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PubMed1989

Capillary tube isotachophoresis of proteins in early postmortem serum, cerebrospinal fluid and pericardial fluid.

Serum, cerebrospinal fluid (CSF) and pericardial fluid (PDF) obtained from 22 early cadavers were subjected to capillary tube isotachophoresis. Separated proteins were grouped into three main fractions, namely, Fr. 1, Fr. 2 and Fr. 3, in order of their decreasing effective (net) mobilities. The percentages of main fractions to total content were calculated by UV absorbance integration. It was found that Fr. 1 decreased and Fr. 2 increased in all three kinds of specimens with an increase in time following death. In serum and also in CSF, the degree of these changes between 6 and 58 hours following death seemed large enough (about 30%) to be used for crude estimations of early postmortem intervals. Changes in PDF proceeded more gradually than in serum and or in CSF, with only 5-20% changes during this period.

Adolescent↗
PubMed1973

Effect of cerebrospinal fluid shunts on intracranial pressure and on cerebrospinal fluid dynamics. 2. A new technique of pressure measurements: results and concepts. 3. A concept of hydrocephalus.

Part 2 describes measurements of intracranial cerebrospinal fluid (CSF) pressure in 18 adult patients with CSF shunts, all pressure measurements being referred to a horizontal plane close to the foramina of Monro. All 18 patients had normal CSF pressure by lumbar puncture; however, in one patient an intracranial pressure of +280 mm was subsequently measured after pneumoencephalography. Twelve patients had pre-shunt CSF pressures measured intracranially: 11 ranged from +20 to +180 mm H(2)O and one was +280 mm H(2)O in the supine position. In the upright posture nine patients had values of -10 to -140 mm H(2)O, while three others were +60, +70, and +280 mm H(2)O. After CSF shunting in these 18 patients the pressures were -30 to +30 mm H(2)O in the supine position and -210 to -370 mm in the upright position. The effect of posture on the siphoning action of these longer shunts in the erect, adult patient is a major uncontrollable variable in maintenance of intracranial pressure after shunting. Other significant variables are reviewed. In Part 3 a concept of the hydrocephalus phenomenon is described. Emphasis is placed on the pressure differential (P(d)) and force differential (F(d)) causing pre-shunt ventricular enlargement and post-shunt ventricular size reduction. The site of P(d), which must be very small and not to be confused with measured ventricular pressure, P, must be at the ventricular wall.

Adult↗
PubMed1986

[Function of the blood-cerebrospinal fluid barrier and selected biochemical cerebrospinal fluid components in senile dementias of various types].

Some selected CSF and serum components were determined in demental patients classified by the Hachinski test into vascular and primary-degenerative groups. As for the vascular group, the frequency distribution of the serum/CSF albumin ratios characterizing the barrier function corresponds to that of controls, in primary-degenerative cases, however, it is shifted to higher values. In vascular dementia higher CSF LAP activities pointing to actual cell damaging processes in the CNS were found. The concentrations of lactate and some trace metals in CSF and serum are not suitable for differential diagnostic purposes.

Aged↗
PubMed1989

Cerebrospinal fluid transthyretin in the neonate and blood-cerebrospinal fluid barrier permeability.

We measured transthyretin levels in the cerebrospinal fluid (CSF) of newborn infants, older children, patients with viral and bacterial meningitis, and adults with increased CSF protein levels. Neonatal CSF transthyretin levels are elevated disproportionately in comparison to levels in the other groups. We conclude that increased levels of transthyretin in the CSF of neonates are not explained by increased permeability of the blood-CSF barrier.

Adolescent↗
PubMed2006

Endoscopic management of cerebrospinal fluid rhinorrhea.

Cerebrospinal fluid rhinorrhea and meningoencephaloceles extending into the nasal cavity from the anterior, middle, and posterior cranial fossae often are managed by otolaryngologists. A thorough understanding of the underlying pathophysiology, management principles, and treatment options is essential to achieve optimal outcomes. Surgical and medical management is highly individualized and depends on many factors, including etiology, anatomic site, and underlying intracranial pressure. This article highlights the history, physiology, pathophysiology, diagnosis, surgical techniques, and postoperative care relevant to nasal cerebrospinal fluid leaks and encephaloceles.

Cerebrospinal Fluid Rhinorrhea↗
PubMed2002

Measurement of cerebrospinal fluid output through external ventricular drainage in one hundred infants and children: correlation with cerebrospinal fluid production.

