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PubMedDate not supplied

Cranial and spinal cerebrospinal fluid absorption and the clearance of water-soluble myelographic contrast media. A review.

Following myelography, water-soluble contrast media are cleared from the subarachnoid space with the cerebrospinal fluid via the cranial and spinal absorption pathways. These cerebrospinal fluid absorption pathways are reviewed. The effects of removal of excessive quantities of cerebrospinal fluid, increased numbers of cells in the cerebrospinal fluid, and dehydration are discussed.

Absorption↗
PubMed1999

Cerebrospinal fluid levels of biotin in various neurological disorders.

OBJECTIVES: To analyse biotin concentrations in human cerebrospinal fluid (CSF) and serum from controls without evidence of nutritional or neurological disorders and patients with common neurological disorders. PATIENTS AND METHODS: Cerebrospinal fluid was obtained from patients by lumbar puncture, serum was prepared from freshly drawn whole blood and biotinidase in samples was inhibited before being analysed for biotin by radioligand assay. RESULTS: Assay characteristics were within an acceptable range (intra-and interassay coefficient of variations were 8.8 and 12.0 respectively, recovery: 91-114% and sensitive, lowest standard concentration 15 ng/l). Significantly lower values for biotin were found in patients with multiple sclerosis (both CSF and serum) in comparison to the controls. Significantly reduced values for cerebrospinal fluid biotin were found in epileptics compared to controls, whereas, in serum the difference was approaching significance. No significant differences were observed in other groups of patients. CONCLUSION: There is a significant reduction in cerebrospinal fluid biotin in epileptics and patients with multiple sclerosis compared to controls. In epileptics this may be related to competition between biotin and anticonvulsants bearing carbamide ring for absorption. Reduction of biotin levels in patients with multiple sclerosis could be attributed to intestinal malabsorption caused by the underlying disease or a biotin-binding immunoglobulin which may be involved in multiple sclerosis pathogenesis.

Adult↗
PubMed1979

Predictive value of cerebrospinal fluid polyamines in medulloblastoma.

Seventy-five cerebrospinal fluid polyamine determinations were evaluated in 16 patients with medulloblastoma. Parameters utilized in evaluating patient status for correlation with the polyamine concentrations were neurological examination, computerized tomography, radionuclide scan, myelography, and cerebrospinal fluid cytology. Fifteen of the 16 patients showed absolute correlation with the eventual clinical picture. One determination on one patient resulted in a false negative. No false positives have been observed to date.

Adolescent↗
PubMedDate not supplied

[Human African trypanosomiasis and normality of the cerebrospinal fluid].

The authors have reviewed their experience with a combination of pentamidine and suramin for Trypanosoma Brucei - Gambiense trypanosomiasis, in order to determine the limit of cerebrospinal fluid (CSF) normality. Among 341 patients with a cerebrospinal fluid (CSF) showing 1-3 white blood cells/millilitre treated with this combination of drugs, there were 30 relapses (8.8%); among 66 patients with a cerebrospinal fluid (CSF) showing 4-5 white blood cells/millilitre, they found 9 relapses (13.6%). This difference was not statistically significant. Therefore, combination of pentamidine- was not statistically significant. Therefore, a combination of pentamidine/suramin remains an acceptable treatment for Trypanosoma brucei-gambiense sleeping sickness patients having 1-5 white blood cells/millilitre in their cerebrospinal fluid (CSF).

Cerebrospinal Fluid↗
PubMed1984

[Determination of dipeptidyl aminopeptidase activities in the cerebrospinal fluid].

The investigation of enzyme activity in cerebrospinal fluid has been without relevant results for laboratories analysing spinal fluid. For neurochemical purposes, it is interesting that the Substance P is convered by Depeptidyl-aminopeptidase IV (DP IV), liberating dipeptides. The hydrolysis of nitroanilids of the form Xaa-Pro-NHNp in cerebrospinal fluid was analysed using them as peptidases substrates. Finally a method for measuring the activity was proposed.

Dipeptides↗
PubMed1986

Efficiency of various methods of identifying cerebrospinal fluid in oto- and rhinorrhea.

This paper describes methods of cerebrospinal fluid (CSF) leakage diagnosis which have been used in the post-war period. We have listed advantages and disadvantages and given our opinion as to the value of each method. In the form of comparison we have provided a detailed breakdown of the exact procedure of beta 2-transferrin identification used for the immunological diagnosis of CSF leakage. This method, which was developed further by us, is discussed with regard to the results of all sample analysis which have been carried out so far. The result of the discussion is to emphasize the many advantages of this method. In addition, there is a direct comparison made between the fluorescein method and the use of beta 2-transferrin.

