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At least 1,423 records · Page 79Linked to original sources
PubMedDate not supplied

[Comparative study of intracerebral and cerebrospinal fluid pressure in neurosurgical clinical practice].

Comparative measurements of cerebrospinal fluid pressure(CSPF), total local intrabrain pressure (IBP) and interstitial fluid pressure(ISFP) have been made in 32 neurosurgical patients in the postoperative period. The obtained data prove that IBP is almost twice higher than ISFP and 1.5 times higher than CSFP. The data of this study show that no direct hydrostatic relation exists between the cerebrospinal fluid and the interstitial fluid. The reasons of "negative" values of ISFP are also discussed. The intracranial pressure is to be considred as a combination of selective mechanical pressures of the main intracranial components. Therefore a more precise term "intracranial pressures" is suggested.

Brain↗
PubMed1987

Cerebrospinal fluid levels of magnesium in patients with preeclampsia after treatment with intravenous magnesium sulfate: a preliminary report.

The purpose of this study is twofold: (1) to correlate magnesium levels of serum with those of cerebrospinal fluid in patients with preeclampsia receiving intravenous magnesium sulfate, and (2) to determine whether the magnesium ion crosses the blood-brain barrier in significant amounts after intravenous magnesium sulfate therapy. Of the 21 patients in whom spinal anesthesia was used for delivery, ten patients with preeclampsia with therapeutic serum magnesium levels made up the study group and 11 term nontreated normotensive gravid women served as controls. At the time of spinal anesthesia, a 1 ml aliquot of cerebrospinal fluid was obtained from each patient. The mean cerebrospinal fluid magnesium level for the control group was 2.56 +/- 0.19 mg/dl (range 2.2 to 2.8 mg/dl). For the preeclamptic group who received intravenous magnesium sulfate, the mean cerebrospinal fluid magnesium level was 3.04 +/- 0.12 mg/dl (range 2.9 to 3.2 mg/dl). Although only a small amount of magnesium crosses the blood-brain barrier after intravenous magnesium sulfate treatment, this increment is highly significant (p less than 0.001).

Adult↗
PubMed1985

Cerebrospinal fluid dynamics in traumatic intracerebral pneumocephalus evaluated with computed tomographic cisternography.

Cerebrospinal fluid dynamics in a case of traumatic intracerebral pneumocephalus are evaluated with metrizamide computed tomographic cisternography. Accumulation of metrizamide into the air cyst through the ventricular system is due to transependymal penetration, which can be explained by the mechanism of the pressure gradient from the ventricle towards the air cyst.

Adolescent↗
PubMed1978

Traumatic cerebrospinal fluid fistula simulating tears. Case report.

A young child developed delayed cerebrospinal fluid (CSF) rhinorrhea and CSF leak from the eye presenting as tears. The "tears" were CSF which had tracked from the cribriform plate through the ethmoidal air sinuses to the medial aspect of the left orbit. There was marked chemosis and it was considered likely that the tears had leaked through damaged conjunctiva.

Accidents, Traffic↗
PubMed1999

Thiopental attenuates energetic impairment but fails to normalize cerebrospinal fluid glutamate in brain-injured patients.

