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PubMed1989

Postmortem cerebrospinal fluid pleocytosis.

We show that postmortem cerebrospinal fluid (CSF) pleocytosis is a common event. Postmortem cerebrospinal or ventricular fluid was obtained from children and adults. The cells were counted and morphologically characterized using several histochemical markers. Infants exhibit a brisk postmortem CSF pleocytosis. Sudden infant death cases have relatively high CSF counts. Typeable cells are mononuclear and consist of approximately 60%-70% lymphocytes and 20%-40% macrophages. When postmortem duration is greater than 12 h, the cells become vacuolated and cannot be identified. The etiology of these findings requires further study.

Adolescent↗
PubMed1982

Cerebrospinal fluid aldolase, lactate and creatine phosphokinase in the differential diagnosis of meningitis and meningo-encephalitis.

Creatine phosphokinase, aldolase and lactate determinations were performed on serum and cerebrospinal fluid to assess their value in the diagnosis of tuberculous and purulent meningitis and meningo-encephalitis. Changes in serum were independent of those in the cerebrospinal fluid. Variable results for cerebrospinal fluid creatine phosphokinase were obtained in the three groups. Lactate concentrations in the cerebrospinal fluid showed a clear distinction between tuberculous meningitis and meningo-encephalitis with levels 5 mmol/1 highly suggesting tuberculous meningitis. Also elevated cerebrospinal fluid aldolase levels may exclude meningo-encephalitis as a likely diagnosis.

Adolescent↗
PubMed1992

Release of superoxide dismutase into cerebrospinal fluid as a marker of brain lesion in acute cerebral infarction.

BACKGROUND AND PURPOSE: Evaluation of biochemical patterns in cerebrospinal fluid may add diagnostic and prognostic information. We tested to determine whether the concentration of superoxide dismutase in cerebrospinal fluid is a marker of brain tissue damage in acute ischemic stroke. METHODS: We investigated 36 acute ischemic stroke patients for cerebrospinal fluid activity of the enzyme superoxide dismutase on two occasions shortly after symptom onset (average, day 1 and day 4). RESULTS: In 75% of the patients, the first of two lumbar punctures revealed the maximal superoxide dismutase value. The amount in the cerebrospinal fluid was significantly correlated with the size of infarction on computed tomographic scan (p less than 0.001 by analysis of variance) and to functional impairment and stroke-related mortality during initial hospital stay (p less than 0.002). The correlation of initial superoxide dismutase concentration with the need for long-term institutional care and mortality at 3 months after the stroke was also significant (p less than 0.03). CONCLUSIONS: We conclude that superoxide dismutase in cerebrospinal fluid is a marker of an acute brain lesion and has some value as a prognostic predictor. This small enzyme leaks rapidly from ischemically injured cells.

Acute Disease↗
PubMed1994

Correlation between the post-mortem cell content of cerebrospinal fluid and time of death.

The number of cells in the cerebrospinal fluid increases after death. It is not clear whether this observation represents a post-mortem or a supravital phenomenon. There is speculation that some of the cells actively enter the cerebrospinal fluid during the first hours after death and that the rest exfoliate from the subarachnoid layer. The post-mortem cell count in cerebrospinal fluid correlates to the time after death and can be described mathematically (polynomial curve of third order).

Adolescent↗
PubMed1990

Cerebrospinal fluid and human immunodeficiency virus. Findings in healthy, asymptomatic, seropositive men.

Involvement of the central nervous system by human immunodeficiency virus is an important cause of morbidity and mortality. We have undertaken a longitudinal study of asymptomatic individuals found to be human immunodeficiency virus seropositive to identify and characterize cerebrospinal fluid abnormalities early in the disease process. Our findings in 25 individuals have been notable for a frequent incidence of cerebrospinal fluid abnormalities. Pleocytosis or elevated cerebrospinal fluid protein was found in 12 (48%) of 15 patients studied. Oligoclonal banding was present in 6 (26%) of 23 patients. Human immunodeficiency virus was isolated by culture in 4 asymptomatic patients. The cerebrospinal fluid abnormalities we observed indicate an active process occurring in the central nervous system, even in early human immunodeficiency virus infection in asymptomatic patients. Serial observation of these patients for development of neuropsychiatric findings may provide answers to the significance of cerebrospinal fluid abnormalities identified in these patients.