Cerebrospinal Fluid↗
PubMed1983

[Current status of cerebrospinal fluid diagnosis].

The possibilities of the analysis of cerebrospinal fluid (CSF) are explained from the aspect of a clearly arranged representation, partly in tabular form, concerning the following details: --the relation of the findings of CSF, in particular the cytological results, to the course of disease, --the special cytological methods for determination of cells in CSF, --cytomorphological characteristics of malignancy in regard of activated cells inflammatory reactions, --the assessment of the results of qualitative analyses of proteins and the differentiation of an intrathecal production of immunoglobulins opposite to the impairment of the barriers, --the damage of parameters of CSF by artificial factors. In case of the determination of distinct CSF syndromes results a special diagnostical consequence before all for exsudative, immunoreactive and inflammatory disorders, vascular disease and tumors of the nervous system.

Blood-Brain Barrier↗
PubMed2005

Approach design and closure techniques to minimize cerebrospinal fluid leak after cerebellopontine angle tumor surgery.

OBJECTIVE: The purpose of the study was to identify specific aspects of surgical approach design and closure technique aimed at reducing the incidence of cerebrospinal fluid leak after cerebellopontine angle tumor surgery. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: All patients undergoing cerebellopontine angle tumor surgery at the study institution from January 1996 through September 2004. MAIN OUTCOME MEASURE: The presence or absence of cerebrospinal fluid leak after various surgical approaches for a wide variety of cerebellopontine angle tumors. RESULTS: Three hundred forty three patients underwent surgery for cerebellopontine angle tumors at the study institution during the study period. Tumor types in descending order of frequency were as follows: acoustic neuroma, 244; cerebellopontine angle meningiomas, 33; petroclival meningiomas, 32; foramen magnum meningiomas, 10; epidermoid tumors, 9; facial nerve tumors, 6; hemangiopericytomas, 3; schwannomas of glossopharyngeal/spinal accessory nerves, 3; and unusual internal auditory canal tumors, 3. Surgical approaches used for tumor resection included translabyrinthine, retrosigmoid, combined transpetrosal, far lateral/transcondylar, middle cranial fossa, and extended middle cranial fossa. During the nearly 8-year study period, four postoperative cerebrospinal fluid leaks were encountered, resulting in a leak rate of 1.2%. Two of these patients required surgical repair of their leaks; the other two stopped spontaneously. The authors describe specific aspects of approach design and closure that appear to have a positive impact on postoperative cerebrospinal fluid leak rates. CONCLUSION: Attention to specific aspects of surgical approach design and wound closure results in a reduced incidence of cerebrospinal fluid leak after surgery for cerebellopontine angle tumors.

Cerebellopontine Angle↗
PubMed1996

Multi-layer neural network analysis of cerebrospinal fluid pressure patterns in idiopathic normal-pressure hydrocephalus.

The cerebrospinal fluid (CSF) pressure patterns have been reported as one of the most relevant indexes for the diagnosis and treatment of idiopathic normal-pressure hydrocephalus (INPH). Forty consecutive patients coming from our observations with the classic Hakim's triad underwent continuous CSF pressure monitoring via lumbar puncture for at least 12 hours. Twenty-eight patients were diagnosed as having INPH and underwent CSF shunt. A multi-layer neural network (perceptron) was employed to study the pressure patterns in order to try an alternative classification to the "expert" neurosurgeon one. Differences between expert and neural network classifications were indeed observed. Such differences may depend on the small group studied or on the inadequacy of CFS pressure patterns in correctly individuating those INPH patients who benefit from shunt surgery. The authors think that neural network processing of INPH could add relevant information to select the "responder" patients to surgery: in fact neural networks represent a powerful methodology for aiding the expert to select the proper choice on the basis of "what learnt" by the networks themselves.

Cerebrospinal Fluid↗
PubMed1993

Milacemide effects on the temporal inter-relationship of amino acids and monoamine metabolites in rat cerebrospinal fluid.

