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Chemotactic activity of cerebrospinal fluid in pyogenic meningitis.

Cerebrospinal fluid from patients with pyogenic meningitis was found to be chemotactic for polymorphonuclear neutrophil leucocytes. No significant difference was found between the mean chemotactic activity of cerebrospinal fluid obtained from patients with pneumococcal meningitis or meningococcal meningitis. The chemotactic factor present in cerebrospinal fluid is probably a low molecular weight protein, perhaps a complement component.

Adult↗

On the mechanism of antiepileptic peptides appearance in the cerebrospinal fluid.

Intraventricular injection of cerebrospinal fluid obtained from cats with electroshock seizures resulted in suppression of generalized picrotoxin-induced seizures in rats. Antiepileptic action of cerebrospinal fluid was abolished by partial bilateral midbrain destruction that included the region of colliculi superii. Electrical stimulation of cerebellum in cats with such destructions caused the appearance of a pronase-sensitive antiepileptic substances in cerebrospinal fluid.

Animals↗

New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer. 2nd part: pathology of cerebrospinal fluid flow in the subarachnoid space of the brain convexity.

The use of the sequential gamma camera technique with evaluation of the stored information in the digital analyzing system to investigate CSF dynamics quantitatively has given interesting new information about the circulation in the epicortical SA space. The streaming of I131HSA-labelled CSF in a protracted bolus or bulk was submitted to quantitative and temporal analysis by defining the activity maxima and their amounts as well as their times of appearance. Different modalities of activity evolution in various regions make it possible to define three main types of circulatory disturbance, which are: 1. Global epicortical inhibition, 2. circumscribed epicortical inhibition by a) restriction of the SA space, b) dilatation of the SA space, and 3. gamma cisternographic asymmetry, apparently due to restriction, with a fully functioning but dilated SA space and no real inhibition. The pathological conditions in the SA space leading to these different flow disturbance modalities are presented, and the necessity to perform quantitative and temporal analysis for definition of the functional flow conditions is emphasized.

Cerebrospinal Fluid↗

Fluid administration, brain edema, and cerebrospinal fluid lactate and glucose concentrations in experimental Escherichia coli meningitis.

The effect of no fluids versus liberal fluid supplementation on brain edema and cerebrospinal fluid (CSF) lactate and glucose concentrations was compared in rabbits with experimental Escherichia coli meningitis. Fluid restriction for the duration of the experiment (19 h) led to a decrease in body weight by approximately 5%, while the high fluid regimen increased body weight by approximately 5%. Infected animals developed brain edema compared with controls, but the fluid regimen had no measurable effect on the degree of edema. In contrast, fluid-restricted animals had significantly higher CSF lactate and lower CSF glucose concentrations than fluid-supplemented animals (lactate, 13.5 +/- 3.5 vs. 10.1 +/- 3.3 mmol/L; glucose, 1.89 +/- 1.39 vs. 4.11 +/- 1.39 mmol/L). These results fail to support the hypothesis that administration of large amounts of fluid in this model of gram-negative bacterial meningitis aggravates brain edema.

Animals↗

Phenylacetic acid in human body fluids: high correlation between plasma and cerebrospinal fluid concentration values.

In a group of six Parkinsonian patients and 13 "controls" with non-Parkinsonian neurological disease, there was a high correlation between both free and conjugated phenylacetic acid concentrations in plasma and cerebrospinal fluid taken at about the same time. This compound is the major metabolite of phenylethylamine, the production of which may be disturbed in a number of neuropsychiatric illnesses. Thus plasma measurements might be employed clinically to provide an estimate of central changes in phenylethylamine economy. A small but significantly higher proportion of conjugated phenylacetic acid was present in the plasma (but not cerebrospinal fluid) of Parkinsonians compared with controls.

Female↗

Choroid plexus papilloma with cerebrospinal fluid rhinorrhea.

Intermittent cerebrospinal fluid rhinorrhea occurred in a 34-year-old male with a papilloma of the choroid plexus in the fourth ventricle. Surgical removal of the tumor preceded plastic repair of the frontonasal fistula. I report an observation 28 years after operation.

Adult↗

Cerebrospinal fluid lymphocytosis in acute bacterial meningitis.

Cerebrospinal fluid lymphocytosis (more than 50 percent lymphocytes or mononuclear cells) occurred in 14 of 103 cases of bacteriologically proved acute bacterial meningitis. Patients with cerebrospinal fluid lymphocytosis accounted for 32 percent (13 of 41) of all patients with bacterial meningitis with a cerebrospinal fluid white blood cell concentration of 1,000/mm3 or less. Cerebrospinal fluid lymphocytosis was significantly more common in neonates and in those without meningismus, but occurred in all ages and without any clear identifying clinical characteristics. The most common etiologic organisms were Streptococcus pneumonia (five), Neisseria meningitidis (two), and Hemophilus influenzae (two). Cerebrospinal fluid lymphocytosis is common in acute bacterial meningitis when the cerebrospinal fluid white blood cell concentration is below 1,000/mm3. It is therefore of little value in differentiating bacterial meningitis from viral, fungal, and tuberculous meningitis.

Acute Disease↗

An improved method for electron microscopic observation of cerebrospinal fluid cells.

Human cerebrospinal fluid (CSF) cells were entrapped between two bovine serum albumin cylinders linked by glutaraldehyde using microhematocrit tubes. The "sandwiched" specimen could be processed in further preparatory steps like tissue for routine electron microscopy. This rapid procedure resulted in adequate cell preservation for transmission electron microscopy without substantial loss of CSF cells.

Cerebrospinal Fluid↗

Complications of spinal drainage in the management of cerebrospinal fluid fistula.

