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PubMed1982

5-hydroxytryptophol in the cerebrospinal fluid and urine of alcoholics and healthy subjects.

The serotonin metabolite 5-hydroxytryptophol was determined in cerebrospinal fluid and urine of alcoholics and healthy subjects, by a glass capillary gas chromatographic-mass spectrometric method. The urinary excretion rate (14.6 +/- 2.9 pmoles/mumoles creatinine) and urine (109 +/- 20 pmoles/ml) and cerebrospinal fluid (4.12 +/- 0.21 pmoles/ml) concentrations in healthy subjects were established. Only 1% of the 5-hydroxytryptophol in urine occurred in free form. Ethanol ingestion (80, 120 g) by healthy subjects lead to a 20--100-fold increase in the urinary excretion rate of 5-hydroxytryptophol. In cerebrospinal fluid the increase was about 60%. Alcoholics had increased urinary excretion rates and cerebrospinal fluid levels during intoxication, which were in the same range as in intoxicated healthy subjects. During recovery from intoxication, the 5-hydroxytryptophol level in alcoholics decreased, but the CSF levels were still higher than in healthy subjects.

Adult↗
PubMed1965

Alpha-amino nitrogen in cerebrospinal fluid and its alterations in meningitis, multiple sclerosis, and some other neurological disorders.

The concentration of alpha-amino nitrogen (a measure of total amino-acids) was estimated in 58 samples of cerebrospinal fluid in which other findings were normal. Values for lumbar and ventricular cerebrospinal fluid in adults, and lumbar cerebrospinal fluid in children, are reported. A relationship was found between the concentrations of alpha-amino nitrogen in lumbar cerebrospinal fluid and in plasma.Alpha-amino nitrogen was also estimated in 79 samples of fluid from patients with meningitis, cerebral tumour, multiple sclerosis, and other neurological disorders. High concentrations were found in meningitis, spinal block, and xanthochromic fluids. In cerebral tumours, the concentrations were mostly normal. Low concentrations were found in children, in many cases of multiple sclerosis, and in benign intracranial hypertension. In some cases, the changes cannot yet be explained.

Amino Acids↗
PubMed1981

Carcinoembryonic antigen estimation in cerebrospinal fluid in patients with metastatic breast cancer.

Cerebrospinal fluid (CSF) and plasma levels of carcinoembryonic antigen (CEA) have been measured in 39 patients with disseminated breast cancer, 22 of whom had metastases involving the central nervous system (CNS). CSF CEA was also measured in 13 patients without cancer who had non-malignant disorders. Thirteen of the 22 patients with CNS metastases had elevated CSF CEA, together with 4 of 17 patients with disseminated breast cancer without neurological involvement. These 4 patients were shown to have extensive dorso-lumbar spine deposits. CSF CEA was not detected in any of the 13 patients without cancer. Estimation of CEA in the cerebrospinal fluid may be a useful adjunct in the diagnosis of disseminated breast cancer involving the CNS, provided that spinal metastases are absent.

Bone Neoplasms↗
PubMed1978

[Autoradiographic findings in cerebrospinal fluid cells (author's transl)].

The report concerns the results of autoradiographic studies of cerebrospinal fluid cells. We investigated pleocytosis in cases of inflammatory diseases of the central nervous system, hemorrhage in the cerebrospinal fluid space, brain tumor and hemoblastosis, as well as in cases of undefined neurologic disease. Cerebrospinal fluid was incubated with tritiated thymidine. The results show that tumor cells have the highest labeling index and monocytes the lowest. Cells from primary brain tumors incorporate tritiated thymidine more rarely and less intensely than cells from cerebral metastases. Lymphocytes from inflammatory disease in infants may demonstrate a high labeling index.

Adolescent↗
PubMed2004

[The clinical analysis of endoscopic repair of cerebrospinal fluid rhinorrhea].

