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	<title>prevents &#8211; USA NEWS LIVE</title>
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		<title>Spending agreement prevents nationwide shutdown and funds government until December</title>
		<link>https://bloggingthree.soflytech.com/2024/09/spending-agreement-prevents-nationwide-shutdown-and-funds-government-until-december/</link>
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		<dc:creator><![CDATA[enzo2go]]></dc:creator>
		<pubDate>Mon, 23 Sep 2024 03:37:18 +0000</pubDate>
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		<category><![CDATA[agreement]]></category>
		<category><![CDATA[December]]></category>
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		<guid isPermaLink="false">https://bloggingthree.soflytech.com/?p=15507</guid>

					<description><![CDATA[By KEVIN FREKING WASHINGTON (AP) — Congressional leaders announced an agreement Sunday on a short-term spending bill that might fund federal agencies for about three months, averting a possible partial government shutdown when the brand new fiscal 12 months begins Oct. 1 and delaying final decisions until after the November election. Temporary budget laws normally [&#8230;]]]></description>
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<p>By KEVIN FREKING</p>
<p>WASHINGTON (AP) — Congressional leaders announced an agreement Sunday on a short-term spending bill that might fund federal agencies for about three months, averting a possible partial government shutdown when the brand new fiscal 12 months begins Oct. 1 and delaying final decisions until after the November election.</p>
<p>Temporary budget laws normally keep agencies funded at their current levels. However, following the 2 assassination attempts on Republican presidential candidate Donald Trump, an extra $231 million was made available to strengthen the Secret Service. Additional funds were also made available to support the presidential transition, amongst other things. </p>
<p>The legislator has <a href="https://apnews.com/article/government-shutdown-funding-speaker-johnson-b77fc73b1474cbee5213219358985f71">fought</a> to get thus far, as the present fiscal 12 months ends at the tip of the month. At the urging of essentially the most conservative members of his party, House Speaker Mike Johnson (R-Louisiana) had tied the temporary funding to a provision that might have required states to require proof of citizenship when registering voters.</p>
<p>But Johnson abandoned this approach so as to reach an agreement, though Trump insisted that there ought to be no interim solution without compulsory voting.</p>
<p>Shortly thereafter, serious negotiations between the parties began, and leadership agreed to increase funding through mid-December, giving the present Congress the chance to draft a full-year budget proposal after the November 5 election, slightly than passing that responsibility on to the following Congress and president. </p>
<p>In a letter to his Republican colleagues, Johnson said the budget proposal could be &#8220;very narrow and limited to the bare minimum&#8221; and would &#8220;include only those expansions that are absolutely necessary.&#8221;</p>
<p>&#8220;While this is not the solution any of us prefer, it is the most sensible course of action in the current circumstances,&#8221; Johnson wrote. &#8220;As history teaches and recent polls confirm, it would be an act of political malpractice to shut down the government less than 40 days before a fateful election.&#8221; </p>
<p>House Democratic Leader Hakeem Jeffries said Democrats would review the bill in its entirety before voting this week, but with the agreement, &#8220;Congress is now on a bipartisan path to avoid a government shutdown that would harm ordinary Americans.&#8221; </p>
<p>The chairman of the House Budget Committee, Tom Cole, said on Friday that the talks were going well.</p>
<p>&#8220;Nothing has happened so far that we can&#39;t handle,&#8221; said Cole, Republican of Oklahoma. &#8220;Most people don&#39;t want a government shutdown and they don&#39;t want it to affect the election. So nobody is saying, &#39;I have to have this or we&#39;re leaving.&#39; It&#39;s just not like that.&#8221;</p>
<p>Johnson&#39;s earlier attempt failed within the Democratic-dominated Senate and faced opposition within the White House, however it did provide the speaker with a chance to indicate Trump and the conservatives on his caucus that he was fighting for his or her cause. </p>
