[Spontaneous intracranial hypotension syndrome. Clinical, neuroradiological and cerebrospinal fluid findings]. / Spontanes Liquorunterdrucksyndrom. Klinische, neuroradiologische, nuklearmedizinische und Liquor-Befunde.

We report 11 patients with orthostatic headache due to spontaneous intracranial hypotension. Nausea (3 patients) and abducens palsy (2 patients) were the main additional symptoms. Ten patients had CSF pleocytosis (6 to 43 white cells/microliter) and/or increased protein (581 to 1668 mg/l). CT and/or MRI documented bifrontal accentuated subdural hygromas and hematomas in 5 patients. MRI also documented diffuse meningeal gadolinium enhancement in all 4 patients examined, and descent of the brain in one. Cisternography was done in 9 patients and revealed a decreased or absent activity over the convexities and early detection of the tracer in the bladder in all, and a CSF leak at the cervicothoracal junction in 2 patients. Most patients improved with bed rest, increased fluid intake (oral or intravenous), steroids, and/or epidural blood patch. Subdural hematomas increased in 2 patients and have to be drained. Spontaneous intracranial hypotension is due to a CSF leak followed by decreased CSF volume and hydrostatic CSF pressure changes. The locations of the leaks are mainly cervical or at the cervicothoracal junction. MRI always documents diffuse meningeal gadolinium enhancement. Treatment of choice is an epidural blood patch. Surgical treatment may be needed in patients with subdural hematomas or meningeal diverticula. Prognosis is typically good, but subdural hematomas may occasionally lead to an increased intracranial pressure.

Proliferation-associated oxygen consumption and morphology of tumor cells in monolayer and spheroid culture.

The oxygen consumption rate, proliferative activity, and morphology of EMT6/Ro mouse mammary sarcoma cells in monolayer and multicellular spheroid culture have been investigated in a comparative study. During the transition of monolayer cells from the exponential into the plateau growth phase, there is a distinct decrease in the cellular volume that is associated with a corresponding decrease in the proliferative and respiratory activity of the cells. The decline in cell volume is mainly due to a decrease in the content of cytoplasm, whereas the size of the nucleus is only slightly reduced. A concomitant decrease in the number of mitochondria per cell obviously accounts for the reduction in cellular oxygen uptake. Despite a continuous decrease of cell proliferation from the surface to interior regions of EMT6 spheroids reflected by a gradient in tritiated thymidine labeling, volume-related oxygen consumption is rather uniform in viable regions of these aggregates. The finding can be explained by the results of the morphometric evaluation showing a uniform volume density of mitochondria, i.e., of oxygen-consuming sites within these spheroids.