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PubMed1993

Regional vasoconstriction and excessive grooming induced by L-arginine injection into the cisterna magna of conscious rats.

Hemodynamic and behavioral changes caused by intracisternally injected L-arginine which has a pressor effect were studied in conscious rats. One week or more after inserting a cannula into the cisterna magna, electromagnetic flow probes were implanted around the superior mesenteric artery, renal artery, or terminal aorta under anesthesia. A catheter for measurement of blood pressure was inserted into the terminal aorta via a femoral artery or into the common carotid. After recovery from surgery, blood flow, arterial blood pressure, heart rate, and behaviors were observed in the conscious state. Peripheral resistance, calculated as pressure divided by flow, increased an average of 80% in the superior mesenteric artery and 60% in the renal artery when the pressure was increased by 25% following intracisternal injection of 5 mumol of L-arginine. Hindquarter (terminal aortic) resistance showed an insignificant decrease of about 10%. The average heart rate showed no significant change. Grooming, moving, and eating all increased significantly after injection of L-arginine. Circulatory events and behaviors did not always synchronize after the injection. Intravenous chlorisondamine chloride, a ganglion blocker, significantly attenuated the pressor effect caused by intracisternal injection of L-arginine. These findings indicate that centrally injected L-arginine not only specifically triggers vasoconstriction in the viscera presumably through excitation of the regional sympathetic vasoconstrictor fibers to raise blood pressure but also centrally induces excessive grooming. However, the relationship between circulation and behavior caused by intracisternal injection of L-arginine remains unknown.

Animals↗
PubMed1976

Encephalography using supra-occipital tapping of the cisterna magna.

A report is given of the results of supra-occipital tapping of the cisterna magna and dynamic encephalography by that route. In 72 patients with cranial hypertension this encephalography was well tolerated. Supra-occipital tapping is less dangerous than suboccipital puncture as regards the possibility of injury to the medulla. In 38 cases, the method led immediately to the diagnosis of herniation of the tonsils.

Encephalocele↗
PubMed1990

[Cavum vergae, cyst of cavum septi pellucidi, mega cisterna magna, and general fibrosis syndrome].

One family of 17 cases of general fibrosis syndrome was reported. Four out of five patients examined with CT and/or MRI revealed cavum vergae or cyst of the cavum septi pellucidi or mega cisterna magna, which were characterized by existing on the midline of the brain. The patient with cavum vergae had also platybasia. In one patient, surgical correction of vertical deviation and blepharoptosis of both eyes was performed. There was abnormal insertion of the superior and inferior rectus muscles in posterior and nasal direction, and adhesion of the superior oblique muscle to the superior rectus muscle at the point of it's insertion was found in both eyes. Histopathological findings of the extraocular muscles of two patients showed mixture of relatively normal muscle tissues and vast amounts of collagen fibers. Electron microscopically many glycogen granules were found in muscle fibers. From these findings, this syndrome may be based on failure in development and differentiation.

Adult↗
PubMed2003

Single blood injection into the ventral cisterna magna through a microcatheter for the production of delayed cerebral vasospasm: experimental study in dogs.

BACKGROUND AND PURPOSE: We developed an experimental canine subarachnoid hemorrhage (SAH) model in which one-time blood injection by means of a microcatheter into the ventral cisterna magna (CM) is performed without direct CM puncture. We assessed the severity and duration of the vasospasm produced in this model. METHODS: Fresh autologous blood (0.25 or 0.5 ml/kg) or saline (0.5 ml/kg) was injected into the ventral CM of dogs through a microcatheter inserted at the lumbar region. Serial angiograms were obtained on days 3, 7, 10, and 14, and chronologic changes in the mean diameter of the basilar artery (BA) were recorded. The BA was examined histologically on day 7 after injection. RESULTS: A remarkable amount of clot was present in front of the brain stem at 24 hours after SAH induction. The clot was smaller in the 0.25 ml/kg SAH than in the 0.5 ml/kg SAH group. On day 3, narrowing of the BA was apparent in both SAH groups compared with the control (P <.05). The BA gradually returned to nearly normal on day 14 in the 0.25 ml/kg SAH group. Arterial narrowing was more severe and persistent in the 0.5 ml/kg SAH than in the 0.25 ml/kg SAH group (P <.05). Histologic examination of the BA on the 7th postinjection day confirmed narrowing of the lumen, indicative of arterial spasm, in both SAH groups. CONCLUSION: Our method of SAH induction by means of a single injection of blood directly into the ventral CM through a microcatheter induced severe, prolonged spasms in the canine BA. Because our model facilitates the induction of different-sized clots, we could control of the severity and duration of the induced vasospasms.

