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At least 1,369 records · Page 76Linked to original sources
PubMed1978

[Correlation of vasospasm and intracranial metabolism under experimental subarachnoid hemorrhage--Part 1. In reference with the acid-base-balance of cerebral blood and cerebrospinal fluid].

Cerebral vasospasm, cerebral metabolism and the acid-base-balance of blood and cerebrospinal fluid of dogs were studied during and after the experimental subarachnoid hemorrhage. Subarachnoid hemorrhage was induced by infusion of fresh blood into the basal cistern through a small sraniectomy in the base of the skull. Eighty adult mongrel dogs were used. Of these a complete recording was obtained in 32 cases under the constant controlled ventilation. The samples of the blood and cerebrospinal fluid (CSF) were obtained repeatedly at the inserted 1 to 3 hours from the Polyethylene tube inserted into the cisterna magna subarachnoid space, carotid artery and internal jugular vein. During these procedures, the luminal size of the intracranial basal artery was measured angiographically. Vasoconstriction of the cerebral arteries in response to experimental subarachnoid hemorrhage had a biphasic course, an acute phase (the vasoconstrictive phenomenon which lasts less than 6 hours) and chronic phase (the revasoconstriction occured and continued more than 24 hours after the hemorrhage). The former was named "Released Group" which consists of 16 dogs and the later was named "Prolonged Group" which consists of 20 dogs. In both group, pH and bicarbonate ion concentration of CSF were found to be reduced by twenty percent of the normal value on the aveaage about three hours after subarachnoid hemorrage, apparently reflecting occurence of early cerebral vasospasm. Remarkable metabolic acidosis was seen in CSF of the prolonged group as compared with in cerebral blood. The occurrence of A-V shunt was suggested in the cerebral circulation from the blood gas findings. The experimental results indicates that prolonged cerebral vasospams phenomenon causes persistent hypoxic state in the cerebral tissue. However, cellular metabolism of cerebral tissue will be probably maintained by oxygen supply necessary to cellular respiration through the blood-brain barrier from the cerebrospinal fluid.

Acid-Base Equilibrium↗
PubMed1997

Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae. A meta-analysis.

OBJECTIVE: To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid fistulae. DESIGN: Meta-analysis with literature review. METHODS: A MEDLINE search was performed to obtain all the reports pertaining to posttraumatic cerebrospinal fluid fistulae between 1970 and 1995. All the series that provided data specifying whether prophylactic antibiotics were provided and the incidence of the meningitis were included in the analysis. RESULTS: The findings of 6 studies, involving 324 patients, were analyzed. In these studies, 237 received prophylactic antibiotics and 87 did not. Only 6 of the 237 patients who received prophylactic antibiotics developed meningitis, yielding an incidence of 2.5%. Nine (10%) of the 87 patients who did not receive prophylactic antibiotics developed meningitis. The incidence of meningitis was significantly lower in the patients who received prophylactic antibiotics than in those who did not receive prophylaxis (Fisher exact test, P = .006). CONCLUSIONS: Individually, each of the studies included in this analysis demonstrated no significant difference in the incidence of meningitis with prophylactic antibiotic therapy. The reason for this is that inadequate numbers of patients were available at each institution. Pooling the data from the past 25 years revealed a statistically significant reduction in the incidence of meningitis with prophylactic antibiotic therapy.

Antibiotic Prophylaxis↗
PubMed1997

Cerebrospinal fluid fistulae in a canine model.

