendie, the opening in the roof of the fourth ventricle, but mistakenly believed that CSF

365-498: A gaping wound in his head, which has penetrated to the bone and split the skull". The objective examination process included visual and olfactory clues, palpation and taking of the pulse. Following the examination are the diagnosis and prognosis, where the physician judges the patient’s chances of survival and makes one of three diagnoses: "An ailment which I will treat," "An ailment with which I will contend," or "An ailment not to be treated". Last, treatment options are offered. In many of

438-648: A more modern understanding of hieratic and medicine. As listed in Medical manual Contemporary and historic views regarding diagnosis, prognosis and treatment of medical conditions have been documented for thousands of years. The Edwin Smith papyrus is the first known medical treatise . Ancient medical literature often described inflictions related to warfare. Throughout history, people have written about diseases, how human beings might contract them and what could be done to remedy it. Medicine ranged from folklore and witchcraft to modern evidence-based medicine . Among

511-636: A much lower concentration of chloride anions than sodium cations. CSF contains a similar concentration of sodium ions to blood plasma but fewer protein cations and therefore a smaller imbalance between sodium and chloride resulting in a higher concentration of chloride ions than plasma. This creates an osmotic pressure difference with the plasma. CSF has less potassium, calcium, glucose and protein. Choroid plexuses also secrete growth factors, iodine , vitamins B 1 , B 12 , C , folate , beta-2 microglobulin , arginine vasopressin and nitric oxide into CSF. A Na-K-Cl cotransporter and Na/K ATPase found on

584-435: A neurologist William Mestrezat gave the first accurate description of the chemical composition of CSF. In 1914, Harvey W. Cushing published conclusive evidence that CSF is secreted by the choroid plexus . During phylogenesis , CSF is present within the neuraxis before it circulates. The CSF of Teleostei fish, which do not have a subarachnoid space, is contained within the ventricles of their brains. In mammals, where

657-585: A number of methods designed to administer therapeutic agents directly into the CSF, bypassing the BBB to achieve higher drug concentrations in the CNS. This technique is particularly beneficial for treating neurological disorders such as brain tumors, infections, and neurodegenerative diseases. Intrathecal injection, where drugs are injected directly into the CSF via the lumbar region, and intracerebroventricular injection, targeting

730-570: A particular drug delivery method where the therapeutic agent is introduced into a reservoir connected to the intrathecal space, rather than being released into the CSF and distributed throughout the CNS. In this approach, the drug interacts with its target within the reservoir, allowing for changing the composition of the CSF without systemic release. This method can be advantageous for maximizing efficacy and minimizing systemic side effects. Various comments by ancient physicians have been read as referring to CSF. Hippocrates discussed "water" surrounding

803-401: A pressure difference between the arachnoid mater and venous sinuses. CSF has also been seen to drain into lymphatic vessels, particularly those surrounding the nose via drainage along the olfactory nerve through the cribriform plate . The pathway and extent are currently not known, but may involve CSF flow along some cranial nerves and be more prominent in the neonate . CSF turns over at

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876-436: A rate of three to four times a day. CSF has also been seen to be reabsorbed through the sheathes of cranial and spinal nerve sheathes, and through the ependyma. The composition and rate of CSF generation are influenced by hormones and the content and pressure of blood and CSF. For example, when CSF pressure is higher, there is less of a pressure difference between the capillary blood in choroid plexuses and CSF, decreasing

949-428: A single outward direction from the ventricles, but multidirectionally in the subarachnoid space. The flow of cerebrospinal fluid is pulsatile, driven by the cardiac cycle . The flow of CSF through perivascular spaces in the brain (surrounding the cerebral arteries ) is obtained through the pumping movements of the walls of the arteries. CSF is derived from blood plasma and is largely similar to it, except that CSF

1022-464: A subarachnoid space is present, CSF is present in it. Absorption of CSF is seen in amniotes and more complex species, and as species become progressively more complex, the system of absorption becomes progressively more enhanced, and the role of spinal epidural veins in absorption plays a progressively smaller and smaller role. The amount of cerebrospinal fluid varies by size and species. In humans and other mammals , cerebrospinal fluid turns over at

1095-544: Is a scroll 4.68 meters or 15.3 feet in length. The recto (front side) has 377 lines in 17 columns, while the verso (backside) has 92 lines in five columns. Aside from the fragmentary outer column of the scroll, the remainder of the papyrus is intact, although it was cut into one-column pages some time in the 20th century. It is written right-to-left in hieratic , the Egyptian cursive form of hieroglyphs , in black ink with explanatory glosses in red ink . The vast majority of