<p>The final result—government funding virtually on autopilot—was exactly what many had predicted. With just weeks to go before the election, few lawmakers in either party had any appetite for the risk-taking politics that usually result in a shutdown. </p>
<p>Senate Majority Leader Chuck Schumer said the identical agreement might have been reached two weeks ago, but &#8220;Speaker Johnson chose the MAGA route and wasted valuable time.&#8221;</p>
<p>&#8220;As I have said throughout this process, there is only one way to get things done: with bipartisan, bicameral support,&#8221; Schumer said.</p>
<p>Now, a bipartisan majority is predicted to pass the short-term measure this week. But agreement on the short-term measure doesn&#8217;t mean it should be easy to pass a final budget bill in December. The election consequence could also affect political calculations if one party fares significantly higher than the opposite, potentially pushing the fight back to early next 12 months.</p>
<p>However, the Secret Service&#39;s funding is conditional: lawmakers have made it contingent on the Department of Homeland Security providing certain information to a House task force and a Senate committee investigating the assassination attempts against Trump. </p>
<p>In a recent letter, the Secret Service told lawmakers that a funding deficit was not the explanation for Trump’s security lapses when a shooter <a href="https://apnews.com/article/trump-assassination-attempt-fbi-secret-service-a382e3ec081dd13e85eaa9e726cca02c">climbed onto an unsecured roof</a> on July 13 at a rally in Butler, Pennsylvania, and opened fire. But acting Secret Service Director Ronald Rowe Jr. said this week that the agency had an &#8220;immediate need&#8221; and that he was talking to Congress.</p>
<p>Originally published: <time datetime="2024-09-22 14:12:20">September 22, 2024 at 2:12 p.m.</time></p>
</div>
<p><em>image credit : www.mercurynews.com</em></p>
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		<title>How the 14th Amendment prevents state legislatures from manipulating presidential elections</title>
		<link>https://bloggingthree.soflytech.com/2024/09/how-the-14th-amendment-prevents-state-legislatures-from-manipulating-presidential-elections/</link>
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		<dc:creator><![CDATA[enzo2go]]></dc:creator>
		<pubDate>Sun, 01 Sep 2024 13:50:17 +0000</pubDate>
				<category><![CDATA[News]]></category>
		<category><![CDATA[14th]]></category>
		<category><![CDATA[Amendment]]></category>
		<category><![CDATA[elections]]></category>
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		<category><![CDATA[Manipulating]]></category>
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		<guid isPermaLink="false">https://bloggingthree.soflytech.com/?p=13591</guid>

					<description><![CDATA[Donald Trump&#39;s efforts to overturn the results of the 2020 presidential election not only failed, but were also based partly on a misinterpretation of the U.S. Constitution. as our recent evaluation arguesThe corresponding constitutional provision dates from the period immediately after the Civil War and was recognized by contemporaries as a central protective mechanism of [&#8230;]]]></description>
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<p>Donald Trump&#39;s efforts to overturn the results of the 2020 presidential election not only failed, but were also based partly on a misinterpretation of the U.S. Constitution. <a href="https://arizonastatelawjournal.org/wp-content/uploads/2024/05/Froomkin_Pub.pdf">as our recent evaluation argues</a>The corresponding constitutional provision dates from the period immediately after the Civil War and was recognized by contemporaries as a central protective mechanism of American democracy.</p>
<p>In November 2020, when it became clear that Trump had lost the favored vote and would lose the Electoral College, Trump and his supporters organized a <a href="https://www.nytimes.com/interactive/2024/01/08/us/trump-2020-overturn-timeline.html">Print campaign</a> to steer the legislatures of several states whose residents voted for Joe Biden to appoint electors who would support Trump&#39;s re-election within the Electoral College vote.</p>