OBJECTIVE: To evaluate the points for attention, repair material and the treatment of complications in repairing cerebrospinal fluid rhinorrhea. METHOD: Fifteen cases of cerebrospinal fluid rhinorrhea were repaired. One case was pituitary tumor involving radiotherapy, two cases were spontaneous, six were traumatic, six were traumatic,six were iatrogenic. RESULT: All cases were successfully repaired by endoscopy. The successful rate were 85.6%. Some cases were relapsed in different positions and some cases needed to be repaired more than two times even five times. CONCLUSION: Endoscopic repair of cerebrospinal fluid rhinorrhea is a very good method with the virtue of convenient, high successful rate, less complication and repeatability. The method is worth spreading.

Adolescent↗
PubMedDate not supplied

[Herpes simplex and lymphocytic choriomeningitis viruses in infections of the central nervous system--clinical and cerebrospinal fluid characteristics].

INTRODUCTION: A great number of various viruses are stated as the cause of acute infections and damages of the central nervous system. In most cases these are minor damages which exhibit as meningeal syndrome and a specific finding in the cerebrospinal fluid. According to the dominant location, central nervous system infections can take a form of meningitis, encephalitis or myelitis. Since the inflammatory process of the meninges can not be separated from the inflammatory process of the brain, we usually speak of meningoencephalitis. The etiological diagnosis of meningitis and encephalitis is established by isolating the virus from the cerebrospinal fluid and by finding the presence of the specific antibodies in the blood and in the cerebrospinal fluid. The most common causes of the viral meningitis are Enteroviruses, the Mumps virus, Arthropode borne viruses, the Herpes viruses, Adeno viruses and the Lymphocytic choriomeningitis virus. The aim of our study was to establish the correlation between the clinical features and immunological and cerebrospinal fluid changes and the degree of the damage to the blood-brain barrier during the infections of the central nervous system, caused by the Herpes Simplex virus and the Lymphocytic choriomeningitis virus. MATERIAL AND METHODS: From a group of 103 patients, who had been treated for viral meningitis and meningoencephalitis, a group of 27 patients with established specific viral etiology--Herpes Simplex virus and Lymphocytic choriomeningitis virus, had been taken into the account. Herpes Simplex infection had been proven by the complement binding reaction and the neutralisation test of the even samples of serum. The diagnosis of Lymphocytic choriomeningitis was confirmed by the immunofluorescence test of the pharynx swabs and cerebrospinal fluid. The clinical features, such as body temperature, encephalitic signs, and electroencephalographic findings had been followed and compared. RESULTS: Herpes Simplex infection had been found in 20 patients, Lymphocytic choriomeningitis had been proven in 7 patients. All the patients had increased body temperature. Only four of the patients exhibited encephalitic signs, all infected by the Herpes Simplex virus. Patients from the Herpes Simplex group showed various degrees of consciousness disturbances, ranging from somnolence to coma, while the Lymphocytic choriomeningitis patients exhibited none. Higher pleocytosis and protein level had been found in the Lymphocytic choriomeningitis group. DISCUSSION: Viral diseases of the central nervous system are the result of the direct damage of the brain and meninges by the virus and immunological processes. Herpes Simplex meningitis usually has a good prognosis. Lymphocytic choriomeningitis has longer course of the disease and exhibits more severe clinical features. CONCLUSION: In cases of the central nervous system infections, caused by Herpes Simplex virus or Lymphocytic choriomeningitis virus, the correlation between the severeness of clinical features and the degree of damage of the blood-brain barrier, the level of pleocytosis and the increase of the cerebrospinal fluid proteins had been established.

Adult↗
PubMed1991

Neuronal acetylcholinesterase levels in cerebrospinal fluid and serum determined by a specific and sensitive immunoassay.