Various diagnostic techniques currently are used to detect the presence of a cerebrospinal fluid fistula. High resolution computerized tomography scanning with the instillation of an intrathecal nonionic contrast medium yields the most accurate diagnostic results. Occasionally, even with optimal conditions, little information is gained other than the confirmation of the presence of a fistula. Intrathecal fluorescein can provide accurate information on the exact location of the fistula. The current study was designed to refine the clinical examination for cerebrospinal fluid fistulae with the use of intrathecal fluorescein. The canine model that we used also served as a vehicle to investigate the histopathologic effects of fluorescein on the central nervous system. We modified a commonly used xenon light source to enable examination with 490 nm light. In the canine model, this allowed accurate visualization of surgically created fistulae using very low doses of intrathecal fluorescein. An examination of the histopathologic features of the central nervous system of the canine model after acute instillation of a higher dose of fluorescein revealed microscopic changes consistent with the introduction of an irritant material. The changes induced by the chemical trauma may explain the serious neurologic sequelae sometimes seen in patients after the instillation of intrathecal fluorescein. Recommendations on the correct dosage of intrathecal fluorescein for diagnosis of cerebrospinal fluid fistulae are proposed.

Animals↗
PubMed1981

Cerebrospinal fluid lactic acidosis in bacterial meningitis.

A rapid, microenzymatic method was used to measure cerebrospinal fluid lactate levels in 205 children with suspected bacterial meningitis. Fifty children with normal CSF containing fewer than 0.005 X 10(9)/l WBC, no segmented neutrophils, glucose 3.4 +/- 0.8 mmol/l (61.2 +/- 14.4 mg/100 ml), and a protein of less than 0.30 g/l had CSF lactate levels below 2.0 mmol/l (18 mg/100 ml) (mean and standard deviation 1.3 +/- 0.3 mmol/l (11.8 +/- 2.7 mg/100 ml)). In 31 cases of proved viral meningitis as with 58 cases of clinically diagnosed viral meningitis, levels were below 3.8 mmol/l (34.5 mg/100 ml), being 2.3 +/- 0.6 mmol/l (20.9 +/- 5.4 mg/100 ml), and 2.1 +/- 0.7 mmol/l (19.1 +/- 6.4 mg/100 ml) respectively. Sixty-six cases of bacterial meningitis had CSF lactate levels ranging from 3.9 mmol/l (35.4 mg/100 ml) to greater than 10.0 mmol/l (90.0 mg/100 ml). Longitudinal studies in 7 children with bacterial meningitis showed that cerebrospinal fluid lactate levels differentiated bacterial from viral meningitis up to 4 days after starting treatment with antibiotics. Use of CSF lactate measurement for monitoring the efficacy of treatment is illustrated in a case of bacterial meningitis due to Pseudomonas aeruginosa. The origin of the cerebrospinal fluid lactate acidosis and the role of lactate in the pathophysiological cycle leading to intensification of brain tissue hypoxia and cellular damage is discussed with respect to the short-term prognosis and the long-term neurological sequelae.

Acidosis↗
PubMed1978

Cerebrospinal fluid lymphocytes in experimental allergic encephalomyelitis.

We report characteristics of the cerebrospinal fluid (CSF) pleocytosis (616+/-148 cells/microliter) that occurred in guinea-pigs with definite clinical experimental allergic encephalomyelitis developing 12 to 16 days after sensitization with homologous myelin basic protein. This pleocytosis was not present in the cerebrospinal fluid of a group of animals studied when still healthy, 9 or 10 days after similar sensitization. Eighty-nine per cent of cells in the CSF pleocytosis were small lymphocytes, 8% were larger lymphocytes and the remainder mostly monocytes. Of the lymphocytes, most were E-rosetting or null cells. B-cell markers were uncommon. The cellular patterns in this CSF pleocytosis appear to be similar to those seen in some delayed hypersensitivity responses.

Animals↗
PubMedDate not supplied

Granulocytic sarcoma with meningeal leukemia but no bone marrow involvement at presentation. A report of two cases with characteristic cerebrospinal fluid cytology.

Two cases occurred of granulocytic sarcoma with cerebrospinal fluid involvement but no associated leukemia on presentation. Both cases were difficult to identify by histology and were initially misdiagnosed as malignant lymphoma. The characteristic cerebrospinal fluid cytologic picture allowed the diagnosis. These cases underscore the value of cytologic examination of tumor imprints and the use of myeloid markers in panels for immunophenotyping lymphomas.