<p>Trump and his allies contacted Republican lawmakers in Michigan, Georgia and Pennsylvania to <a href="https://www.govinfo.gov/content/pkg/GPO-J6-REPORT/html-submitted/ch2.html">State parliaments</a> to overturn the end result of the favored vote. Ginni Thomas, the wife of Supreme Court Justice Clarence Thomas, <a href="https://www.washingtonpost.com/investigations/2022/06/10/ginni-thomas-election-arizona-lawmakers/">via email to GOP lawmakers in Arizona</a>and called on them to “ensure that a clean slate of electors is elected.”</p>
<p>These efforts were based on a provision of the Constitution in Article II, Section 1, which states: “Each State shall appoint <a href="https://constitution.congress.gov/constitution/article-2/#article-2-section-1-clause-2">in the manner prescribed by the legislator</a>a number of electors.” Trump and his supporters wanted state legislatures to discard their residents’ votes and easily appoint electors who would support Trump’s re-election campaign.</p>
<p>As a part of their efforts, Trump and his supporters claimed that the Constitution allows state legislatures to <a href="https://lawecommons.luc.edu/luclj/vol51/iss2/3">directly elect an inventory of electors</a> and not using a referendum.</p>
<p>But they were improper. There was already a safeguard in place – and it still exists today – to forestall this approach from getting used to <a href="https://azmirror.com/2024/02/15/republican-resolution-shows-intent-to-bypass-voters-in-the-2024-presidential-election/">undermine the 2024 presidential election</a>.</p>
<h2>An try and protect the facility of the voters</h2>
<figure class="align-right zoomable">
<div class="placeholder-container" style="--aspect-ratio-percent:170.46413502109706%;--background-color:#807f80"><img decoding="async" alt="" class="lazyload" src="https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=237&#038;fit=clip" srcset="https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=600&#038;h=1024&#038;fit=crop&#038;dpr=1 600w, https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=600&#038;h=1024&#038;fit=crop&#038;dpr=2 1200w, https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=600&#038;h=1024&#038;fit=crop&#038;dpr=3 1800w, https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=754&#038;h=1286&#038;fit=crop&#038;dpr=1 754w, https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=754&#038;h=1286&#038;fit=crop&#038;dpr=2 1508w, https://images.theconversation.com/files/614355/original/file-20240819-19-wspmii.png?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=754&#038;h=1286&#038;fit=crop&#038;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></div><figcaption>
              <span class="caption">A message published in South Carolina on August 19, 1868, provides insight into the then-understanding of Section 2 of the 14th Amendment.</span><br />
              <span class="attribution"><a class="source" href="https://www.newspapers.com/image/73824534/?match=1&#038;amp%3Bterms=%22then%20the%20basis%20of%20representation%20in%20such%20State%20must%20be%20reduced%20by%20the%20number%20of%20all%20the%20voters%2C%20which%20is%20to%20say%20that%20it%20is%20to%20have%20no%20basis%20of%20representation%20at%20all%22">The Anderson Intelligencer via newspapers.com</a></span><br />
            </figcaption></figure>
<p>In just about all states <a href="https://www.ncsl.org/elections-and-campaigns/the-electoral-college">Candidate who receives probably the most votes</a> For the presidency, the candidate receives all of the votes of the electors of the respective state. <a href="https://www.ncsl.org/elections-and-campaigns/the-electoral-college">Nebraska and Maine have small exceptions</a> – but under the laws of those states, nearly all of electoral votes still go to whoever receives nearly all of votes nationwide.</p>
<p>In the late 1860s, when the 14th Amendment was drafted and ratified, the identical was true – although the proper to vote <a href="https://www.archives.gov/milestone-documents/19th-amendment">limited to men until 1920</a>and states often denied or restricted the proper to vote for some residents, particularly members of ethnic minorities. After the Civil War, Congress attempted to cut back barriers to voting for black men, particularly within the South. </p>
<p>When Congress debated the 14th Amendment in 1866, its drafters drafted Section 2 in a <a href="https://doi.org/10.1353/cwe.2024.a919853">Efforts to force reluctant white Southerners to grant black men the proper to vote</a>.</p>