Acetylcholinesterase levels were determined in cerebrospinal fluid and serum of 272 patients with various neurological disorders. The patients were ordered in 13 diagnostic groups. The assay employed was an antigen capture assay based on an immobilized monoclonal antibody selective for neuronal acetylcholinesterase (Rasmussen et al., Clin. Chim. Acta 166 (1987) 17-25 (1)). In 100% of the cases the acetylcholinesterase levels in cerebrospinal fluid were 500-10,000 fold higher than expected for a regular serum-derived protein (0.1-0.5%) at the intact blood-brain barrier. In both compartments the test values showed wide variations, which were much greater in serum than in cerebrospinal fluid. No specific relationship was discernible between the values obtained and any of the diagnostic groups, although decreased levels of acetylcholinesterase were found in bacterial and viral meningitis, and elevated levels were found in groups with more chronic diseases. A possible transfer of acetylcholinesterase from cerebrospinal fluid to blood is discussed.

Acetylcholinesterase↗
PubMed1999

[Two cases of recurrent bacterial meningitis following traumatic cerebrospinal fluid rinorrhea].

We report here two cases of recurrent bacterial meningitis following traumatic cerebrospinal fluid rhinorrhea. Case-1: an 1-year-old girl had a penetrating injury to the nasal cavity with a chopstick. From 1 day after this accident, she had suffered from recurrent bacterial meningitis. She was diagnosed as having cerebrospinal fluid rhinorrhea, and underwent surgical repair of the bone defect. Case-2: a 5-year-old girl had suffered from bacterial meningitis 4 times after head trauma. A bone defect was demonstrated by 3-D CT and repaired surgically. We consider that 3-D CT is a useful tools to detect cerebrospinal fluid fistula.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1987

Cerebrospinal fluid shunt infections in children.

Forty-six episodes of cerebrospinal fluid shunt infections developed in 32 patients undergoing cerebrospinal fluid shunt operations during a 13-year period (1972 to 1984). The infection rate was 21%/operative procedure and 33%/patient. The shunt infection rate in revisions of infected shunts was 52%, a rate significantly larger than that in revisions of noninfected shunts (11%). Eight patients (25%) of the initially infected patients had more than one infectious episode. Predominating pathogens in patients who had shunt revisions included coagulase-negative staphylococci in 8 of 15 episodes (4 patients). Coagulase-negative staphylococci accounted for 28% and coagulase-positive staphylococci for 14% of the initial infectious episodes. Risk factors for development of shunt infection included age younger than 3 years, a previously infected shunt and surgery to revise the infected shunt. Therapy of infected shunts with antibiotics alone or with antibiotics plus an operative shunt revision resulted in similar success rates.

Adolescent↗
PubMed1984

Contrast medium causes the apparent increase in beta-endorphin levels in human cerebrospinal fluid following brain stimulation.

Levels of beta-endorphin immunoreactivity in cerebrospinal fluid were measured in 12 chronic pain patients undergoing the surgical implantation of an electrode into the periventricular gray matter. Cerebrospinal fluid fractions were collected following placement of a cannula into the third ventricle, following injection of metrizamide contrast medium into the ventricles, following implantation of the electrode, and following electrical stimulation. A second set of samples was collected on a non-surgical day before and after stimulation. Levels of beta-endorphin immunoreactivity increased significantly from baseline levels to post-electrode implantation in one group of patients, but no significant change was seen following the onset of stimulation. Immunoreactivity increased significantly following metrizamide injection in a second group and was still elevated, in comparison to baseline, following electrode placement, but no increase was seen following the onset of stimulation. Levels of immunoreactive beta-endorphin did not increase in either group after stimulation on a post-surgical day, despite consistent reports of pain relief. Addition of metrizamide or a related contrast medium, iothalamate meglumine (Conray) to the beta-endorphin radioimmunoassay revealed that both compounds interfered with antigen-antibody binding and also quenched the gamma radiation emitted by iodinated peptide ligands. Due to these combined effects, the contrast media alone produced results similar to those of the beta-endorphin standard. Moreover, similar observations were made when contrast media were incorporated into radioimmunoassays for met-enkephalin, dynorphin and cholecystokinin octapeptide. These findings indicate that increased levels of beta-endorphin in cerebrospinal fluid are not directly associated with patient report of pain relief following periventricular gray stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗
PubMed2000

Cerebrospinal fluid flow dynamics study in Chiari I malformation: implications for syrinx formation.