Adult↗
PubMed1985

Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow in patients with benign intracranial hypertension (pseudotumor cerebri).

Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow were investigated in 14 patients with benign intracranial hypertension (pseudotumor cerebri). Intracranial pressure was increased in 9 patients (20 to 30 mm Hg), borderline in 4 patients (15 to 18 mm Hg), and normal in 1 patient (8 mm Hg). Six patients had plateau waves, and all had B waves in more than 50% of the monitored time. Conductance to cerebrospinal fluid outflow, measured by a lumbo-lumbar perfusion method, was significantly reduced: 0.042 ml X mm Hg-1 X min-1 (+/- 0.004 [SEM]; normal, more than 0.080 ml X mm Hg-1 X min-1). Cerebral blood flow was measured by xenon 133 inhalation and single photon emission computer tomography. Mean hemispheric flow was normal in all cases, averaging 59 +/- 9 ml X 100 gm-1 X min-1. Only 2 patients showed focal low-flow areas. Thus, a disturbance of cerebrospinal fluid circulation seems to be of pathogenetic significance in benign intracranial hypertension.

Adolescent↗
PubMed1994

[Our experiences with cerebrospinal fluid rhinorrhea and its surgical treatment using an extracranial approach].

The cerebrospinal fluid rhinorrhea is usually due to a skull lesion and is potentially dangerous for the patient, as it can be followed by an ascending meningitis. The extracranial approach (external ethmoidectomy, osteoplasty of the frontal sinus) has substituted craniotomy, especially in cases where the cerebrospinal fluid rhinorrhea is not due to intracranial lesions. In this study, we describe the surgical treatment of 9 patients treated in our clinic, and we make a brief review of the literature.

Adipose Tissue↗
PubMed1987

Nitrous oxide and cerebrospinal fluid markers of ischaemia following cardiopulmonary bypass.

Twenty patients with good ventricular function undergoing coronary artery bypass surgery were studied to determine whether the pre-bypass use of nitrous oxide resulted in any differences in cerebrospinal fluid markers indicative of cerebral ischaemia. All patients were anaesthetised with diazepam, fentanyl and pancuronium, after which ten patients received 50-60% nitrous oxide in oxygen until commencement of bypass, and the remaining patients 100% oxygen. Because of the known effect of nitrous oxide in expanding gaseous bubbles, any neurological dysfunction of gaseous microembolic origin may be worsened in the presence of nitrous oxide. Patients were lumbar punctured 24 hours after cardiopulmonary bypass and cerebrospinal fluid analysed for the following markers of central nervous system ischaemia: creatine kinase, lactate, total protein, noradrenaline, adrenaline and adenylate kinase. There was a statistically significant difference in cerebrospinal fluid lactate between the two groups. There were no statistically significant differences in the other cerebrospinal fluid markers of ischaemia.

Adenylate Kinase↗
PubMed1997

Detectable concentrations of Fas ligand in cerebrospinal fluid after severe head injury.

When the cell surface molecule Fas is triggered by its agonist Fas ligand the result is apoptosis of these cells and tissue destruction. To elucidate the pathophysiological relevance of Fas ligand in patients with cerebral oedema caused by trauma, we examined its concentrations in cerebrospinal fluid in 18 patients using specific ELISA. Serum and cerebrospinal fluid from healthy people and injured patients without head trauma did not contain detectable Fas ligand. In contrast, cerebrospinal fluid from patients with severe brain injury contained high concentrations of Fas ligand without detectable concentrations in serum. Soluble Fas ligand concentrations in cerebrospinal fluid correlated significantly with severity of brain injury. The Fas-Fas ligand-system may have a pivotal role in causing oedema and local tissue destruction in the brain after severe head injury.

Adult↗
PubMed2000

[Glioblastoma with a marked elevation of total protein and albumin in the cerebrospinal fluid].

