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At least 19 recordsLinked to original sources

Afferents to brain stem nuclei (brain stem raphe, nucleus reticularis pontis caudalis and nucleus gigantocellularis) in the rat as demonstrated by microiontophoretically applied horseradish peroxidase.

Using a retrograde tracer technique with microiontophoretically applied horseradish peroxidase (HRP), afferent projections to the brain stem raphe nuclei (BR, raphe magnus, pallidus and obscurus) and to two adjacent reticular nuclei, nucleus reticularis pontis caudalis (nRPC) and nucleus gigantocellularis (nGC) were identified. The most striking difference between the afferent projections to the BR and the adjacent nuclei as determined by this method is that afferents to the BR originate primarily from structures rostral to the pons, especially the mesencephalic central gray and the dorsal and ventral tegmentum. In contrast, the two reticular nuclei studied (nGC and nRPC) received afferent projections within or caudal to the pons-medulla. For example, the nGC receives prominent afferent projections from the gray matter of the spinal cord. In addition, evidence for interconnections between all of the adjacent nuclei (BR, nGC and nRPC) was found. Such afferent projections are compatible with the notion that the brain stem raphe nuclei may serve as connections within the brain stem for a descending system, while the nGC may be a relay in a feedback loop between the spinal cord and the reticular formation.

Animals↗

Localizing brain stem lesions with brain stem auditory evoked potentials.

Based on a survey of brain stem auditory evoked potentials (BAEPs) in animals and humans with localized brain stem lesions compared to the recognizability of BAEP components in normal materials, it was concluded that BAEP examination might localize lesions to a high or low level and diffusely within the brain stem. In 155 patients with multiple sclerosis, vascular disorders or other lesions from a neurological department, the involvement of the brain stem was clinically estimated to be negative, situated at a high or low level or diffuse. Correlation between location of the lesions assessed by clinical versus BAEP examination showed correspondence between negative and diffusely abnormal findings, but not with regard to levels within the brain stem. CT-scanning similarly failed to localize lesions to various levels. This was probably due to poorly circumscribed or widespread lesions. The main value of BAEP in neurological patients was to establish clinically silent lesions, especially in patients with multiple sclerosis and only spinal signs.

Animals↗

Abnormal brain-stem function (brain-stem auditory evoked response) correlates with acoustic cry features in term infants with hyperbilirubinemia.

We hypothesized that changes in brain-stem auditory evoked responses related to bilirubin would be associated with changes in cry because of the anatomic proximity in the brain stem of cranial nerves 8 (auditory) and 9 to 12 (vagal complex, which controls cry). Brain-stem auditory evoked responses and computerized cry analysis were used to study the concurrent effects of moderate hyperbilirubinemia on auditory function and cry. Fifty term infants were divided equally into two groups on the basis of serum bilirubin concentrations: low (less than 8 mg/dl; 136) mumol/L and moderate (10 to 20 mg/dl, 170 to 342 mumol/L). Forty-three infants had successful tracings of brain-stem auditory evoked responses recorded with a Cadwell model 5200A evoked response unit during two successive trials, and a cry recording of each infant was analyzed by computer. The moderate serum bilirubin group had an increase in percent cry phonation (p less than 0.02) and an increase in the variability of the first formant (p less than 0.04) in comparison with the low serum bilirubin group. Serum bilirubin values correlated positively with brain-stem conduction time (r = 0.36, p less than 0.01), percent phonation (r = 0.42, p less than 0.004), and variability of the first formant (r = 0.39, p less than 0.02). Percent phonation, the voiced component produced by increased neural control, correlated with the interpeak of waves latencies I to III (r = 0.32, p less than 0.03) and brain-stem conduction time (wave I to V) (r = 0.35, p less than 0.01). We conclude that hyperbilirubinemia affects adjoining areas of the brain stem that control hearing and cry production.

Brain Stem↗

Epidermoid cyst involving the brain stem.

