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PubMedDate not supplied

Percutaneous catheter placement for cyst drainage in the subarachnoid space.

A technique for percutaneous catheter drainage of cystic masses in the subarachnoid space was developed and shown to be safe and effective in an 18-year-old boy with life-threatening, recurrent neuroenteric cysts that compressed the brain stem, cerebellum, and spinal cord. Percutaneous drainage through a C1-C2 approach was performed on 11 separate occasions. Decompression was always accomplished and no infection or other complication occurred, even with continuous catheter drainage for 9 months. This technique provides opportunities for interventional neuroradiologic therapy in the subarachnoid space. It appears to be suited for percutaneous drainage of intraspinal and intracranial cysts when surgery is not indicated due to intractability or inaccessibility.

Adolescent↗

PubMed1989

[Infiltration of India ink from subarachnoid space to nasal mucosa along olfactory nerves in rabbits].

The mode of the transportation of India ink to the nasal cavity was studied when it was given to the subarachnoid space chiefly through facial nerve sheath and partly by cisterna magna injection. From subarachnoid space India ink infiltrated through perineurium, epineurium and perineural space of the fila olfactoria and of olfactory nerve fibers to lamina propria of the olfactory mucosa and spread also to the respiratory mucosa. It was further taken into lymphatic vessels and accumulated in bilateral cervical lymph nodes. In normal rabbits, India ink didn't penetrate the basement membrane into the epithelial layer at all, but in rabbits with chronic rhinitis showing edema, degeneration and destruction of mucosa, India ink was found to pass easily through the basement membrane into the epithelial layer and further to leak into the nasal cavity in all cases. It was a new finding that in cases with rhinitis large particles like India ink could infiltrate from the subarachnoid space to the nasal cavity passing through the nasal mucosa, and was considered to be a possible cause of idiopathic cerebrospinal fluid rhinorrhea.

Animals↗

PubMed1976

Chronic catheterization of the spinal subarachnoid space.

To administer drugs into the spinal subarachnoid space of unanesthetized and intact rats and rabbits, a procedure is described whereby a polyethylene catheter (PE-10) may be inserted through a puncture of the atlanto-occipital membrane and secured to the skull. Calibration experiments carried out with bromophenol blue dye, 3H-naloxone and 14C-urea revealed first, that there was little rostro-caudal diffusion of the injectate along the spinal axis and secondly, that even for compounds such as naloxone which can rapidly permeate neural tissues, the levels which do appear in the brain are small following the spinal subarachnoid administration of the drug. Control injections, administered either acutely or repeatedly over a prolonged period of time, had no detectable effect on the animal's behavior. These observations, as well as the lack of pathology in the spinal cords of rats having such catheters for periods of up to 4 months suggests that the implant is well tolerated.

Animals↗

PubMed2002

Gene transfer of hepatocyte growth factor to subarachnoid space in cerebral hypoperfusion model.

Although cerebral hypoperfusion caused by cerebral occlusive disease leads to cerebral ischemic events, an effective treatment has not yet been established. Recently, a novel therapeutic strategy for ischemic disease using angiogenic growth factors to expedite and/or augment collateral artery development has been proposed. Therapeutic angiogenesis might be useful for the treatment of cerebral occlusive disease. Hepatocyte growth factor (HGF) is a potent angiogenic factor, in addition to vascular endothelial growth factor (VEGF), whereas in the nervous system HGF also acts as neurotrophic factor. Therefore, we hypothesized that gene transfer of these angiogenic growth factors could induce angiogenesis, thus providing an effective therapy for cerebral hypoperfusion or stroke. In this study, we employed a highly efficient gene transfer method, the viral envelop (Hemagglutinating Virus of Japan [HVJ]-liposome) method, because we previously documented that beta-galactosidase gene could be transfected into the brain by the HVJ-liposome method. Indeed, we confirmed wide distribution of transgene expression using beta-galactosidase via injection into the subarachnoid space. Of importance, transfection of HGF or VEGF gene into the subarachnoid space 7 days before occlusion induced angiogenesis on the brain surface as assessed by alkaline phosphatase staining (P<0.01). In addition, significant improvement of cerebral blood flow (CBF) was observed by laser Doppler imaging (LDI) 7 days after occlusion (P<0.01). Unexpectedly, transfection of HGF or VEGF gene into the subarachnoid space immediately after occlusion of the bilateral carotid arteries also induced angiogenesis on the brain surface and had a significant protective effect on the impairment of CBF by carotid occlusion (P<0.01). Interestingly, coinjection of recombinant HGF with HGF gene transfer revealed a further increase in CBF (P<0.01). Here, we demonstrated successful therapeutic angiogenesis using HGF or VEGF gene transfer into the subarachnoid space to improve cerebral hypoperfusion, thus providing a new therapeutic strategy for cerebral ischemic disease.