Animals↗
PubMed2003

Effect on cerebral vasospasm of coil embolization followed by microcatheter intrathecal urokinase infusion into the cisterna magna: a prospective randomized study.

BACKGROUND AND PURPOSE: Vasospasm remains the leading cause of death and permanent neurological disability in patients with aneurysmal subarachnoid hemorrhage (SAH). The objective of our prospective randomized trial of coil embolization followed by intrathecal urokinase infusion into the cisterna magna (ITUKI therapy) was to test its effectiveness in preventing or alleviating the severity of ischemic neurological deficits caused by vasospasm. METHODS: We enrolled 110 patients with ruptured intracranial aneurysms eligible for coil embolization and randomly assigned them to embolization with (n=57) or without (n=53) ITUKI therapy performed within 24 hours of aneurysmal SAH. The incidence of symptomatic vasospasms and the clinical outcomes, based on the Glasgow Outcome Scale, 6 months after SAH onset were assessed. RESULTS: There were no side effects or adverse reactions attributable to ITUKI therapy. Symptomatic vasospasm occurred in 5 patients (8.8%) with and 16 (30.2%) without ITUKI therapy; the difference was significant (P=0.012). Although the mortality rate did not differ between the groups, patients with ITUKI therapy had significantly better outcomes than those without (P=0.036). CONCLUSIONS: Our results demonstrate that ITUKI therapy significantly reduced the occurrence of symptomatic vasospasm. Although it did not completely prevent vasospasms, ITUKI therapy resulted in a lower rate of permanent neurological deficits.

Adult↗
PubMed2001

Cisterna magna clot and subsequent post-hemorrhagic hydrocephalus.

BACKGROUND: Posthemorrhagic hydrocephalus (PHH) is an ominous complication of intraventricular hemorrhage (IVH) in premature infants. Previous studies have correlated lateral intraventricular clot with subsequent PHH, but there are no studies assessing the outcome of clot in the cisterna magna (CM). OBJECTIVE: The purpose of this study was to determine if the identification of clot in the CM on the initial positive cranial ultrasound for intraventricular hemorrhage increased the risk of subsequent PHH. MATERIALS AND METHODS: A review of ultrasound records over a 4-year period identified 41 neonates with at least grade 2 IVH who had specific CM views prospectively performed. RESULTS: Thirty-six survived more than 3 months. Overall, 22 (61%) developed hydrocephalus. On the initial positive cranial ultrasound, CM blood was identified in 21 (58%). Of these 18 (86%) developed hydrocephalus [odds ratio (OR) 16.5, confidence interval (CI) 2.5-125.7, P < 0.001] and 14 (67%) required intervention or remained dilated (OR 28.0, CI 2.8-1265.8). All patients that required permanent shunt placement had initial CM clot (P < 0.01). Initial ventriculomegaly was not a significant predictor of subsequent hydrocephalus, but a dilated third ventricle (> or = 8 mm) was (OR 9.0, CI 1.2-103.3, P < 0.04). Asymmetric intraventricular clot filling of more than 50% was not predictive of hydrocephalus, but symmetric clot of more than 50% was (OR 10.8, CI 1.4-61.6, P < 0.01). Nine neonates had concomitant parenchymal damage with varying outcomes (three shunted, two persistent ventriculomegaly, four resolved with normal sized ventricles). CONCLUSION: In this study CM clot significantly increased the risk and was a better predictor of posthemorrhagic hydrocephalus than initial hydrocephalus.

Cerebral Hemorrhage↗
PubMed2003

Prenatal diagnosis of occipital encephalocele, mega-cisterna magna, mesomelic shortening, and clubfeet associated with pure tetrasomy 20p.