The temporal inter-relationship of various amino acids and monoamine metabolites in rat cerebrospinal fluid was examined after acute administration of milacemide (100, 200 or 400 mg/kg i.p.), a glycine prodrug. Glycine concentrations rose linearly and dose dependently (20-190%) but were only significantly elevated at the higher milacemide dose (200 and 400 mg/kg). In animals given 400 mg/kg, glycine values were still significantly elevated 8 h later. A concomitant increase (20-25%) in serine and taurine and a decrease in alanine cerebrospinal fluid values were observed at the highest milacemide dose. Other amino acids were unaffected. While cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations were unaffected, the dopamine metabolites, 3,4-dihydroxyphenylacetic acid and homovanillic acid, exhibited a linear dose-dependent reduction. However, only homovanillic acid values were significantly decreased after 400 mg/kg milacemide. Cerebrospinal fluid analysis may be useful as a first screen in ascertaining putative neurochemical changes associated with drug administration.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1976

Multiple sclerosis cerebrospinal fluid produces myelin lesions in tadpole optic nerves.

To investigate the myelinotoxicity of cerebropsinal fluid in multiple sclerosis, we used an in vivo model of the myelinated central-nervous-system tract of tadpoles for quantitative double-blind tests of 46 cerebrospinal-fluid samples. Groups of xenopus tadpoles were injected with cerebrospinal fluid near the optic nerve. Forty-eight hours later, whole mounts of optic nerves were prepared, and a differential interference microscope was used to count myelin lesions. Cerebrospinal-fluid samples from 60 per cent of the patients with an acute attack of definite multiple sclerosis had myelinotoxic activity. This activity correlated best with the severity and duration of the disease, rather than with gamma-globulin or total protein concentrations. Activity was negative in 85 per cent of cerebrospinal-fluid samples from a control group with other neurologic diseases. This assay is a useful method for investigating myelinotoxic factors of cerebrospinal fluid in patients with multiple sclerosis, but was not helpful diagnostically.

Acute Disease↗
PubMed1989

[Comparative measurement of cocaine and its metabolites in blood, cerebrospinal fluid and the brain].

This study investigated the transfer of cocaine and its metabolites from plasma into the cerebrospinal fluid. The concentration of cocaine and its metabolites in plasma and cerebrospinal fluid was determined by radioimmunoassay because this method only, the sum of the drug and metabolites restored. In sheeps a sublethal cocaine hydrochloride dose (2,4 mg/kg b. wt.) was administered intraarterial daily for up to 8 days. In the first hours after administration the concentration of cocaine in cerebrospinal fluid was low. It is supposed that a barrier against the transport of cocaine from blood into cerebrospinal fluid exists. After intrathecal administration a delay of transport could from CSF to blood not be seen.

Animals↗
PubMed1989

[Cerebrospinal fluid findings in 108 Japanese cases of herpes simplex encephalitis].

Cerebrospinal fluid (CSF) findings were evaluated in 108 Japanese cases of herpes simplex encephalitis (HSE). The diagnosis was based on clinical, neurodiagnostic and serological examinations. The maximum abnormal values for opening pressure, red blood cell number, total protein concentration, white blood cell number and percentage of polymorphonuclear cell recorded in each case throughout the course of the illness were distributed widely in the range of 80 to 450 mm CSF, 0 to 20,700/cu mm, 15 to 1,390 mg/dl, 0 to 1,089/cu mm and 0 to 85%, respectively. Xanthochromia was revealed in CSF in 30 out of 101 HSE cases (30%), in 21 of which the xanthochromia was independent of traumatic bleeding during the punctures. The frequency of high density lesion in brain computed X-ray tomography was 43% (9 out of 21) in patients with xanthochromia. On the other hand, it was only 7% (7 out of 71) in patients without xanthochromia. This difference was statistically significant (p less than 0.01). The main cause for xanthochromia was considered to be an escape of red blood cell from the hemorrhagic necrotizing lesion to CSF in 14% of cases, the elevation of protein in CSF in 9% and both in 29%. Red blood cell was revealed in CSF in 24 out of 61 HSE cases (40%). The number of cases with more than 51 red blood cells/cu mm was 5 out of 10 patients with xanthochromia compared with only 8 out of 50 without xanthochromia. This difference was statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebrospinal Fluid↗
PubMed1991

Granulocyte colony-stimulating factor in cerebrospinal fluid from patients with meningitis.

Granulocyte colony-stimulating factor (G-CSF) in the cerebrospinal fluid from patients with meningitis was measured by our modified enzyme-linked immunosorbent assay for G-CSF. The minimal detection level was 20 pg/mL G-CSF. In patients with bacterial meningitis, the G-CSF levels in the cerebrospinal fluid were extremely elevated, showing a mean value of approximately 1,500 pg/mL. On the other hand, G-CSF levels in the cerebrospinal fluid from 67% patients with aseptic meningitis were moderately increased, showing a mean value of about 80 pg/mL, whereas G-CSF levels in 33% samples remained undetectable. The G-CSF levels and neutrophil counts in the cerebrospinal fluid were proven to be related by Spearman's rank correlation coefficient analysis (r = .724). These elevations of G-CSF levels at inflammation sites associated with bacterial meningitis may indicate that G-CSF plays an important role in the combat of bacterial infections.