We describe a patient with glioblastoma who showed very high levels of total protein and albumin in the cerebrospinal fluid. The patient was a 57-year-old man who underwent subtotal removal of a glioblastoma from the left temporal lobe. Two weeks after the operation, he had quadriplegia and a lumbar puncture was performed. The concentrations of total protein and albumin in the cerebrospinal fluid were 6000 mg/dl and 3600 mg/dl, respectively, which were more than 100 times higher than the upper limits of the reference ranges and were close to their serum levels. The magnetic resonance image suggested that these abnormal values were due to total spinal cord dissemination of the tumor. The results of the cerebrospinal fluid examination showed that the albumin concentration in the fluid might increase to the serum level and the prozone phenomenon should be kept in mind when measuring its concentration in the fluid.

Albumins↗
PubMed1986

Intracranial hypertension and cerebrospinal fluid production in dogs: effects of furosemide.

A method using chronically prepared, anesthetized dogs was devised for studying the effects of treatments of intracranial hypertension induced by applying a reversible extradural mass lesion while simultaneously measuring production of cerebrospinal fluid. This was measured with a ventricular-cisternal perfusion technique in which the rate of cisternal outflow could be controlled by a pump and matched to the inflow, allowing intracranial pressure to fluctuate despite simultaneous measurement of cerebrospinal fluid formation. Elevations of intracranial pressure to the range 20 to 35 Torr were induced and maintained during perfusion, but elevations above 35 Torr would not permit continued perfusion. At normal intracranial pressure, 10 Torr or less, rates of cerebrospinal fluid formation were the same whether the outflow controlling pump or free outflow was used. Formation of cerebrospinal fluid decreased progressively as intracranial pressure increased above 20 Torr. It also decreased with time after the start of perfusion during the course of 5 h, but returned to the initial range during the control phase of subsequent experiments in the same animal. Furosemide, 3 mg kg-1, i.v., had no significant effect on rate of formation but did induce a small decrease in ICP in time-controlled experiments in which i.v. fluid replacement limited net fluid losses to 20 ml kg-1 with no change in mean arterial or central venous pressures.

Animals↗
PubMed1982

Evaluation of Bactogen and Phadebact for detection of Haemophilus influenzae type b antigen in cerebrospinal fluid.

Latex agglutination and coagglutination tests are commercially available as Bactogen and the Phadebact Haemophilus Test, respectively. We evaluated both for the detection of Haemophilus influenzae type b in cerebrospinal fluids. Both tests were positive in all of 51 culture-positive cases of meningitis caused by H. influenzae. Both were more sensitive than counterimmunoelectrophoresis. Antigen was also detected by Bactogen in seven of seven additional cerebrospinal fluid specimens (compared with four of seven by Phadebact) after 1 to 15 days of antimicrobial therapy. The cerebrospinal fluid of infants with meningitis owing to other common causative agents did not react with Bactogen or Phadebact. However, the cerebrospinal fluid of one patient with overwhelming infection owing to Proteus mirabilis reacted positively with Bactogen. Cost analysis revealed that Phadebact was less expensive to perform than Bactogen.

Agglutination Tests↗
PubMed1989

Lumboperitoneal shunt for the treatment of postoperative persistent collection of subcutaneous cerebrospinal fluid (pseudomeningocoele).

Ten patients with postoperative collection of subcutaneous cerebrospinal fluid (pseudomeningocoele) refractory to nonsurgical treatment underwent lumboperitoneal (LP) shunt. In all patients rapid resolution of the subcutaneous collection was achieved, and no recurrence was observed during the follow-up period. Complications of the LP shunt included transient sciatica in one patient, and acute subdural haematoma after a mild head trauma in another patient who had had a subdural fluid collection. A LP shunt proved to be a less invasive and reliable method of treatment for this condition when it fails to resolve despite aspiration of cerebrospinal fluid combined with mechanical compression of the wound. However, in cases with subdural fluid collection, early withdrawal of the LP shunt may be recommended.

