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1.
Medicine (Baltimore) ; 95(29): e4281, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27442666

RESUMO

BACKGROUND: Bilateral paramedian thalamic infarctions (BPTIs) due to artery of Percheron occlusion are known to cause hypersomnia. However, the role of hypocretin-1, a wake-promoting peptide that is located at the lateral hypothalamus, in hypersomnia in these patients remains unclear. METHODS: To clarify the role of hypocretin-1 in hypersomnia in patients with BPTIs, hypocretin-1 levels in the cerebrospinal fluid (CSF) were measured in 6 patients with BPTIs: 2 with rostral midbrain involvement (BPT+RMI) and 4 without midbrain involvement (BPT-MI). RESULTS: CSF hypocretin-1 levels were decreased in 2 patients with BPT+RMI and were within normal ranges in 4 patients with BPT-MI. Hypersomnia was noted in all the patients. In one BPT+RMI patient, hypersomnia was improved within 2 weeks and decreased CSF hypocretin-1 levels were reversed (acute phase (on day 9), 109.2 pg/mL; chronic phase (at 3 months), 323 pg/mL), whereas another BPT+RMI patient who displayed coma in the acute phase had decreased CSF orexin levels (107 pg/mL) at day 49 and exhibited severe disability. CONCLUSION: Hypocretin deficiency was not involved in hypersomnia observed in BPT-MI patients; however, CSF hypocretin-1 levels were reduced in BPT+RMI patients. Reduced CSF hypocretin-1 levels in the chronic phase may possibly predict a poor clinical outcome in patients with Percheron artery infarction.


Assuntos
Infarto Cerebral/líquido cefalorraquidiano , Distúrbios do Sono por Sonolência Excessiva/líquido cefalorraquidiano , Dominância Cerebral/fisiologia , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Mesencéfalo/irrigação sanguínea , Orexinas/líquido cefalorraquidiano , Artéria Cerebral Posterior/anormalidades , Doenças Talâmicas/líquido cefalorraquidiano , Adulto , Idoso , Idoso de 80 Anos ou mais , Núcleos Anteriores do Tálamo/irrigação sanguínea , Doença Crônica , Coma/líquido cefalorraquidiano , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Vigília/fisiologia
2.
Minim Invasive Neurosurg ; 39(2): 38-40, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8811654

RESUMO

We experienced that therapeutic embolization of a large cerebral arteriovenous malformation (AVM) led to venous outflow obstruction resulting in intracranial hypertension in a patient who had undergone external decompression. To evaluate hemodynamic changes after embolization, we monitored the cerebrospinal fluid pressure in the next four patients who underwent endovascular treatment. The embolization of a medium AVM resulted in a slight increase in the cerebrospinal fluid pressure. In two medium AVMs, embolization produced slight decreases in the cerebrospinal fluid pressure. In a small AVM, we did not observe any changes in the cerebrospinal fluid pressure during the endovascular treatment. We discuss the mechanism of changes in the intracranial pressure after embolization and conclude that monitoring of the cerebrospinal fluid pressure immediately yields useful information for hemodynamic changes during endovascular treatment.


Assuntos
Pressão do Líquido Cefalorraquidiano/fisiologia , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Malformações Arteriovenosas Intracranianas/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica
3.
Acta Neurol (Napoli) ; 16(3): 103-9, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7992658

RESUMO

Hyaluronan (HYA) is a large molecular weight polysaccharide which functions in various roles throughout the body. Little is known regarding HYA in human cerebrospinal fluid (CSF). We measured CSF and serum HYA concentrations in eleven patients with varying degrees of head injury. In these patients, CSF HYA ranged from 46 to 772 micrograms/l and serum HYA from 16 to 573 micrograms/l. We did not find any relationship between HYA values in CSF or serum and underlying disease or Glasgow Coma Scale (GCS). The role of CSF HYA in the injured human brain has yet to be elucidated.


