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At least 19 recordsLinked to original sources
PubMed2001

Laparoscopic repositioning of a ventriculo-peritoneal catheter tip for a sterile abdominal cerebrospinal fluid (CSF) pseudocyst.

Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but well-described complication that is reported to occur in <1% of ventriculo-peritoneal (VP) shunts. Management options for pseudocysts include various types of shunt revisions, which recently have been conducted laparoscopically. We report the case of an 11-year-old girl in whom a sterile abdominal CSF pseudocyst was successfully fenestrated and the VP catheter repositioned using laparoscopy. This technique in the setting of a noninfected pseudocyst has proven to be safe, with results comparable to the conventional open technique. However, the long-term success rate is still unknown.

Abdomen↗
PubMedDate not supplied

Cytotoxic activity of cerebrospinal fluids (CSF's) against lymphocytes and phagocytes: comparison of normal and systemic lupus erythematosus CSF's.

Fifty cerebrospinal fluids (CSF), 24 normal, 26 from systemic lupus erythematosus (SLE) patients were tested for cytotoxic activity against human lymphocytes, granulocytes and monocytes. Normal and SLE CSF's frequently killed all 3 cell types. Lympho- and granulocytotoxins often reacted at both 4 degrees/24 degrees C, and at 37 degrees C. They were more active when no complement was added (p less than 0.01), whereas monocytotoxicity was complement-dependent (p less than 0.01). Normal CSF's more often contained cold-reacting lymphocytotoxins and SLE CSF's more often had warm-reacting monocytotoxins, but the differences were not significant (p = 0.03). Cytotoxins were easily absorbed to and eluted from lymphocytes and granulocytes, and when CSF's were toxic to both types of cells, the corresponding eluates usually retained this activity. Sometimes, only 1 type of cell was killed by the eluate, whereas cytotoxicity against another was retained by the corresponding supernatant. In SLE remarkable differences were noted between CSF cytotoxins and serum cytotoxins. The former were often more potent at 37 degrees C not requiring non-human complement. Preliminary characterization of CSF cytotoxins suggests they may be IgG, however, participation of non-Ig cytotoxic substances cannot be excluded.

Cytotoxins↗
PubMed1984

Cerebrospinal fluid (CSF) findings in amyotrophic lateral sclerosis.

The cerebrospinal fluid (CSF) was examined in 90 amyotrophic lateral sclerosis (ALS) patients and in 50 age-matched normal controls. Total protein concentration was significantly higher in ALS patients than in normal controls. CSF IgG and albumin, quantitatively determined by single radial immunodiffusion, were significantly increased in ALS. No difference in serum concentrations was observed between ALS patients and normal controls. On isoelectric focusing a clearcut "fingerprint" pattern was observed in 11 of 12 cases. These findings support the hypothesis that blood-brain barrier damage occurs in ALS. The finding of a higher mononuclear cell count in young ALS patients is briefly discussed in the light of the hypothesis that an exogenous agent might be of some relevance in pathogenesis. An alteration of at least one of the CSF parameters considered was found in 45.5% of ALS cases.

Adult↗
PubMed2005

Efficacy of cerebrospinal fluid (CSF)-penetrating antiretroviral drugs against HIV in the neurological compartment: different patterns of phenotypic resistance in CSF and plasma.

