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PubMed1980

Simple sedimentation method for cytology of cerebrospinal fluid.

A simpler and more practical sedimentation method for cerebrospinal fluid cytology is described. One-tenth milliliter of cerebrospinal fluid was applied dropwise within the circle of a Reich counting slide, and after sedimentation of the cells to the glass, the fluid was removed. Slides can be stained automatically with a slide stainer. Less cell distortion was observed with the sedimentation method. This method is much simpler and less time-consuming than the original sedimentation method.

Cerebrospinal Fluid↗
PubMed1992

Distribution of intraventricularly injected horseradish peroxidase in cerebrospinal fluid compartments of the rat spinal cord.

The circulation of the cerebrospinal fluid along the central canal and its access to the parenchyma of the spinal cord of the rat have been analyzed by injection of horseradish peroxidase (HRP) into the lateral ventricle. Peroxidase was found throughout the central canal 13 min after injection, suggesting a rapid circulation of cerebrospinal fluid along the central canal of the rat spinal cord. It was cleared from the central canal within 2 h, in contrast with the situation in the brain tissue, where it remained in the periventricular areas for 4 h. In the central canal, HRP bound to Reissner's fiber and the luminal surface of the ependymal cells; it penetrated through the intercellular space of the ependymal lining, reached the subependymal neuropil, the basement membrane of local capillaries, and appeared in the lumen of endothelial pinocytotic vesicles. Furthermore, it accumulated in the labyrinths of the basement membrane contacting the basolateral aspect of the ependymal cells. In ependymocytes, HRP was found in single pinocytotic vesicles. The blood vessels supplying the spinal cord were classified into two types. Type-A vessels penetrated the spinal cord laterally and dorsally and displayed the tracer along their external wall as far as the gray matter. Type-B vessels intruded into the spinal cord from the medial ventral sulcus and occupied the anterior commissure of the gray matter, approaching the central canal. They represented the only vessels marked by HRP along their course through the gray matter. HRP spread from the wall of type-B vessels, labeling the labyrinths, the intercellular space of the ependymal lining, and the lumen of the central canal. This suggests a communication between the central canal and the outer cerebrospinal fluid space, at the level of the medial ventral sulcus, via the intercellular spaces, the perivascular basement membrane and its labyrinthine extensions.

Animals↗
PubMed1984

Protein composition of cerebrospinal fluid in the developing chick embryo.

Proteins from cerebrospinal fluid of chick embryos at 4-19 days of development were qualitative and quantitatively analyzed. The total protein concentration and the relative concentration of each protein fraction were calculated for each day. The main proteins found along development were immunoglobulin G, transferrin, alpha-fetoprotein, serum albumin, ovalbumin, prealbumin, and an unidentified component. alpha-Fetoprotein was found to be the major protein at 4-16 days, and serum albumin at 17-19 days of development. The unidentified fraction was present from 4 to 11 days; at day 5 it represented 28% of the total cerebrospinal fluid protein concentration.

Albumins↗
PubMed1995

The effect of reversal of myoneural blockade on cerebrospinal fluid pressure following cerebral aneurysm surgery.

Drugs with a depolarizing action at the myoneural junction may cause a rise in intracranial pressure. Neostigmine, which is commonly used to reverse residual myoneural blockade, has a depolarizing action, and yet its effect on intracranial pressure is unknown. Lumbar cerebrospinal fluid pressure, which mirrors intracranial pressure, was determined in 12 patients undergoing cerebral aneurysm surgery. Cerebrospinal fluid pressure was measured during dense myoneural blockade and after its reversal with neostigmine. These effects on cerebrospinal fluid pressure were compared with those produced when the arterial partial pressure of carbon dioxide (PaCO2) rose from 4 to 5 kPa. After reversal of myoneural block, there was a small (non-significant) change in cerebrospinal fluid pressure from 3.6 to 4.3 kPa and a larger (significant) rise in cerebrospinal fluid pressure to 9.7 kPa when the PaCO2 was allowed to rise. In this group of patients, reversal of myoneural blockade with neostigmine causes no significant change in cerebrospinal fluid pressure.

