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PubMed1984

Potential complications of unrecognized cerebrospinal fluid leaks secondary to mastoid surgery.

Unrecognized cerebrospinal fluid (CSF) drainage from a dural tear created during mastoidectomy rarely occurs, but when it does the consequences may be catastrophic. The potential complications discussed in this article are CSF otorrhea, meningitis, pneumocephalus, and hydrocephalus. The pathophysiology and diagnosis of these complications are individually discussed. The medical management and surgical procedures required to treat such complications are reviewed using a case presentation as an illustration. In addition, a flow sheet detailing the interrelationship between these potential complications and their treatment is outlined.

Cerebrospinal Fluid Otorrhea↗
PubMed2000

Proton magnetic resonance spectroscopy of cerebrospinal fluid in neurodegenerative disease: indication of glial energy impairment in Huntington chorea, but not Parkinson disease.

Metabolite levels in cerebrospinal fluid from patients with Parkinson disease or Huntington chorea were compared with the levels in healthy controls using proton magnetic resonance spectroscopy. No significant differences were found for any metabolite measured in cerebrospinal fluid from patients with Parkinson disease compared to controls. Slight but significantly reduced levels of both lactate and citrate, however, were found in cerebrospinal fluid from patients with Huntington chorea compared to controls. This suggests possible impairment of both glycolysis and tricarboxylic acid cycle function. The reduction in lactate found in the present study may reflect neuronal loss. The decrease in citrate supports the theory of mitochondrial dysfunction in the brain of patients with Huntington chorea, but also suggests that there may be an important astrocytic component in this disease. If so, it would certainly have implications for neuronal function.

Adult↗
PubMed1987

High angiotensin converting enzyme (kininase II) activity in the cerebrospinal fluid of spontaneously hypertensive adult rats.

Angiotensin converting enzyme (ACE, Kininase II, E.C. 3.4.15.1) activity was measured in the cerebrospinal fluid of 4- and 16-week-old spontaneously hypertensive rats (SHR) and age-matched Wistar-Kyoto (WKY) normotensive controls. Adult SHR showed higher cerebrospinal fluid enzyme activity than normotensive age-matched WKY (19.6 +/- 1 and 32.3 +/- 5 nmol/h per ml in WKY and SHR, respectively, P less than 0.025). Conversely, there were no significant differences in enzyme activity in the cerebrospinal fluid of young animals. Our results support the hypothesis of enhanced activity of the central angiotensin system during the established phase of spontaneous hypertension in rats.

Age Factors↗
PubMed1977

Cerebrospinal fluid immunoglobulins and complement in meningococcal meningitis.

Cerebrospinal fluid (CSF) immunoglobulins (IgA, IgG, IgM) were measured in 107 patients with meningococcal meningitis. Levels were correlated significantly with CSF total protein, and both CSF immunoglobulin and protein increased with age. C3 was measured in the CSF of 38 patients and was also closely correlated with the CSF protein level. C3 breakdown products were found in all six CSFs tested. The CSF immunoglobulin and complement were thought to have leaked from the plasma due to inflammation of the meninges and had little value in diagnosis or prognosis.

Adolescent↗
PubMed1991

Extracranial repair of cerebrospinal fluid otorhinorrhea.

Forty-eight patients with cerebrospinal fluid leaks comprise this retrospective study. There were 39 traumatic and 9 spontaneous leaks. Nine patients were initially managed with bed rest and spinal drainage, but 3 patients in this group ultimately required surgical intervention for repair of their persistent leaks. Thirty-nine patients had surgery as initial therapy, with 33 extracranial repairs, 2 intracranial repairs, and 4 combined approaches. The extracranial approach was used in 36 of 42 patients, with an initial success rate of 86%.

Adolescent↗
PubMed1977

Effects of blood contamination on cerebrospinal fluid analysis.

