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At least 1,405 records · Page 78Linked to original sources
PubMed2006

Atypical symptoms in patients with herpesvirus DNA detected by PCR in cerebrospinal fluid.

BACKGROUND: Polymerase chain reaction (PCR) detection of herpesvirus DNA in cerebrospinal fluid (CSF) is an important tool in the diagnosis of central nervous system (CNS) syndromes. The corresponding viral infections present with diverse clinical signs, which are often classical although no sign can be considered as specific. This retrospective study aims to describe atypical symptoms in patients with herpesvirus DNA detected in CSF by PCR. A total of 3452 cerebrospinal fluid samples from patients with suspected herpesvirus infection of the CNS were investigated between 1998 and 2003 in our clinical virology laboratory. "In-house" PCRs for each herpesvirus [herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV), or human herpes virus 6 (HHV6)] were used until 2001 and a commercially available "Herpes Consensus PCR" was used thereafter. One of the five herpesviruses investigated in this study was found in 71 (2.1%) of CSF samples (37 HSV, 14 VZV, 1 CMV, 9 EBV and 10 HHV6). These samples were obtained from 62 patients whose clinical findings were generally consistent with the PCR data. However, some little known features of herpesvirus-related symptoms, such as partial seizure associated with HSV infection, and unusual VZV or HHV6-related myelitis were also observed.

Adolescent↗
PubMedDate not supplied

[Changes in the cerebrospinal fluid in patients with subacute sclerosing panencephalitis during intrathecal administration of interferon beta].

Changes were observed in the cerebrospinal fluid in SSPE cases during administration of beta-interferon 1 million units in 3.3 ml of normal saline intrathecally every second day for one month. During and after the treatment the cell count rose to a mean value of 277/mm3, with prevalence of monocytes initially and then lymphocytes. The total protein level increased by a mean threefold value, with a particular increase in the gamma-globulin and IgG fractions. In control investigations 3-10 months after completion of treatment the cell count became normal and the total protein level was slightly above the normal one, while the electrophoretically demonstrated changes regressed. The changes in the cerebrospinal fluid during intrathecal administration of beta-interferon are due probably to a non-specific irritative action of the drug on the reticulo-histiocytic system of the leptomeninx and the effect of interferon on the immune system.

Adolescent↗
PubMed1998

Concentrations of cefpirome in cerebrospinal fluid of children with bacterial meningitis after a single intravenous dose.

A single intravenous dose of cefpirome, 50 mg/kg, was administered to 15 children with bacterial meningitis 24 to 48 h after initiation of standard antibiotic and steroid therapy. Cefpirome concentrations in serum and cerebrospinal fluid were determined at selected time intervals. The mean (standard deviation) peak concentration in cerebrospinal fluid (n = 5) was 10.8 (7.8) microg/ml. Drug concentrations in cerebrospinal fluid above the MIC for Streptococcus pneumoniae at which 90% of the isolates were inhibited were found 2, 4, and 8 h after the dose of cefpirome was given. The penetration of cefpirome into cerebrospinal fluid compares favorably with that of other extended-spectrum cephalosporins and suggests that this agent would be useful in the therapy of childhood meningitis, including cases caused by drug-resistant S. pneumoniae.

Cephalosporins↗
PubMed1982

Cefotaxime in treatment of meningitis and ventriculitis? Evaluation of drug concentrations in human cerebrospinal fluid.

In three groups of patients levels of cefotaxime in serumand cerebrospinal fluid were determined. Therapeutic value and efficacy are discussed in meningitis patients. Nine concentrations of cefotaxime in lumbar and ventricular CSF out of 19 in a group of seven neurosurgical patients with mild to moderate impairment of the blood-CSF-barrier were higher than 0.5 micrograms/ml. In seven determinations in a second group of six patients with no or very little dysfunction of the blood-cerebrospinal-fluid barrier only twice cefotaxime was not detectable in lumbar CSF. Concentrations of cefotaxime in 25 determinations of lumbar or ventricular CSF in six patients with bacterial meningitis ranged from 1.1 micrograms/ml to 19.2 micrograms/ml. Treatment with cefotaxime alone was successful in a patient with E. coli meningitis and ventriculitis after infection of a ventriculo-atrial shunt and in another patient with pneumococcal meningitis and penicillin allergy. The other four patients with bacterial meningitis were treated successfully by antibiotics including cefotaxime.

Bacterial Infections↗
PubMed1982

Arginine vasopressin levels in cerebrospinal fluid in neurological disease.

