[Cerebrospinal fluid changes in severe craniocerebral injury and their therapy]

The sign of a traumatically caused alveolar hyperventilation in severe cranio-cerebral injury is a respiratory alcalosis as well as hypoxia and hypoxemia in the arterial as well in the cerebral veneous blood. The combination of decreased oxygen tension or saturation and hypocapnia can exist for several days and in a lethal course transform into a combined metabolic respiratory acidosis with increasing carbonic acid tension and so initiate the prefinal state. The extremely pathological blood gases are usually the first sign of shock-specific changes of the lung. The most impressing changes of the cerebrospinal fluid are the metabolic acidosis in combination with a diminished oxygen tension and tissue hypoxia of the brain. The acidosis of cerebrospinal fluid in severe brain injury is not only of prognostic but also of therapeutical importance. The treatment of the acidosis of cerebrospinal fluid by intrathecal administration of buffering substances in severe brain injuries and its sequelae can have a favourable influence on the cerebral circulation and brain metabolism.