Cerebrospinal Fluid↗
PubMed1986

Ceftriaxone kinetics and cerebrospinal fluid penetration in infants and children with meningitis.

20 patients (0.4-5.6 years old) receiving ceftriaxone for the treatment of bacterial meningitis were studied. Simultaneous serum and cerebrospinal fluid concentrations of ceftriaxone were determined by HPLC in 15 patients at 11.4-12.8 h after an intravenous loading dose of 75 mg/kg. Serum and cerebrospinal fluid concentrations ranged from 20.5 to 44.9 (31.3 +/- 7.8) and from 1.1 to 8.0 (3.7 +/- 1.8) micrograms/ml, respectively. Cerebrospinal fluid concentrations ranged from 3 to 25% (12 +/- 6%) of the simultaneous serum concentrations. In 6 patients, serum and cerebrospinal fluid concentrations were determined after maintenance doses of 50 mg/kg/12 h. Serum and cerebrospinal fluid concentrations ranged from 120 to 144 and 2.3-4.9 micrograms/ml at 1.8-5.5 h after the first maintenance dose in 2 patients; 74-139 and 5.7-7.9 micrograms/ml at 1.3-5.8 h after the second dose in 3 patients and was 101 and 4.1 micrograms/ml at 4 h after the 3rd dose in 1 patient. Multiple blood samples were collected after the loading dose in 5 patients and after 9-10 days of maintenance doses in 3 patients. Steady-state peak and trough serum concentrations ranged from 295 to 440 and 32.6-44.8 micrograms/ml, respectively. After the loading and maintenance dose at steady-state, total body clearance averaged 1.17 and 0.64 ml/min (p = 0.01); apparent volume of distribution averaged 0.37 and 0.26 l/kg (p greater than 0.05); and elimination half-life averaged 3.7 and 4.6 h (p = 0.01), respectively. These results suggest that (1) adequate cerebrospinal fluid concentrations of ceftriaxone can be achieved in patients with meningitis with the dosage regimen studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Ceftriaxone↗
PubMed1982

Plasma and cerebrospinal fluid amino acid patterns in hepatic encephalopathy.

Plasma and cerebrospinal fluid amino acid levels wee measured in 12 cirrhotic patients in grade 0 hepatic encephalopathy and 17 in grade 3-4 hepatic encephalopathy. In 5 of these patients amino acid determinations were performed during the evolution of the encephalopathy. No correlation was found between the degree of hepatic encephalopathy and the plasma amino acid imbalance. In the CSF of cirrhotic patients without encephalopathy, a significant increase was found in nearly all amino acids, including those known to not easily cross the blood-brain barrier; this suggests the presence of a nonspecific modification of the blood-brain barrier permeability. In patients with severe hepatic encephalopathy, the further increase only in cerebrospinal fluid aromatic amino acids and methionine levels suggests the presence of a selective stimulation of the neutral amino acid transport system across the blood-brain barrier. Finally, the good correlation between glutamine and the sum of neutral amino acids found in the cerebrospinal fluid only in the presence of encephalopathy supports the hypothesis that brain glutamine may stimulate neutral amino acid transport across the blood-brain barrier.

Adult↗
PubMed1991

The effects of composition of subarachnoid gas space and anesthetic gas mixture on cerebrospinal fluid pressure changes during cisternography for transsphenoidal craniectomy.

The effects of gas composition in the subarachnoid space (injection of air or N(2)O) and in an anesthetic gas mixture (inhalation with or without N(2)O) on cerebrospinal fluid pressure were studied in 22 patients with pneumocisternography for transsphenoidal craniectomy. N(2)O (66%) anesthesia for 10 min increased cerebrospinal fluid pressure by up to 150% in 7 patients who were intrathecally injected with air. Withdrawal of N(2)O from the anesthetic gas mixture for sixty minutes reduced cerebrospinal fluid pressure to the initial pressure. A second N(2)O administration to the anesthetic gas mixture did not elevate cerebrospinal fluid pressure by as much as the first N(2)O administration. In 7 patients receiving subarachnoid air injection, replacing 66% N(2)O with 66% nitrogen prevented the change in cerebrospinal fluid pressure throughout the operation. In 8 patients N(2)O anesthesia and N(2)O intrathecal injection failed to eliminate the rise in cerebrospinal fluid pressure in 8 patients. Withdrawal of N(2)O from the anesthetic gas mixture for 60 min is recommended to prevent an extreme increase in cerebrospinal fluid pressure during pneumocisternography.