We present the first case of a fetus with pure tetrasomy 20p proven by cord-blood sampling at 24 weeks of gestation. This case was diagnosed in utero with multiple congenital anomalies including occipital encephalocele, mega-cisterna magna, mesomelic shortening, and clubfeet. An analysis of GTG-banded chromosomes of 20 metaphase cells was performed. Female karyotype [47,XX, +i(20)(p10)] was revealed in all cells. Pure tetrasomy 20p was confirmed using fluorescent in situ hybridization (FISH) with a telomere probe for chromosome 20p in all seven metaphase cells. The pregnancy was terminated because of associated multiple anomalies and severe oligohydramnios. The postmortem examination confirmed the prenatal diagnosis.

Abnormalities, Multiple↗
PubMed2000

[A case of hematoma in cisterna magna after mild head injury].

An 18-year-old man suffered severe neck pain, signs of meningeal irritation, and dysesthesia of his left breast and left arm after mild head injury incurred in a traffic accident. On the next day, magnetic resonance imaging(MRI) revealed a hematoma in the cisterna magna, and it extended into the posterior spinal subdural space. Eight days after admission, MRI demonstrated the hematoma on the right posterior aspect of the spinal cord at the level of craniovertebral junction. These MRI findings suggested a ruptured bridging dorsal vein from the spinal cord to the occipital or marginal sinus. The usefulness of MRI for diagnosis of localized hematoma around the craniovertebral junction and the mechanism of this hemorrhage are discussed.

Accidents, Traffic↗
PubMed1983

Method for cisterna magna perfusion of synthetic cerebrospinal fluid in the awake goat.

We developed a method to produce stable alterations in the ionic composition of the medullary chemoreceptor environment. A double-lumen catheter system (Hustead epidural needle and epidural catheter) was placed through a plastic cisternal guide tube into the cisterna magna of awake goats. A push-pull perfusion system using a modified infusion pump delivered matched cerebrospinal fluid (CSF) perfusate inflow and outflow of 3.1 ml/min. Ventilation changed within 15 min of the initiation of perfusion and reached steady state within 45-65 min. Steady-state ventilatory responses could be maintained for up to 240 min and were readily reversed in response to a change in [HCO-3]. Perfusions with normal mock CSF ( [HCO-3] = 23 meq/l) caused no change from nonperfused values. Over the range of CSF perfusate [HCO-3] used (13.5-34.4 meq/l), the gain of the steady-state ventilatory response averaged 0.6 Torr X meq-1 X l. [3H]inulin and [HCO-3] were equal in inflow and outflow by 20-30 min of perfusion indicating complete mixing of bulk CSF in the cistern. Anatomic study after methylene blue dye perfusion showed dye distribution to subarachnoid spaces of midbrain, cervical cord, cerebellum, medulla, and most of the cortex but not to any ventricles. This perfusion technique produces prolonged, stable, reproducible, and repeatable changes in the medullary chemoreceptor ionic environment of awake goats, is relatively atraumatic, and permits high flow through the cisternal subarachnoid space.

Animals↗
PubMed2003

An alternative method of chronic cerebrospinal fluid collection via the cisterna magna in conscious rhesus monkeys.

Models of chronic cerebrospinal fluid (CSF) collection previously have been established for nonhuman primates and canines; many of these methods implement stainless-steel cannulas into the lateral or 4th ventricles or catheters into the cerebral or spinal subarachnoid space. These models have proved successful and reliable but unfortunately require invasive techniques to pass through the skull or require a laminectomy to enter the spinal subarachnoid space, involve the use of expensive and highly specialized stereotaxic equipment for the precise placement of the implants, and may require exteriorized hardware which is cumbersome to maintain and unaesthetic. The model we developed for the rhesus monkey allows for direct access to CSF outflow from the cisterna magna by using a 3.5-French fenestrated silicone catheter which was placed 1.0 cm into the cisterna. The catheter was attached to a titanium port placed subcutaneously between the scapulae to permit easy access for sampling CSF in a conscious, chaired rhesus monkey. We currently have instrumented animals from which we have consistently collected CSF for over 18 months. This novel, economical, less-invasive method permits chronic, reliable collection of CSF in conscious rhesus monkeys and has the additional advantages that the model is easier to maintain and more aesthetic.

Animals↗
PubMed1991

Measurements of regional cerebral blood flow and blood flow velocity in experimental intracranial hypertension: infusion via the cisterna magna in rabbits.