BACKGROUND: Cerebrospinal fluid (CSF) concentrations of multiple drugs in a large human immunodeficiency virus (HIV)-infected patient population, the virtual phenotype profiles for HIV in the plasma and CSF compartments, and the correlation of these profiles with exposure to antiretroviral therapy need to be further investigated. METHODS: Drug concentrations in CSF and plasma were concomitantly determined for a large group of HIV-infected individuals receiving highly active antiretroviral therapy (HAART). Samples were analyzed using a validated method consisting of liquid chromatography with mass spectrometry. For patients with detectable levels of virus, genotypic analysis was performed, followed by a virtual phenotype study. RESULTS: Sixty-three HIV-infected patients were included in the study, 78% of whom were affected by neurological disease. Drug concentrations in CSF specimens were undetectable for didanosine, efavirenz, nelfinavir, and concomitantly administered ritonavir and saquinavir. CSF concentrations were higher for nevirapine, with a median CSF-to-plasma concentration ratio of 0.63, followed by lamivudine (0.23), stavudine (0.20), and indinavir (0.11). In 18 of the 40 patients with virtual phenotype data available for virus recovered from CSF samples and from plasma samples, differences in fold-change of resistance between the CSF virus and the plasma virus were noted for at least 1 drug. Factors associated with having differences in fold-change of resistance were number of drugs to which the patient had been exposed (P=.02) and presence of neurological disease (P=.05). A significant association was found between duration of therapy and fold-change of resistance in CSF and plasma isolates. CONCLUSIONS: Antiretrovirals have different levels of penetration in the CSF, with several drugs achieving only low CSF concentrations. CSF isolates have different resistance profiles than do plasma isolates. Effective treatment decisions for CSF manifestations of disease may require better knowledge of drug penetration and the drug susceptibility of HIV in the CSF.

Adult↗
PubMed1983

The concentration of prealbumin in cerebrospinal fluid (CSF), indicator of CSF circulation disorders.

Prealbumin, was determined in serum, lumbar and ventricular cerebrospinal fluid (CSF) and compared with albumin and IgG. The measured concentrations of prealbumin in the CSF indicate that there are two sources of prealbumin: a minor fraction enters the CSF via the blood-cerebrospinal fluid (B-CSF) barrier like albumin, and the major fraction enters the CSF at the ventricles, probably during production of the CSF in the ventricles. The two fractions can be calculated from the CSF concentration of prealbumin, serum prealbumin and the concentration gradient (serum/CSF) of albumin. The B-CSF barrier-independent prealbumin can be used as an indicator of CSF circulation. This was proved by the investigation of several special cases.

Albumins↗
PubMed1992

Alcohol in cerebrospinal fluid (CSF) and alcoholism.

Alcohol levels were measured in 15 cerebrospinal fluid (CSF) samples and 14 blood samples from grade III and IV male alcoholic patients with signs of nervous system involvement, and compared with levels detected in 11 CSF samples and 11 blood samples from abstemious patients or patients with grade I or II alcoholism whose CSF had been found to be normal by routine analysis (controls). Among the alcoholic patients, alcohol levels were lower in the CSF than in blood, whereas the opposite was true for the controls. The possible mechanisms underlying this difference are discussed and the need for further study of this topic is emphasized.

Alcoholism↗
PubMed2001

SPAMM, cine phase contrast imaging and fast spin-echo T2-weighted imaging in the study of intracranial cerebrospinal fluid (CSF) flow.

AIM: To compare the qualitative assessment of cerebrospinal fluid (CSF) flow using a SPAMM (spatial modulation of magnetization) technique with cine phase contrast images (cine PC) and fast spin echo (FSE) T2-weighted images. MATERIALS AND METHODS: SPAMM, PC and T2-weighted sequences were performed on 22 occasions in 19 patients. Eleven of the studies were performed following a neuroendoscopic third ventriculostomy (NTV), and in these cases, the success of the NTV was determined by clinical follow-up. Two observers used consensus to grade the presence of CSF flow at nine different sites for each study. RESULTS: At 14 of the 178 matched sites, which could be assessed by both SPAMM and cine PC, SPAMM CSF flow grade was higher than that of cine PC. At a further 14/178 matched sites, the cine PC grade was higher than that of SPAMM. There was definite CSF flow at 113/182 (62%) of all the cine PC sites assessed, and 110/181 (61%) of all SPAMM sites assessed whilst 108/198 (54%) of FSE T2-weighted image sites demonstrated flow voids. Cine PC grades were higher than SPAMM at the cerebral aqueduct (P < 0.05, Wilcoxon sign rank test). Definite CSF flow within the anterior third ventricle was present in 4/5 (SPAMM) and 3/5 (cine PC) successful NTVs, 0/2 (SPAMM and cine PC) unsuccessful NTVs and 1/10 (SPAMM and cine PC) patients without NTV. CONCLUSION: SPAMM provides a comparable assessment of intracranial CSF flow to that of cine phase contrast imaging at all CSF sites except the cerebral aqueduct.