Journal Article↗
PubMed2004

Cell-free fetal DNA in the cerebrospinal fluid of women during the peripartum period.

OBJECTIVE: The purpose of this study was to determine whether cell-free fetal DNA is detectable in the cerebrospinal fluid of women during pregnancy and after delivery. STUDY DESIGN: Cerebrospinal fluid was collected from 39 women who underwent an indicated spinal anesthesia procedure. Twenty-six samples were from women who carried at least 1 male fetus, and 13 samples were from women with only a female fetus. DNA was analyzed with the use of real-time polymerase chain reaction for DYS-1 (which represented male fetal DNA) and beta-globin (which represented maternal and fetal DNA). RESULTS: beta-Globin DNA was detected in all cerebrospinal samples. DYS-1 gene sequences were detected in 4 cerebrospinal fluid samples from women who had male fetuses (2 samples were from women who underwent cesarean delivery of singleton pregnancies, 1 sample was from a triplet pregnancy, and 1 sample was from a woman after delivery). No male DNA was detected in the cerebrospinal fluid of women who carried female fetuses. CONCLUSION: Male fetal cells and/or cell-free fetal DNA is detectable in the cerebrospinal fluid of some pregnant women or some women after delivery.

Cerebrospinal Fluid↗
PubMed1991

[A case of metoclopramide-induced neuroleptic malignant syndrome with cerebrospinal fluid lactic acidosis].

A case of metoclopramide-induced neuroleptic malignant syndrome with cerebrospinal fluid (CSF) lactic acidosis was reported. A 44-year-old Japanese woman noted tarry stool on July 2, 1988 and was treated with metoclopramide and cimetidine for nausea and vomiting. Hydroxyzine pamoate was also administered for insomnia at 3:10 am and she became comatose with muscle rigidity at 3:40-4:30 am on July 3. Tachycardia and high fever (39.5 degrees C) were evident at 8:00 am on July 4. She was transferred to the Kyushu University Hospital. On admission, serum creatine kinase was elevated to 1640 IU/1; MM fraction was 100%. She was diagnosed as malignant syndrome. Cerebrospinal fluid was normocellular with protein 38 mg/dl and glucose 122 mg/dl. Cerebrospinal fluid lactate increased markedly to 3.43 mmol/l, CSF pH was 7.264, HCO3- 14.4 mEq/l, indicating CSF metabolic acidosis. She became afebrile after the 10th hospital day, and gradually but completely recovered within a month. She was discharged on August 16, 1988. The anti-dopaminergic activity of metoclopramide was considered to be primarily responsible for the development of malignant syndrome in this case. Cerebrospinal fluid lactic acidosis seemed to reflect hyperpyrexia or malignant syndrome induced derangement of the brain metabolism.

Acidosis, Lactic↗
PubMed1994

Cerebrospinal fluid concentrations of interleukin-1 beta, tumour necrosis factor-alpha, and interferon gamma in bacterial meningitis.

To investigate the role of the inflammatory cytokines, the cerebrospinal fluid concentrations of interleukin (IL)-1 beta, tumour necrosis factor-alpha (TNF-alpha), and interferon gamma (IFN-gamma) were measured in 11 children with bacterial meningitis and two with mycoplasmic meningoencephalitis and compared with those in 50 children with aseptic meningitis and 15 with non-pleocytotic cerebrospinal fluid. Concentrations of IL-1 beta and TNF-alpha were each significantly higher in the cerebrospinal fluid of patients with bacterial meningitis than in those with aseptic meningitis or those with non-pleocytotic cerebrospinal fluid. IFN-gamma was detected at low concentrations in the cerebrospinal fluid of only 2/11 of those with bacterial meningitis. On the other hand, the IFN-gamma concentration was the highest in the cerebrospinal fluid of patients with aseptic meningitis. These results suggest that the inflammatory cytokines are differently released in the intrathecal space infected with viruses or bacteria.