Cerebral blood flow velocity, as measured in the intracranial segment of the internal carotid artery by transcranial Doppler sonography via the transorbital route, and regional cerebral blood flow and volume in corresponding cortical areas, as measured by the hydrogen clearance technique, were recorded for eight New Zealand White rabbits subjected to infusion via the cisterna magna to elevate intracranial pressure. In the lower range of autoregulation, that is, at perfusion pressures between 80 and 40 mm Hg and even lower, the changes in cerebral blood flow velocity and cerebral blood flow showed a strong correlation (0.86) under conditions of standard pCO2 (PaCO2 = 35 +/- 2 mm Hg). Autoregulation was exhausted at 40 mm Hg, and the cerebrovascular resistance was minimal. Below this perfusion pressure, the cerebral blood flow and volume dropped sharply, whereas the cerebrovascular resistance gradually increased, indicating that, despite the maximally dilated resistance vessels, intracranial hypertension causes vascular resistance to increase, possibly via blocking of the venous outflow. Our results confirmed that noninvasive and easily (even at bedside) applicable measurements of changes in cerebral blood flow velocity could be a substitute for the cumbersome and expensive isotope measurements of cerebral blood flow in patients with intracranial hypertension.

Animals↗
PubMed2006

Effect of graded hyperventilation on cerebral metabolism in a cisterna magna blood injection model of subarachnoid hemorrhage in rats.

In subarachnoid hemorrhage (SAH) with cerebrovascular instability, hyperventilation may induce a risk of inducing or aggravating cerebral ischemia. We measured cerebral blood flow (CBF) and cerebral metabolic rates of oxygen (CMRO2), glucose (CMRglc), and lactate (CMRlac) at different PaCO2 levels after experimental SAH in rats (injection of 0.07 mL of autologous blood into the cisterna magna). Four groups of Sprague-Dawley male rats were studied at predetermined PaCO2 levels: group A: normocapnia (5.01-5.66 kPa [38.0-42.0 mm Hg]); group B: slight hyperventilation (4.34-5.00 kPa [32.5-37.5 mm Hg]); group C: moderate hyperventilation (3.67-4.33 kPa [27.5-32.4 mm Hg]); group D: profound hyperventilation (3.00-3.66 kPa [22.5-27.4 mm Hg]). Each of the four groups included eight rats with SAH and eight sham-operated controls. CBF was determined by the intracarotid Xe method; CMRo2, CMRglc, and CMRlac were obtained by cerebral arteriovenous differences. In both SAH rats and controls, hyperventilation decreased CBF in proportion to the decrement in PaCO2 without affecting either CMRO2, CMRglc, or CMRlac. In groups C and D, CBF decreased by 20%-35%, but CMRs were maintained by a compensatory increase in oxygen extraction fraction (OEF). The results show that even profound hyperventilation in this model of SAH is associated with an adequate increase in OEF so that CMRs of oxygen, glucose, and lactate remain similar to levels observed in normocapnic conditions.

Animals↗
PubMed2000

Studies of cerebrospinal fluid flow and penetration into brain following lateral ventricle and cisterna magna injections of the tracer [14C]inulin in rat.

Parasynaptic communication, also termed volume transmission, has been suggested as an important means to mediate information transfer within the central nervous system. The purpose of the present study was to visualize by autoradiography the available channels for fluid movement within the extracellular space following injection of the inert extracellular marker [14C]inulin into the lateral ventricle or cisterna magna. Bolus injections of 5 microl of 1 microCi of [14C]inulin were made in awake rats via chronically implanted cannulae. After survival times ranging from 5 min to 4 h, brains were processed for in vivo autoradiography. At 5 min the tracer distributed throughout the ventricles, subarachnoid spaces and cisterns "downstream" of the injection sites. Penetration into the brain from these sites was complex with preferential entry along the ventral side of the brain, especially into the hypothalamus and brainstem. By 4 h virtually the entire brain was labeled irrespective of the site of tracer application. Sustained tracer entry from subarachnoid spaces suggests that some areas act as depots to trap circulating material. This mechanism may contribute to the pattern of deep penetration at later time-points. The spatial and temporal characteristics of fluid movement throughout the brain are instructive in the interpretation of many experimental procedures involving injection of molecules into the cerebrospinal fluid.