Data were obtained from 190 cerebrospinal fluid samples collected from both clinically normal and diseased dogs, cats, cows, and horses. Red blood cells, indicating blood contamination, were identified in 115 samples. White blood cells were a rare finding in normal animals. Blood contamination appeared to have little effect on white blood cell numbers even though, in several samples, thousands of red blood cells were identified. An accepted formula to correct for blood contamination was found to be an unreliable method to determine "uncontaminated" values for white blood cells, total protein, or creatine phosphokinase.

Animals↗
PubMed1979

Some measurements of autonomic nervous system influence on production of cerebrospinal fluid in the cat.

The effects on cerebrospinal fluid (CSF) production of specific agonists and antagonists for the autonomic nervous system were studied during ventriculocisternal perfusion in cats. Both carbachol and phenylephrine increased the rate of CSF formation 11 microliter/min from control rates of 17 and 11 microliter/min, resepctively; albuterol increased formation 6 microliter/min above the control 16 microliter/min. Atropine or phentolamine administered alone caused slight but significant decreases in CSF production; propranolol had no effect. All three antagonists reduced the changes in fluid formation elicited by their respective agonists. Atropine also blocked the action of phenylephrine. Hemicholinium-3, which reduced the synthesis of acetylcholine, sharply attenuated the increase caused by phenylephrine. These observations were taken to indicate that phenylephrine increased CSF production by stimulating a cholinergic pathway to the choroid plexus. Bilateral electrical stimulation of the cervical sympathetic trunks decreased CSF formation. Agents which increased CSF production caused no significant changes in cerebral or choroid plexus blood flow, possibly indicating that their effect is a direct action on the choroid plexus secretory mechanisms.

Animals↗
PubMed1995

Detection of cerebrospinal fluid metastasis: CT myelography or MR?

PURPOSE: To determine the sensitivity of contrast MR versus myelography followed by CT in the detection of cerebrospinal fluid metastases in children with primary central nervous system tumors. METHODS: Thirty-three patients who had primary central nervous system malignancies had spinal MR with gadolinium within 2 weeks of a myelogram followed by CT. MR technique included T1-weighted image sequences of the entire spine with and without gadolinium. CT scans were routinely performed at T-12 to L-2, L-4 to S-1, and foramen magnum to C-2. All studies were reviewed blindly; the number, character, and location of all metastases was recorded and the results of the two studies compared. Cerebrospinal fluid cytologic findings were recorded for each patient, and compared with the results of the imaging studies. RESULTS: Seven of the 33 patients had metastases detected; metastases were seen on both MR and myelography followed by CT. However, MR showed 24 lesions and myelography followed by CT showed only 15. When a lesion was seen on both MR and myelography followed by CT, the MR was usually more convincing. Superficial lesions seen on MR sometimes would be missed on myelography followed by CT. Both MR and myelography followed by CT were quite sensitive in the detection of small lesions (2 to 3 mm) when present on spinal nerve roots. Whereas MR showed multiple lesions not seen on myelography followed by CT, CT failed to show any metastases not seen on MR. Imaging studies showed metastases in 3 patients who had normal cytologic findings. CONCLUSIONS: MR shows significantly more cerebrospinal fluid metastases than myelography followed by CT.

Adolescent↗
PubMedDate not supplied

[Clinical picture and roentgenoradiological diagnosis of suprasellar cerebrospinal fluid cysts in children].

Suprasellar cysts containing cerebrospinal fluid are considered a rare pathological condition. Characteristic symptom complexes in children are discussed on the basis of 12 cases. It is assumed that signs of affection of the chiasma and optic nerves in slowly progressive hydrocephalus, diencephalic disorders, and hyperkinesis suggest the presence of a suprasellar cyst. The authors present data on the use of diagnostic methods of examination and give their opinion on the informative value of these methods: craniography, gamma-topography and radionuclide cisterno- and ventriculography, computerized tomography, and computerized-tomographic cisterno- and ventriculography.