1168-410: Is a three-layered disc , covered with ectoderm , mesoderm and endoderm . A tube-like formation develops in the midline, called the notochord . The notochord releases extracellular molecules that affect the transformation of the overlying ectoderm into nervous tissue. The neural tube , forming from the ectoderm, contains CSF prior to the development of the choroid plexuses. The open neuropores of

1241-439: Is also a connection from the subarachnoid space to the bony labyrinth of the inner ear via the perilymphatic duct where the perilymph is continuous with the cerebrospinal fluid. The ependymal cells of the choroid plexus have multiple motile cilia on their apical surfaces that beat to move the CSF through the ventricles. A sample of CSF can be taken from around the spinal cord via lumbar puncture . This can be used to test

1314-482: Is believed that the papyrus served as a textbook for the trauma that resulted from military battles. The Edwin Smith Papyrus dates to Dynasties 16–17 of the Second Intermediate Period . Egypt was ruled from Thebes during this time and the papyrus is likely to have originated from there. Edwin Smith , an American Egyptologist, purchased it in Luxor , Egypt in 1862, from an Egyptian dealer named Mustafa Agha. The papyrus

1387-467: Is carried out under sterile conditions by inserting a needle into the subarachnoid space, usually between the third and fourth lumbar vertebrae . CSF is extracted through the needle, and tested. About one third of people experience a headache after lumbar puncture, and pain or discomfort at the needle entry site is common. Rarer complications may include bruising, meningitis or ongoing post lumbar-puncture leakage of CSF. Testing often includes observing

1460-417: Is identified. Caffeine , given either orally or intravenously , often offers symptomatic relief. Treatment of an identified leak may include injection of a person's blood into the epidural space (an epidural blood patch ), spinal surgery , or fibrin glue . CSF can be tested for the diagnosis of a variety of neurological diseases , usually obtained by a procedure called lumbar puncture. Lumbar puncture

1533-466: Is incorporated in textbooks . There are textbooks on every medical specialty and they contain comprehensive discussion on all diseases and their diagnosis , therapy and prognosis . The first textbook to utilize experts to write specific chapters within the book was the Cecil Textbook of Medicine edited by Russell Cecil , MD in 1927. The book was an immediate international success because of

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1606-470: Is nearly protein-free compared with plasma and has some different electrolyte levels. Due to the way it is produced, CSF has a lower chloride level than plasma, and a higher sodium level. CSF contains approximately 0.59% plasma proteins, or approximately 15 to 40 mg/dL, depending on sampling site. In general, globular proteins and albumin are in lower concentration in ventricular CSF compared to lumbar or cisternal fluid. This continuous flow into

1679-420: Is suspected due to certain situations such as a tumour, because it can lead to fatal brain herniation . Some anaesthetics and chemotherapy are injected intrathecally into the subarachnoid space, where they spread around CSF, meaning substances that cannot cross the blood–brain barrier can still be active throughout the central nervous system. Baricity refers to the density of a substance compared to

1752-583: Is unique among the four principal medical papyri that survive today. While other papyri, such as the Ebers Papyrus and London Medical Papyrus , are medical texts based in magic , the Edwin Smith Papyrus presents a rational and scientific approach to medicine in ancient Egypt, in which medicine and magic do not conflict. Magic would be more prevalent had the cases of illness been mysterious, such as internal disease. The Edwin Smith papyrus

1825-554: The Na-K-Cl cotransporter ) have the potential to impact membrane channels. CSF pressure , as measured by lumbar puncture , is 10–18  cmH 2 O (8–15  mmHg or 1.1–2  kPa ) with the patient lying on the side and 20–30 cmH 2 O (16–24 mmHg or 2.1–3.2 kPa) with the patient sitting up. In newborns, CSF pressure ranges from 8 to 10 cmH 2 O (4.4–7.3 mmHg or 0.78–0.98 kPa). Most variations are due to coughing or internal compression of jugular veins in

1898-573: The National Library of Medicine 's PubMed database . Peer reviewed journals are ranked higher thus are a better source for medical information than non-peer reviewed journals. A medical manual is literature (usually a book) describing diagnosis , treatment , management , and prognosis of various disorders . The first known medical manual is the Edwin Smith papyrus of ancient Egypt. After consensus has been reached, it