Adult↗
PubMed2001

A comparison of cerebrospinal fluid pressure and block height after spinal anaesthesia in the right and left lateral position in pregnant women undergoing Caesarean section.

BACKGROUND AND OBJECTIVE: Little information exists on cerebrospinal fluid pressures in non-labouring pregnant women. The technique of spinal anaesthesia means that inadequate levels of sensory blockade are difficult to manage. If the block is found to be inadequate after surgery has commenced, then conversion to general anaesthesia may be the only option. It is important that any manoeuvre altering the spread of local anaesthetic is considered at the time of subarachnoid injection. This study investigates the feasibility of using a fine bore needle with an electronic transducer to measure cerebrospinal fluid pressure and whether this was affected by either of the two lateral positions. We also sought to measure whether the right or left lateral position affected subsequent block height and requirements for supplementary analgesia. METHODS: Two groups of 17 women presenting for elective Caesarean section were allocated to receive spinal anaesthesia in either the right or left lateral position. Cerebrospinal fluid pressure was measured by use of a rapid response electronic transducer connected to the hub of the spinal needle. Anaesthetic levels to cold sensation were assessed at 5, 10 and 15 min after injection of hyperbaric bupivacaine. During surgery, requirements for supplementary analgesia were recorded. RESULTS: There was no significant difference in cerebrospinal fluid pressure between the two positions. While there was a trend towards more rapid analgesia in the right lateral group, this did not reach statistical significance. Two blocks performed in the left lateral group were inadequate for surgery but this was not statistically significant. Overall, 39% of women required supplementary analgesia during surgery. The incidence was not significantly different between the two groups. CONCLUSION: Adoption of either the right or left lateral position for placement of spinal anaesthesia results in no difference in cerebrospinal fluid pressure or quality of block. The technique described gives a reliable and reproducible method of cerebrospinal fluid pressure measurement.

Adult↗
PubMed1980

Recovery of pathogenic bacteria from cerebrospinal fluid.

We studied the conditions necessary for optimal recovery of bacteria from cerebrospinal fluid. Our results indicated that Streptopcoccus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae can be quantitatively recovered in the sediment after centrifugation at 1,500 X g for 15 min. Equivalent numbers of bacteria were recovered by centrifugation or filtration of antibiotic-free cerebrospinal fluid; however, bacterial recovery by filtration was less effective with antibiotic-supplemented cerebrospinal fluid.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Interferon gamma concentration in the cerebrospinal fluid of patients with tick-borne encephalitis].

BACKGROUND AND PURPOSE: The purpose of this work was to evaluate interferon gamma (IFN-g) concentration in the cerebrospinal fluid of patients with diagnosed tick-borne encephalitis (TBE) early in the course of the disease and after the treatment. MATERIAL AND METHODS: The cerebrospinal fluid of 40 patients with TBE was examined. Patients were divided into 4 groups: group 1 consisted of 13 patients with mild clinical course, group 2 included 12 patients with prolonged TBE showing the presence of inflammatory markers after the treatment, group 3 comprised 9 patients with severe TBE presenting with disorders of consciousness and group 4 consisted of 6 patients with a simultaneous B. burgdorferi infection. The cerebrospinal fluid was examined twice--during TBE diagnosing and after the treatment. IFN-g was detected by the ELISA method. RESULTS: The concentration of IFN-g in the cerebrospinal fluid in the first examination was significantly higher in all four groups of patients in comparison with controls. After the treatment, concentration of IFN-g decreased significantly in all studied groups. The highest concentration of IFN-g at the first examination was found in group 3. The concentration of IFN-g at the second examination was similar among 4 groups of patients and in controls. CONCLUSIONS: We found the correlation between IFN-g concentration in the cerebrospinal fluid of patients at the early stage of TBE and inflammation activity. We did not find any association between IFN-g concentration and a persistent increase of the cerebrospinal fluid parameters.