Animals↗
PubMedDate not supplied

A new technique: serial puncture of the cisterna magna for obtaining cerebrospinal fluid in the mouse--application in a model of herpes simplex virus encephalitis.

This report describes a new technique for obtaining cerebrospinal fluid from the living mouse (SJL/NBom) in a model of herpes simplex virus encephalitis which is also applicable to other mouse models. The puncture technique was performed in living animals which had been infected with Herpes Simplex Virus Type I strain F in the living animal. The cisterna magna was micro-surgically prepared: The neck muscles were dissected microscopically down to the dura which subsequently was punctured by a glass micropipette. This newly developed minimally invasive technique was performed in a group of living animals (n = 20) and results compared with those of a second group of perfusion fixed animals (n = 20). For the first time, repeated cerebrospinal fluid punctures of individual, living animals are possible. This is of great value for the assessment of new therapeutic and diagnostic strategies in experimental research using mouse models. In addition, this refined methodology significantly reduces the number of experimental animals.

Animals↗
PubMedDate not supplied

A case of Isaacs syndrome with high CSF protein and a large cisterna magna.

An 11-year-old boy exhibited continuous muscle fiber activity. He had suffered from stiffness of his hands, difficulty in relaxing his hands after gripping, and making skilled movements with his fingers. His clinical symptoms improved after treatment with carbamazepine. Electromyography (EMG) showed that he had continuous electrical discharges both at rest and during sleep. These discharges completely disappeared after the peripheral nerve was blocked with Lidocaine. An evoked electromyogram showed suppression of abnormal discharges after the F response. These electrophysiological findings indicated that the disorder originated in the spinal anterior horn cells. CT scanning showed a large cisterna magna in the posterior cranial fossa. Protein in the cerebrospinal fluid was elevated.

Carbamazepine↗
PubMed1988

[A syndrome due to pathology of the base of the inferior cerebellar peduncle in cystic-adhesive arachnoiditis of the cisterna magna and craniospinal area].

A syndrome is described which emerged with the lesions localized in the dorsal parts of lower cerebellar limbs just at their branching from medulla. Spinocerebellar pathways are damaged as well as those of profound sensitivity from Gall and especially Burdach nuclei, the latter giving fibers which partially run along the lower limb to cerebellum. The postural inclination toward the afflicted side is characteristic of the patients in a standing position. Vibration sensitivity is impaired ipsilaterally and predominantly on the foot. The truncal inclination increases when eyes are closed. This syndrome was detected in 115 patients with cisterna magna or craniospinal arachnoiditis. The focus has been confirmed by pneumoencephalography in 110 patients and during surgical interventions on the posterior cerebral fossa in 5 patients.

Adult↗
PubMed1994

A technique for cannulating the Cisterna magna and sampling cerebrospinal fluid from socially housed birds.

The measurement of central levels of neurochemicals is an important approach to the understanding of the neurophysiological basis of behavior patterns in animals. Previous studies have utilized central sampling techniques developed for individually housed animals. The purpose of this study was to develop a cannulation technique and a method for sampling cerebrospinal fluid (CSF) from socially housed birds to facilitate the study of the neurophysiological basis of social behaviors. The cannulation technique involved the surgical implantation of a 22-gauge concentric guide cannula into the cisterna magna of 16-wk-old, feed-restricted male broiler breeders (n = 6). Individual-specific coordinates and optimum angle and depth of implantation of the cannula were determined in order to place the cannula correctly in the designated site. Once implanted, the guide cannula proved to be unobtrusive and secure and did not attract aggressive pecking from other birds in the pen. Two methods of CSF sampling were then examined. The first method required the use of a push-pull perfusion pump to withdraw CSF at a rate of 1 to 2 microL/min. The second method (passive), which did not use a pump, involved simply removing a "dummy" cannula from the guide cannula to release the CSF, which was then collected with a glass Hamilton syringe. Samples ranging from 100 to 500 microL were collected using the passive method. The combination of the cannulation technique described and the passive sampling method proved to be the most simple, efficient, and reliable method for measuring central levels of neurochemicals in socially housed broiler breeder males.

Animals↗