Animals↗

PubMed2000

Methotrexate distribution within the subarachnoid space after intraventricular and intravenous administration.

PURPOSE: Intrathecal methotrexate achieves high concentrations in cerebrospinal fluid (CSF), but drug distribution throughout the subarachnoid space after an intralumbar dose is limited. The objective of this study was to quantify methotrexate distribution in CSF after intraventricular and intravenous administration and to identify factors that influence CSF distribution. METHODS: Nonhuman primates (Macaca mulatta) with permanently implanted catheters in the lateral and fourth ventricles received methotrexate by bolus injection (0.5 mg) and infusion (0.05 to 0.5 mg/day over 24 to 168 h) into the lateral ventricle, as well as intravenous infusions. CSF was sampled from the lumbar space, fourth ventricle and the subarachnoid space at the vertex. Methotrexate in CSF and plasma was measured with the dihydrofolate reductase inhibition assay. RESULTS: After bolus intraventricular injection, methotrexate exposure in lumbar CSF ranged from 11% to 69% of that achieved in the fourth ventricle. During continuous intraventricular infusions, methotrexate steady-state concentrations (C(ss)) in lumbar CSF and CSF from the vertex were only 20% to 25% of the ventricular CSF C(ss). The dose, duration of infusion, and infusate volume did not influence drug distribution to the lumbar CSF, but probenicid increased the lumbar to ventricular C(ss) ratio, suggesting the involvement of a probenicid-sensitive transport pump in the efflux of MTX from the CSF. During the intravenous infusions, the ventricular methotrexate C(ss) was lower than the lumbar C(ss) and the C(ss) in CSF from the vertex. CONCLUSION: Methotrexate CSF distribution after intraventricular injection was uneven, and at steady-state CSF methotrexate concentrations were lower at sites that were more distant from the injection site.

Animals↗

PubMed1989

[Substantiation of puncture perfusion of the subarachnoid space in experiments with biomanikins].

Experiments were performed in 30 biomannequins. Single puncture subarachnoidal perfusion cleared the subarachnoidal spaces of the brain and medulla free of preinjected dye. The clearance was more radical at the base, in the brain hemisphere cysterns and sulci, at the pons, medullar and spinal levels. This can be regarded as anatomical ground for the expedience of puncture perfusion in order to clear the subarachnoidal space.

Adult↗

PubMed1996

Lumbar catheterization of the spinal subarachnoid space in the rat.

The method commonly used for catheterization of the lumbar subarachnoid space in the rat implies inserting the catheter through the atlanto-occipital (A-O) membrane and moving the catheter caudally along the spinal cord. The method is associated with a considerable morbidity. A method for direct catheterization of the lumbar subarachnoid space was therefore developed. Major surgery was avoided by using a catheter-through-needle technique. Of 32 rats, none died. There were no signs of neurological disturbances, and all animals gained weight as normal the first week after implantation. Data from rats catheterized by the A-O method were used for comparison. Of 40 animals, 2 died, 11 showed signs of neurological disturbances, and the mean weight was reduced during the first week after catheterization. The two groups of animals showed different behavioural responses to intrathecal injection of N-methyl-D-aspartate (NMDA, 0.1-1.6 mM, 15 microliters) which is thought to stimulate afferent pathways mediating nociception. Animals with a lumbar catheter showed licking, biting and scratching behaviour in a dose-related manner for concentrations up to 1.6 mM. The animals with A-O catheters showed a maximum level of this behaviour already at 0.4 mM, while 0.5 mM induced convulsions. A possible explanation of this difference in response to NMDA could be a long-lasting pain state in the A-O group, caused by catheter-induced changes in the spinal cord and by the extensive surgery. It is concluded that the direct lumbar catheterization has several advantages compared to the A-O method, decreasing the suffering of the animals, the neurological disturbances and the interference with nociceptive functions of the spinal cord.