OBJECTIVES: Brain-injured patients are susceptible to secondary brain damage related to decreased cerebral perfusion pressure associated with edema formation and increased intracranial pressure (ICP). Whenever conventional therapy fails to reduce elevated ICP, barbiturate coma represents an additional intervention that may control ICP. In patients suffering from severe traumatic brain injury, cerebrospinal fluid levels of glutamate, hypoxanthine, and lactate were measured during barbiturate coma and correlated to electroencephalographic recordings and ICP. DESIGN: Prospective, descriptive study. SETTING: Ten-bed surgical intensive care unit in a university hospital. PATIENTS: Twenty-one patients with severe traumatic brain injury (Glasgow Coma Scale score < or = 9); 11 required barbiturate coma because of refractory intracranial hypertension, and 10 were manageable with continuous administration of fentanyl and midazolam. INTERVENTIONS: Thiopental was administered continuously for increased ICP within the first 24 hrs after trauma and adjusted to the burst-suppression pattern (four to six bursts per minute) on continuous electroencephalographic monitoring. MEASUREMENTS AND MAIN RESULTS: Glutamate and hypoxanthine were analyzed using high-performance liquid chromatography, whereas lactate was measured enzymatically. Patients requiring thiopental presented with significantly higher ICP, glutamate, and hypoxanthine levels than patients receiving fentanyl and midazolam (p < .05). Within the first 24 hrs, thiopental significantly reduced cerebrospinal fluid glutamate and hypoxanthine levels in all patients, i.e., the burst-suppression pattern was successfully induced (p < .001). Interestingly, in five patients cerebrospinal fluid glutamate increased to initial values again despite unchanged neuronal activity. In these patients, ICP, hypoxanthine, and lactate remained significantly elevated compared with the six patients with steadily decreasing cerebrospinal fluid glutamate, hypoxanthine, lactate, and ICP values (p < .02). CONCLUSIONS: Barbiturate coma does not unequivocally preserve energetic stability despite successful suppression of neuronal activity. Despite the use of barbiturate coma in patients with refractory intracranial hypertension, persistent release or impaired uptake of glutamate may be associated with continuous anaerobic metabolism, as shown by increases in cerebrospinal fluid hypoxanthine and lactate levels.

Adolescent↗
PubMed1986

Measurement of beta-2-microglobulin in human cerebrospinal fluid by ELISA technique.

This study introduces an enzyme-linked immunosorbent assay for measurement of beta-2-microglobulin in human cerebrospinal fluid. The concentration of beta-2-microglobulin in cerebrospinal fluid correlated with the age (p less than 0.001) of a control group of 40 subjects, probably reflecting age-related processes in the central nervous system. The reference interval of beta-2-microglobulin was considered to be 0.62-3.28 mg/1. Results obtained with various CNS disorders demonstrated that estimation of beta-2-microglobulin in cerebrospinal fluid add diagnostic information. The concentration of beta-2-microglobulin may increase without simultaneous aberrations in the content of protein, glucose and white blood cells.

Adolescent↗
PubMedDate not supplied

[Pressure-volume relation in the craniospinal cavity in the presence of supra- and subtentorial pathology. II. Changes in local intracerebral pressure subsequent to cerebrospinal fluid compression and decompression of the brain].

Comparative measurements of cerebrospinal fluid pressure (FP) and local intracerebral pressure of the interstitial fluid (ICPIF) both during their spontaneous changes and during artificial changes in cerebrospinal fluid volume were conducted in 15 neuro-oncological patients in the postoperative period. ICPIF pressure was measured by means of a double-layer perforated capsule perceiving pressure of the surrounding interstitial fluid. In patients who underwent removal of a tumor from the posterior cranial fossa ICPIF ranged from -15.8 to +9.5 mm Hg, and FP from 15 to 37.5 mm Hg. In patients subjected to removal of meningioma of the chiasmal-sellar area ICPIF ranged from -11.2 to +0.4 mm Hg, while FP ranged from 4 to 18.7 mm Hg. In artificial decrease in FP to 5 mm Hg and subsequent increase to 35-50 mm Hg, ICPIF changed as a rule, though only slightly (from 0.5 to 10 mm Hg), and often the changes in FP and ICPIF were opposite in direction. In approximately 1/3 of cases ICPIF did not change while the changes in FP ranged from 5 to 50 mm Hg. The possible causes of changes in intracerebral pressure in dosaged FP changes are discussed and a conclusion is drawn that the changes in ICPIF are not a simple reflection of FP dynamics but are linked with the effect exerted on the interstitial fluid by some factors among which are changes in intra-capillary pressure and tension in the cerebral tissue.

Biomechanical Phenomena↗
PubMed1975

[Studies on cerebrospinal fluid diffusion of trimethoprim in children].

Full quantitative fluorometric analysis of TMP in serum and cerebrospinal fluid in 91 infants and children (all anyhow designed for lumbar puncture for other reasons) 1/2 - 12 hours after i. v. injection of TMP in a single dose of 4 mg/kg (73 cases, tab. 1-2, fig. 1) or 12 mg/kg (18 cases, tab. 3, fig. 2). TMP in serum and cerebrospinal fluid showed regularly high plateaus for the whole time investigated, i.e. 12 hours after i. v. injection (fig. 1-2). The c.s.f./serum ratio for TMP (2-12 hours after injection) was 30-40%(fig. 1). After a dose of 12 mg/kg the ratio was even 50% and more (fig. 2). There were - in our material - no differences of the ratio according to c.s.f. state (normal - tab. 1, or pathological-tab. 2), or age. Considerating published data on enteral resorption of trimethoprim-sulfamethoxazole and c.s.f. diffussion of SMZ together with our results, we can expect a very intensifying proportion TMP: SMZ near 1:10 in cerebrospinal fluid after intake of officinal TMP-SMZ (Co-trimoxazol). This might have diagnostic and therapeutic consequences.

