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At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Needle placement of myelography.

Proper placement of the entire bevel of the spinal needle within the subarachnoid space at myelography is necessary to prevent partial extra-arachnoid deposition of the contrast medium. A Cuatico aspiration cannula passed through the spinal needle at the time of spinal puncture serves to indicate the depth of the needle tip within the subarachnoid space.

Humans↗
PubMed2004

Permanent neurologic symptoms after prolonged epidural analgesia.

OBJECTIVE: Although transient neurologic symptoms may occur after neuraxial anesthetics with lidocaine, permanent neurologic symptoms (PNS) are unusual after uncomplicated continuous epidural analgesia (CEA). This report demonstrates that PNS may follow CEA uncomplicated by paresthesias, dural puncture, spinal hemorrhage, or intravascular local anesthetic injection; and performed with bupivacaine alone administered at high dosages with vasoconstrictors over a prolonged time period. CASE REPORT: An obstetrical patient developed fixed left L5-S1 sensorimotor radiculopathy following L5-S1 level CEA with bupivacaine alone administered at high doses (270 mg) with a vasoconstrictor (epinephrine, 225 mg) over a prolonged time period (62 hours). CONCLUSIONS: CEA should be administered at higher lumbar levels for labor analgesia rather than at lumbosacral levels that may require higher volumes and concentrations of local anesthetics with greater potential for local anesthetic neurotoxicity. Local anesthetics with vasoconstrictors should only be used as sentinel markers of unrecognized intravascular entry, rather than as primary local anesthetics during CEA to avoid any potential for ischemic neuropathy.

Journal Article↗
PubMed1988

The value of routine CSF analysis during lumbar radiculography for low back pain.

The medical notes of 370 orthopaedic patients with low back pain, who underwent lumbar radiculography, were retrospectively reviewed to determine the effect, if any, that CSF analysis had on their subsequent management. It was found that no apparent alteration of management occurred in a single patient and hence the routine sampling of CSF during lumbar radiculography for uncomplicated low back pain has been discontinued in our department.

Back Pain↗
PubMed1992

Hearing loss as a sequel of lumbar puncture.

Only a few case reports have been published about hearing impairment following lumbar puncture, and not all were thoroughly documented by audiograms. We present nine cases of hearing loss following myelography, lumbar puncture, and spinal anesthesia. We speculate that this rare complication arises only in persons with a wholly or partially patent cochlear aqueduct, and occurs via the release of perilymphatic fluid in the cerebrospinal space. Hearing loss was seen in eight of the nine patients in the lower frequencies, and in six of the nine patients on both sides. Recovery to normal hearing was noticed in six of the nine patients. Transient hearing loss may occur more often than it is generally assumed, and the symptom can remain unnoticed. Since not all of these hearing losses proved to be fully reversible, we suggest informing patients about this complication for medicolegal reasons.

Adult↗
PubMed1991

Total circulating B lymphocyte abnormalities in a primary cerebral localization of non-Hodgkin lymphoma: a case report.

The authors describe a case of primary central nervous system lymphoma in a 43-year-old male. Interest in this rare form of B-lymphocyte non-Hodgkin's lymphoma is due to its increasing incidence in the last decade, especially in immunodeficient patients. Extraneural involvement was excluded by staging examinations: bilateral bone marrow biopsy from the posterior iliac crest, bipedal lymphography, abdominal CT scan, skeletal, thoracic and gastrointestinal X-rays, spinal puncture, ORL and clinical examination. The peripheral immunologic state was particularly interesting: there was a substantial decrease in total circulating B-lymphocytes at diagnosis (4.4% = 80/mmc; nv 13 +/- 4% = 287 +/- 130/mmc) and a further decrease after 2 and 4 months of therapy (0.16% = 2/mmc). Three months after completion of therapy, the B-lymphocyte level returned to the base level at diagnosis (7% = 88/mmc). At 10 months after diagnosis and 3 months after completion of chemotherapy, the patient is alive and in good health except for the after-effects of a left hemiparesis. The etiologic and possible pathogenic factors are considered.

Adult↗
PubMed1993

Computed tomography and magnetic resonance findings of meningeal syndrome in a leukemic cat.

A 3-year-old Japanese domestic cat with a diagnosis of lymphocytic leukemia showed severe generalized seizures in the course of chemotherapy after leukemic condition was improved clinically. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain were carried out. Both contrast procedures disclosed enhancements at the falx cerebri and the margin of cerebral cortex. Among these procedures contrast MR imaging demonstrated the lesion most clearly. Cytological examination of cerebrospinal fluid obtained by spinal puncture showed the infiltration of malignant cells and the diagnosis of meningeal syndrome associated with lymphocytic leukemia was defined. Intrathecal administration of cytosine arabinoside partially improved the neurologic dysfunction. Autopsy and histopathological examination confirmed the infiltration of leukemic cells in the areas of meningeal lesion demonstrated with contrast CT and MR imaging. Thus these imaging techniques, especially contrast MR imaging, are useful tools for rapid and precise diagnosis of meningeal syndrome.

