[Fluid pressure level in the intermeningeal spaces of the rabbit optic nerve].
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
By means of noninjective methods of investigation a specific capillary network of a sinusoidal type, peculiar arteriolovenular anastomoses, additional reservoirs in the area of postcapillaries and venules described in the microcirculatory bed of the spinal dura mater. The peculiarity of this vascular bed is thought by the authors to be connected with liquor resorption from the subdural space of the spinal cord.
An allogeneic cerebral dura mater prepared under nonsterile conditions will become fully sterilized after 48 hours of storage in a 0.75% formalin solution. The long-term (up to 3 years) conservation of this tissue in the above mentioned solution preserves it in a condition permitting transplantation. The experimental transplantation of such tissue results in making the subdural space airtight. This occurs primarily because of the adhesion of the edges of the donor and recipients dura mater in the area of the defect as a result of aseptic inflammation with subsequent resolution and replacement of the transplant with the connective tissue of a similar structure with the dura mater.
A wide incision of the dura mater of the spinal cord helps to inspect the subdural space in detail. If there is a defect in the dura mater, or if it is impossible to suture it due to edema and swelling of the spinal cord, it is rational to resort to plastic replacement with a band of capron mesh which resolves completely by the end of the third year after the surgical intervention.
Prolonged liquor fistula following puncture of the subdural space for diagnostic or anaesthetic purposes has been reported repeatedly. These among other factors are held responsible for headache as well as neurological complications in connection with lumbar puncture. In contrast the appearance of an external liquor fistula in the lumbar region is an extremely rare event. Two patients developed a cutaneous liquor fistula after lumbar laminectomy following an inadvertant dural penetration when an epidural steroid injection was performed. The same occurred in a healthy young patient who had undergone several trials to puncture the epidural space for an epidural anaesthesia in a case of emergency cesarean section Our own observation concerns a 62 years old woman who developed a cutaneous cerebrospinal fluid fistula 12 h after the removal of an epidural catheter, which had caused a secondary perforation of the dura.
Adhesive spinal arachnoiditis is a rare condition of several causes, including complications of myelography. An experiment was conducted to study the effects of surgical glove powder contamination in the cerebrospinal fluid. The subarachnoid space of 45 rabbits was injected with either a suspension of powder from sterile surgical gloves, Pantopaque (iophendylate), or a combination of the two agents. Mild to severe arachnoiditis was produced in 10 of 17 animals injected with the combination of powder and Pantopaque. Only two of 16 rabbits injected with glove powder and one of nine with Pantopaque had more than minimal changes of arachnoiditis. Three rabbits (two injected with glove powder alone and one with both agents) died of meningitis within 1 week of injection. The combination of glove powder and Pantopaque is synergistic in producing arachnoiditis. These results emphasize the importance of meticulous technique in myelography.
Explore the source record for details and available documents.
On the basis of control angiographies after surgical treatment of 59 intracranial aneurysms full effectiveness of aneurysm elimination from the circulation was assessed and found to be fully effective in 93.2% of cases. In 3 cases the aneurysmal sac was partially visualized, and in 2 cases the metal clip was found to have slipped off from the aneurysm neck. One of these patients was reoperated successfully. The investigations demonstrated in 17 cases (29%) presence of postoperative vasospasm, in 8 cases internal hydrocephalus following past bleeding and in 2 cases accumulation of cerebrospinal fluid in the subdural space. On the basis of literature reports and own experiences the authors stress the necessity of possibly early control angiography which should be accepted as a routine method. In case of internal hydrocephalus demonstration insertion of a ventriculoatrial shunt is suggested.