Adolescent↗
PubMed1988

Cerebrospinal fluid (CSF) TRAP. A method to improve CSF laboratory efficiency.

Establishment of a procedure termed cerebrospinal fluid (CSF) TRAP ("Transport and Rapid Accessioning for Additional Procedures") allows clinicians to appropriately store, at -75 degrees C, and rapidly access CSF specimens. The CSF TRAP enhances patient care by decreasing the need for repeat lumbar punctures and providing reserve fluid for the following: (1) further CSF testing; (2) repeating questionable test results; and (3) laboratory accidents. The CSF TRAP has been approved for third-party payment because it promotes efficient laboratory utilization by encouraging clinicians to review initial CSF findings before ordering low-yield CSF assays such as the venereal disease research laboratory (VDRL) and cryptococcal antigen latex agglutination tests. Currently, CSF TRAP samples are being obtained with 40% of all CSF acquisitions at the Duke University Medical Center. The availability of the CSF TRAP was associated with a significant decrease in the ordering of CSF VDRL and cryptococcal antigen assays (P less than 0.05); however, there was no significant change in the proportion of those studies being performed on normal CSF. The CSF TRAP procedure provides the framework for an overall restructuring of CSF testing that is being investigated.

Antigens, Bacterial↗
PubMed1992

Cerebrospinal fluid (CSF) cytology: current status and diagnostic applications.

Cytologic evaluation of cerebrospinal fluid (CSF) is an effective means for diagnosing many disorders involving the central nervous system (CNS). Interpretation of these samples requires an understanding of the spectrum of neurologic diseases which involves the subarachnoid space, either primarily or secondarily, as well as familiarity with the cytologic characteristics of these lesions. Here the clinical features and cytologic presentation of common conditions which can be diagnosed by CSF cytology are reviewed. Preparatory methods for CSF examination are discussed and normal and reactive conditions involving CSF, lymphoma, leukemia, meningeal carcinomatosis and the subarachnoid spread of primary brain tumors are described and illustrated.

Carcinoma↗
PubMed1988

Penicillin concentrations in cerebrospinal fluid (CSF) during repository treatment regimen for syphilis.

Penicillin concentrations in cerebrospinal fluid (CSF) were measured in 40 asymptomatic patients with syphilis, 10 of whom had neurosyphilis. The patients were treated with 2.4 MIU procaine penicillin a day intramuscularly in combination with 500 mg probenecid every six hours orally. This intramuscular treatment regimen did not consistently yield treponemicidal penicillin concentrations in the CSF (subtreponemicidal CSF concentrations were found in 17 patients, four of whom had neurosyphilis). These data provide additional evidence that the cure of asymptomatic neurosyphilis is not guaranteed by intramuscular penicillin treatment.

Drug Therapy, Combination↗
PubMed1993

Ascorbate concentration in human cerebrospinal fluid (CSF) and serum. Intrathecal accumulation and CSF flow rate.

Concentrations of ascorbate (vitamin C) in cerebrospinal fluid (CSF) from human controls (median 163 mumol/l, n = 63) were found to be in the same range as CSF samples from patients (n = 56) with various neurological diseases, but excluding those with blood-CSF barrier dysfunction. The CSF/serum concentration ratio in the former group is non-linear, decreasing with increasing serum concentration. Surprisingly, ascorbate concentration in blood (median 41 mumol/l, n = 119) was decreased significantly in cases of neurological diseases with a blood-CSF barrier dysfunction (median 26 mumol/l, n = 30). In this latter group a linear CSF to serum ratio with a mean of 5.7:1 (with CSF/serum albumin quotients QAlb = 7.8-70.8 x 10(-3), median 10.0 x 10(-3)) was observed, approaching a value > 12.5:1 in the case of complete stop of CSF flow. Serum ascorbate concentrations decreased with decreasing CSF flow rate (1 square root of QAlb), indicating a CSF flow-dependent constant contribution from high intrathecal ascorbate concentration to the varying diet-dependent concentrations in blood. In the control group the biological coefficient of variation for CSF ascorbate concentrations (C.V. = 21.1%) was smaller than for serum concentrations (C.V. = 42.6%), confirming an efficient ascorbate homeostasis in human brain. This was different from uric acid which was used as a reference molecule with an inversed gradient in the same group of control patients. Similar variations in CSF(y) and serum(x) for urate concentrations are observed due to the strong correlation y = 0.1x +/- 10 mumol/l, including 99% of the cases with an urate serum concentration range from 80 mumol/l to 460 mumol/l.

