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At least 559 records · Page 31Linked to original sources
PubMed1998

The effect of increasing degrees of spinal flexion on cerebrospinal fluid pressure.

The effects of increasing degrees of flexion on cerebrospinal fluid pressure were investigated in 12 neurosurgical patients requiring lumbar subarachnoid drains. Cerebrospinal fluid pressure and central venous pressure were measured in three positions: fully flexed ('chin on chest'), flexed at ninety degrees and straight. There was a significant increase in cerebrospinal fluid pressure on moving from the fully flexed to the flexed position (p < 0.0001), but not from the flexed to the straight position. These results were mirrored by smaller changes in central venous pressure. In patients without intracranial pathology these increases in cerebrospinal fluid pressure are probably unimportant. However, intracranial pathology may result in low cerebral perfusion pressures and any increase in cerebrospinal fluid pressure in this group may be harmful. The fully flexed position should be avoided when inserting lumbar drains in at risk patients.

Central Venous Pressure↗
PubMedDate not supplied

Cerebrospinal fluid retrieval in the conscious dog: a methods development study.

A chronic cerebrospinal fluid access system is described for use in the conscious sling-restrained dog. In a pilot study of ten dogs, a fenestrated barium-impregnated silastic catheter was surgically implanted in the subarachnoid space of the second cervical vertebra through a dorsal laminectomy. This fenestrated catheter was coupled to a subcutaneous access port. Following surgery, cerebrospinal fluid was sampled weekly and evaluated for protein content and cytology. The cerebrospinal fluid albumin to serum albumin ratio was calculated for each sample to evaluate blood-brain barrier integrity. The instrumentation was successfully implanted in five of the first eight dogs using a midbody dorsal laminectomy. Cerebrospinal fluid access was maintained in these dogs for 21 +/- 10 days. Using a slight modification of the original technique, the final two dogs were instrumented through a caudodorsal laminectomy of the second cervical vertebra. The cerebrospinal fluid access system remains patent after 444 days of study in these two dogs. Necropsy evaluation suggested that catheter failure in the immediate postoperative period was due to gross malposition of the catheter. Chronic catheter failure occurred secondary to obstruction by local fibrous tissue reaction. Using this instrumentation, a pharmacokinetic evaluation of the plasma and cerebrospinal fluid deposition of an intravenous bolus of acyclovir was successfully performed twice in a single dog without complications. This instrumentation could provide chronic cerebrospinal fluid access for multiple pharmacokinetic studies in the conscious dog.

Acyclovir↗
PubMed1979

Diagnostic cytology of cerebrospinal fluid by the cytocentrifuge method.

Seven hundred seventy-five cerebrospinal fluid samples from 748 patients with neurologic and non-neurologic disorders were studied by a modified cytocentrifuge technic for diagnostic evaluation. The technic proved to be simple, rapid, and inexpensive, and provided consistently good artifact-free morphologic detail suitable for differential and cytochemical analysis. Specimens from 525 patients (70%) had normal cytologic characteristics regardless of underlying condition. Examination of the cerebrospinal fluids of 40 patients (5%) revealed hemorrhage, confirming the presence of intracranial hemorrhage. Inflammatory reactions of various types (acute, chronic, and mixed) were encountered in 120 patients (16%). The appearance of neoplastic cells in cerebrospinal fluid was sometimes the first indication of malignancy. Twenty-six patients (4%) had tumor cells of various types in their cerebrospinal fluids on initial examination. Twenty patients (3%) had abnormal cells initially classified as suspect for malignancy; tumor cells subsequently were found in the spinal fluids of 11 of these, while five were proven to have neoplasms at autopsy without having had tumor cells found in their cerebrospinal fluids. There was no false-positive result. Samples of cerebrospinal fluid from 17 patients (2%) were classified as non-diagnostic, usually because of autolysis.

Brain Neoplasms↗
PubMed1990

[The course and outcome of tuberculous meningitis in cases of detection of Mycobacterium tuberculosis in the cerebrospinal fluid].

The cases of M. tuberculosis detected in cerebrospinal fluid of the patients with tuberculous meningitis being under observation during 1968-1987, are analysed. The second decade (1978-1987) witnessed a greater percentage of M. tuberculosis found in the cerebrospinal fluid of the patients (including children, adolescents and adults). Children and adolescents constituted the majority of the cases. M. tuberculosis agents were detected by means of bacterioscopy and inoculation in 33.3 and 66.7% of the patients, respectively. In 15.5% of the cases, primary resistance to antibacterial drugs was revealed. The detection of M. tuberculosis in the cerebrospinal fluid is now considered to be an unfavourable factor indicating the severity of the disease and entailing, to a certain extent, its adverse outcome. Antibacillary drug resistance of the M. tuberculosis strains isolated from cerebrospinal fluid may serve as an aggravating condition. As a rule, the disease in these cases has a serious course, making the treatment much more difficult and causing unfavourable outcomes.