1971-424: The brain and spinal cord of all vertebrates . CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the brain, and absorbed in the arachnoid granulations . In humans, there is about 125 mL of CSF at any one time, and about 500 mL is generated every day. CSF acts as a shock absorber, cushion or buffer, providing basic mechanical and immunological protection to

2044-430: The choroid plexus . The choroid plexus is a network of blood vessels present within sections of the four ventricles of the brain. It is present throughout the ventricular system except for the cerebral aqueduct , and the frontal and occipital horns of the lateral ventricles . CSF is mostly produced by the lateral ventricles . CSF is also produced by the single layer of column-shaped ependymal cells which line

2117-442: The intracranial pressure , as well as indicate diseases including infections of the brain or the surrounding meninges . Although noted by Hippocrates , it was forgotten for centuries, though later was described in the 18th century by Emanuel Swedenborg . In 1914, Harvey Cushing demonstrated that CSF is secreted by the choroid plexus. In humans, there is about 125–150 mL of CSF at any one time. This CSF circulates within

2190-404: The microorganism that has caused the infection, or PCR may be used to identify a viral cause. Investigations to the total type and nature of proteins reveal point to specific diseases, including multiple sclerosis , paraneoplastic syndromes , systemic lupus erythematosus , neurosarcoidosis , cerebral angiitis ; and specific antibodies such as aquaporin-4 may be tested for to assist in

2263-401: The venous system dilutes the concentration of larger, lipid-insoluble molecules penetrating the brain and CSF. CSF is normally free of red blood cells and at most contains fewer than 5 white blood cells per mm (if the white cell count is higher than this it constitutes pleocytosis and can indicate inflammation or infection). At around the fifth week of its development , the embryo

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2336-449: The ventricular system of the brain. The ventricles are a series of cavities filled with CSF. The majority of CSF is produced from within the two lateral ventricles . From here, CSF passes through the interventricular foramina to the third ventricle , then the cerebral aqueduct to the fourth ventricle . From the fourth ventricle, the fluid passes into the subarachnoid space through four openings – the central canal of

2409-425: The 32nd day of development near the rhombencephalon; circulation is visible from the 41st day. At this time, the first choroid plexus can be seen, found in the fourth ventricle, although the time at which they first secrete CSF is not yet known. The developing forebrain surrounds the neural cord. As the forebrain develops, the neural cord within it becomes a ventricle, ultimately forming the lateral ventricles. Along

2482-458: The U.S. and Media Doctor in Australia. Most prominent journals and textbooks are currently available on-line or via CD-ROM . Certain online services including Medscape and MDLinx offer aggregated digests of new articles from prominent medical journals. Cerebrospinal fluid Cerebrospinal fluid ( CSF ) is a clear, colorless body fluid found within the tissue that surrounds

2555-411: The adjacent part of the lateral recess), the posterior inferior cerebellar artery (roof and median opening), and the superior cerebellar artery . CSF returns to the vascular system by entering the dural venous sinuses via arachnoid granulations . These are outpouchings of the arachnoid mater into the venous sinuses around the brain, with valves to ensure one-way drainage. This occurs because of

2628-401: The blood in the capillaries and the interstitial fluid. This fluid then needs to pass through the epithelium cells lining the choroid plexus into the ventricles, an active process requiring the transport of sodium , potassium and chloride that draws water into CSF by creating osmotic pressure . Unlike blood passing from the capillaries into the choroid plexus, the epithelial cells lining

2701-442: The body. Idiopathic intracranial hypertension is a condition of unknown cause characterized by a rise in CSF pressure. It is associated with headaches, double vision , difficulties seeing, and a swollen optic disc . It can occur in association with the use of vitamin A and tetracycline antibiotics, or without any identifiable cause at all, particularly in younger obese women. Management may include ceasing any known causes,

2774-461: The bones of the skull have not yet fused, seizures, irritability and drowsiness. A CT scan or MRI scan may reveal enlargement of one or both lateral ventricles, or causative masses or lesions, and lumbar puncture may be used to demonstrate and in some circumstances relieve high intracranial pressure. Hydrocephalus is usually treated through the insertion of a shunt , such as a ventriculo-peritoneal shunt , which diverts fluid to another part of

2847-539: The book by region and symptom, allowing students to learn the myriad causes of a patient's symptom, without first knowing the specific disease. Harrison's is also credited for a strong commitment to linking basic science to clinical medicine. Health-related information is often disseminated to the public via mainstream media outlets; these reports influence doctors, the general public, and the government. According to one study of 500 US health news stories, between 62 and 77% failed to adequately address costs, harms, benefits,

