Ammonia Levels in Blood and Cerebrospinal Fluid.

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Abstract
Recent studies from this and other laboratories have emphasized that elevations in blood ammonia levels occur in association with the encephalo-pathies of liver disease and portacaval shunts. These studies were designed to observe concomitant changes in ammonia levels in the blood and cerebrospinal fluid. Ammonia levels were measured by a previously reported modification of the microdiffusion technique described by Conway. Concomitant measurements of ammonia levels in the blood and cerebrospinal fluid were made on normal individuals and on patients with diseases of the liver and portal circulation. The observations show that no appreciable ammonia exists in the cerebrospinal fluid of normal individuals. In diseases of the liver or portal circulation however, abnormal elevations in the level of ammonia in the peripheral blood may occur and these are accompanied by corresponding but lesser elevations in levels of ammonia in the cerebrospinal fluid. The significance of these findings is discussed.