OBJECTIVE: Cerebrospinal fluid (CSF) production rates influence shunt design and the care of children with hydrocephalus. Measurement of hourly CSF output through external ventricular drainage (EVD) reflects the CSF production. In the present study, hourly CSF outputs in children with hydrocephalus were measured while they were treated with EVD and correlated with the age, sex and body weight of the patients as well as other clinical parameters. METHODS: One hundred children with hydrocephalus due to various causes had EVD treatment. Twenty-six had EVD on two or three separate occasions; thus, the CSF output measurements were observed and analyzed on the basis of 130 EVDs. The most common reason for EVD treatment was shunt infection (n = 75). The duration of EVDs ranged from 25 to 774 h (mean 269 h). The height of the drip chamber from the mid-head position ranged from 0 to 23 cm (mean 9.8 cm). The hourly CSF output was analyzed according to the patient's age, sex and body weight as well as the presence of CSF infection. RESULTS: The hourly CSF output rapidly increases during the first year of life. By the second year, it reaches 64% of the hourly CSF output of 15-year-old children. The mean hourly output ranged from 0.1 to 26.5 ml/h (mean 8.1 ml/h), with the standard deviation ranging from 0.4 to 10.8 ml/h (mean 5.2 ml/h). A regression analysis indicated that the age and body weight appeared to correlate with the hourly CSF output. Using the natural logarithm of age, body weight and sex, these predictors accounted for 50.9% of the variability in hourly CSF output. The regression equation is as follows: hourly CSF output = 2.78 - 2.23(male = 0, female = 1) + 0.97 log(age in years) + 2.26 log(body weight in kg). R sd = 3.36, R(2) = 0.509. The type of infecting organism and the height of EVD did not influence the overall CSF output. CONCLUSION: The hourly CSF output fluctuates, but the CSF output increases logarithmically with age and body weight. The gender also influences the CSF output, with males having a greater output than females. The data produced by the present study will help us to understand CSF production rates in developing children. They will also help us in the care of children receiving EVD treatment, as well as in selecting and designing shunt systems.

Adolescent↗
PubMed1986

Pathophysiology of cerebrospinal fluid in head injury: Part 1. Pathological changes in cerebrospinal fluid solute composition after traumatic injury.

After head injury, many complex neurochemical events occur locally, at the site of initial injury, and globally, as a result of secondary phenomena. Neurochemical alterations in the cerebrospinal fluid after injury can be utilized to reflect these events. The authors review the role of the cerebrospinal fluid in the treatment of head injury as it relates to the diagnosis, prognosis, and further elucidation of the pathophysiological manifestations of head injury at the cellular and biochemical level.

Acetylcholine↗
PubMed1983

Ouabain-like activity in human cerebrospinal fluid.

Human cerebrospinal fluid has been found to mimic the effect of ouabain on net Na+ efflux and 86Rb+ influx across erythrocyte membranes and on the in vitro activity of a purified Na+/K+-ATPase (ATP phosphohydrolase, EC 3.6.1.3) derived from canine kidney. These results indicate the possible existence in human cerebrospinal fluid of an endogenous factor with ouabain-like activity, which might be linked to sodium metabolism.

Biological Transport, Active↗
PubMed1994

Surgical treatment of difficult cerebrospinal fluid otorhinorrhea.

Cerebrospinal fluid (CSF) otorhinorrhea may be a result of infection, congenital abnormality, trauma, or it may be iatrogenic. Despite its etiology, most cases of CSF otorhinorrhea resolve spontaneously or with conservative management. For those instances where the leak does not resolve, a large variety of drainage, packing, and obliteration procedures have been developed in an attempt to stop the CSF drainage and prevent the development of meningitis. Seven cases are reviewed that resulted in complete control of the leak with minimal morbidity. The authors' approach to difficult cerebrospinal fluid otorhinorrhea is presented and described in detail.

Aged↗
PubMed1975

On the tau-protein in cerebrospinal fluid.

128 cerebrospinal fluid samples were obtained. About 5 mul of each of the samples was subjected unconcentrated to agar gel electrophoresis. The remaining 44 of these samples were concentrated and the concentrates were electrophoresed. The proteins were stained. Analysis of the relative mobilities of the peaks makes two conclusions possible: the albumin in cerebrospinal fluid has the same electrophoretic mobility as purified serum albumin. The tau-protein possibly arises from transferrin by proteolytic breakdown, some products (such as the classical tau-protein) being less unstable than others (the intermediate peaks).

Albumins↗
PubMed2000

Otogenic cerebrospinal fluid rhinorrhea: a new technique for closure of cerebrospinal fluid leak.

OBJECTIVE: To describe a new technique for control of cerebrospinal fluid (CSF) rhinorrhea and to review alternative approaches. STUDY DESIGN: Five cases and literature review. SETTING: Tertiary referral center. PATIENTS: Five case study patients. INTERVENTION: Surgical. MAIN OUTCOME MEASURE: Control of CSF rhinorrhea. RESULTS: CSF rhinorrhea can be controlled through eustachian tube ligation in the nasopharynx, distal to all known pathways through which CSF leaks may occur from the temporal bone into the eustachian tube. CONCLUSION: Transoral eustachian tube ligation appears to be a safe and effective alternative to other techniques for controlling CSF rhinorrhea and should be included in the otologist's repertoire.

Adult↗