Numerous investigators endeavored to make clear pathophysiological changes in a traumatic spinal cord lesion. The development of neuroscience contributed to have an influence on methods of these researches. This study was undertaken to assess electrophysiological changes resulting from variable periods of experimental spinal cord compression or ischemia by using the evoked spinal cord potentials. Experiments were performed on dogs. Following laminectomies at Th7-9 and L3-4 levels under anesthesia, cord injuries were produced at the lower thoracic level by inflation of an extradurally placed balloon which produced slow graded compression of cord dorsum. Evoked spinal cord potentials to sciatic nerve stimulation were recorded from bipolar electrodes in the midline dorsal subdural space at the operative sites. The normal wave forms of two responses consisted of initially positive triphasic potentials (P1, N1, P2). The conduction velocity of the ascending afferent from the leg was found on the average to be 54.8 +/- 9.7 m/sec between lumbar and dorsal cord. On the basis of the conduction velocities and the responses to stimulus intensities, the afferent volley recorded in the present experiments might reflect synaptic cord afferent pathways originated without Group I fibers in the cord dorsum which were situated ipsilateral to the stimulated nerve. After inflation of the balloon with 0.1 cc of water, spinal canal narrowing rate increased to 14.3 +/- 2.9%. The evoked spinal cord potentials in the lead rostral to the site of compression began to decrease in amplitude. When more water was added into the balloon up to 0.4 - 0.6 cc, spinal canal narrowing rate was enhanced to 42.5 - 77.7% in which potentials were abolished. P2 wave was the first to be abolished and subsequently N1, P1 disappeared in order. On the other hand, the potentials reappeared after decompression in the reverse of their disappearance in order. Responses in dogs with complete recovery from paraplegia returned to the precompression wave pattern both in the amplitude and in latency. On the contrary, in dogs with spastic paraparesis, the recovery of wave form was shown as P1, N1 or P1, N1 with depressed P2. Despite this variability, the evoked response from animals with reversible cord injury were discernible in the early period of spinal shock phase. The degree of recovery varied and had no linear relationship to the recovery grade of clinical symptoms. The experimental cord ischemia was made by inflation of a balloon catheter which was inserted from femoral artery into the upper thoracic aorta. The evoked spinal cord potentials were recorded at the midthoracic and lumbar level. Changes of wave form resulting from the ischemic period of 30 minutes were first the amplitude loss of N1 and subsequently that of P2, P1. On the other hand, the responses gradually returned to their pre-ischemic characteristic about 30 minutes after circulatory reestablishment...
A 43-year-old man underwent a surgical total removal of a tumor followed by radiotherapy (a total of 6,000 rad of 60Co) and chemotherapy. In the preoperative CT scan, a well-defined, nodular-shaped tumor was found in the left parietal region. This tumor disappeared when the combination treatment had been completed. Subsequently, CT scan demonstrated multifocal tumors with involvement of the roof of the fourth ventricle, frontal cortex and lateral ventricle. The patient expired 20 months after the onset of symptoms. The tumors in the frontal lobes, left thalamus and subdural space of the upper cervical cord showed dense sheets of polymorphous, large to medium-sized lymphocytes. The microscopic findings were interpreted as showing malignant lymphoma, lymphocytic, poorly differentiated, diffuse. Immunologically, E rosettes were formed by sheep red blood cells around the tumor cells. Immunofluorescence technique failed to demonstrate IgG, IgM and/or IgA in the cytoplasm of the tumor cells. By scanning electron microscopy, the tumor cells were devoid of microvilli.
We reported a case of traumatic acute intracerebellar hematoma which was surgically treated with good success. Of all types (by region) of traumatic intracranial hematoma, the posterior fossa hematoma, particularly the intracerebellar hematoma is of relatively rare kind. Our patient was a 7-year-old girl, who fell into coma and showed decerebrate posture four hours after a blow of the occiput. On CT, a left intracerebellar hematoma was found, and a suboccipital craniectomy was therefore immediately done to remove the hematoma. Hematomas were found also in the extradural and subdural spaces. Postoperatively she developed typical cerebellar signs and right 7th cranial nerve palsy plus left hemiparesis (Millard-Gubler syndrome), but in six months, her neurological abnormalities disappeared and she recovered completely and returned to her normal life. When a severely injured patient who has an occipital contusion or laceration was found, we should consider the existence of posterior fossa hematoma.
A case of intracranial dural malignant lymphoma was presented. A 35-year-old woman was admitted with generalized seizure. The neurological findings and laboratory data were normal. Computed tomography (CT) showed a nodular lesion in the left frontal convexity with marked enhancement by contrast medium. Angiography showed a slight tumor stain and the feeding artery from the ethmoid artery. On surgery, a soft pinkish tumor was found to be located in the dura and subdural space. It was resected subtotally. The histological diagnosis was malignant lymphoma of B cell origin. Postoperative Ga scintigraphy and abdominal CT disclosed no abnormalities in other organs, but bone marrow examination revealed lymphoma cells, which suggested that the patient might have systemic lymphoma. The patient and her family refused additional treatment. The patient is alive and well now over six years after the craniotomy. Primary central nervous system (CNS) lymphomas usually arise in the cerebral parenchyma, while secondary CNS lymphomas commonly involve leptomeninges and perivascular spaces. Mass lesions arising in the dura are very rare.
