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[6] [7] Regional volume reduction is not uniform; some brain regions shrink at a rate of up to 1% per year, whereas others remain relatively stable until the end of the life-span. [8] The brain is very complex, and is composed of many different areas and types of tissue, or matter.
The brain volume decreases roughly 5% per decade after forty. It is currently unclear why brain volume decreases with age. However, a few causes may include cell death, decreased cell volume, and changes in synaptic structure.
Severe drops in blood pressure can lead to fainting, with a possibility of injury. Moderate drops in blood pressure can cause confusion/inattention, delirium, and episodes of ataxia. Chronic orthostatic hypotension is associated with cerebral hypoperfusion that may accelerate the pathophysiology of dementia. [5]
The primary and most serious complication of a spontaneous cerebrospinal fluid leak is spontaneous intracranial hypotension, where pressure in the brain is severely decreased. [ 23 ] [ 42 ] [ 54 ] This complication leads to the hallmark symptom of severe orthostatic headaches .
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Accumulation of extracellular fluid increases brain volume and then intracranial pressure causing the symptoms of cerebral edema. [1] There are several clinical conditions in which vasogenic edema is present: CNS tumors, like glioblastoma and meningioma [1] [21] Infections like meningitis, abscess, and encephalitis [1] [21]
The cerebral blood volume value of gray matter is about 3.5 +/- 0.4 ml/100g, and the white matter is about 1.7 +/- 0.4 ml/100g. The gray matter is nearly twice that of white matter. [3] In both white and gray matter, cerebral blood volume decreases by about 0.50% per year with increasing age. [4]
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