Cerebrospinal fluid (CSF) flow abnormalities are known to be present in Chiari I malformation and to underlie the origin and progression of associated syringomyelia. The incidence of syrinx formation, however, is variable for unknown reasons. The aim of this study was to investigate whether differences in CSF flow dynamics in patients with Chiari I malformation may account for the different clinical and radiological presentation. Presurgical and postsurgical phase-contrast magnetic resonance imaging investigations were prospectively conducted in 47 adult patients with symptomatic Chiari I malformation. Patients were divided into two groups according to the presence (32 cases) or absence (15 cases) of syrinx. Cerebrospinal fluid flow patterns were evaluated at four regions of interest: prebulbar cistern, foramen magnum, and the ventral and dorsal spinal subarachnoid spaces at the C-5 level. A temporal analysis of CSF flow waveforms was performed with measurement of cranial- and caudal-directed flow durations. All patients underwent a craniocervical decompressive procedure. Preoperatively, a prolonged caudal- directed (systolic) flow pattern was observed in patients with syringomyelia, as compared with normal control values obtained in 15 healthy volunteers. Conversely, a decreased systolic duration was observed in Chiari I patients who had malformation without syrinx. These trends were not statistically significant because of the considerable degree of overlap with the control values recorded in both groups. Additional comparison of the observed preoperative values obtained in patients with and those without syringomyelia indicated that the difference in systolic flow duration was significant at the ventral spinal subarachnoid space level (p = 0.003) and remarkable at the other levels, although not reaching statistical significance. Cerebrospinal fluid flow was minimal or absent at the foramen magnum (dorsal aspect) due to tonsillar herniation, precluding reliable quantitative measurement at this level. There was no evidence of communication between the fourth ventricle and syrinx in any case. Postoperatively, unobstructed CSF flow was recorded across the enlarged foramen magnum and into the artificial cisterna magna in all patients. A gradual restoration of near-normal flow patterns was observed in both groups. Inside the syrinx, fluid motion gradually tapered, no longer being detectable in 12 patients (37.5%) 1 year postsurgery. In patients with Chiari I malformation and associated syringomyelia different CSF flow patterns were demonstrated as compared with patients in whom syrinx was absent. Analysis of this study's findings supports the hypothesis that in Chiari I malformation an elongated systolic flow may prolong the condition of increased spinal subarachnoid pressure caused by the junctional obstruction, thus favoring CSF penetration into the spinal cord. It may be also proposed that a shortened systolic flow may be insufficient to maintain a hypertensive condition for enough time to induce syrinx formation.

Adult↗
PubMed2007

The positive role of lumbar puncture in the diagnosis of Vogt-Koyanagi-Harada disease: lymphocyte subsets in the aqueous humor and cerebrospinal fluid.

PURPOSE AND METHODS: Activated T cells are believed to be important at the inflammatory sites in the pathogenesis of Vogt-Koyanagi-Harada disease. Patients are often affected by meningitis and uveitis. In this work, to examine the positive role of lumbar puncture in the diagnosis of VKH disease, we analyzed and compared the surface markers of aqueous humor cells, cerebrospinal fluid cells, and peripheral blood lymphocytes by use of flow cytometry. RESULTS: Most lymphocytes were T cells. In aqueous humor and cerebrospinal fluid, numbers of CD3(+), CD4(+), and CD4(+)CD45RO(+) cells were significantly greater than in peripheral blood lymphocytes (P < 0.01). The CD4(+)/CD8(+) ratio for aqueous humor and cerebrospinal fluid was significantly higher than that for peripheral blood cells (P < 0.01). Four weeks after starting systemic corticosteroid treatment, numbers of CD4(+) and CD4(+)CD45RO(+) cells in cerebrospinal fluid were significantly lower than before treatment. CONCLUSIONS: Profiles of surface markers were similar for cerebrospinal fluid and aqueous humor, but apparently different from that for peripheral blood cells. This suggests that cerebrospinal fluid may reflect the active local immunological reaction at sites affected by the disease, i.e. the uvea and the meninges.