2920-409: The brain inside the skull . CSF also serves a vital function in the cerebral autoregulation of cerebral blood flow . CSF occupies the subarachnoid space (between the arachnoid mater and the pia mater ) and the ventricular system around and inside the brain and spinal cord. It fills the ventricles of the brain, cisterns , and sulci , as well as the central canal of the spinal cord. There

2993-403: The brain was examined. The modern rediscovery of CSF is credited to Emanuel Swedenborg . In a manuscript written between 1741 and 1744, unpublished in his lifetime, Swedenborg referred to CSF as "spirituous lymph" secreted from the roof of the fourth ventricle down to the medulla oblongata and spinal cord. This manuscript was eventually published in translation in 1887. Albrecht von Haller ,

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3066-423: The brain when describing congenital hydrocephalus , and Galen referred to "excremental liquid" in the ventricles of the brain, which he believed was purged into the nose. But for some 16 intervening centuries of ongoing anatomical study, CSF remained unmentioned in the literature. This is perhaps because of the prevailing autopsy technique, which involved cutting off the head, thereby removing evidence of CSF before

3139-416: The brain's ventricles, are common approaches. These methods ensure that drugs can reach the CNS more effectively than systemic administration, potentially improving therapeutic outcomes and reducing systemic side effects. Advances in this field are driven by ongoing research into novel delivery systems and drug formulations, enhancing the precision and efficacy of treatments. Intrathecal pseudodelivery refers to

3212-504: The cases, explanations of trauma are included to provide further clarity. Among the treatments are closing wounds with sutures (for wounds of the lip, throat, and shoulder), bandaging, splints, poultices , preventing and curing infection with honey, and stopping bleeding with raw meat. Immobilization is advised for head and spinal cord injuries, as well as other lower body fractures. The papyrus also describes realistic anatomical , physiological and pathological observations. It contains

3285-455: The cell surface facing the interstitium. Sodium, chloride, bicarbonate and potassium are then actively secreted into the ventricular lumen. This creates osmotic pressure and draws water into CSF, facilitated by aquaporins . CSF contains many fewer protein anions than blood plasma. Protein in the blood is primarily composed of anions where each anion has many negative charges on it. As a result, to maintain electroneutrality blood plasma has

3358-460: The cerebral aqueduct. It is present in early intrauterine life but disappears during early development. CSF serves several purposes: The brain produces roughly 500 mL of cerebrospinal fluid per day at a rate of about 20 mL an hour. This transcellular fluid is constantly reabsorbed, so that only 125–150 mL is present at any one time. CSF volume is higher on a mL per kg body weight basis in children compared to adults. Infants have

3431-455: The choroid plexus contain tight junctions between cells, which act to prevent most substances flowing freely into CSF. Cilia on the apical surfaces of the ependymal cells beat to help transport the CSF. Water and carbon dioxide from the interstitial fluid diffuse into the epithelial cells. Within these cells, carbonic anhydrase converts the substances into bicarbonate and hydrogen ions . These are exchanged for sodium and chloride on

3504-429: The colour of the fluid, measuring CSF pressure, and counting and identifying white and red blood cells within the fluid; measuring protein and glucose levels; and culturing the fluid. The presence of red blood cells and xanthochromia may indicate subarachnoid hemorrhage ; whereas central nervous system infections such as meningitis , may be indicated by elevated white blood cell levels. A CSF culture may yield

3577-433: The density of human cerebrospinal fluid and is used in regional anesthesia to determine the manner in which a particular drug will spread in the intrathecal space. Liquorpheresis is the process of filtering the CSF in order to clear it from endogen or exogen pathogens. It can be achieved by means of fully implantable or extracorporeal devices, though the technique remains experimental today. CSF drug delivery refers to

3650-452: The diagnosis of autoimmune conditions. A lumbar puncture that drains CSF may also be used as part of treatment for some conditions, including idiopathic intracranial hypertension and normal pressure hydrocephalus . Lumbar puncture can also be performed to measure the intracranial pressure , which might be increased in certain types of hydrocephalus . However, a lumbar puncture should never be performed if increased intracranial pressure

3723-413: The exceptions to the practical nature of this medical text. Generic spells and incantations may have been used as a last resort in terminal cases. Authorship of the Edwin Smith Papyrus is debated. The majority of the papyrus was written by one scribe, with only small sections copied by a second scribe. The papyrus ends abruptly in the middle of a line, without any inclusion of an author. It is believed that