Ascorbic Acid↗
PubMed1979

Malignant cells in cerebrospinal fluid (CSF): the meaning of a positive CSF cytology.

We reviewed the correlation between malignant cells in cerebrospinal fluid (CSF) (positive cytology) and pathologic findings at autopsy. The purpose was to discover: (1) the incidence of negative CSF cytology in patients with CNS malignancy, (2) the incidence of false-positive cytology, and (3) the relationship between a true-positive cytology and the distribution of malignant tumor at autopsy. Of 117 patients with CNS tumor and premortem cytologic examination of the CSF, 31 (26 percent) were positive and 86 (74 percent) were negative. Only 1 of 66 patients with tumor that did not reach the leptomeninges had a positive cytology. Of 51 patients with leptomeningeal tumor at autopsy, cytology was positive in 30 (59 percent) and negative in 21 (41 percent). Five potentially "false-positive" cytologies were encountered: three patients were treated, and tumor may have been eradicated; in two patients with lymphoma, inflammatory cells associated with infection were apparently mistaken for malignant cells. These data indicate that a positive CSF cytology is a reliable indicator of CNS malignancy and almost always reflects leptomeningeal tumor.

Brain Neoplasms↗
PubMed1986

Evaluation of adenosine deaminase activity and antibody to Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid and the radioactive bromide partition test for the early diagnosis of tuberculosis meningitis.

A number of different biochemical and serological tests have been described recently for the early and accurate diagnosis of tuberculous meningitis. None of these tests has yet gained widespread acceptance in clinical medicine or in microbiology laboratories. To investigate this problem we evaluated adenosine deaminase activity (ADA), an enzyme linked immunosorbent assay (ELISA) that detects antibody to antigen 5 of Mycobacterium tuberculosis, and the radioactive bromide partition test (BPT) in the cerebrospinal fluid (CSF). Cerebrospinal fluid specimens from children with tuberculous, pyogenic, and viral meningitis as well as from patients with pulmonary tuberculosis without meningitis and from controls with normal CSFs were included inn the study. In addition, we estimated ADAs in serum samples from selected children in these groups. The sensitivity and specificity of the three tests evaluated in the CSF were: ADA assay 73% and 71%; BPT 92% and 92%; and ELISA for antibody to antigen 5, 53% and 90%, 40% and 94%, and 27% and 100%, respectively, at tires of more than or equal to 1:20, 1:40, and 1:80. The serum ADA was lower (11.0 +/- 6.15 IU/l) in children with tuberculous meningitis when compared with those with pulmonary tuberculosis alone (25.8 +/- 20.9 IU/l). The BPT was found to be the most reliable test in the early differentiation of tuberculous from other causes of meningitis and remained abnormal for a period of up to five months after the beginning of treatment. Accordingly, we believe that the BPT should be used in conjunction with bacterial and fungal antigen detection systems for the initial differentiation of clinically suspicious tuberculous meningitis from Gram or culture negative cases, or both, of bacterial and fungal meningitis.

Adenosine Deaminase↗
PubMed1979

[Cerebrospinal fluid (CSF) cytology using "cytospin" in patients with brain tumors (author's transl)].