Child↗
PubMedDate not supplied

Association of demyelination with deficiency of cerebrospinal-fluid S-adenosylmethionine in inborn errors of methyl-transfer pathway.

Long-term deficiency of cobalamin or folate causes a demyelinating disease of the brain and spinal cord. A reduced supply of methyl groups has been implicated as its cause. To examine the mechanisms of demyelination in human beings, we have studied three children with sequential inborn errors of the methyl-transfer pathway. One child had abnormal methylfolate metabolism, one abnormal methylcobalamin metabolism, and one hypermethioninaemia probably caused by methionine adenosyltransferase deficiency. Magnetic resonance imaging of the brain and measurement of cerebrospinal-fluid concentrations of 5-methyltetrahydrofolate, methionine, and S-adenosylmethionine were carried out before and after 6-12 months of appropriate treatment. Each patient had abnormal myelination before treatment; the scans suggested demyelination. The only consistent biochemical abnormality in the cerebrospinal fluid was a low concentration of S-adenosylmethionine. Treatment led to substantial clinical improvement, apparent remyelination, and increases in cerebrospinal-fluid S-adenosylmethionine concentration into the normal range. Cerebrospinal-fluid concentrations of S-adenosylmethionine and methionine were significantly lower in eight other children with errors of the methyl-transfer pathway than in an age-matched reference population (mean [95% confidence interval] standard deviation score -1.81 [0.57], p less than 0.001 for S-adenosyl methionine and -1.82 [0.19], p less than 0.001 for methionine). The concentrations of these metabolites increased to within the reference range on treatment. We have shown that demyelination is associated with cerebrospinal-fluid S-adenosylmethionine deficiency and that restoration of S-adenosylmethionine is associated with remyelination.

5,10-Methylenetetrahydrofolate Reductase (FADH2)↗
PubMed1977

Cerebrospinal fluid production: stimulation by cholera toxin.

Large increases in the production of cerebrospinal fluid have been observed after the intraventricular administration of cholera toxin. Because cholera toxin stimulates adenylate cyclase, the data suggest that adenosine 3',5'-monophosphate plays a role in cerebrospinal fluid production.

Adenylyl Cyclases↗
PubMed1997

[Assay of lactic acid in the cerebrospinal fluid for the diagnosis of bacterial meningitis. Strategies for the choice of discriminatory threshold].

OBJECTIVES: In search for a supplementary marker of bacterial meningitis in cases where conventional bacteriology, cytology and chemistry are insufficiently contributive to diagnosis, we assessed the value of cerebrospinal fluid lactate levels in children with bacterial meningitis. PATIENTS AND METHODS: Cerebrospinal fluid lactate levels were measured from all spinal taps performed in a pediatric emergency care unit over a two-year period. Of the 332 usable samples there were 32 cases of bacterial meningitis, 104 cases of viral meningitis and 196 other diagnoses (non meningitis). RESULTS: Average lactate concentration 7 +/- 4 mmol/l in bacterial meningitis versus 2.1 +/- 0.6 mmol/l in viral meningitis (p < 0.0001). The value of lactic acid concentrations in discriminating between bacterial and viral meningitis was found to be superior to that of other chemistry results: protein, glucose, chloride. The discriminatory threshold of cerebrospinal fluid lactate was 3.7 mmol/l with sensitivity of 80% and a specificity of 98%. CONCLUSION: We propose routine assay of cerebrospinal fluid lactate in all cases of suspected meningitis.

Adolescent↗
PubMedDate not supplied

Hepatic encephalopathy: lack of changes of gamma-aminobutyric acid content in plasma and cerebrospinal fluid.