Animals↗

PubMed1996

Pericerebral fluid collection: differentiation of enlarged subarachnoid spaces from subdural collections with color Doppler US.

PURPOSE: To determine if the cerebral cortical vain sign seen on magnetic resonance (MR) images can be used with color Doppler ultrasound (US) to differentiate enlarged subarachnoid space from subdural collection. MATERIALS AND METHODS: Eighteen infants with pericerebral fluid collection were prospectively examined with color Doppler US and MR imaging. Patients were classified into two groups: group A, with positive cortical vein sign (visualization of color-coded cortical veins that cross fluid collections at cerebral convexities); and group B, without the sign. RESULTS: Positive cortical vein sign was seen at US in 12 patients (group A): nine with benign enlargement of subarachnoid spaces, two with brain atrophy, and one with meningococcal meningitis. The veins were displaced and embedded within the echogenic pia-arachnoid that surrounds the brain or were trapped in the subarachnoid spaces between the neo-membrane and cortical surface (group B, negative cortical vein sign) in four patients with meningitis, two victims of child abuse, and one patient with leukemia. Findings from subsequent MR imaging confirmed the color Doppler US findings. CONCLUSION: Color Doppler US depiction of the cortical vain sign appears to be as effective as MR imaging in differentiating enlargement of the subarachnoid fluid space from subdural effusion.

Brain↗

PubMed1983

GnRH in the spinal subarachnoid space potentiates lordosis behavior in the female rat.

Gonadotropin releasing hormone (GnRH) (100 ng) infused directly into the spinal subarachnoid space via a chronically implanted catheter, induced a prompt facilitation of lordosis behavior in estrogen-primed ovariectomized female rats. Facilitation occurred within 5 min and lasted for 3 1/2 hr. This effect of GnRH could be blocked by a GnRH antagonist analog, [D-Phe2, Pro3, D-Phe6] GnRH (250 ng) which also completely abolished lordosis within 2 1/2 hr. The antagonist analog (250 ng) but not a high titre specific anti-GnRH antiserum (enough to neutralize 24 micrograms of GnRH) abolished lordosis when infused alone in the subarachnoid space in estrogen-primed rats. The antagonist but not the anti-GnRH antiserum also significantly suppressed lordosis in estrogen-progesterone primed female rats. Supporting experiments showed that the effects of GnRH and its antagonist may not be due to their effects on supraspinal structures by diffusion from the spinal subarachnoid space. These results may indicate a direct effect of GnRH and its antagonist at the level of the spinal cord and may suggest a possible role for GnRH in the processing of somatosensory information necessary for the trigger of lordosis.

Animals↗

PubMed1975

Scanning electron microscopy of the subarachnoid space in the dog. III. Cranial levels.

Young dogs were anesthetized by intrathoracic injection of sodium pentobarbital and perfused with buffered aldehydes. Lining tissue samples from the cranial subarachnoid space were prepared for scanning electron microscopy (SEM) by postfixing in buffered OSO4. Samples were then dehydrated, dried in a Critical Point Drying System, and coated with carbon and palladium-gold. Specimens were viewed in a Cambridge S4 scanning electron microscope. After thorough scanning, selected samples were routinely prepared for transmission electron microscopy (TEM) and viewed in a Philips EM-200 transmission electron microscope. This study depicts the surface morphology of the meningeal linings of the cranial subarachnoid space. The cranial pia mater possesses natural gaps or fenestrations between cells. SEM reveals a more complex morphology of arachnoid trabeculae than previously interpreted from light and transmission electron microscopy. Many free cells are observed on the meningeal linings of the subarachnoid space. The present study establishes that these free cells are macrophages by means of definitive TEM correlates. Microvillous-like processes extending between macrophages and the pial surface are present. The frequency and the nature of these thin processes suggest the possibility of a plasmalemma-mediated system of communication.