<p>Section 2 of the 14th Amendment states: “<a href="https://constitution.congress.gov/constitution/amendment-14/#amendment-14-section-2">if the right to vote in every election</a> for choosing Electors for President and Vice President of the United States … is denied … or in any manner abridged …, the basis of representation” for that State within the United States House of Representatives “shall be reduced” in proportion to the quantity of the abridgement.</p>
<p>So if a state were to deprive one in all its residents of the proper to vote, it might immediately <a href="https://arizonastatelawjournal.org/wp-content/uploads/2024/05/Froomkin_Pub.pdf">lose the identical percentage of seats within the House of Representatives</a> as a percentage of people that were disenfranchised.</p>
<p>Just just a few weeks after ratification, this provision was questioned for the primary time. </p>
<p>The Republican-dominated Reconstruction Legislature of Florida <a href="https://perma.cc/LS26-Y5TW">decided to carry presidential elections without popular vote</a>. The Democrats—then the party that supported black disenfranchisement—were furious. Many Southern newspaper journalists, still indignant concerning the ratification of the 14th Amendment, saw a chance to show the amendment against its Republican authors.</p>
<p>&#8220;<a href="https://www.newspapers.com/image/72230217/?match=1&#038;terms=%22is%20that%20if%20in%20any%20State%20the%20election%20of%20Presidential%20electors%20%22">The easy conclusion is that if in a state</a> “If the choice of Presidential Electors is no longer left to the people, and placed in the hands of the Legislature, the whole citizenry of the State… will be excluded from it,” wrote the Charleston Daily News on August 10, 1868.</p>
<p>This was not a rare or local view: nine days later, the Anderson Intelligencer, a South Carolina newspaper, published a brief article attributed to the New York Herald that stated similarly:</p>
<blockquote>
<p>&#8220;<a href="https://www.newspapers.com/image/73824534/?match=1&#038;terms=%22then%20the%20basis%20of%20representation%20in%20such%20State%20must%20be%20reduced%20by%20the%20number%20of%20all%20the%20voters%2C%20which%20is%20to%20say%20that%20it%20is%20to%20have%20no%20basis%20of%20representation%20at%20all%22">If all voters in a state are denied the proper to decide on presidential electors</a>then the premise of representation on this state have to be reduced by the variety of all voters, that&#8217;s, there must not be any basis of representation in any respect.&#8221;</p>
</blockquote>
<p>These opinion pieces don&#8217;t have any legal authority, but they reflect a standard – albeit controversial – <a href="https://timesmachine.nytimes.com/timesmachine/1868/08/08/78952288.html?pageNumber=4">Understanding the provisions of the 14th Amendment</a> on the time of its passage. No one filed a lawsuit, so no court had the chance to comment. And the Republican-dominated Congress had no qualms about accepting electoral votes &#8211; even and not using a popular vote &#8211; for the Republican presidential candidate.</p>
<h2>The right to have your vote counted</h2>
<p>After the 2020 election, Congress took steps to make clear that electors have to be those who select presidential electors. A law passed in 2022 revised the federal law governing electoral college selection to require state legislatures to find out their state&#39;s method for choosing electors before Election Day and <a href="https://www.ncsl.org/state-legislatures-news/details/what-the-electoral-count-reform-act-means-for-states">can not change it after the votes have been forged</a>. </p>
<p>This clarification is consistent with, and even strengthens, the provisions of Section 2 of the 14th Amendment.</p>
<p>As our evaluation shows, a direct election of electors by a state legislature would disenfranchise all voters within the state. After all, the proper to vote is the proper to have one&#39;s vote counted, not the proper to have one&#39;s candidate win. </p>
<p>Thus, even when the legislature were to pick out a slate of electors that might have received significant support in the favored election, the legislature&#39;s decision would limit the rights of each voter within the state. Disenfranchisement is determined by whether the people or the legislature selects the electors, not on which electors are chosen.</p>