The aim of the study was to verify the role of gamma-aminobutyric acid in the pathogenesis of hepatic encephalopathy occurring in cirrhotic patients by attempting to correlate plasma and cerebrospinal fluid content of authentic gamma-aminobutyric acid with the neurological manifestations of hepatic encephalopathy. For this purpose, plasma and cerebrospinal fluid gamma-aminobutyric acid levels were measured by means of mass fragmentography in 17 cirrhotic patients with hepatic encephalopathy and in 6 cirrhotics without neurological symptoms. Moreover, in all patients, a second sample was obtained during the clinical course of hepatic encephalopathy. The mean plasma and cerebrospinal fluid gamma-aminobutyric acid levels were not different in patients with or without hepatic encephalopathy and did not change during the evolution of the neurological symptoms. The lack of changes in the gamma-aminobutyric acid content in plasma and cerebrospinal fluid during hepatic encephalopathy is in contrast with the hypothesized importance of increased entry into the brain of gamma-aminobutyric acid in the pathogenesis of hepatic encephalopathy.

Adult↗
PubMed2001

Cerebrospinal fluid abeta42, tau, and f2-isoprostane concentrations in patients with Alzheimer disease, other dementias, and in age-matched controls.

OBJECTIVE: To test the hypothesis that quantification of cerebrospinal fluid (CSF) F(2)-isoprostanes (F(2)-IsoPs), in vivo biomarkers of free radical damage, along with CSF Abeta(42) and tau levels improves laboratory diagnostic accuracy for Alzheimer disease (AD). PARTICIPANTS: Patients with probable AD (n = 19), dementias other than AD (n = 8), and age-matched controls (n = 10). MAIN OUTCOME MEASURES: Cerebrospinal fluid concentrations of Abeta(42) and tau were determined by a commercially available test (Athena Diagnostics, Worcester, Mass). Cerebrospinal fluid F(2)-IsoP levels were quantified by gas chromatography/mass spectrometry. RESULTS: Individuals were classified as AD or non-AD by a published method using CSF Abeta(42) and tau levels (95% sensitivity, 50% specificity), by CSF F(2)-IsoP levels greater than 25 pg/mL and Abeta(42) concentrations less than 1125 pg/mL (90% sensitivity, 83% specificity), and by combined analysis using CSF F(2)-IsoP, Abeta(42), and tau levels (84% sensitivity, 89% specificity). CONCLUSION: Cerebrospinal fluid F(2)-IsoP quantification may enhance the accuracy of the laboratory diagnosis of AD.

Aged↗
PubMedDate not supplied

[Immunologic study of cerebrospinal fluid in the diagnosis of posttraumatic meningitis].

Immunological examination of the cerebrospinal fluid (CSF) in 280 patients in the acute period of craniocerebral trauma demonstrated an increase in the beta-lysin content and lysozyme concentration in it when meningitis developed. Increase in the CSF beta lytic and lysozyme activity reflects the severity of the inflammatory process. Tests for these factors in the CSF may be used in the early diagnosis of post-traumatic meningitis.

Antimicrobial Cationic Peptides↗
PubMed2001

The influence of lidocaine on the permeability of the blood-cerebrospinal fluid barrier in experimental acute hypercapnia in the rabbit.

In a previous study we have provided evidence, that acute experimental hypercapnia due to hypoventilation in the rabbit alters blood-cerebrospinal fluid barrier function in the brain (Pakulski et al. 1998). The purpose of this study therefore was to determine if lidocaine would prevent the observed alterations in the blood-cerebrospinal fluid barrier function. The experiments were conducted in 16 adult Chinchilla rabbits submitted to acute hypercapnia due to mechanical hypoventilation (PaCO2 between 8-9.5 kPa over 180 minutes) under pentobarbital anaesthesia. The studied group (n = 8) was treated by lidocaine infusion 10 mg kg-1 h-1. After 180 minutes of hypercapnia the value of cerebrospinal fluid-blood index of gentamycin concentration, indicating the permeability of the blood-cerebrospinal fluid barrier, was significantly lower in animals treated with lidocaine (4.03 +/- 2.32 vs. 19.05 +/- 5.49; P < 0.01). We conclude that lidocaine may attenuate the increase of blood-cerebrospinal fluid barrier permeability under conditions of experimental acute hypercapnia lasting 180 minutes in the mechanically ventilated rabbit.