Adolescent↗
PubMed2002

Determination of cefotaxime and desacetylcefotaxime in cerebrospinal fluid by solid-phase extraction and high-performance liquid chromatography.

A high-performance liquid chromatographic procedure has been developed for the measurement of cefotaxime and desacetylcefotaxime in cerebrospinal fluid. Both compounds were isolated from cerebrospinal fluid samples using solid-phase extraction (SPE). LiChrolut RP-18 (200 mg; 3 ml) columns and a mixture of methanol-phosphate buffer pH 7 (1:1) were applied to elute cefotaxime and its desacetyl metabolite. The separation was performed on a LiChrospher 100RP-18 (5 microm; 250 x 4 mm I.D.) column. The mobile phase consisted of 0.01 M acetate buffer pH 4.8-methanol (85:15), flow-rate was 1.5 ml/min. Cefotaxime and desacetylcefotaxime were detected at a wavelength of 254 nm by UV-Vis detector. The range of concentrations for method calibration and for analytical studies was 1.56-100 microg/ml. The quantitation limit in cerebrospinal fluid was 0.39 microg/ml for cefotaxime and 0.78 microg/ml for desacetylcefotaxime. The extraction recovery from cerebrospinal fluid spiked with cefotaxime and desacetylcefotaxime was 90.4-100.1% and 97.4-102.9%, respectively. The RSDs were below 10.7% for cefotaxime and 6.8% for desacetylcefotaxime. The developed SPE-HPLC method was applied for cefotaxime and desacetylcefotaxime determination in cerebrospinal fluid of children with hydrocephalus after intraventricular administration.

Calibration↗
PubMed1985

Cobalamin binding proteins (haptocorrin and transcobalamin) in human cerebrospinal fluid.

The unsaturated cobalamin binding capacity of transcobalamin and haptocorrin was studied in cerebrospinal fluid (CSF) and plasma (P) from 37 reference individuals. These comprised 27 males and 10 females who underwent minor surgery in spinal anaesthesia. The 5th and 95th percentiles were as follows: P-Transcobalamin 300-870 pmol/l (median 550 pmol/l); CSF-Transcobalamin 90-540 pmol/l (median 194 pmol/l); P-Haptocorrin 75-290 pmol/l (median 159 pmol/l); CSF-Haptocorrin 10-41 pmol/l (median 21 pmol/l). No sex difference was found between the levels of haptocorrin or transcobalamin in plasma or cerebrospinal fluid. A positive correlation between P-Transcobalamin and CSF-Transcobalamin was found, whereas no correlation between P-Haptocorrin and CSF-Haptocorrin values was found. The plasma/CSF ratios of transcobalamin, haptocorrin, albumin and IgG indicated that the binders may be synthetized into the cerebrospinal fluid or are actively being transported into the cerebrospinal fluid.

Female↗
PubMedDate not supplied

Low serum potassium in mid life associated with decreased cerebrospinal fluid Abeta42 in late life.

Low serum potassium increases risk of hypertension and stroke, and cardiovascular factors increase the risk of Alzheimer disease (AD). We examined the association between serum potassium and the biologic marker cerebrospinal fluid amyloid-beta (Abeta42), which is decreased in Alzheimer disease patients. Psychiatric examinations, laboratory and other tests were conducted on a population-based sample of 1080 women aged 46 to 60 in 1968, with follow-ups in 1974, 1980, and 1992. In 1992, cerebrospinal fluid Abeta42 levels were obtained from 81 women. Increasing serum potassium in 1968 was associated with increasing cerebrospinal fluid Abeta42 (beta = 153.9, P = 0.041) in 1992 using age-adjusted linear regression. Compared with the lowest tertile of potassium, the middle (beta = 95.3, P = 0.138) and highest tertiles (beta = 193.5, P = 0.004) had incrementally increased cerebrospinal fluid Abeta42 levels. Associations remained after controlling for blood pressure and other factors, and were similar among the 17 women in 1974 with available serum potassium. Potassium in 1980 and 1992 was not associated with cerebrospinal fluid Abeta42. Findings suggest low serum potassium in mid life, but not late life, is associated with low cerebrospinal fluid Abeta42 levels in late life. It is possible potassium co-varies with another variable that is associated with cerebrospinal fluid Abeta42. Nonetheless, serum potassium is a modifiable risk factor and further examination of the potassium-dementia relationship is warranted.