Cerebrospinal fluid (CSF) cytology was performed using cytocentrifugation method ("Cytospin") in 88 preoperative patients who had been known to have deeply seated brain tumors by CT. 20 cases (22.7%) among them showed positive findings and 11 cases (12.5%) probably positive findings. High incidence of positive results were obtained in germinomas (60.9%), ependymomas (50.0%), medulloblastomas (40.0%), followed by malignant lymphomas (20.0%), pontine gliomas (16.7%) and metastatic tumors (16.7%). In contrast, it was persistently negative in cerebral astrocytomas, glioblastomas, teratomas, epidermoids, meningiomas and neurinomas. This method was quickly prepared in 30 minutes and was superior in retaining detailed cytomorphology. It was concluded that the CSF cytology is a less invasive diagnostic investigation, can provide an additional information as regards the nature of some kinds of brain tumors and is still useful even in the CT era.

Adolescent↗
PubMed1999

Interpretation of high levels of HIV-1 RNA in the cerebrospinal fluid (CSF) using amplicor HIV-1 monitor test.

A retrospective study of 19 cerebrospinal fluid (CSF) specimens from 14 HIV-positive subjects with subacute encephalopathy, neuropathy, or unexplained peripheral myelopathy was done comparatively with plasma specimens collected on the same day and tested in the same run as the corresponding CSF specimen. A single patient had a high HIV RNA level in CSF as compared to plasma (CSF/plasma ratio > 10), which seemed correlated with the clinical course. Further studies are needed to confirm that a high CSF/plasma HIV RNA ratio is associated with greater symptom severity.

HIV Infections↗
PubMed1989

Suppression of cerebrospinal fluid (CSF) production by a Na+/K+ pump inhibitor extracted from human cerebrospinal fluid.

A low molecular weight compound (about 600 daltons) extracted from human cerebrospinal fluid, and sensitive to proteolytic enzymes, has been shown to mimic the specific inhibitory effects of cardiac glycosides on the Na+/K+ pump of erythrocytes. The compound, which was labelled CSF-inhibitor (CSF-I) and reconstituted in artificial rabbit CSF, was used to study its effects on the rate of CSF formation in rabbits. Three groups of adult New Zealand white rabbits of either sex, anesthetized with ketamine and xylazine, and artificially respired were subjected to ventriculocisternal perfusions. Baseline rates of CSF formation were obtained during the first 2 hours of perfusion when plain rabbit CSF was used as the perfusate. Thereafter, the animals were perfused for an additional 2 to 3 hours with either plain rabbits CSF (controls), rabbit CSF containing 10(-6) M ouabain (group 2) or CSF-I (group 3). The rate of CSF formation in control animals was observed to gradually decline with time (about 7.5% in 4 hours). The addition of ouabain to the perfusate caused an abrupt and marked 43% decline in the rate of formation while the addition of CSF-I resulted in a 57% decline. These results suggest that the peptide CSF-I which is present in human CSF may act as an endogenous regulator of CSF production.

Animals↗
PubMed1994

Cerebrospinal fluid (CSF) neuropeptide Y- and somatostatin-like immunoreactivities in man.

We have measured cerebrospinal fluid (CSF) neuropeptide Y-like immunoreactivity (NPY-LI) and somatostatin-like immunoreactivity (SLI) in control subjects and in patients with various neurologic disorders. We observed a significant reduction in CSF SLI in control subjects over 60 years of age, compared with the younger controls. CSF SLI was significantly decreased in multiple sclerosis (MS), or Guillain-Barre syndrome, compared with that of age-matched control subjects. A reduced concentration of NPY-LI was found in CSF of patients with MS. We have also examined the molecular heterogeneity of peptide-LI in CSF. Gel chromatography, not high performance liquid chromatography (HPLC), suggested two NPY immunoreactive materials in CSF. Gel chromatography and HPLC revealed three SLI components in CSF: somatostatin 14, somatostatin 28 and a higher molecular weight precursor. Our results suggest that 1) there may be more than one form of NPY in human CSF, and 2) somatostatin neurons might be more susceptible to alteration than NPY neurons in various pathological conditions and aging.

Adult↗