Adolescent↗
PubMedDate not supplied

Proteinergic profiles in cerebrospinal fluid from alcoholic subjects.

Minute amounts of cerebrospinal fluid samples from alcoholics were subjected to separation by HPLC-molecular sieving, combined with multispectral UV analysis of the acquired data. A significant difference in the protein/polypeptide pattern within the molecular weight range of 7-10 kDa has been observed between samples, taken directly after detoxification and 2 weeks later. Spectral analysis of the results suggests that the components are of peptidergic nature. On the other hand, albumin content did not differ significantly, suggesting that the blood-brain barrier was not affected. An enzyme marker, dynorphin converting enzyme, remained unchanged in both groups.

Adult↗
PubMed1992

Cardiovascular responses to intracerebroventricular infusion of artificial cerebrospinal fluid in anesthetized strain 13 guinea pigs.

The cardiovascular effects of constant intracerebroventricular infusion in anesthetized strain 13 guinea pigs were studied. Bilateral cerebroventricles of the animals were catheterized stereotaxically with two 20-gauge blunt needles, penetrating 5 to 6 mm into the skull. Baseline cerebroventricular pressure values were 1.3 +/- 0.6 mmHg. After artificial cerebrospinal fluid was infused into the left ventricle at 0.5 ml/h, left cerebroventricular pressure increased to 8.1 +/- 1.6 mmHg (P less than 0.01), while right cerebroventricular pressure reached 5.6 +/- 2.2 mmHg within 20 minutes. No significant changes in mean blood pressure or heart rate were observed. When intracerebroventricular infusion rate increased to 5.0 ml/h, cerebrospinal fluid pressures of left and right cerebroventricles increased to 40.0 +/- 4.8 and 38.4 +/- 4.7 mmHg within 10 minutes from baseline values of 1.5 +/- 0.5 and 1.7 +/- 0.7 mmHg, respectively. Simultaneously, mean blood pressure and heart rate increased from 72 +/- 4 to 101 +/- 9 mmHg and from 195 +/- 11 to 218 +/- 17 beats/min, respectively. However, 30 to 50 minutes later, mean blood pressure, heart rate, and cerebrospinal fluid pressure decreased abruptly, and two of four animals died. We suggest that this technique with a low infusion rate (less than 0.5 ml/h) can be used to deliver certain drugs into the brain ventricles directly without producing undesirable effects on blood pressure or heart rate.

Anesthesia↗
PubMed1980

[In vitro studies on the determination of the coagulating activity of normal, inflammatory and bloody cerebrospinal fluids].

Selective analyses of the coagulation factors II, V, VIII, and X in cerebrospinal fluid resulted in activity values ranging from 0.01-0.05 as a portion of the relative ratio 1 pertaining to the plasma activity. The increase of activity did not correlate with the protein increase in cerebrospinal fluid at F-VIII, and only to a slight extent at F-II, F-V,, and F-X. As compared with plasma a stimulating effect on coagulation can be recorded thromboelastographically in plasma mixtures.

Blood Coagulation Factors↗
PubMed2004

Sonographically guided aspiration of cerebrospinal fluid pseudocysts in children and adolescents.

OBJECTIVE: Cerebrospinal fluid (CSF) pseudocyst formation is an uncommon cause of ventriculoperitoneal shunt malfunction in children. Traditional staged treatment consists of shunt externalization, antibiotics, and later shunt revision and internalization. We sought to evaluate whether sonographically guided pseudocyst aspiration to alleviate acute symptoms and to exclude CSF infection could obviate shunt externalization and expedite the care of these patients. CONCLUSION: Sonographically guided CSF pseudocyst aspiration is an effective technique, allowing exclusion or confirmation of infection and providing relief of abdominal symptoms. In patients with sterile collections, staged surgical revision with shunt externalization can be avoided, speeding and simplifying treatment.

Adolescent↗
PubMed1990

Inhibition of MAO activity, 3H-imipramine binding, 3H-paroxetine binding and 3H-5-HT uptake by human cerebrospinal fluid.