Adult↗
PubMed1977

Vitamin B12 levels of cerebrospinal fluid in patients with a variety of neurological disorders.

The vitamin B12 levels of cerebrospinal fluid were assayed microbiologically (Lactobacillus leichmannii method) using samples from 44 patients with various neurological disorders, 4 patients with megaloblastic anemia and 34 controls. Twenty-seven controls that did not receive vitamin B12 showed a mean cerebrospinal fluid vitamin B12 level of 21.5 pg/ml (range: 0-60). No decrease in cerebrospinal fluid vitamin B12 level was seen in patients with subacute myelo-optico-neuropathy (SMON). High levels of cerebrospinal fluid vitamin B12 were observed only in the patients receiving long term administration of the vitamin. Intrathecal administration of vitamin B12 caused only a slight increase in serum vitamin B12 level after four hours. The existence of blood brain barrier for vitamin B12 was suggested.

Anemia, Megaloblastic↗
PubMed1989

Cerebrospinal fluid eosinophilia and ataxia in five llamas.

Cerebrospinal fluid eosinophilia was associated with ataxia in five llamas. A presumptive diagnosis of cerebrospinal parasitism was made, and a response to combined anthelmintic and anti-inflammatory therapy was seen in each animal. The results demonstrate the value of an examination of cerebrospinal fluid in the evaluation of neurological disease in llamas.

Animals↗
PubMed1993

Protein analyses in cerebrospinal fluid. I. Influence of concentration gradients for proteins on cerebrospinal fluid/serum albumin ratio.

Concentration gradients in lumbar cerebrospinal fluid (CSF) for albumin and IgG were studied in 8 healthy individuals and 44 neuropsychiatric patients by serial sampling of 6 successive portions of CSF, each containing 4 ml, in all 24 ml. Significant and identical decreases between the first (0-4th ml) and the last (21st-24th ml) portions were found for CSF-albumin (21% decrease, p < 0.0001) and CSF-IgG (21% decrease, p < 0.0001). Therefore, the CSF/serum albumin ratio also showed a significant gradient with a 21% decrease (p < 0.0001), while no gradients were found to the IgG index. These results imply that analyses of proteins in the CSF should be performed on a standardized volume of CSF, preferably the first 12 ml, to allow comparisons of scientific results between various patient groups and controls and between different laboratories and to increase the validity of protein analyses in clinical practice.

Adolescent↗
PubMed1978

[Acid-base equilibrium in the cerebrospinal fluid in diseases of the central nervous parenchyma].

A number of case studies reveal and dynamic changes of the acid-base balance in the blood and cerebrospinal fluid, such as the increasing decompensation of the metabolic lactate acidosis in the cerebrospinal fluid in lethal cases or the gradual regression in patients who were cured. Individual metabolic cerebrospinal parameters are correlated with the disturbance of consciousness. The cerebrospinal fluid parameters of patients with clouded consiciousness constitute prognostically critical values: lactate 3.6 mmol/l, pyruvate 0.19 mmol/l, pH 7.249 and bicarbonate 18.1 mmol/l. Affections of the central nervous parenchyma are better reflected in the cerebrospinal fluid than in the blood. The determination of the CSF/blood relationship of individual parameters shows a significant increase of the lactate quotient as well as a decrease of the pH quotient and of bicarbonate quotient. Respiratory parameters do not show any statistically significant changes. Statistically significant correlations show that, in the case of primary central nervous diseases, the increased hydrogen ion supply in the cerebrospinal fluid is quickly intercepted by the bicarbonate buffer and that, with a corresponding pH decrease, there is a rapid decompensation of the acid-base balance.

Acid-Base Equilibrium↗