Adult↗
PubMed2003

Diurnal variation of cerebrospinal fluid hypocretin-1 (Orexin-A) levels in control and depressed subjects.

BACKGROUND: Hypocretins, excitatory neuropeptides at monoaminergic synapses, appear to regulate human sleep-wake cycles. Undetectable cerebrospinal fluid hypocretin-1 levels are seen in narcolepsy, which is frequently associated with secondary depression. Shortened rapid eye movement latency is observed in both narcolepsy and depression. Cerebrospinal fluid hypocretin-1 levels have not been reported in mood disorders. METHODS: We examined hypocretin-1 levels in 14 control and 15 depressed subjects. Cerebrospinal fluid was drawn continuously in supine subjects for 24 hours with an indwelling intrathecal catheter under entrained light-dark conditions. Depressed subjects were studied before and after 5 weeks of sertraline (n=10, three nonresponders) or bupropion (n=5, two nonresponders). RESULTS: Hypocretin-1 levels varied slightly (amplitude 10%) but significantly across the diurnal cycle in control subjects, with amplitude significantly reduced in depression (3%). Levels were lowest at midday, surprising for a hypothetically wake-promoting peptide. Mean hypocretin levels trended higher in depressive than in control subjects. Hypocretin-1 levels decreased modestly but significantly after sertraline (-14%) but not bupropion. CONCLUSIONS: Our results are consistent with previous physiologic findings in depression indicating dampened diurnal variations in hypocretin-1. The finding that sertraline but not bupropion slightly decreased cerebrospinal fluid hypocretin-1 indicates a serotoninergic influence on hypocretin tone.

Adult↗
PubMed1993

Greater abnormalities of brain cerebrospinal fluid volumes in younger than in older patients with Alzheimer's disease.

OBJECTIVE: This study used a semiautomated analysis technique to quantify differences in regional brain cerebrospinal fluid volumes observed with computed tomography between healthy adults and patients with Alzheimer's disease (AD). DESIGN: Cross-sectional, between-subject design, using an age-regression model. SETTING: Palo Alto (Calif) Department of Veterans Affairs Medical Center. PATIENTS AND OTHER PARTICIPANTS: The 117 patients with probable or definite AD were recruited from the Geriatric Psychiatry Research Unit and National Institute of Mental Health Clinical Research Center of the Palo Alto Department of Veterans Affairs Medical Center. The 114 healthy volunteers were recruited from the local community. MAIN OUTCOME MEASURES: Cerebrospinal fluid volumes estimated from computed tomographic scans and neuropsychological test scores. RESULTS: The computed tomographic estimates of ventricular and sulcal cerebrospinal fluid volumes increased significantly in all sampled brain regions in normal aging and were vastly larger in AD than in normal aging. Furthermore, younger patients with AD had significantly greater cerebrospinal fluid volume enlargement than did older patients with AD compared with healthy controls of their age. When the AD group was divided on the basis of reported age at symptom onset, patients in the early-onset group (onset before age 65 years) were quantitatively more abnormal than and showed a different pattern of abnormality from the patients in the late-onset group. This onset difference was also evident in neuropsychological test performance. CONCLUSIONS: This cross-sectional study revealed a number of converging findings that suggested greater abnormality in the early-onset than in the late-onset group of patients with AD. The possibility remains, however, that the two onset groups represent different stages along a continuum of pathologic changes.

Adult↗
PubMed1982

Cerebrospinal fluid rhinorrhoea and its management.

A series of 100 cases of cerebrospinal fluid rhinorrhoea has been analysed with reference to the incidence and pattern of meningitis in order to formulate a rationale for the future management of such cases. Most cases are best managed conservatively for the first 14 days during which the majority resolve spontaneously. Of those requiring surgery, the trans-ethmoid/sphenoidal route of repair is preferred except in certain specified circumstances. The high incidence of meningitis in cerebrospinal fluid rhinorrhoea following nasal or trans-sphenoidal surgery probably demands early operation by craniotomy.

Adolescent↗