Brain stem epidermoid cysts are extremely rare. We describe an unusual case of prepontine epidermoid cyst with a large part of the tumour insinuating itself into the pons. Microsurgical total excision of tumour was done without producing any new neurological deficits. Cases reported in the literature either had high mortality/morbidity or were only subtotally removed. Relevant literature is reviewed.

Brain Diseases↗

[Auditory evoked potentials of the brain stem in brain injury. Prognostic value].

The study of brain stem auditory way in severe head trauma patients with auditory evoked potentials is very important for giving elements about functional and anatomic situation of analyzed neuronal substratum; ABR will be normal or altered in conformity with the level and/or the gravity of the damage. Authors have examined 20 post-traumatic comatose patients pointing out the existence of a strict relation between auditory brain stem responses and prognosis. Authors, in accordance with the ample literature in existence, agree to point out the auditory brain stem responses such as a very effective instrument for the prognostic valuation of post-traumatic comatose patients.

Adolescent↗

Alcohol and the auditory brain-stem response, brain temperature, and blood alcohol curves: explanation of a paradox.

A previous study found temperature-independent effects of alcohol upon the auditory brain-stem response (ABR): another found only temperature-dependent effects. To understand these paradoxical results, we measured the ABR and brain temperature in unrestrained rats before and after 3 alcohol doses (0.5, 2.5 and 5.0 g/kg). In a separate experiment, blood ethanol concentration (BEC) curves were determined for the same 3 alcohol doses. Integration of dose- and time-related effects of alcohol upon the ABR, brain temperature, and BEC suggested that alcohol has both temperature-dependent and temperature-independent effects, which vary according to dose and BEC curve phase. Temperature-dependent effects are likely during a BEC curve falling phase with a steep slope, following a high alcohol dose. Temperature-independent effects are likely during a BEC curve falling phase with a flatter slope, when BEC is still high following a moderate alcohol dose, or during a BEC curve rising phase soon after alcohol administration. The two previous studies with contradictory results each used procedural combinations likely to produce their respective results. Although both research groups administered similar alcohol doses, their alcohol solutions, administration routes, and time of ABR recording differed; consequently, they probably recorded ABR during different portions of BEC curve falling phases, which differed in slope. In view of the complex interactions among alcohol effects, BEC curve phase, temperature, and the ABR, we recommend temperature measurement during alcohol-ABR studies.

Analysis of Variance↗

Serial observations of brain stem function by auditory brain stem responses in central transtentorial herniation.

Changes in auditory brain stem responses were serially investigated in a patient with downward transtentorial herniation due to acute obstructive hydrocephalus to correlate the neurological signs with the results of computerized tomography. Neurological deterioration correlated highly with disruption of auditory brain stem responses, especially with that of the components of waves V to VII. A noninvasive technique, the measurement of auditory brain stem responses is thought to be useful in detecting the severity of downward transtentorial herniation and in estimating the recovery of brain stem function after surgical treatment of intracranial hypertension.

Brain Stem↗

The effects of experimental brain-stem ischaemia on brain-stem auditory evoked potentials in primates.

We related intracranial auditory brain-stem evoked potentials (BAEPs) to the surface BAEP using a model of focal brain-stem ischaemia. In 17 baboons anaesthetised with alpha-chloralose, BAEPs were recorded bilaterally at the mastoids and in the caudal lateral lemniscus (LL) and inferior colliculus (IC), in response to monaural click stimulation. Electrodes at these sites were each connected to the positive input of a differential amplifier, and one other electrode, placed at the vertex, was connected to all the negative inputs. Measurements of local cerebral blood flow (CBF) by hydrogen clearance were made at the LL and IC sites. The LL wave form contained 5-7 positive peaks, the second (B wave) being dominant and coinciding with the negative wave II of the surface BAEP. Following graded ischaemia, produced by basilar artery occlusion and controlled hypotension, the latency changes of these two peaks were significantly correlated, as were those of the third wave (C wave) of the LL response and the surface wave III. In the IC, the contralateral wave form contained 4 positive waves (A-D) and a later, dominant, slow negative wave; changes in its peak latency and those of the slow negative surface wave were similarly correlated. The thresholds of local CBF for increases in latency of waves B and C in the LL were similar (12-15 ml/100 g/min), but in the IC the thresholds were 20, 30-35 and 20-24 ml/100 g/min for the B, C and slow negative waves, respectively. Our data indicate that a gradient of sensitivity to ischaemia is present along the brain-stem auditory pathways; this could explain the earlier change of the late, rather than early, BAEP components as reported in clinical cases involving brain-stem lesions.