Adult↗
PubMed2001

Pitfalls in cerebrospinal fluid test for the diagnosis of neurosyphilis.

OBJECTIVE: To determine the usefulness of cerebrospinal fluid tests in the diagnosis of neurosyphilis. METHODS: Two hundred and seven cerebrospinal fluid-Venereal Disease Research Laboratories tests were performed at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia between 1992 and 1997. The records of 14 cases with progressive neurological disease and reactive serum fluorescent treponemal absorbent antibodies or treponemal pallidum hemagglutination test were reviewed for clinical presentation, cerebrospinal fluid analysis and Venereal Disease Research Laboratories, neuro-imaging abnormalities and compatibility with the diagnosis of neurosyphilis. The diagnosis of neurosyphilis was made if the patient had reactive serum fluorescent treponemal absorbent antibodies or treponemal pallidum hemagglutination, history of progressive neurological disease and increased cerebrospinal fluid cells or protein. RESULTS: None of the 207 cerebrospinal fluid-Venereal Disease Research Laboratories tests were reactive. The diagnosis of neurosyphilis was made in 10 out of 14 cases with progressive neurological disease and reactive serum rapid plasma reagin, fluorescent treponemal absorbent antibodies and treponemal pallidum hemagglutination. CONCLUSION: We conclude that if reactive cerebrospinal fluid-Venereal Disease Research Laboratories is required to confirm or diagnose neurosyphilis, most cases will be overlooked.

Cerebrospinal Fluid Proteins↗
PubMed2004

[Spontaneous trans-sphenoidal encephalocele presenting with nontraumatic cerebrospinal fluid rhinorrhea (case report)].

Encephaloceles are uncommon and can arise from congenital, traumatic, or spontaneous origins. Approximately 80% of all cerebrospinal fluid rhinorrheas are caused by head injuries. Spontaneous or nontraumatic encephaloceles or cerebrospinal fluid leaks have been the least common in most series, accounting for only 3% to 5% of all cerebrospinal fluid leaks. There is a high incidence of meningitis and brain abscess. Thus, early diagnosis is very important. We present an adult patient with uncomplicated nontraumatic cerebrospinal fluid rhinorrhea that was caused by spontaneous trans-sphenoidal encephalocele.

Cerebrospinal Fluid Rhinorrhea↗
PubMedDate not supplied

Resolution of serum and cerebrospinal fluid abnormalities after treatment of neurosyphilis. Influence of concomitant human immunodeficiency virus infection.

BACKGROUND AND OBJECTIVES: Little is known about resolution of serum and cerebrospinal fluid abnormalities after neurosyphilis treatment, especially in patients infected with human immunodeficiency virus (HIV). GOAL: To examine the time course of resolution of these abnormalities. STUDY DESIGN: Case series of 22 patients with neurosyphilis (13 infected with HIV) with reactive cerebrospinal fluid Venereal Disease Research Laboratory test who underwent at least one lumbar puncture after treatment. RESULTS: Resolution of all serum and cerebrospinal fluid measures was slower in patients infected with HIV. Serum and cerebrospinal fluid abnormalities resolved in most patients not infected with HIV by 30 weeks, and all met Centers for Disease Control and Prevention criteria for cure. One patient infected with HIV failed therapy by Centers for Disease Control and Prevention criteria, and three others had persistent pleocytosis. CONCLUSIONS: HIV-infected patients with neurosyphilis have slower resolution of serum and cerebrospinal fluid abnormalities after therapy. This observation may suggest impaired clearance of Treponema pallidum from the central nervous system.

Antibodies, Bacterial↗
PubMed1994

Cerebrospinal fluid and therapy of isolated angiitis of the central nervous system.