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3796-420: The first known descriptions of the cranial structures, the meninges , the external surface of the brain, the cerebrospinal fluid , and the intracranial pulsations. The procedures of this papyrus demonstrate an Egyptian level of knowledge of medicines that surpassed that of Hippocrates , who lived 1000 years later, and the documented rationale for diagnosis and treatment of spinal injuries can still be regarded as

3869-466: The idea that single or double author medical books was outmoded, "since the scope of medical knowledge was far surpassing the capacity of any single individual to encompass". Since that time, this has been the standard. Examples are: Harrison's Principal of Internal Medicine is widely considered the most read textbook of medicine ever. It was able to eclipse Cecil's by changing the organization. Instead of organizing by disease, Tinsley Harrison organized

3942-460: The inner surface of both ventricles, the ventricular wall remains thin, and a choroid plexus develops, producing and releasing CSF. CSF quickly fills the neural canal. Arachnoid villi are formed around the 35th week of development, with arachnoid granulations noted around the 39th, and continuing developing until 18 months of age. The subcommissural organ secretes SCO-spondin , which forms Reissner's fiber within CSF assisting movement through

4015-409: The low CSF pressure causes the brain to "sag" downwards and put pressure on its lower structures. If a leak is identified, a beta-2 transferrin test of the leaking fluid, when positive, is highly specific and sensitive for the detection for CSF leakage. Medical imaging such as CT scans and MRI scans can be used to investigate for a presumed CSF leak when no obvious leak is found but low CSF pressure

4088-422: The mechanisms not fully understood, but potentially relating to differences in the activation of the autonomic nervous system over the course of the day. Choroid plexus of the lateral ventricle produces CSF from the arterial blood provided by the anterior choroidal artery . In the fourth ventricle, CSF is produced from the arterial blood from the anterior inferior cerebellar artery (cerebellopontine angle and

4161-428: The medical community have changed the way it conducts research . After incorporating the scientific method , medical literature has introduced peer review , and is currently divided into journals and textbooks. These are publications in which the medical community shares information. The common articles are original articles, reviews and case reports . When looking for specific information in any journal one can use

4234-915: The most notable early medical descriptions are found in texts from Egypt ( Edwin Smith Papyrus , Ebers Papyrus , Kahun Gynecological Papyrus ), Mesopotamia ( Diagnostic Handbook ), India ( Sushruta Samhita , Charaka Samhita ), China ( Huangdi Neijing ), Rome ( De Medicina ), and Greece ( De Materia Medica ). Important medical works in the medieval Islamic era include texts from Persia ( The Canon of Medicine of Ibn Sina ), Spain (Abu al-Qasim al-Zahrawi's Kitab al-Tasrif ), Iraq ( De Gradibus ), and Syria ( Ibn al-Nafis ' Comprehensive Book on Medicine ), while important medical texts from early medieval Europe include those from England ( Compendium Medicinæ ) and Byzantine Greece ( Medical Compendium in Seven Books ). Following Vesalius , William Harvey , Ignaz Semmelweis , Louis Pasteur , and others,

4307-646: The neck. When lying down, the CSF pressure as estimated by lumbar puncture is similar to the intracranial pressure . Hydrocephalus is an abnormal accumulation of CSF in the ventricles of the brain. Hydrocephalus can occur because of obstruction of the passage of CSF, such as from an infection, injury, mass, or congenital abnormality . Hydrocephalus without obstruction associated with normal CSF pressure may also occur. Symptoms can include problems with gait and coordination , urinary incontinence , nausea and vomiting , and progressively impaired cognition . In infants, hydrocephalus can cause an enlarged head, as

4380-530: The neural tube close after the first month of development, and CSF pressure gradually increases. By the fourth week of embryonic development the brain has begun to develop . Three swellings ( primary brain vesicles ), have formed within the embryo around the canal, near to where the head will develop. These swellings represent different components of the central nervous system : the prosencephalon (forebrain), mesencephalon (midbrain), and rhombencephalon (hindbrain). Subarachnoid spaces are first evident around

4453-475: The papyrus is an incomplete copy of an older reference manuscript from the Old Kingdom, evidenced by archaic grammar, terminology, form and commentary. James Henry Breasted speculates - but emphasises that this is pure conjecture based on no evidence - that the original author might be Imhotep , an architect, high priest, and physician of the Old Kingdom, 3000–2500 BCE. The rational and practical nature of