Acute Disease↗
PubMed1999

Epidural blood patch under fluoroscopic control: non-surgical treatment of lumbar cerebrospinal fluid fistula following implantation of an intrathecal pump system.

The treatment of lumbar cerebrospinal fluid fistula in the presence of an intrathecal catheter is known to be difficult. Open revision surgery is recommended in the literature, although the rate of recurrence is high. The epidural blood patch technique is well established as a successful treatment for post-dural-puncture headaches. Recent work about the distribution of the injected blood and theoretical considerations about the mechanism of action make this method suitable for the occlusion of spinal leakage even in the presence of an intrathecal catheter. In this note technical details are given for a successful therapy of lumbar cerebrospinal fluid fistula including the right positioning of the opening of the needle (cerebrospinal fluid can be expected intrathecally and epidurally) by injection of contrast medium first for myelography then for epidurography. In this procedure the (epidural) distribution of autologous blood can be indirectly controlled by compression of the dural sac. The method is easy to perform, and the possible risks are small.

Adult↗
PubMed1991

Antibodies in the cerebrospinal fluid of some Alzheimer's disease patients recognize amoeboid microglial cells in the developing rat central nervous system.

Previous investigations have demonstrated that the cerebrospinal fluid from Alzheimer's disease patients contains antibodies that recognize specific neuronal populations in the adult rat central nervous system. These findings suggest a pathogenic role for immunological aberrations in this disorder. In the present report the investigation of antibodies in the cerebrospinal fluid of Alzheimer's disease patients was extended to developing rat central nervous system. The antibody in cerebrospinal fluid from Alzheimer's disease patients recognized entirely different types of antigens in the developing rat central nervous system as compared to adult rat central nervous system. One of the most remarkable differences was the recognition of amoeboid microglial cells. Diverse morphological forms of amoeboid microglial cells were observed, located mainly in the cavum septum pellucidum and in the corpus callosum. Electron microscopy revealed that the cerebrospinal fluid antibody from the Alzheimer's disease patients recognized specific membrane receptors in the macrophagic microglia. The unexpected recognition of amoeboid microglia by antibodies in Alzheimer's disease-cerebrospinal fluid is particularly interesting since these cells proliferate in response to nervous system disease and also engulf debris. The results add further support to the concept that inflammation and similar immune mechanisms may contribute to Alzheimer's disease pathogenesis.

Adult↗
PubMed1994

Time course of variations in rabbit cerebrospinal fluid levels of calcitonin gene-related peptide- and substance P-like immunoreactivity in experimental subarachnoid hemorrhage.