Continuous cerebrospinal fluid (CSF) drainage may be used in the treatment CSF fistula. The procedure, however, is not without risk. Marked gradients between the intracranial and intraspinal CSF pressures and intravasation of air through an unsealed fistula may produce serious neurological problems. The use of continuous CSF drainage requires an alert, informed nursing staff to avert catastrophe.

Adult↗

Malignant blast cells in the cerebrospinal fluid.

In the cerebrospinal fluid of 45 patients, 240 cytological examinations has been performed. Sixteen patients were investigated serially in the course of intrathecal methotrexate treatment. The different mechanisms of nuclear fragmentation, various types of cytoplasmic vacuoles and the features of the reticulo-histiocytic reactions due to methotrexate has been analyzed. The morphological changes caused by methotrexate are attributed to depend on the cell type and on its response to therapy.

Cerebrospinal Fluid↗

[The cerebrospinal fluid shunt].

The cerebrospinal fluid shunt is one of the most common surgical procedures in pediatric neurosurgery. Nevertheless, an important rate of failure (mechanical, infectious or functional) can occur. These complications can result from the hydrocephalus itself, the surgical technique (type of material and surgeon experience) and infectious problems related to foreign material. Most of the time, the clinical signs of these failures are obvious (intracranial hypertension or signs of meningitis) but can also be insidious.

Cerebrospinal Fluid Shunts↗

Cerebrospinal fluid diversion procedures.

Cerebrospinal fluid (CSF) diversion procedures remain the principal method of treatment of hydrocephalus and an important option in treating idiopathic intracranial hypertension. Recent advances in CSF shunt hardware offer some promise in reducing the rate of complications. Third ventriculostomy has become an increasingly practiced alternative to conventional shunting in an ever-widening patient population. Long-term follow-up studies have identified complications of lumboperitoneal shunt placement. Advances in surgical navigation suggest that ventriculoperitoneal shunting may be a viable alternative in patients with idiopathic intracranial hypertension.

Cerebrospinal Fluid Shunts↗

Antibiotic prophylaxis in ventricular shunt surgery. II. Antibiotic concentrations in cerebrospinal fluid.

Investigation of cerebrospinal fluid (CSF) antibiotic levels from patients operated upon under short-term prophylactic protocols for shunt insertions or revisions revealed low-level CSF penetration by nafcillin and virtually no methicillin activity. Nafcillin levels were not influenced by route of injection or CSF sampling time, but were inversely proportional to ventricular size. The authors recommend nafcillin over methicillin as the preferred prophylactic agent in shunt surgery. Although the 25 mg/kg preoperative dose may be adequate for reducing infection risk, higher dosages should be considered when the ventricles are markedly dilated.

Cerebrospinal Fluid Shunts↗

[3H]Diazepam displacing activity in human cerebrospinal fluid.

Pooled human cerebrospinal fluid was separated by Sephadex G-50 chromatography. The presence of three peaks, A, B and C, was demonstrated by monitoring absorbance at 254 and 280 nm. All peaks showed [3H]diazepam displacing activity in the membrane receptor test. Peak B was further separated on Bio-Gel P-4. At least two major fractions free of salt and GABA in the molecular weight range of approximately 700--3600 were shown to displace [3H]diazepam in the receptor test. This activity was enhanced by a factor of 3 in the presence of 10 microM-GABA.

Animals↗

Estimation of reference intervals for total protein in cerebrospinal fluid.

Protein in cerebrospinal fluid (CSF) was measured by a modified biuret procedure and in two automated instruments, the Du Pont aca and the Kodak Ektachem. The latter's dry-slide reagent was also evaluated for precision, linearity, and effect of potential interferents. In vitro, ampicillin and vancomycin increase the apparent value for CSF protein as measured with the Ektachem slides. We excluded patients with disorders of the central nervous system, and we estimated the central 95% percentile reference intervals for CSF protein for each of the three methods. We found no age or gender dependence of values. By the biuret procedure, the reference interval is 140 to 620 mg/L.

Adult↗

Complement-fixing antibrain antibodies in multiple sclerosis. Comparison of their occurrence in cerebrospinal fluid and serum.

Cerebrospinal fluid (CSF) and serum samples from 40 multiple sclerosis (MS) patients and 48 control patients were examined by a microcomplement fixation test for the presence of antibodies against saline extracts of human brain. When tested with an IgG content standardized in 100 mg per 100 ml, 13 of the MS CSF and one of the corresponding MS sera were positive, whereas none of the control specimens were positive. The antibody was shown to be highly organ specific when tested against extracts of myocard, spleen, kidney and peripheral nerve. Chromatographic experiments showed the antibody to belong to the IgG class. It was concluded that the antibody was probably synthesized intrathecally in 12 and extrathecally in one MS patient.

Adolescent↗

Primary spontaneous cerebrospinal fluid rhinorrhea.

Spontaneous cerebrospinal fluid (CSF) rhinorrhea constitutes only 3% to 4% of CSF fistulas. Nontraumatic, normal pressure CSF fistulas with resultant rhinorrhea, in which no cause can be identified, or primary spontaneous CSF rhinorrhea, is considerably rarer. Presented here are two cases of CSF rhinorrhea of this nature, including the diagnostic workup and treatment. Reviews of literature support laboratory quantitative glucose determination as the most effective and least morbid method for confirming the presence of CSF. Iodine-contrast (metrizamide/lohexol) computerized tomographic cisternography has been shown to be the most effective and least morbid method for localizing the fistula. For inactive, intermittent, small, or questionable CSF leaks, radionuclide cisternography has been shown to be more effective in identifying the presence of these leaks, although not necessarily the location. Numerous reports provide evidence to support the use of an extracranial rhinologic approach for surgical repair of the leak, as a more successful yet less morbid procedure than a craniotomy when used appropriately.

Adult↗