Levels of arginine vasopressin have been measured in the blood and cerebrospinal fluid of patients with benign intracranial hypertension and raised intracranial pressure, patients with other neurological diseases and in normal control subjects. There was no difference in blood levels in each of the 3 groups (mean +/- SEM, 2.8 +/- 0.5, 2.5 +/- 0.25, 2.53 +/- 0.4 pg/ml). However, levels of arginine vasopressin in the cerebrospinal fluid in patients with benign intracranial hypertension and other neurological diseases were higher (mean +/- SEM, 0.64 +/- 0.005, 0.61 +/- 0.04 pg/ml), than in the control group (0.49 +/- 0.06), but not different from each other. The origin of arginine vasopressin in cerebrospinal fluid is uncertain and a number of possibilities are discussed.

Arginine Vasopressin↗
PubMed1992

Changes in the rate of formation and resistance to reabsorption of cerebrospinal fluid during deliberate hypotension induced with adenosine or hemorrhage.

Adenosine is recommended for induction of deliberate hypotension. Although its effects on brain vasculature and metabolism and intracranial pressure have been reported, its effects on cerebrospinal fluid dynamics have not. In this study the rate of cerebrospinal fluid formation (Vf), resistance to reabsorption of cerebrospinal fluid (Ra), and electroencephalogram (EEG) activity were determined in rabbits before and during decrease of cerebral perfusion pressure (CPP) with intravenous (iv) adenosine or hemorrhage. In the adenosine group (n = 6), Vf and Ra were determined at control CPP, at CPP of 50, 35, and 28 mmHg achieved with iv adenosine, and at CPP greater than 60 mmHg achieved with iv adenosine combined with iv phenylephrine. In the hemorrhage group (n = 6), Vf and Ra were determined at the first four experimental conditions only. Control values for Vf (9 +/- 3 and 9 +/- 4 microliter.min-1, mean +/- SD) and Ra (428 +/- 567 and 412 +/- 144 cmH2O.ml-1.min) did not differ between groups. In the adenosine group, Vf did not change significantly when CPP was decreased. However, in the hemorrhage group, Vf decreased significantly at CPP of 50 and 35 mmHg and became unmeasurable at CPP of 28 mmHg. Ra did not change significantly in either group. An increase of low-frequency (0.5-3.0 Hz) EEG activity and/or decrease of higher-frequency (3.5-30 Hz) EEG activity occurred at CPP of 28 mmHg in the adenosine group and at CPP of 35 mmHg in the hemorrhage group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMedDate not supplied

[Cortisol in plasma and cerebrospinal fluid of patients with brain ischemia].

INTRODUCTION: One of the reactions to ischemia is increased release of glucocorticoid hormones, included in regulation of effects of numerous mediators/modulators that could be released in the acute phase of brain ischemia. The aim of our investigation was to define temporal dynamics of cortisol concentrations in plasma and cerebrospinal fluid of patients with different types of ischemic brain disease. MATERIAL AND METHODS: The study included 263 patients of both sexes, aged 55-68 years. History, clinical examination and cerebral computerized tomography were performed to establish the diagnosis. 97 patients had brain infarction, 66 had a reversible ischemic attack, 66 had a transient ischemic attack, and 34 patients had chronic encephalopathy. The control group included 22 age- and sex-matched patients, subjected to diagnostic lumbar radiculography, without disturbances in the cerebrospinal fluid passage. Cortisol concentrations were measured by direct radioimmunoassay. RESULTS AND DISCUSSION: Results obtained in this research showed that in acute brain ischemic period there was a significant increase of cortisol concentration in plasma and cerebrospinal fluid. The increase was highest in patients with brain infarction, somewhat lower in reversible ischemic attack, and the lowest in transient ischemic attack compared to controls (331.7 +/- 92.8 pmol/ml of plasma and 2.5 < or = 1.1 pmol/ml of cerebrospinal fluid). Maximum concentrations were found during the first two days after insult. The main potentially protective effects of increased cortisol concentrations in patients with acute stroke could be the decrease of effects of deleterious reactions induced by ischemia. This mechanism might be an attempt of organism to compensate for disturbed homeostasis. CONCLUSION: Measurement of cortisol in plasma and cerebrospinal fluid in patients with acute stroke is significant for monitoring the intensity of response of an organisam to acute brain damage.

Acute Disease↗
PubMed1988

Reassessment of cytologic values in canine cerebrospinal fluid by use of cytocentrifugation.