Child↗
PubMed1976

Concentrations of bacteria in cerebrospinal fluid of patients with bacterial meningitis.

Concentrations of bacteria in cerebrospinal fluid ranged from 4.5 X 10(3) to 3 X 10(8) colony-forming units/ml in 27 patients with bacterial meningitis before antibiotic therapy and from 4 X 10(1) to 1.4 X 10(6) CFU/ml in four patients after one to two days of antibiotic therapy. All patients with persistent positive cultures had pretreatment concentrations of 10(7) CFU/ml or greater. A significant association was observed between cerebrospinal fluid lactic acid dehydrogenase activity and concentrations of bacteria (p less than 0.01). Large inocula of Hemophilus influenzae type b (10(7)) increased the minimal inhibitory concentration for penicillin and ampicillin but not for chloramphenicol. The minimal inhibitory concentration of each of the three antibiotics increased when group B streptococci were assayed. These data indicate that persistence of a positive culture may be related to large initial concentrations of bacteria. The relative "resistance" in vitro of large inocula possibly contributes to this persistence. These observations are also consistent with the hypothesis that lactic acid dehydrogenase activity in cerebrospinal fluid is derived from bacteria.

Ampicillin↗
PubMed1998

Cerebrospinal fluid prostaglandins after systemic dipyrone intake.

OBJECTIVE: The object of this study was to evaluate the time course of thromboxane B2 and prostaglandin E2 concentrations in cerebrospinal fluid after oral administration of dipyrone (INN, metamizole). METHODS: A single 1.0 gm oral dose of dipyrone was given to consenting patients undergoing elective diagnostic lumbar puncture 0.5, 1, 1.5, 2, 4, 6, 8, or 12 hours before the tap. RESULTS: For thromboxane B2 a time decrease in cerebrospinal fluid concentration was apparent. In contrast, for prostaglandin E2 cerebrospinal fluid levels no consistent trend was observed. CONCLUSIONS: A time-related decrease in cerebrospinal fluid thromboxane B2 level was noted in patients receiving dipyrone. Thirty minutes after dipyrone intake cerebrospinal fluid thromboxane B2 levels already tended to be lower than those seen in patients with neurologic diseases who were not receiving dipyrone. These results are consistent with the hypothesis that dipyrone acts in the central nervous system by inhibition of particular prostanoids.

Administration, Oral↗
PubMed1980

Penetration of spectinomycin into cerebrospinal fluid duirng experimental meningitis.

The concentration of spectinomycin in serum and cerebrospinal fluid was compared in rabbits with and without experimental pneumococcal meningitis. When injected intravenously, spectinomycin could not be detected in the cerebrospinal fluid of normal rabbits. In rabbits with meningeal inflammation, however, spectinomycin penetrated the blood-brain barrier and produced significant cerebrospinal fluid concentrations, equal to or well above spectinomycin minimal inhibitory concentrations for many bacterial species.

Animals↗
PubMed1988

Prostaglandin concentrations in cerebrospinal fluid of rabbits under normal and ischemic conditions.

Clinical studies have demonstrated elevated levels of both arachidonic acid and prostaglandins in the cerebrospinal fluid of humans after ischemic stroke and subarachnoid hemorrhage. Such increases in free fatty acid, arachidonic acid, and prostaglandin concentrations suggest excessive production and accumulation of these substances in the ischemic brain. We used a rabbit model of ischemic infarction to examine the relation between controlled central nervous system ischemia and cerebrospinal fluid prostaglandin levels. We found that following stroke PGF2 alpha and not PGD2 was the predominant prostaglandin present in the cerebrospinal fluid. PGF2 alpha also underwent the largest percent increase over control prostaglandin concentrations. This is similar to human and dog cerebrospinal fluid studies, which demonstrate PGF2 alpha as the predominant prostaglandin following ischemic injury. The lack of PGD2 elevation under ischemic conditions may suggest that the rabbit model is more like stroke in humans than the rat or gerbil models. Our preliminary work demonstrates that it is practical to study postischemic prostaglandin changes in cerebrospinal fluid rather than in brain tissue in a rabbit model of central nervous system ischemia.

Animals↗