BACKGROUND: Serial cerebral angiograms, computed tomography, and magnetic resonance imaging are among the proposed methods for monitoring disease activity and response to therapy in isolated angiitis of the central nervous system. Cerebrospinal fluid has not proved to be useful in monitoring clinical course. CASE DESCRIPTION: We describe a 45-year-old man with histological diagnosis of isolated angiitis of the central nervous system that was treated with prednisone plus azathioprine and monitored for 2 years. Samples of the cerebrospinal fluid were obtained for cytological and routine chemical examination, as well as albumin and immunoglobulin content. Before treatment, cerebrospinal fluid showed marked plasmatic transudation of albumin and intrathecal synthesis of immunoglobulins. During the first year of immunosuppression no events were noticed, and the previously abnormal aspects of the cerebrospinal fluid showed improvement. During the weaning of azathioprine, a new stroke occurred in conjunction with a marked deterioration of cerebrospinal fluid parameters. Immunosuppression was resumed at previous levels, and during the following year no further events occurred. Once again, abnormal cerebrospinal fluid values improved significantly. CONCLUSIONS: We report a case of isolated angiitis of the central nervous system in which the serial cerebrospinal fluid examinations (albumin and immunoglobulin content) showed a close correlation with clinical course. This method may be useful in monitoring response to therapy.

Albumins↗
PubMed1998

[The diagnosis and treatment of cerebrospinal fluid rhinorrhea].

OBJECTIVE: To summarize our experience in managing cerebrospinal fluid(CSF) rhinorrhea. METHODS: Twenty-nine cases with cerebrospinal fluid rhinorrhea from 1982 to March of 1997 were reviewed. The duration of CSF rhinorrhea varied from 3 months to 23 years. The ages of the patients ranged from 7 to 72 years. RESULTS: The causes of CSF leak were spontaneous in 18 cases, traumatic in 6 (1 had two accidents and got two different leaking sites) and iatrogenic in 5 cases. Twenty-two cases underwent surgical repair. Overall closure rate was 81.8%. The causes, symptoms and signs, sites of leakage and surgical techniques were analyzed. The classification, diagnosis and treatment of CSF rhinorrhea were discussed. CONCLUSION: Transnasal extracranial repair undertaken by otorhinolaryngologist got better closure rate(93.8%) in this group. Transnasal endoscopic repair could afford excellent view, facilitate precise tissue graft placement and get better closure rate.

Adolescent↗
PubMed2003

Cerebrospinal fluid rhinorrhea: diagnosis and treatment.

The diagnosis of cerebrospinal fluid rhinorrhea is usually straightforward. It need not be. The location of the leak is usually clear. It need not be. With modern rigid endoscopes, the repair is usually technically straightforward. It need not be. When a cerebrospinal fluid leak is suggested and the fluid is collectable, testing for beta 2 transferrin will usually settle the issue. The site of the leak is usually obvious. If it is not, but the leak is active, an isoview computed tomography scan will reveal it. Once the leak is established and located, the experienced endoscopic sinus surgeon can generally repair it using the instruments and materials currently available.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1982

Zoster encephalitis. Isolation of virus and measurement of varicella-zoster-specific antibodies in cerebrospinal fluid.

Varicella-zoster virus (VZV) was isolated on two occasions from the cerebrospinal fluid of an elderly woman with encephalomyelitis complicating thoracic zoster. Antibodies to ZV-induced membrane antigen (FAMA) were present in cerebrospinal fluid in a titer of 1:64; serum antibodies were 64-fold higher. Further evidence for local antibody production was derived from simultaneous measurements of immunoglobulin G and albumin in cerebrospinal fluid and serum and calculation of a cerebrospinal fluid-IgG index.

Aged↗
PubMed2002

[Headache with transient neurologic deficits and lymphocytosis in the cerebrospinal fluid].