Acute Disease↗
PubMed2004

Cerebrospinal fluid tau and Abeta42 concentrations in healthy subjects: delineation of reference intervals and their limitations.

Many limitations and conflicting results have cast serious doubts on the validity of cerebrospinal fluid tau and Abeta42 levels for the biological diagnosis of Alzheimer's disease, particularly extreme variations of the reference limits found by unrelated groups as a consequence of different reference populations used. In this study, we addressed the issue of defining reference limits for cerebrospinal fluid tau and Abeta42 in healthy adult individuals. One hundred and five neurologically intact subjects were enrolled according to strict inclusion criteria, 10 of them with autopsy confirmation of brain integrity. All cerebrospinal fluid samples were similarly and optimally processed as were the dosage methods used and the statistical analyses performed. A robust correlation with age was demonstrated for Abeta42 but not for tau. For tau, we found that an upper cut-off value of 443 ng/l allowed 95% of the subjects to be correctly classified as normal. For Abeta42, a lower cut-off value of 90 ng/l allowed a correct classification of 90% of the subjects. However, a large variance of the reference values, partly explained by the potential contamination of the reference population with presymptomatic dementia patients, may limit the use of reference limits based on living subjects. We propose that the issue of defining reference limits for both cerebrospinal fluid tau and Abeta42 may ultimately be settled by studying large numbers of autopsy-proven neurologically intact individuals only.

Adult↗
PubMed2004

Plasma and cerebrospinal fluid amino acids in epileptic patients.

Altered plasma and cerebrospinal fluid amino acid levels may be associated with human epilepsy. We studied three groups of patients, those with a generalized epileptic syndrome, juvenile myoclonic epilepsy, patients with refractory localization-related epilepsies, and patients with acute seizures (within 24 h). Plasma levels of amino acids were studied in all patient groups, as were those in the cerebrospinal fluid (CSF) of patients with acute seizures. After acute seizures, the amino acid changes in the CSF were limited to a reduction in the level of taurine, whereas the levels of most amino acids in plasma were decreased. On the other hand, levels of the excitatory amino acids glutamate and aspartate were increased. The most notable finding in the juvenile myoclonic epilepsy patients was an increase in glutamate level in the plasma. Our study supports the conception of an altered metabolism of glutamate in generalized epilepsies.

Adult↗
PubMed1998

[Determination of levofloxacin in plasma and cerebrospinal fluid with HPLC and its pharmacokinetics in patients undergoing neurosurgical operations].

A RP-HPLC method was developed to determine the concentrations of levofloxacin in plasma and cerebrospinal fluid and its pharmacokinetics were studied in patients undergoing neurosurgical operations. C18H37 column was eluted with the mobile phase consisting of 10 mmol.L-1 KH2PO4-10 mmol.L-1(C4H9)4Br-CH3CN(45:45:10, pH 3.0) and the utraviolet absorbance was monitored at 295 nm. Ciprofloxacin was used as internal standard. The mean recoveries were 74.76% in plasma and 82.43% in cerebrospinal fluid, with the lowest detectable limits of 10 micrograms.L-1 and 6 micrograms.L-1, respectively. The RSD for the intra-day and inter-day were all less than 5%. A single oral administration of 300 mg levofloxacin tablet was given to 10 patients undergoing neurosurgical operations. The pharmacokinetic parameters in blood and in cerebrospinal fluid could be described by one compartment open model. The pharmacokinetic parameters were: blood Ke 0.12 +/- 0.04 h-1, T1/2 6.05 +/- 1.68 h, Tmax 1.05 +/- 0.29 h, Cmax 3.67 +/- 0.42 mg.L-1, AUC 33.43 +/- 7.32 mg.h.L-1, CLs 9.46 +/- 2.53 L.h-1, Vd 77.49 +/- 7.39 L; cerebrospinal fluid Ke 0.11 +/- 0.04 h-1, T1/2 6.95 +/- 1.88 h, Tmax 3.56 +/- 1.24 h, Cmax 1.68 +/- 0.25 mg.L-1, AUC 23.70 +/- 5.62 mg.h.L-1, CLs 13.70 +/- 5.11 L.h-1, Vd 126.61 +/- 13.20 L.

Adult↗