Animals↗

Malignant brain stem hyperthermia caused by brain stem hemorrhage.

BACKGROUND: We report two cases of brain stem hemorrhage characterized by severe hyperthermia, rhabdomyolysis, acute renal failure, and a rapidly fatal course. METHODS: A 55-year-old man and a 65-year-old man were admitted with coma-producing brain stem hemorrhage accompanied by hyperthermia. Both underwent ventricular drainage. RESULTS: Within 1 day of onset, both patients developed hyperthermia of over 41 degrees C, increased serum creatine phosphokinase (CPK) level indicating rhabdomyolysis, and acute renal failure. One patient died on the second day and the other on the third day after onset despite supportive treatment. CONCLUSIONS: These cases of brain stem hemorrhage with fulminant hyperthermia should be distinguished from those with simple hyperthermia. They may represent a kind of malignant hyperthermia, in which case dantrolene sodium might be beneficial. Monitoring serum CPK levels would be of help in making the diagnosis early in the course.

Aged↗

Acute intracranial hypertension and auditory brain-stem responses. Part 2: The effects of brain-stem movement on the auditory brain-stem responses due to transtentorial herniation.

Movement of the upper brain stem (inferior colliculus) was correlated with the alterations in the amplitude of wave V of the auditory brain-stem responses (BER's) during supratentorial brain compression in cats. In vivo observation of the brain stem and postmortem inspection show that suppression of the amplitude of BER wave V reflects the extent of caudal displacement of the inferior colliculus. Marked suppression of the amplitude of BER wave V (approximately 30% of control) correlates with the beginning of transtentorial herniation, and complete suppression of the wave V indicates complete transtentorial herniation of the brain-stem and supratentorial structures. The BER wave V is thought to be a sensitive index of caudal movement of the upper brain stem due to transtentorial herniation.

Animals↗

The auditory brain stem response in patients with brain stem or cochlear pathology.

OBJECTIVE: The purpose of this study was to determine the value, based on true-positive and false-positive rates, of various auditory brain stem response (ABR) indices in discriminating patients with brain stem lesions from patients with cochlear lesions. DESIGN: A factorial design was used in this retrospective study. Receiver operating characteristics (ROC) curves were constructed to analyze the performance of 32 patients with brain stem lesions and 33 patients with cochlear involvement for the absolute latency of wave V; the I-III, III-V, and I-V interwave intervals; the interaural latency difference and the V/I amplitude ratio. Analyzed in the same manner were four combinations of ABR indices. RESULTS: Based on the ROC curves, the clinically most valuable index was the I-V interval, but overall the individual indices showed only moderate sensitivity to brain stem pathology. By combining several indices, the sensitivity to brain stem involvement was improved. However, as expected, the overall false-positive rate also increased. CONCLUSIONS: There is a diagnostic advantage to using more than one ABR index in evaluating patients suspected of having brain stem involvement.

Adolescent↗

Neuroimaging of pediatric brain stem diseases other than brain stem glioma.

A wide variety of both neoplastic and non-neoplastic lesions affect the pediatric brain stem. Of these, inflammatory and infectious, along with occult vascular malformations produce the greatest concern regarding the interpretation of imaging studies that could lead to inappropriate therapeutic modalities in the treatment of the patient. Awareness of the differential diagnosis and, when appropriate, the judicious use of follow-up examination are warranted.

Brain Diseases↗