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This chapter describes the cerebrospinal fluid (CSF) dynamics and how fluid inside the central nervous system (CNS) is generated, stored, and absorbed within the context of a mathematical model developed by A. Marmarou. It explains the main Lumbar infusion techniques in theory and their practical applications by various clinics. Clinical prognostic applications of infusion methods can be classified into two groups: transient and steady-state. External lumbar drainage (ELD) is a prognostic tool for which the accuracy of prediction rate can be more than 90%. The test is based on the idea of simulating the shunt operation in real life by withdrawing CSF for relatively long time durations at drainage rates roughly comparable to regular shunt drainage. ELD yields the most accurate prognostic indications since it simulates the shunt for an extended time duration, which also helps to exclude some placebo effects.
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