Using cytocentrifugation, nearly one fourth of canine cerebrospinal fluid (CSF) samples with cell counts in the normal range had abnormalities in cell type or morphologic features. Cerebrospinal fluid samples from 145 dogs with neurologic disorders were evaluated by use of this method. These results indicate that low hemacytometer counts in canine CSF should not be interpreted as normal. By increasing the detection of abnormalities in CSF, cytocentrifugation might improve diagnosis and treatment of canine neurologic disease.

Animals↗
PubMed1960

True glucose content of lumbar and ventricular cerebrospinal fluid.

Glucose levels in 154 random specimens of lumbar cerebrospinal fluid, normal as regards cell and protein content, were estimated by the glucose-oxidase method and a mean value of 60.5 mg./100 ml. (S.D. 7.3) was obtained. In 33 fasting patients subject to air encephalography the mean cerebrospinal fluid (C.S.F.) glucose level was 56.5 mg., and mean blood glucose level 65.5 mg. with an average C.S.F. glucose: blood glucose ratio of 0.85.

Blood Glucose↗
PubMedDate not supplied

The cytologic manifestations of lymphomatoid granulomatosis in cerebrospinal fluid. A case report.

The cytologic manifestations of lymphomatoid granulomatosis in the cerebrospinal fluid observed in a 50 year old white male with midbrain and spinal cord involvement are presented. The cerebrospinal fluid, obtained by cisternal puncture, contained predominantly undifferentiated medium-sized cells, which were retrospectively interpreted as reticular cells, These cells were characterized by an atypical nucleus with one or more prominent nucleoli and clumped chromatin granules, abundant cytoplasm and frequent amoeboid protrusions of the cytoplasmic membrane. Small numbers of undifferentiated plasmacytoid cells, lymphocytes, neutrophils and erythrocytes were evident. A few mitoses were also observed. These cellular characteristics are correlated with histology of the parent lesion in the midbrain obtained at the postmortem examination.

Cerebrospinal Fluid↗
PubMed1995

Neuroanesthesia adjunct therapy (mannitol and hyperventilation) is as effective as cerebrospinal fluid drainage for prevention of paraplegia after descending thoracic aortic cross-clamping in the dog.

We compared cerebrospinal fluid (CSF) drainage (Group D; n = 8) to neuroanesthesia adjunct therapy (hyperventilation and mannitol administration; Group N; n = 8) for the prevention of paraplegia using a canine model of descending thoracic aortic cross-clamping (AXC; 2.5 mm distal to the left subclavian artery for 30 min). We expected no difference in neurologic outcome between groups. After surgical preparation and a 30-min stabilization period, dogs in Group D had CSF drained prior to application of the AXC. During the period of AXC, CSF was allowed to drain freely in an attempt to have cerebrospinal fluid pressure (CSFP) no greater than central venous pressure (CVP). Dogs in Group N were hyperventilated (PaCO2 28-32 mm Hg) and received 2 g/kg of mannitol prior to AXC and then 1 g.kg-1.hr-1 during clamping. Systemic hemodynamics, CSFP, and arterial blood gases were measured at 1) baseline, 2) 2 min after AXC, 3) 20 min after AXC, 4) 5 min after AXC release, and 5) 30 min after resuscitation. With release of the AXC, PaCO2 was not controlled in Group D; in Group N the minute ventilation was further increased to maintain PaCO2 constant. At precisely 24 h after AXC, the animals were assessed for incidence and severity of paraplegia, using the Tarlov score, by an observer unaware of the experimental protocol. The animals were then killed, and the entire spinal cord was removed for histologic assessment. Multiple sections of the lumbar spinal cord were processed and stained with hematoxylin and eosin, then examined by light microscopy for nonviable neurons in the anterior spinal cord.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1991

Altered serotonin activity in anorexia nervosa after long-term weight restoration. Does elevated cerebrospinal fluid 5-hydroxyindoleacetic acid level correlate with rigid and obsessive behavior?

To avoid the confounding influences of malnutrition or weight loss, we studied patients with anorexia nervosa at normal weight and stable dietary intake. Compared with 15 controls, 17 long-term weight-restored anorectic subjects had elevated concentrations of cerebrospinal fluid 5-hydroxyindoleacetic acid, the major serotonin metabolite, whereas levels of cerebrospinal fluid homovanillic acid, the major dopamine metabolite, were normal. Elevated levels of cerebrospinal fluid 5-hydroxyindoleacetic acid may indicate increased serotonin activity. Such activity could contribute to pathological feeding behavior. Most importantly, this study raises the question as to whether increased cerebrospinal fluid 5-hydroxyindoleacetic acid levels are associated with overly inhibited, anxious, or obsessive traits.