<p>If all voters in a state are disenfranchised, Section 2 requires that the <a href="https://arizonastatelawjournal.org/wp-content/uploads/2024/05/Froomkin_Pub.pdf">The state’s representation within the House of Representatives will probably be immediately and mechanically reduced to zero</a>. The Constitution elsewhere provides that the representation of every state within the Electoral College <a href="https://constitution.congress.gov/constitution/article-2/#article-2-section-1-clause-2">Total of the delegations of the House of Representatives and the Senate of the State</a>. </p>
<p>If a state doesn&#8217;t have a representative within the House of Representatives, it might only have two electors, making its influence on the presidential election negligible and largely irrelevant.</p>
<h2>A single exception</h2>
<p>To date, it&#8217;s the only case, other than Florida in 1868, during which a state legislature has chosen its presidential electors and not using a popular vote. <a href="https://ir.law.fsu.edu/cgi/viewcontent.cgi?article=1609&#038;context=lr">got here in 1876</a>. </p>
<figure class="align-center zoomable">
<div class="placeholder-container" style="--aspect-ratio-percent:68.96551724137932%;--background-color:#85827d"><img decoding="async" alt="Copperplate engraving of portraits of two men." class="lazyload" src="https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=754&#038;fit=clip" srcset="https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=600&#038;h=414&#038;fit=crop&#038;dpr=1 600w, https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=600&#038;h=414&#038;fit=crop&#038;dpr=2 1200w, https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=600&#038;h=414&#038;fit=crop&#038;dpr=3 1800w, https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=754&#038;h=520&#038;fit=crop&#038;dpr=1 754w, https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=754&#038;h=520&#038;fit=crop&#038;dpr=2 1508w, https://images.theconversation.com/files/615878/original/file-20240827-18-eoeuuf.jpg?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=754&#038;h=520&#038;fit=crop&#038;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></div><figcaption>
              <span class="caption">Democrat Samuel Tilden (left) and Republican Rutherford Hayes ran for president within the 1876 election.</span><br />
              <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/the-presidental-contest-in-america-samuel-tilden-the-news-photo/464769291">Universal History Archive/Universal Images Group via Getty Images</a></span><br />
            </figcaption></figure>
<p><a href="https://millercenter.org/the-presidency/educational-resources/disputed-election-1876">Electoral fraud, political violence and voter intimidation</a> <a href="https://kansaspress.ku.edu/9780700617876/">undermined the integrity of the 1876 presidential election</a>The Constitution of Colorado, which was newly recognized as a state, provided that the legislature <a href="https://archives.colorado.gov/sites/archives/files/Colorado%20Constitution.pdf">In 1876, elect the state&#39;s presidential electors and not using a popular vote</a>Overshadowed by an exceptionally bitter election, the number of Colorado’s presidential electors by the legislature <a href="https://duurjportal.com/index.php/duurj/article/view/221/119">relatively little attention or debate</a>.</p>
<p>Overall, one can conclude that Southern newspapers in 1868 read the text of Section 2 accurately. The authors could have been cynical opportunists looking for to defend an untenable racist hierarchy, but their interpretation of the text is cheap.</p>
<p>The meaning of Section 2 is obvious and provides for severe penalties if a state doesn&#8217;t allow its residents to vote for presidential electors. The 14th Amendment continues to guard American democracy greater than 150 years after its ratification.</p>
</p></div>
<p><em>image credit : theconversation.com</em></p>
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		<title>Fluid prevents your brain from being crushed and protects your spine from impact – a neurologist explains what happens when it stops working</title>
		<link>https://bloggingthree.soflytech.com/2024/08/fluid-prevents-your-brain-from-being-crushed-and-protects-your-spine-from-impact-a-neurologist-explains-what-happens-when-it-stops-working/</link>