Animals↗

PubMed2001

Gene therapy for preventing neuronal death using hepatocyte growth factor: in vivo gene transfer of HGF to subarachnoid space prevents delayed neuronal death in gerbil hippocampal CA1 neurons.

To develop a novel strategy to prevent delayed neuronal death (DND) following transient occlusion of arteries, the gene of hepatocyte growth factor (HGF), a novel neurotrophic factor, was transfected into the subarachnoid space of gerbils after transient forebrain ischemia. Importantly, transfection of HGF gene into the subarachnoid space prevented DND, accompanied by a significant increase in HGF in the cerebrospinal fluid. Prevention of DND by HGF is due to the inhibition of apoptosis through the blockade of bax translocation from the cytoplasm to the nucleus. HGF gene transfer into the subarachnoid space may provide a new therapeutic strategy for cerebrovascular disease.

Animals↗

PubMed1993

Intradural parenchymal involvement in the spinal subarachnoid space associated with primary lung cancer.

BACKGROUND: Intradural parenchymal involvement (IPI) in the spinal subarachnoid space associated with primary lung cancer is rare. A retrospective study was undertaken to investigate the clinical and pathologic features of IPI. METHOD: A total of 1215 cases of primary lung cancer were studied at autopsy; the results were reviewed retrospectively. RESULTS: Twenty (1.65%) of the cases revealed IPI in the spinal subarachnoid space. The histologic diagnoses were small cell carcinoma in ten cases, adenocarcinoma in eight cases, and squamous cell carcinoma in two cases. In 14 (70%) cases, the IPI was located between the lumbar and cauda equina of the spinal cord. However, no metastases were observed in the cervical spinal cord. Brain metastasis, vertebral metastasis, and meningeal carcinomatosis were seen in 70%, 60%, and 40% of the 20 cases, respectively, suggesting that these metastases may be related to the metastatic pathway to the spinal cord. Most patients had neurologic symptoms or signs referable to IPI; IPI could be diagnosed before death in only one patient by magnetic resonance imaging. The median interval between diagnosis of lung cancer and development of IPI and median survival after the onset of neurologic symptoms referable to IPI were 415 days and 110 days, respectively. CONCLUSION: The authors retrospectively received 1215 autopsies of patients with primary lung cancer and found 20 (1.65%) with IPI.

Adult↗

PubMed1990

A rabbit model for evaluation of spinal anesthesia: chronic cannulation of the subarachnoid space.

A rabbit model for evaluation of spinal anesthesia is presented. Chronic cannulation of the subarachnoid space was performed in 44 rabbits using the translumbar approach. An autopsy was performed 24 h after the operation on four of the animals. Intrathecal injections of methylene blue did not reveal any leakage from the spinal space. X-ray examination performed on the second and 30th days after the implantation indicated free spread of the injected solution in the subarachnoid space without any obstruction. Repeated injections of four identical doses of bupivacaine at 3-day intervals showed reproducible pharmacologic effects. Administration of different doses of the anesthetic produced a clear dose-response relationship. The relative activity of the anesthetic agents was found to be identical to that previously obtained in humans. No significant complications after the implantation have been recorded. We suggest the current model as an additional appropriate tool for the investigation of spinal anesthesia.

Anesthesia, Spinal↗

PubMed1998

Compressive lesions of the abducens nerve in the subarachnoid space disclosed by thin-slice magnetic resonance imaging.

We evaluated the usefulness of thin-slice magnetic resonance (MR) imaging as a tool for diagnosing compressive lesions of the abducens nerve in the subarachnoid space. We performed thin-slice MR imaging of the brain stem in two patients with abducens nerve palsy. Thin-slice MR images showed the abducens nerves in the subarachnoid space and clearly showed compressive lesions of the nerves by a brain tumor in both cases. These findings suggest that thin-slice MR imaging is useful for the evaluation of compressive lesions of the abducens nerve in the subarachnoid space.

Abducens Nerve↗

PubMed1978

Absence of formation of cerebrospinal fluid in the spinal subarachnoid space of the cat.

