Lancet
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Head-up tilt, a recognised stimulus to vasovagal syncope, was used to investigate syncope that remained unexplained despite full clinical and electrophysiological assessment in fifteen patients, mean age 65 +/- 10 years, who had had 15 +/- 19 episodes of unexplained syncope over periods of a week to 26 years. After overnight fast systolic blood pressure and heart rate were continuously monitored during 40 degrees head-up tilt for 60 min. Ten control subjects with no history of syncope were studied similarly. ⋯ No clinical findings predicted development of syncope during tilt. Baseline systolic blood pressure and heart rate did not differ significantly between patients and controls. Pacemakers were implanted in seven patients who have remained symptom-free since implant (follow-up 10 +/- 3 mo).
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Magnetic resonance imaging was used to measure intracranial extraventricular and ventricular cerebrospinal fluid (CSF) volume. In 10 normal subjects lateral ventricular and extraventricular intracranial CSF volumes were 25.3 +/- 4.6 ml (mean +/- SD) and 97.6 +/- 6.6 ml, respectively (total 122.8 +/- 38.7). ⋯ The technique gave highly reproducible results (SD less than 5.7% of mean value). It may be useful in differential diagnosis and as an objective means of monitoring therapy or progress in conditions such as cerebral atrophy, hydrocephalus, and benign intracranial hypertension.