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		<dc:creator><![CDATA[enzo2go]]></dc:creator>
		<pubDate>Thu, 15 Aug 2024 05:04:22 +0000</pubDate>
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					<description><![CDATA[Cerebrospinal fluid or CSFis a transparent, colorless fluid that plays a vital role in maintaining the health and performance of your central nervous system. It cushions the brain and spinal cord, delivers nutrients, and removes waste products. Despite their importance, problems related to cerebrospinal fluid often go unnoticed until something goes unsuitable. I&#8217;m a Neurologist [&#8230;]]]></description>
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<p><a href="https://doi.org/10.3389%2Ffnhum.2021.737217">Cerebrospinal fluid or CSF</a>is a transparent, colorless fluid that plays a vital role in maintaining the health and performance of your central nervous system. It cushions the brain and spinal cord, delivers nutrients, and removes waste products. </p>
<p>Despite their importance, problems related to cerebrospinal fluid often go unnoticed until something goes unsuitable. </p>
<p>I&#8217;m a <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/29586">Neurologist and headache specialist</a>. In my work with patients with CSF pressure disorders, I actually have seen many alternative manifestations of those conditions. Here&#39;s what happens when your cerebrospinal fluid stops working:</p>
<h2>What is cerebrospinal fluid?</h2>
<p>CBF <a href="https://doi.org/10.3390/biomedicines11051461">consists of</a> Water, proteins, sugars, ions and neurotransmitters. It is principally produced by a network of cells that <a href="https://doi.org/10.3389%2Ffnhum.2021.737217/">Choroid plexus</a>which is positioned within the ventricles or cavities of the brain. </p>
<p>The choroid plexus produces approx. <a href="https://doi.org/10.1016/j.anorl.2011.03.002">500 milliliters of cerebrospinal fluid each day</a>but within the central nervous system only about 150 milliliters are present at anybody time, because the brain is always being absorbed and replenished. This fluid circulates through the <a href="https://www.ncbi.nlm.nih.gov/books/NBK532932/">Ventricles of the brain</a>The <a href="https://doi.org/10.7759%2Fcureus.927">Central canal of the spinal cord</a> and the <a href="https://www.ncbi.nlm.nih.gov/books/NBK557521/">Subarachnoid space</a> across the brain and spinal cord.</p>
<figure class="align-center zoomable">
<div class="placeholder-container" style="--aspect-ratio-percent:65.11936339522546%;--background-color:#a6705e"><img decoding="async" alt="Diagram of a cross section of the brain showing the circulation of cerebrospinal fluid" class="lazyload" src="https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=754&#038;fit=clip" srcset="https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=600&#038;h=390&#038;fit=crop&#038;dpr=1 600w, https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=600&#038;h=390&#038;fit=crop&#038;dpr=2 1200w, https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=600&#038;h=390&#038;fit=crop&#038;dpr=3 1800w, https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=754&#038;h=491&#038;fit=crop&#038;dpr=1 754w, https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=30&#038;auto=format&#038;w=754&#038;h=491&#038;fit=crop&#038;dpr=2 1508w, https://images.theconversation.com/files/613040/original/file-20240812-17-hsnmir.jpg?ixlib=rb-4.1.0&#038;q=15&#038;auto=format&#038;w=754&#038;h=491&#038;fit=crop&#038;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></div><figcaption>
              <span class="caption">The cerebrospinal fluid circulates throughout the brain and spinal cord.</span><br />
              <span class="attribution"><a class="source" href="https://openstax.org/books/anatomy-and-physiology/pages/13-3-circulation-and-the-central-nervous-system">OpenStax</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span><br />
            </figcaption></figure>
<p>CSF has <a href="https://doi.org/10.3390%2Fbiomedicines11051461">several critical functions</a>. It protects the brain and spinal cord from injury by absorbing shock. Suspending the brain on this fluid reduces <a href="https://doi.org/10.3390%2Fbiomedicines11051461">its effective weight</a> and prevents it from being crushed by its own mass. In addition, CSF helps maintain a stable chemical environment within the central nervous system, facilitating the removal of metabolic waste and the distribution of nutrients and hormones.</p>