Thirty mongrel dogs were divided into 3 groups. Group I was a normal control group (n = 4) without transplantation procedure. Group II was a transplantation control group (n = 5) with left lung allotransplantation from heart-beating donor. Group III consisted of animals (n = 8) which received lung allografts from non-heart-beating donor following brain death. In Group III, brain death was brought about by intracranial hypertension with the inflation of balloon in the subdural space of donor. After 6 hours, the mechanical ventilation was discontinued followed by cardiac arrest. Left lung was excised twenty minutes after the cardiac arrest and was washed out with cold Ep4 solution for subsequent orthotopic allotransplantation. Right pulmonary arterial occlusion test (RPAO) were carried out under right thoracotomy to evaluate graft function immediately and 7 to 14 days after the surgery. PaO2, PAP and CO were measured before and 20 minutes after RPAO. All animals in Group II and 7 of 8 animals in Group III survived more than 7 days after surgery. No significant differences in the value of PaO2, mean PAP and TPVR with RPAO among three groups at each time of assessment, showing the possibility of lung transplantation from non-heart-beating donor followed by brain death.
An unusual case of an intracranial glioma which demonstrated extramedullary growth is reported. The patient was a 39-year-old woman who had experienced headache, nausea and vomiting for about 1 month. On admission she showed slight disturbance of consciousness and bilateral papilloedema. CT scan and MR imaging disclosed a mass approximately 5 cm in diameter in the right frontal region, with clear demarcation from the neighboring gyri. Right external carotid angiogram revealed A-V shunts in the mass, but by right internal carotid angiogram, no abnormal findings were disclosed except for the deviation of normal intracranial vessels due to the existence of the mass. Therefore, a preoperative diagnosis of extramedullary tumor such as meningioma and epidermoid was made. Right frontal craniotomy was performed, and the tumor was proven to exist in subdural space. The boundary of the tumor to the brain surface was distinct except for one part. Histopathologically, the tumor cells had abundant eosinophillic cytoplasms, with eccentric-distribution of their nuclei. Furthermore, they were positive for staining for GFAP and S-100 protein. Therefore, a final diagnosis of gemistocytic astrocytoma was made. Reviewing some references the authors discuss here the form of development and progression of intracranial gliomas which demonstrate extramedullary growth such as this case.
Twenty infants aged 2 weeks to 3 months with the diagnosis of bleeding disorder secondary to low prothrombin complex level were studied. Sixty children of the control group were matched to the cases by age +/- 2 weeks, sex and race. The ratio of boys to girls was 2.3:1. The median, mean, and range of age of the cases and controls were 43.5 days, 43.7 days, 21-73 days and 43.5 days, 46.8 days, 26-28 days respectively. Most of them were pale with a mean hematocrit of 23.55%. The partial thromboplastin time and prothrombin time were markedly prolonged. The means of vitamin K dependent coagulation factors II, VII, IX and X were 1.10%, 5.87%, 2.86%, and 4.47% of adult activity, respectively. The clinical manifestations related to the bleeding of the cases were drowsiness and convulsion (95%), pallor (85%), and apparent bleeding (10%). The sites of the bleeding were demonstrated in the cranial cavity (95%), gastrointestinal tract and oral cavity (15%), and skin (5%). Nineteen patients with intracranial hemorrhage had bleeding in the subdural space (79%), intracerebral (42%), intraventricular (32%), and subarachnoid space (5.2%). The mortality rate and permanent brain damage occurred in 10% and 45%, respectively. Only 45% of the cases recovered normally. The permanent neurological sequelaes were hemiparesis (44.4%), microcephaly (33.3%), convulsive disorder (33.3%), mental retardation (33.3%), spasticity (22.2%), and hydrocephalus (11.1%). Breast feeding alone up to the day of study (OR = 7.0, p < 0.005) was found to be a significant risk factor for bleeding in these infants.(ABSTRACT TRUNCATED AT 250 WORDS)