Adolescent↗
PubMed1977

Nephritis associated with a diphtheroid-infected cerebrospinal fluid shunt.

Hypocomplementemic proliferative glomerulonephritis occurred during diphtheroid infection of a ventricular decompression shunt for cerebrospinal fluid diversion (cerebrospinal fluid shunt) in a young man. Granular deposits of immunoglobulin M (IgM) and the third component of complement (C3) were found along the glomerular basement membrane. This report provides supportive evidence for immune complex-mediated glomerular injury due to diphtheroid infection in a cerebrospinal fluid shunt.

Adult↗
PubMed1995

[Clinical chemical investigation of selected laboratory parameters of cerebrospinal fluid and blood of health cattle].

Selected Parameters in cerebrospinal fluid of adult, healthy cattle of different breeds were analyzed. Group size amounted to 68. Liquor samples were taken by lumbosacral punction. At the same time blood was taken from the Vena jugularis for analysis of the same parameters as in cerebrospinal fluid. Classification into 3 groups based on the macroscopic aspect of the cerebrospinal fluid: clear-colourless, flaky-colourless, bloody-flaky. In the first group all parameters were analyzed in order to fix standard distribution. A range of standard values of every parameter in cerebrospinal fluid was defined after finding of runaways and narrowing of random sample to 95%. Standard values for the parameters were: TP 0.83-1.40 g/l, GLU 1.18-3.20 mmol/l, LAC 1.4-1.9 mmol/l, CK 0.2-18.7 U/l, GLDH 0.7-3.7 U/l, AST 3.2-12.8 U/l. Possibilities to integrate results from the other two groups into these standard values were shown. A linear correlation between cerebrospinal fluid and blood serum values was found to exist for GLU (r = 0.91), LAC (r = 0.55) and GLDH (r = 0.48).

Animals↗
PubMed1999

Entry of tromethamine into the cerebrospinal fluid of humans after cerebrovascular events.

OBJECTIVE: The intravenous administration of tromethamine (INN, trometamol) lowers the intracranial pressure in patients with brain edema. One postulated mechanism of action is the increase of the pH of the cerebrospinal fluid. METHODS: To study tromethamine kinetics in serum and cerebrospinal fluid, nine patients with external ventriculostomies and normal serum creatinine values received 60 mmol intravenous tromethamine (Tris 36.34%, pH 11) over 30 minutes. Serum and cerebrospinal fluid were drawn repeatedly, and concentrations were determined by HPLC. RESULTS: Maximum serum concentrations (Cmax) ranged from 211 to 426 mg/L (median, 302 mg/L). The volume of distribution was 0.34 to 0.86 L/kg body weight (median, 0.53 L/kg), and the elimination half-life in serum (t1/2beta) 3.22 to 8.44 hours (median, 4.53 hours). Cerebrospinal fluid Cmax values ranging from 0.68 to 34.14 mg/L (median, 3.88 mg/L) were observed 1 to 12 hours after the end of the tromethamine infusion (median, 2 hours). AUC(CSF)/AUC(S) as a measure of overall cerebrospinal fluid penetration was 0.015 to 0.46 (median, 0.068). Cerebrospinal fluid Cmax and AUC(CSF)/AUC(S) depended on the function of the blood-cerebrospinal fluid barrier. Cerebrospinal fluid t1/2 (8.52 to 14.2 hours; median, 11.2 hours) was substantially longer than the t1/2beta in serum. In vitro, cerebrospinal fluid concentrations < or =30 mg/L did not influence cerebrospinal fluid pH. CONCLUSION: Tromethamine cerebrospinal fluid concentrations will be high enough to increase the pH of the cerebrospinal fluid only at large doses and in patients with a pronounced disruption of the blood-cerebrospinal fluid barrier.

Adult↗
PubMed1962

Stimulation and sensitization of the isolated Venus heart by cerebrospinal fluid.

5-Hydroxytryptamine was not detected in animal cerebrospinal fluid after amine oxidase inhibitors, reserpine, or both. Both human and animal cerebrospinal fluid can produce a stimulating effect on the clam heart which is not due to 5-hydroxytryptamine. Cerebrospinal fluid also has the property of increasing the sensitivity of the clam heart to 5-hydroxytryptamine.