<p>When the production, circulation, or absorption of cerebrospinal fluid is impaired, it might probably cause significant health problems. Two necessary conditions are cerebrospinal fluid leaks and idiopathic intracranial hypertension.</p>
<h2>Cerebrospinal fluid leak</h2>
<p>A <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/cerebrospinal-fluid-csf-leak">Cerebrospinal fluid leak</a> occurs when fluid escapes through a tear or hole within the dura mater – the tough outermost layer. <a href="https://my.clevelandclinic.org/health/articles/22266-meninges">the meninges</a> that surrounds the brain and spinal cord. </p>
<p>The dura will be damaged by head trauma or punctured during surgical procedures involving the sinuses, brain, or spine, corresponding to a lumbar puncture, epidural, spinal, or myelogram. <a href="https://doi.org/10.1001/jama.295.19.2286">Spontaneous CSF leaks</a> can even occur with none identifiable cause.</p>
<p>Originally it was assumed that CSF leaks were relatively rare. <a href="https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/">Incidence of 5 per 100,000 people</a>However, with increasing awareness and advances in imaging, healthcare providers are discovering increasingly more leaks. They are likely to <a href="https://doi.org/10.1016/j.ncl.2013.11.002">occur more steadily</a> in middle-aged adults and are more common in women than in men. </p>
<p>Risk aspects for the disease include connective tissue diseases corresponding to Ehlers-Danlos syndrome and postural orthostatic tachycardia syndrome. </p>
<figure>
<p><iframe title="Upright Headache -  my spinal CSF leak" width="1170" height="658" src="https://www.youtube.com/embed/TJS2g6DNfHA?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></p><figcaption><span class="caption">Headaches when lying down generally is a sign of a cerebrospinal fluid leak.</span></figcaption></figure>
<p>Unfortunately, it is not uncommon for healthcare providers <a href="https://doi.org/10.1001/archneur.60.12.1713">Misdiagnosis of a CSF leak</a> than one other disease, corresponding to migraines, sinusitis or allergies. What can <a href="https://spinalcsfleak.org/about-spinal-csf-leaks/diagnosis-of-spinal-csf-leak/">Diagnosis of a CSF leak difficult</a> is the broad symptomatology. Most individuals with a CSF leak have a <a href="https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246">Positional headache</a> This improves when lying down and gets worse when standing. The pain often occurs at the back of the top and might extend to the neck and between the shoulder blades. In addition to the headache, patients may experience ringing within the ears, visual disturbances, memory problems, difficulty concentrating, dizziness and nausea.</p>
<p><a href="https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cerebrospinal-fluid-leak.html">Imaging might help with diagnosis</a>including an MRI of your brain or entire spine, <a href="https://radiology.ucsf.edu/patient-care/prepare/myelogram">or a myelogram</a> of the space surrounding your spinal cord. Characteristics of a CSF leak which are visible in a scan are your <a href="https://spinalcsfleak.org/about-spinal-csf-leaks/diagnosis-of-spinal-csf-leak/">Brain sags</a> within the skull base and a fluid accumulation outside the dura. However, it&#8217;s estimated <a href="https://doi.org/10.1001/jamaneurol.2020.4799">In 19% of patients with a CSF leak, the scans are normal</a>subsequently, it can&#8217;t be completely ruled out that there&#8217;s a leak if there are not any signs in the images.</p>
<p><a href="https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak">Conservative treatment</a> If you have got a CSF leak, you need to rest, lie flat, and drink more fluids to offer your spine time to heal the puncture. Increasing your caffeine intake to the equivalent of three to 4 cups of coffee a day can also help. <a href="https://doi.org/10.1186%2F1471-2202-10-110">increasing CSF production</a> by stimulating the choroid plexus. Caffeine also relieves pain by interacting with <a href="https://doi.org/10.7759/cureus.25603">Adenosine receptors</a>which play a key role within the body&#39;s pain perception mechanisms.</p>
