Mechanism for intracranial hypertension during experimental subarachnoid hemorrhage: acute malfunction of arachnoid villi by components of plasma.
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Acute Disease↗
Biomedical subjects
R G Dacey
Publications and source records attributed to R G Dacey.
Intracranial subarachnoid pressure recording: experience with 650 patients.
One hundred and forty-seven patients had intracranial pressure monitoring by means of a subarachnoid screw as part of their routine neurosurgical care. Average length of monitoring was five days. Successful recordings were obtained in 92% of the patients. Improper technical placement caused the majority of failures. The overall infection rate associated with the monitor was 2.1%, with 0.7% CNS infection (one patient developed a brain abscess). We have since monitored an additional 500 patients and find the subarachnoid screw to be a reliable, low risk means of clinically recording intracranial pressure in neurosurgical patients.
Adolescent↗
Effect of probenecid on cerebrospinal fluid concentrations of penicillin and cephalosporin derivatives.
Probenecid may elevate the cerebrospinal fluid (CSF) concentration of penicillin G by inhibiting the excretion of organic acids from CSF. We have studied this phenomenon with various penicillin and cephalosporin derivatives. Penicillin concentrations were determined in rabbits under steady-state conditions before and after intravenous probenecid administration. With both low-dose and high-dose probenecid, CSF penicillin levels increased two to three times as did CSF concentration as a percentage of serum level. The same probenecid effect was consistently demonstrated in animals with experimental pneumococcal meningitis. Probenecid likewise increased the CSF concentration of ampicillin, carbenicillin, nafcillin, cephacatrile, and cefazolin. Probenecid may prove useful in certain bacterial infections where high CSF antibiotic levels are necessary.
Animals↗
Production of sustained hypertension by lesions in the nucleus tractus solitarii of the American foxhound.
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Aldosterone↗
Spinal subdural empyema: report of two cases.
Spinal subdural empyema (SSE) is a rare variety of intraspinal infection. SSE should be suspected in patients presenting with fever, back pain, and signs of cord or nerve root compression. Two patients with SSE are presented. The first patient complained of fever and back pain. She had no neurological deficit but was found to have SSE. The second patient, who presented with intracerebral hemorrhage in the fifth month of pregnancy and spontaneous abortion, was found to have SSE at lumbar puncture. The clinical manifestations and management are discussed.
Adult↗
Polyvinyl alcohol particle size and suspension characteristics.
PURPOSE: To evaluate the size and shape of commercially available polyvinyl alcohol (PVA) particles and to determine whether they change in size when suspended in nonionic contrast and in a solution of nonionic contrast and absolute alcohol. METHODS: The two-dimensional area and the long and short axis of PVA particles from several different vendors were measured using a light microscope attached to a video system and an image-processing software program. Particles were measured as packaged (dry or suspended in saline), suspended in ioversol, and suspended in ioversol containing 30% alcohol. RESULTS: All brands of dry particles had similar microscopic appearances. The saline-suspended particles had fewer and finer perforations. After suspension in contrast, all sizes and brands of dry particles significantly increased in size. The particles packaged in saline did not expand. The addition of alcohol to the contrast did not consistently change particle size. Particle aggregation was similar in both contrast suspensions for all groups of particles. Particles less than 50 microns in size were rarely observed in any PVA preparation after suspension. CONCLUSIONS: The three dry PVA preparations seem to be similar. All increase significantly in size when suspended in nonionic contrast or contrast-alcohol solutions. The saline-packaged PVA particles were different from the dry variety and did not enlarge in contrast or contrast-alcohol solutions. Alcohol did not change the size or suspension characteristics of PVA particles. Particles less than 50 microns in size were rarely identified.
Contrast Media↗
Effect of intraarterial papaverine on cerebral circulation time.
PURPOSE: To measure the mean cerebral circulation time (CCT) in patients with symptomatic vasospasm stemming from subarachnoid hemorrhage and to determine any change after papaverine treatment. METHODS: We studied 27 patients who received intraarterial papaverine from November 1992 to August 1995 to determine the CCT in 59 carotid territories. CCT was measured from the first image in which contrast was seen above the supraclinoid internal carotid artery to the peak filling of parietal cortical veins. Angiograms at the time of presentation were examined in 19 of the 27 patients. A control population of 19 patients (30 carotid territories) was also studied. RESULTS: The mean CCT on presentation was 6.8 seconds +/- 1.1. The prepapaverine mean CCT was 6.1 seconds +/- 1.2. The immediate postpapaverine mean CCT was 3.8 seconds +/- 0.8. CCT decreased in 58 of 59 territories treated with papaverine; the mean change was -35.7%. In eight of these patients, CCT rose on the following day to 6.1 seconds +/- 1.1. In the control group, mean CCT was 5.9 seconds +/- 0.8. The mean CCT in patients with subarachnoid hemorrhage was slightly prolonged on presentation relative to that in control subjects. CONCLUSION: Intraarterial papaverine produces a consistent decrease in CCT in patients with vasospasm.
Adult↗