BACKGROUND AND PURPOSE: Cerebral vasospasm after subarachnoid hemorrhage may result partially from the imbalance between vasodilator and vasoconstrictor factors. The vasodilator peptides substance P and calcitonin gene-related peptide contained in the trigeminovascular system are involved in the vasomotor phenomenon occurring after subarachnoid hemorrhage. The delayed arterial narrowing may reflect the time course of the release of these peptides. Therefore, we followed the time course of the changes in cerebrospinal fluid immunoreactivity of substance P and calcitonin gene-related peptide in a model of experimental subarachnoid hemorrhage. METHODS: Cerebrospinal fluid samples were taken in the basal state and at 30 minutes, 24 hours, and 3 days after a single injection of 1 mL autologous arterial blood into the cisterna magna of rabbits using a percutaneous suboccipital route. Substance P-like and calcitonin gene-related peptide-like immunoreactivities were determined in centrifuged cerebrospinal fluid and plasma by use of enzyme immunoassay. RESULTS: Early (30 minutes) after induced subarachnoid hemorrhage, there was a large increase in cerebrospinal fluid substance P-like immunoreactivity (P < .01) and calcitonin gene-related peptide-like immunoreactivity (P < .01). Arterial and hemorrhagic cerebrospinal fluid levels of substance P-like immunoreactivity were different (P < .03), indicating that the increased cerebrospinal fluid level did not result only from the blood contamination. Twenty-four hours after induced subarachnoid hemorrhage, the immunoreactivities of substance P and calcitonin gene-related peptide remained significantly higher than the basal level (P < .01). At day 3, both immunoreactivities had decreased to a level nonsignificantly different from the basal level. CONCLUSIONS: The early high values of the cerebrospinal fluid immunoreactivities for substance P and calcitonin gene-related peptide, apart from the contamination by arterial blood, probably resulted from the depletion of neurotransmitter peptides from the trigeminovascular fibers.

Animals↗
PubMed1991

Determination of S-100 and glial fibrillary acidic protein concentrations in cerebrospinal fluid after brain infarction.

BACKGROUND AND PURPOSE: We initiated the present study to evaluate the clinical value of consecutive concentration determinations of S-100 and glial fibrillary acidic proteins in cerebrospinal fluid from patients with brain infarction. METHODS: We took sequential samples of cerebrospinal fluid from 28 patients within 48 hours, at 7 days, and at 18-21 days after the ictus. We measured astroglial protein concentrations using an enzyme-linked immunosorbent assay and also determined size of the infarction (computed tomography), clinical state of the patient (simplified activities of daily living test), blood-brain barrier dysfunction (cerebrospinal fluid/serum albumin ratio), and a myelin marker (myelin basic protein). RESULTS: We found a transient increase of both proteins in the cerebrospinal fluid during the first week after the ischemic stroke (p less than 0.05). This increment was significantly correlated with the size of the infarction and the clinical state of the patients. CONCLUSIONS: Transient release of astroglial proteins into the cerebrospinal fluid possibly reflects initial focal ischemic damage and, in the later phase, ongoing destruction of astroglial cells in the penumbra zone. We suggest that determinations of cerebrospinal fluid astroglial protein concentrations can be used to estimate ischemic brain damage, which should be of particular value in clinical trials of pharmacological agents, such as calcium antagonists, on stroke patients.

Adult↗
PubMedDate not supplied

[Transthyretin levels in serum and cerebrospinal fluid sustain the nutrio-viral hypothesis of the Cuban epidemic neuropathy].

INTRODUCTION: Transthyretin is considered an excellent marker for monitoring nutritional status in serum. In cerebrospinal fluid it is synthesized by chroroid plexus. Cuban epidemic neuropathy is an emergent disease with a hypothetically viral and nutritional origin. OBJECTIVE: To know the behavior of this transport molecule in serum and cerebrospinal fluid in patients with Cuban epidemic neuropathy. PATIENTS AND METHODS: Serum and cerebrospinal fluid was quantified in 11 patients with Cuban epidemic neuropathy, eight patients suffering from other neuropathies and 15 patients with Down's syndrome and 10 patients with Alzheimer's disease. RESULTS: Serum transthyretin was diminished in patients with Cuban epidemic neuropathy, other neuropathies and Alzheimer's disease. Down's syndrome patients had significantly higher transthyretin levels in comparison with Cuban epidemic neuropathy and Alzheimer's disease. Cerebrospinal fluid transthyretin was significantly increased in patients with Cuban epidemic neuropathy in comparison with the normal values and with Alzheimer's disease patients whose values were settled below the normal values. CONCLUSIONS: The decrement of serum transthyretin in Cuban epidemic neuropathy indicates malnutrition and its higher levels in cerebrospinal fluid also indicate a viral infection. These findings support the nutrio-viral hypothesis of the disease.

Adolescent↗