<p>If a conservative approach isn&#8217;t successful, <a href="https://www.ncbi.nlm.nih.gov/books/NBK482336/">Epidural blood patch</a> could also be crucial. This procedure involves drawing blood out of your arm and injecting it into your spine. The injected blood might help form a covering over the outlet and promote the healing process. The headache may improve quickly, but when the patch doesn&#8217;t work or the outcomes are short-lived, additional tests could also be needed to raised locate the positioning of the leak. In rare cases <a href="https://spinalcsfleak.org/about-spinal-csf-leaks/treatment/">Surgery could also be beneficial</a>Most patients with a CSF leak reply to some form of those treatments.</p>
<h2>Idiopathic intracranial hypertension</h2>
<p><a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/idiopathic-intracranial-hypertension">Idiopathic intracranial hypertension</a> is a condition through which excess cerebrospinal fluid increases pressure within the skull and compresses the brain. The term &#8220;idiopathic&#8221; signifies that the reason behind the increased pressure is unknown.</p>
<p>Most patients with idiopathic intracranial hypertension have a <a href="https://www.medsafe.govt.nz/profs/PUArticles/March2016/IdiopathicIntracranialHypertension.htm">History of Obesity</a> or recent weight gain. Other risk aspects include taking certain medications corresponding to tetracycline, excessive vitamin A, tretinoin, steroids and growth hormones. Overweight middle-aged women are <a href="https://doi.org/10.1177/1756285616635987">20 times more likely</a> Patients with idiopathic intracranial hypertension are diagnosed at a better rate than other patient groups. As obesity becomes more prevalent, the incidence of this disease can be increasing.</p>
<figure>
<p><iframe title="Idiopathic intracranial hypertension (Year of the Zebra)" width="1170" height="658" src="https://www.youtube.com/embed/F1HKRPJAB2g?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></p><figcaption><span class="caption">Idiopathic intracranial hypertension is the results of increased intracranial pressure.</span></figcaption></figure>
<p>Patients with idiopathic intracranial hypertension typically experience <a href="https://www.aao.org/eye-health/diseases/what-is-idiopathic-intracranial-hypertension">Headaches and visual disturbances</a>Tinnitus or eye pain. <a href="https://my.clevelandclinic.org/health/diseases/24445-papilledema">Papilledema</a>or swelling of the optic disc, is the standard finding in a <a href="https://stanfordmedicine25.stanford.edu/the25/fundoscopic.html">Funduscopic examination</a> the back of the attention. Doctors can also observe paralysis of the patient&#39;s eye muscles.</p>
<p>Brain imaging in patients with suspected idiopathic intracranial hypertension is crucial for <a href="https://eye.hms.harvard.edu/book/how-patient-diagnosed-and-treated">Exclusion of other causes</a> of increased cerebrospinal fluid pressure, corresponding to brain tumors or blood clots within the brain. <a href="https://doi.org/10.1177/1756285616635987">Lumbar puncture or spinal puncture</a> Measuring the pressure and composition of the cerebrospinal fluid can be crucial for diagnosis.</p>
<p>Since high intracranial pressure can damage the optic nerve and <a href="https://doi.org/10.1007/s11910-020-1026-8">result in everlasting vision loss</a>The most important goal of treatment is to scale back pressure and preserve the optic nerve. <a href="https://eye.hms.harvard.edu/book/what-are-treatment-options">Treatment options</a> These include weight reduction, dietary changes and medications to scale back cerebrospinal fluid production. <a href="https://doi.org/10.1007/s10143-020-01288-1">Surgical procedures</a> can even reduce intracranial pressure.</p>
<h2>Future directions and unknowns</h2>
<p>Cerebrospinal fluid is important for brain health. Despite advances within the understanding of CSF-related diseases, some features remain unclear. </p>
<p>The exact mechanisms resulting in conditions corresponding to CSF leaks and idiopathic intracranial hypertension should not fully understood, but there are <a href="https://doi.org/10.1136/jnnp-2023-332222">many theories</a>Further research is required to enhance diagnostic accuracy and supply more practical treatments for cerebrospinal fluid disorders.</p>
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<p><em>image credit : theconversation.com</em></p>
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