It is widely believed that formation of cerebrospinal fluid (CSF) takes place within the cerebral ventricles--80 to 85% being produced by the choroid plexus and the remaining 15 to 20% being secreted by the lining ependyma. It has also been suggested that CSF is formed within the subarachnoid space. To investigate this possibility. CSF formation was measured in the isolated subarachnoid space of the cat. In 16 animals that underwent 26 steady-state perfusions, the rate of formation of CSF was found to be only 0.00005 +/- 0.00056 (SE) ml/min. It is therefore concluded that little or no CSF is formed in the spinal subarachnoid space of the cat.

Animals↗

PubMedDate not supplied

Experiences with morphine injected into the subarachnoid space in sheep.

The effects of morphine (M), 0.1 mg/kg, administered into the lumbosacral subarachnoid space of sheep used for experimental stifle surgery, were investigated. In a pilot study, preservative-free morphine was administered to three sheep, morphine containing preservatives to two sheep, and saline (S) to one sheep. After recovery from anesthesia, all five sheep administered M displayed rear limb weakness. One sheep, which had received morphine containing preservatives, also licked and chewed incessantly at its flank and hindquarters during recovery. A group of 24 sheep was used to study the effects of morphine containing preservatives, injected intrathecally, on recovery from general anesthesia and hindlimb orthopedic surgery. Eight sheep received M, eight sheep received S, and eight sheep had a needle placed in the subarachnoid space without any injection (N). Times from end of anesthesia to standing varied greatly and did not differ significantly among groups (P = .73), with M sheep averaging 119 minutes; S sheep, 87 minutes; and N sheep, 83 minutes. One sheep administered M licked and chewed at its hindquarters during recovery. Another group of 24 sheep was used to study the effects of morphine containing preservatives, injected intrathecally, on postoperative lameness. Treatments were as described previously. Sheep were videotaped intermittently for 36 hours after surgery, and each sheep was scored as follows: 0 = not lame; 1 = slightly lame; and 2 = very lame. The average lameness scores, which did not differ significantly among groups (P = .21), were: M sheep, 1.07; S sheep, 0.81; and N sheep, 0.68. One sheep administered M displayed extensor spasms of the hindlimbs, and could not stand until several hours after surgery. We conclude that subarachnoid morphine at the dosage used produces no apparent benefit in sheep which have had stifle surgery, and in fact may cause detrimental side effects, such as hindlimb weakness, and pruritus or irritation of the hindquarters.

Analgesics, Opioid↗

PubMedDate not supplied

[An autopsy case of purulent meningitis, presenting high signals in subarachnoid space and ventricles in diffusion weighted images (DWIs)].

A 79-year-old, bedridden woman with an untreated colon cancer, developed abrupt disturbance of consciousness and high fever. Brain MRI showed significant high signals in the subarachnoid space and ventricles in diffusion-weighted images (DWIs), and she died on the same day. At autopsy, much exudate was found over the base of the brain, leading to a diagnosis of purulent meningitis. On histological findings, inflammatory cell infiltration was significantly restricted within the subarachnoid space, but not into the brain parenchyma. This case report demonstrated that high signals in subarachnoid space and ventricles in DWIs may be very useful for diagnosis of purulent meningitis.

Aged↗

PubMedDate not supplied

Value of a single-shot turbo spin-echo pulse sequence for assessing the architecture of the subarachnoid space and the constitutive nature of cerebrospinal fluid.

Three case history reports are presented to illustrate the value of the single-shot turbo spin-echo pulse sequence for assessment of the subarachnoid space. The use of the single-shot turbo spin-echo pulse sequence, which is a heavily T2-weighted sequence, allows for a rapid, noninvasive evaluation of the subarachnoid space by using the high signal from cerebrospinal fluid. This sequence can be completed in seconds rather than the several minutes required for a T2-fast spin-echo sequence. Unlike the standard T2-fast spin-echo sequence, a single-shot turbo spin-echo pulse sequence also provides qualitative information about the protein and the cellular content of the cerebrospinal fluid, such as in patients with inflammatory debris or hemorrhage in the cerebrospinal fluid. Although the resolution of the single-shot turbo spin-echo pulse sequence images is relatively poor compared with more conventional sequences, the qualitative information about the subarachnoid space and cerebrospinal fluid and the rapid acquisition time, make it a useful sequence to include in standard protocols of spinal magnetic resonance imaging.

Animals↗