Animals↗
PubMed1984

Factors influencing the cholinesterases of cerebrospinal fluid in the anaesthetized cat.

Both acetylcholinesterase and non-specific cholinesterase are found in cerebrospinal fluid and blood plasma of the cat; the ratio of activities acetylcholinesterase/non-specific cholinesterase is about 1.5 in cerebrospinal fluid and 0.15 in plasma. A search was made for factors capable of influencing the concentration of the two cholinesterases in cerebrospinal fluid. Either the ventricular system was perfused with artificial cerebrospinal fluid from a lateral ventricle to the aqueduct, or the atlanto-occipital membrane was punctured and cerebrospinal fluid was collected continuously from the cisterna magna. Factors studied included: (a) procedures affecting the composition or formation of cerebrospinal fluid, such as changes in the ionic constituents of the perfusate, the inhibition of cerebrospinal fluid formation by acetazolamide or ouabain, or the rapid intra-carotid infusion of hypertonic urea; (b) arousal (noise or stimulation of the central ends of the sciatic nerves), or deepening of anaesthesia; (c) changes in blood pressure; (d) central stimulants and depressants, pyrogens, prostaglandins, antagonists of acetylcholine. Whereas most procedures or drugs tested increased the concentration of acetylcholinesterase, some central depressants (e.g. chlorpromazine) reduced, while another (ether) increased the appearance of acetylcholinesterase in the cerebrospinal fluid. The effect of ether was, in all probability, due to damage to the blood-brain barrier. A rise in acetylcholinesterase concentration was obtained upon stimulation of the central ends of the sciatic nerves; this was inhibited by atropine but not by N-methylatropine, indicating that the rise was due to increased nervous activity and not to the circulatory effects of the stimulation, since the changes in blood pressure caused by the stimulation remained the same after atropine administration. Amphetamine or leptazol raised the levels of acetylcholinesterase but it was not possible to determine whether this was due only to increased central nervous activity, since there was invariably leakage through the blood-brain barrier which by itself would be sufficient to produce the effect. A rise in the level of acetylcholinesterase was seen after administration of pyrogen; this was apparently not a simple effect of warming the body, but due to the action of the pyrogen on centers concerned with temperature control, since warming the animal by external heat failed to produce a similar change.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholinesterase↗
PubMed1997

[Cytopathology of cerebrospinal fluid].

Cytological examination of cerebrospinal fluid provides extremely useful informations and contributes to the diagnosis of infection, inflammation or neoplasia. Reliable technical procedures and knowledge of the clinical data are mandatory. Cytological features are described. Current cytodiagnostic dilemmas and pittfalls are reviewed including interpretation of cell clusters, lymphocytic cell population and cellular modifications due to sampling from ventriculoperitoneal shunts.

Cerebrospinal Fluid↗
PubMed1990

Mechanism of increased cerebrospinal fluid pressure with thoracic aortic occlusion.

Recent clinical reports have suggested that drainage of cerebrospinal fluid lowers the incidence of perioperative paraplegia in patients with thoracoabdominal aneurysms. Unfortunately, the precise mechanisms for both the neurologic deficits and the beneficial effects of cerebrospinal fluid drainage remain unclear. To better understand the relationship between cerebrospinal fluid pressure, central venous pressure, and the compliance of the cerebrospinal fluid compartment, we studied 12 anesthetized dogs subjected to thoracic aortic occlusion. Pericardia were opened in six (group I), and left intact in six (group II). Systemic hemodynamics and cerebrospinal fluid pressure (mm Hg) were measured before and after thoracic aortic occlusion. In group II, intravenous volume loading (15 ml/kg) was superimposed on aortic occlusion. Compliance of the cerebrospinal fluid space (ml/mm Hg) was measured at each interval by use of sequential injection and withdrawal of small aliquots of fluid. Results are expressed as mean +/- SE; *p less than 0.05. Thoracic aortic occlusion resulted in predictable changes in mean arterial pressure (group I 95.8 +/- 7.1 to 123.3 +/- 7.1*, group II 82.5 +/- 6.9 to 98.3 +/- 9.5*) and central venous pressure (1.9 +/- 0.7 to 3.8 +/- 0.6*, 3.0 +/- 0.8 to 4.0 +/- 0.9*). Although cerebrospinal fluid pressure was increased by thoracic aortic occlusion in both groups (8.0 +/- 1.2 to 12.6 +/- 1.9*; 5.8 +/- 0.9 to 8.5 +/- 1.1*), compliance of the dural space was was not changed (0.61 +/- 0.19 to 0.60 +/- 0.18; 0.54 +/- 0.14 to 0.62 +/- 0.09).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