BACKGROUND: Patients with episodes of headache associated with transient neurologic deficits and lymphocytes in the cerebrospinal fluid have been reported over the last two decades. MATERIAL AND METHODS: We present five patients without a prior history of migraine who experienced a limited series of 1-10 episodes of headache associated with transient neurologic deficits and lymphocytosis ranging from 85 to 500 x 10(6)/l in the cerebrospinal fluid. RESULTS: Some patients had elevated protein levels in the cerebrospinal fluid and focal EEG pathology. Analysis of cerebrospinal fluid, blood tests and imagining investigations did not give plausible aetiological explanations. INTERPRETATION: The prognosis of this syndrome is good. Its aetiology is unknown. It is reasonable to search for neurotropic viruses in future cases.

Adolescent↗
PubMed2025

Sex differences in cerebrospinal fluid proteomics of patients with restless legs syndrome.

STUDY OBJECTIVES: The pathobiology of restless legs syndrome (RLS) remains poorly understood, complicating effective treatment. This observational cross-sectional study aimed to identify a cerebrospinal fluid proteomic signature of RLS and to explore sex-specific differences in cerebrospinal fluid proteomics. METHODS: Cerebrospinal fluid samples were collected from 22 untreated RLS patients and 18 controls, matched for age, body mass index, and sex. Proteomic analysis was conducted using the SOMAscan platform, assessing over 7000 peptides. RESULTS: Eight proteins were differentially abundant between patients and controls, with CRP and JAML increased, and TAPBPL and IL1RL1 decreased. Pathway analysis highlighted significant involvement in immune response, coagulation, and cytoskeletal regulation. Analyses were then carried out using sex stratification, comparing men and women separately. Sex-specific analyses revealed more pronounced proteomic alterations in males (68 differentially abundant proteins vs. control males) than in females (17 proteins). Gene enrichment analysis revealed that men with RLS had more involvement in gene regulation and epigenetic factors than control males and women with restless legs syndrome had greater involvement in systemic inflammatory and vascular processes than control females. CONCLUSIONS: This study identified a cerebrospinal fluid proteomic signature in RLS, implicating immune and inflammatory pathways in the disease's pathophysiology. Significant sex differences in protein level suggest potential sex-specific mechanisms in RLS, warranting further investigation. These findings contribute to the current understanding of RLS and could inform future therapeutic strategies.

Humans↗
PubMed1988

Methotrexate concentration levels in the cerebrospinal fluid during high-dose methotrexate infusions: an unreliable prediction.

In 25 children with lymphoid malignancies, 96 high-dose methotrexate infusions (3 g/m2) with a duration of 24 h have been administered as a part of the treatment schedule. A lumbar puncture was performed to apply methotrexate intrathecally. The moment of lumbar puncture during the infusion was chosen at different times. In 76 of the infusions the concentration of methotrexate in the cerebrospinal fluid and in plasma were determined just prior to the intrathecal administration. From the second to the eighth hour after the initiation of the infusion the concentration of methotrexate in the cerebrospinal fluid and in plasma were determined just prior to the intrathecal administration. From the second to the eighth hour after the initiation of the infusion the concentration of methotrexate in the cerebrospinal fluid appeared to be significantly lower than 16 or 24 h after the initiation of the infusion. Of all samples during the infusions, the plasma concentration varied a tenfold (2-20 X 10(-5) mol/L), but the cerebrospinal fluid concentration of methotrexate varied about a 300-fold (3.5-900 x 10(-8) mol/L). No correlation could be found between the plasma concentration of methotrexate and the cerebrospinal fluid concentration. It is concluded that the methotrexate concentration in the cerebrospinal fluid cannot be predicted by determining the plasma concentration. It takes at least 8 h of infusion before a steady-state concentration of methotrexate is reached in the cerebrospinal fluid. In high-dose methotrexate infusions without intrathecal therapy, the dose of 3 g/m2 is the minimum amount of methotrexate to reach the minimum therapeutic concentration 5 x 10(-7) mol/L) in the cerebrospinal fluid for the treatment of subclinical central nervous system invasion of malignant lymphoid cells. To maintain the minimum therapeutic concentration according to the CxT principle the duration of the infusion should be preferably longer than 24 h.

Adolescent↗