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4526-468: The papyrus is concerned with trauma and surgery, with short sections on gynaecology and cosmetics on the verso. On the recto side, there are 48 cases of injury. Each case details the type of the injury, examination of the patient, diagnosis and prognosis, and treatment. The verso side consists of eight magic spells and five prescriptions. The spells of the verso side and two incidents in Case 8 and Case 9 are

4599-421: The papyrus is illustrated in 48 case histories, which are listed according to each organ. Presented cases are typical, not individual. The papyrus begins by addressing injuries to the head, and continues with treatments for injuries to neck, arms and torso, detailing injuries in descending anatomical order like a modern anatomical exposition. The title of each case details the nature of trauma, such as "Practices for

4672-613: The papyrus to the New York Academy of Medicine , where it remains today. From 2005 through 2006, the Edwin Smith Papyrus was on exhibition at the Metropolitan Museum of Art in New York. James P. Allen , curator of Egyptian Art at the museum, published a new translation of the work, coincident with the exhibition. This was the first complete English translation since Breasted’s in 1930. This translation offers

4745-442: The quality of the evidence, and the existence of other options. Although medical news articles often deliver public health messages effectively, they often convey wrong or misleading information about health care, partly when reporters do not know or cannot convey the results of clinical studies, and partly when they fail to supply reasonable context. Several web sites review medical journalism; examples include Health News Review in

4818-406: The rate at which fluids move into the choroid plexus and CSF generation. The autonomic nervous system influences choroid plexus CSF secretion, with activation of the sympathetic nervous system decreasing secretion and the parasympathetic nervous system increasing it. Changes in the pH of the blood can affect the activity of carbonic anhydrase , and some drugs (such as furosemide , acting on

4891-415: The spinal cord, the median aperture , and the two lateral apertures . CSF is present within the subarachnoid space, which covers the brain and spinal cord, and stretches below the end of the spinal cord to the sacrum . There is a connection from the subarachnoid space to the bony labyrinth of the inner ear making the cerebrospinal fluid continuous with the perilymph in 93% of people. CSF moves in

4964-415: The state-of-the-art reasoning for modern clinical practice. The influence of brain injuries on parts of the body is recognized, such as paralysis . The relationship between the location of a cranial injury and the side of the body affected is also recorded, while crushing injuries of vertebrae were noted to impair motor and sensory functions. Due to its practical nature and the types of trauma investigated, it

5037-461: The surface of the choroid endothelium, appears to play a role in regulating CSF secretion and composition. It has been hypothesised that CSF is not primarily produced by the choroid plexus, but is being permanently produced inside the entire CSF system, as a consequence of water filtration through the capillary walls into the interstitial fluid of the surrounding brain tissue, regulated by AQP-4 . There are circadian variations in CSF secretion, with

5110-628: The understanding of the history of medicine. It demonstrates that Egyptian medical care was not limited to the magical modes of healing demonstrated in other Egyptian medical sources. Rational, scientific practices were used, constructed through observation and examination. From 1938 through 1948, the papyrus was at the Brooklyn Museum . In 1948, the New York Historical Society and the Brooklyn Museum presented

5183-399: The ventricles; by the lining surrounding the subarachnoid space ; and a small amount directly from the tiny spaces surrounding blood vessels around the brain. CSF is produced by the choroid plexus in two steps. Firstly, a filtered form of plasma moves from fenestrated capillaries in the choroid plexus into an interstitial space, with movement guided by a difference in pressure between

5256-459: Was in the possession of Smith until his death, when his daughter donated the papyrus to New York Historical Society . There its importance was recognized by Caroline Ransom Williams , who wrote to James Henry Breasted in 1920 about "the medical papyrus of the Smith collection" in hopes that he could work on it. He completed the first translation of the papyrus in 1930, with the medical advice of Dr. Arno B. Luckhardt . Breasted’s translation changed

5329-515: Was secreted by the pia mater . Thomas Willis (noted as the discoverer of the circle of Willis ) made note of the fact that the consistency of CSF is altered in meningitis. In 1869 Gustav Schwalbe proposed that CSF drainage could occur via lymphatic vessels. In 1891, W. Essex Wynter began treating tubercular meningitis by removing CSF from the subarachnoid space, and Heinrich Quincke began to popularize lumbar puncture, which he advocated for both diagnostic and therapeutic purposes. In 1912,

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