Animals↗
PubMed1985

Effects of pregnancy and labor on oxytocin levels in human plasma and cerebrospinal fluid.

In order to investigate the significance of oxytocin in pregnancy and labor, oxytocin concentrations in plasma and cerebrospinal fluid (CSF) were determined using the specific radioimmunoassay. Plasma and CSF samples were obtained from 23 pregnant women (11 pre labor, 12 in labor), 15 nonpregnant women and 4 men at spinal puncture for anesthesia. In males and nongravidas, CSF levels of oxytocin were significantly higher than plasma levels. Plasma levels in pregnant patients pre or in labor were significantly higher than those in nongravidas. No significant difference between CSF levels in prelabor gravidas (mean +/- SE, 9.7 +/- 1.5 mu u/ml) and nongravidas (10.1 +/- 1.2 mu u/ml) was found. However, CSF levels in gravidas in labor (18.6 +/- 2.3 micromicrons/ml were significantly higher than the levels in prelabor gravidas. These results strongly suggest that oxytocin levels in human plasma and CSF are controlled by different mechanisms and that the increased oxytocin could have some specific central actions.

Adolescent↗
PubMed2003

[Hopkins' syndrome in the differential diagnosis of flaccid paralysis in children: clinical and neurophysiological features. Case report].

INTRODUCTION: Hopkins syndrome is a motor neuron disease which leads to a flaccid paralysis affecting one or more limbs resembling poliomyelites. It follows an asthmatic attack and the prognosis is poor. All the 34 related cases occured after 13 months of age and there is no report in South America. Our objective is to describe a case of Hopkins Syndrome in Brazil affecting a patient younger than 1 year. CASE: Male 4 months-old infant, started presenting wheezing that turned into respiratory failure which required mecanical ventilation. Three days later he initiated with loss of strength in the lower limbs (LL). The patient was dismissed from hospital better of his respiratory complains but still paraparetic. Five months later, the patient returned with another episode of severe bronchospasm. At that time, he presented with flaccid paralysis, arreflexia and atrophy of the LL. There were no upper limbs and sensory abnormalities. The patient undergone to lumbar puncture, spinal MRI and SEPs which were all normal. MUSCLE BIOPSY: type grouping. EMG and NCS were in keeping with motor neuron disease affecting just the lumbosacral region. CONCLUSION: Hopkins syndrome should be included in the differential diagnosis of any flaccid paralysis when it is associated with an asthma attack.

Acute Disease↗
PubMed1988

Penetration of roxatidine into the cerebrospinal fluid.

Central nervous system side effects are occasionally associated with the administration of H2-receptor antagonists. There seems to be a direct correlation between the occurrence of side effects such as mental confusion and the drug concentration in the cerebrospinal fluid. In animal experiments the new H2-blocker roxatidine did not cross the blood-brain barrier. We therefore investigated the penetration of roxatidine into human cerebrospinal fluid (CSF). Nine healthy subjects scheduled for elective spinal anesthesia were premedicated with 150 mg roxatidine orally. Blood samples were taken at 30-min intervals for up to 6 h. A 2-ml CSF sample was taken from each patient at the time of spinal puncture. Small amounts of roxatidine were detectable in the CSF, the CSF to plasma ratio ranging from 0 to 0.89.

Animals↗
PubMed1999

Persistent bilateral hearing loss after shunt placement for hydrocephalus. Case report.

Transient hearing decrease following loss of cerebrospinal fluid (CSF) has been reported in patients undergoing lumbar puncture, spinal anesthesia, myelography, and/or different neurosurgical interventions. The authors present the first well-documented case of a patient with persistent bilateral low-frequency sensorineural hearing loss after shunt placement for hydrocephalus and discuss the possible pathophysiological mechanisms including the role of the cochlear aqueduct. These findings challenge the opinion that hearing decreases after loss of CSF are always transient. The authors provide a suggestion for treatment.

Audiometry, Pure-Tone↗
PubMed1998

Transient oculomotor cranial nerves palsy in spontaneous intracranial hypotension.

Transient sixth cranial nerves palsy may occur in rare cases after lumbar puncture, spinal anesthesia and myelography as well as in more rare cases of spontaneous intracranial hypotension. We report three cases of spontaneous intracranial hypotension with sixth cranial nerves palsy. One of these patients presented also third cranial nerve palsy, never reported in spontaneous intracranial hypotension.

Abducens Nerve↗
PubMedDate not supplied

[Acute nosocomial bacterial meningitis. Apropos 27 cases].

Our series includes 27 patients with nosocomial meningitis (22 post neurosurgery and 5 post spinal puncture) of whom 15 with stated etiology (gram-negative bacilli and staphylococcus aureus in equal shares). Under the treatment with chloramphenicol + rifampicin + gentamicin a cure was obtained in 22 cases, improvement in 3 cases and 2 patients died.

Acute Disease↗