The absorption of phenolsulphonephthalein from the subarachnoid space in diseases of the central nervous system

Abstract

Since 1842 various observers, beginning with Magendie, have demonstrated that pigments injected into the subarachnoid space eventually appear in the urine. Dandy and Blackfan1 were the first to apply this knowledge to the study of pathologic conditions. They showed that phenolsulphonephthalein injected into the subarachnoid space is harmless and appears in the urine in normal infants in from four to ten minutes. Their studies were confined to hydrocephalus in infants and to certain animal experiments. As a result of these observations they were led to conclude that there is an active circulation of the spinal fluid; that it is constantly absorbed; and that absorption takes place directly into the vascular supply of the whole subarachnoid space. So far as we know, no other pathologic studies have been made in this way. Cushing and Weed,2 using the same dye in connection with their work on the spinal fluid, were convinced that absorption takes place largely by way of the subarachnoid villi into the cerebral sinuses. Motte and Nageotte3 believe that there may be considerable absorption of the spinal fluid by way of the perineural lymphatics.The following observations were made to determine, if possible, whether there might be some disturbance in the excretion of phenolsulphonephthalein in diseases of the central nervous system other than hydrocephalus. The method adopted consisted, in brief, of doing a lumbar puncture, injecting 1 c.c. of neutral phenolsulphonephthalein,1 catheterizing the patient and timing the appearance of the dye in the urine.Certain practical points were soon evident, both from the stand¬ point of accuracy in results and in maintaining aseptic conditions. In the first place it was noted that there was a tendency for the dye

Inhibition of Penicillin Transport from the Cerebrospinal Fluid after Intracisternal Inoculation of Bacteria

“…In all four animals, more than 90%o of the 14C was penicillin. Similarly, 5 [3H]inulin (0.1 juCi) was spotted directly as purchased from the company. In all cases more than 98% of the 'H activity was at the origin.…”

“…However, Harter and Petersdorf (2) suggested that another factor, viz., an inhibition of efflux from CSF to blood in meningitis, might affect drug distribution. Thlis perceptive insight was based on an analysis of phenolsulphonphthalein (PSP) transport from the CSF in meningitis in humans (5). Subsequently, the active transport of PSP (6) and other substances such as penicillin (7)(8)(9) from the CSF was documented.…”