Addition of small amount of human cerebrospinal fluid (CSF) inhibited both types of MAO in monkey brain mitochondria. The specific binding of 3H-paroxetine decreased remarkably with increasing CSF volumes, while 3H-imipramine binding was slightly inhibited. Scatchard analysis of 3H-paroxetine binding in the presence and absence of CSF indicated that the inhibitory effect was associated with a decreased Bmax without an appreciable change in Kd. Addition of CSF induced an inhibition of uncompetitive 3H-5-HT uptake to monkey cerebral membranes. These results indicate that the materials in human CSF inhibit 3H-paroxetine binding, and modulate the uptake system for 5-HT.

Animals↗
PubMed1977

identification of Cryptococcus neoformans in cytologic preparations of cerebrospinal fluid.

Review of routine Papanicolaou-stained cerebrospinal fluid preparations from 13 patients who had meningeal cryptococcosis documented by other methods demonstrated the yeast in 11 cases. Special stains greatly facilitated the detection of the organisms in two samples and discriminated them from artifacts. An increased number of cells was present in nine cases. Correlation with the clinical data revealed that every patient but one had a malignant lymphoma, most commonly Hodgkin's disease. The exception was a patient who had disseminated carcinoma of the breast treated with adrenal corticosteroids. The clinical history and the cellularity of the smear should alert one to the possibility of cryptococcosis.

Adult↗
PubMed2005

An unusual case of cerebrospinal fluid pseudocyst in a previously augmented breast.

Cerebrospinal fluid (CSF) drainage catheters can cause a myriad of complications, in large part because they may migrate from their normal location to almost anywhere in the body. We present the unique case of a female patient who had previously undergone bilateral breast augmentation who experienced sudden painless swelling of her right breast 6 weeks after placement of a ventriculoperitoneal shunt. Radiologic examination demonstrated ensnarement of the distal aspect of the shunt around her implant, with subsequent formation of a CSF pseudocyst. Management of this patient included replacement of the shunt, drainage of the CSF pseudocyst, and preservation of the implant.

Breast Implantation↗
PubMed1985

[Diagnostic significance of immunologic study of cerebrospinal fluid in neuroinfections].

An increase in the antibody titre in the blood serum, previously considered sufficient for determining the etiology of neuroinfection can no longer be regarded as a satisfactory index in the light of the contemporary level of our knowledge. The literature and the authors' own data show the importance of a simultaneous examination of antibodies in the cerebrospinal fluid and the blood serum in some neuroinfections. For example, the determination in the cerebrospinal fluid of antibodies to herpes simplex virus in herpetic encephalitis is considered sufficient (in the presence of the characteristic clinical picture) to make the diagnosis of this severe disease. The examination of antibodies to herpes simplex virus in the cerebrospinal fluid of 35 patients with a suspected herpetic encephalitis revealed their presence in 34% of those studied. The data obtained suggest that immunoassay of the cerebrospinal fluid and blood sera should be used on a broader scale in patients with acute and chronic neuroinfections. The method plays an the early diagnosis of these diseases and early administration of the appropriate treatment.

Antibodies, Viral↗
PubMed1979

Dynamics of cerebrospinal fluid circulation evaluated by metrizamide CT cisternography.

Cerebrospinal fluid (CSF) circulation has been analyzed by metrizamide computed tomography (CT) cisternography in 46 patients. Included were 7 patients without any clinical evidence of impaired CSF circulation, and 39 with hydrocephalus due to various causes. CT cisternography delineated the anatomical structures of the CSF pathways clearly and accurately and enabled us to analyze ventricular filling in a quantitative manner. As a result, a new, more precise CT cisternographic classification of the CSF flow patterns has been established. On the basis of the presence of ventricular reflux and stasis, extent of ventricular filling, and convexity flow of metrizamide, seven groups of flow patterns have been defined.

Adult↗