Adult↗
PubMed2004

Persistent cerebrospinal fluid leak: a complication of the combined spinal-epidural technique.

UNLABELLED: Persistent cerebrospinal fluid (CSF) leak is an apparently rare complication of dural puncture from spinal or epidural anesthesia. Combined spinal-epidural techniques are increasingly popular but persistent CSF leak has not been reported. We describe three parturients with persistent fluid leak from the insertion site after epidural catheter removal following combined spinal-epidural anesthesia. Uncertainties related to the diagnosis, treatment, and the implications of this complication are discussed, including beta(2)-transferrin immunofixation assay as a diagnostic test for the presence of CSF in this situation. IMPLICATIONS: Combined spinal-epidural block can be complicated by persistent fluid leak from the skin insertion site. Testing for the presence of cerebrospinal fluid may be a useful aid to management.

Adult↗
PubMed1993

Cerebrospinal fluid levels of substance P and calcitonin-gene-related peptide: correlation with sural nerve levels and neuropathic signs in sensory diabetic polyneuropathy.

1. Lumbar spinal substance P and calcitonin-gene-related peptide derive from spillage out of the dorsal horns associated with activity of small primary sensory afferents (C- and A delta-fibres). Cerebrospinal fluid and sural nerve levels of substance P and calcitonin-gene-related peptide have been measured in patients with diabetic polyneuropathy to determine whether differences in small primary sensory afferent activity are related to the presence or absence of painful symptoms. 2. Calcitonin-gene-related peptide was undetectable in the cerebrospinal fluid of the majority of diabetic patients (14 out of 22); it was lower overall in diabetic patients as compared with control subjects (P < 0.01), it was lower in those diabetic patients with painless neuropathy (100% undetectable) as compared with those with painful neuropathy (50% undetectable; P < 0.05) and it correlated conversely with warming threshold (r = 0.50; P < 0.01). 3. Substance P showed no overall numerical intergroup differences or correlation with other measured variables, but six diabetic patients as compared with one control subject had undetectable cerebrospinal fluid levels and the proportion of patients with undetectable levels was higher in the group with painless neuropathy than in the group with painful neuropathy (P < 0.05). 4. The levels of each peptide in cerebrospinal fluid correlated with its equivalent in sural nerve (P < 0.01 for calcitonin-gene-related peptide and P < 0.03 for substance P). Calcitonin-gene-related peptide correlated with substance P in the sural nerve (r = 0.84; P < 0.002) and in the cerebrospinal fluid (r = 0.30; P < 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitonin Gene-Related Peptide↗
PubMed1986

Poorly encapsulated Cryptococcus neoformans from patients with AIDS. II. Correlation of capsule size observed directly in cerebrospinal fluid with that after animal passage.

Cryptococcus neoformans recovered from the cerebrospinal fluid (CSF) of eight patients, seven with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC), were studied to assess the relationship between degree of encapsulation noted in fresh CSF with that observed after animal passage. We further correlated encapsulation with extent of immunodeficiency in these patients. Results of these studies showed poor encapsulation (mean capsule plus cell diameter less than 10 micron) in six patients, intermediate in one (mean 15.5 micron), and full encapsulation in one (mean 24.4 micron). The last isolate was observed in the CSF from the only patient without convincing clinical evidence for AIDS. Mouse passage of cryptococci from 5 AIDS patients and one with ARC resulted in a statistically significant (P less than 0.05) increase in capsule size over that observed directly in fresh cerebrospinal fluid. Cryptococci derived from the non-AIDS patient did not show an increase in encapsulation after mouse passage. These studies suggest that the immune deficiency state associated with AIDS exerts little selective pressure on inhaled poorly encapsulated C. neoformans.

AIDS-Related Complex↗
PubMed1978

Tension pneumocephalus complicating ventriculoperitoneal shunt for cerebrospinal fluid rhinorrhoea: case report.

A case of spontaneous nontraumatic cerebrospinal fluid rhinorrhoea secondary to aqueductal stenosis is reported. The patient required direct repair of the fistula after the insertion of a ventriculoperitoneal shunt for aqueductal stenosis. We emphasise an unusual complication of tension pneumocephalus in a case where the shunt patency had been substantiated. Intracranial pressure fall due to the siphon effect in the ventriculoperitoneal shunt tubing in the erect position might be responsible for ingress of an excessive amount of air.

Adult↗