Assuntos
Dano Encefálico Crônico/diagnóstico , Lesões Encefálicas/diagnóstico , Ácido Hialurônico/líquido cefalorraquidiano , Adolescente , Adulto , Dano Encefálico Crônico/líquido cefalorraquidiano , Encefalopatias/líquido cefalorraquidiano , Encefalopatias/diagnóstico , Lesões Encefálicas/líquido cefalorraquidiano , Feminino , Humanos , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Malformações Arteriovenosas Intracranianas/diagnóstico , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Hemorragia Subaracnóidea/líquido cefalorraquidiano , Hemorragia Subaracnóidea/diagnóstico , Ferimentos por Arma de Fogo/líquido cefalorraquidiano , Ferimentos por Arma de Fogo/diagnóstico
4.
Artigo em Russo | MEDLINE | ID: mdl-8256544

RESUMO

The authors examined the semiotics of hydrocephalus occurring after subarachnoidal hemorrhages (SAH) from arterial aneurysms and arteriovenous malformations to provide pathogenetic evidence for surgical or conservative hydrocephalus. The spinal fluid tract was examined in 44 patients after SAH by computed tomography and radionuclide cysternomyelography using 99mTc. Variability was found in the radiological semiotics of open internal hydrocephalus. Radiological studies revealed frequently open internal hydrocephalus in patients with arterial aneurysms and arteriovenous malformations without subarachnoidal hemorrhages. The radiological semiotics of open hydrocephalus after SAH determines both morphological changes of the spinal fluid tract and liquorodynamic disturbances.


Assuntos
Hidrocefalia/líquido cefalorraquidiano , Hidrocefalia/diagnóstico , Hemorragia Subaracnóidea/líquido cefalorraquidiano , Hemorragia Subaracnóidea/diagnóstico , Adulto , Encéfalo/diagnóstico por imagem , Cisterna Magna/diagnóstico por imagem , Feminino , Humanos , Hidrocefalia/etiologia , Aneurisma Intracraniano/líquido cefalorraquidiano , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Malformações Arteriovenosas Intracranianas/complicações , Malformações Arteriovenosas Intracranianas/diagnóstico , Masculino , Pessoa de Meia-Idade , Cintilografia , Medula Espinal/diagnóstico por imagem , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/etiologia , Pentetato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios X
6.
AJNR Am J Neuroradiol ; 10(3): 523-7, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2501983

RESUMO

Sixty-six samples of CSF from 66 patients with a variety of diseases, including tumors, arteriovenous malformations, aneurysms, brain infarctions, and lumbar back pain, were studied with 1H MR spectroscopy at 360 MHz. 1H MR spectroscopy offers a simple means to obtain fast information about different metabolites simultaneously. As compared with the control group, which consisted of 19 CSF samples from the same group of 66 patients, but from individuals who had no abnormal findings on neurologic examination, common clinicochemical tests, or neuroradiologic studies, our preliminary results suggest that tumors and hemorrhages may be differentiated by 1H MR spectroscopy. MR peak intensities relative to lactate peak intensity were used as variables in a statistical analysis to determine the significance of individual resonance intensities in predicting CNS abnormalities. The most important factors for diagnosis were analyzed by means of a multivariate general linear hypothesis and a principal component method. The most important factors for predicting CNS abnormalities in the studied diseases were creatinine, glucose, creatine, citrate, protein content, glutamine, amount of cells, and valine. By using this model for discriminant analysis, we could predict hemorrhages correctly in 88% of cases and tumors in 75% of cases. All samples of controls were determined correctly. In cases of brain infarctions, different signals were observed, which may lead to further characterization of such lesions. 1H MR spectroscopy may offer a simple means for further characterizing CNS lesions. However, this needs confirmation by a prospective study, which would include a larger patient population with different diseases.


Assuntos
Doenças do Sistema Nervoso Central/líquido cefalorraquidiano , Espectroscopia de Ressonância Magnética , Doenças do Sistema Nervoso Central/diagnóstico , Hemorragia Cerebral/líquido cefalorraquidiano , Hemorragia Cerebral/diagnóstico , Glucose/líquido cefalorraquidiano , Humanos , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Malformações Arteriovenosas Intracranianas/diagnóstico , Lactatos/líquido cefalorraquidiano , Ácido Láctico , Neoplasias da Coluna Vertebral/líquido cefalorraquidiano , Neoplasias da Coluna Vertebral/diagnóstico
7.
No Shinkei Geka ; 5(2): 137-43, 1977 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-557733

RESUMO

Penetration of Sodium Cephalothin (CET) into CSF follwing intravenous administration was studied in 23 patients with intracranial diseases excluding inflammation and severe subarachnoid hemorrhage. 1) After intravenous injection of 2 g of CET, ventricular CSF was obtained in 4 cases. All these 4 cases showed CET concentration in CSF to be below 0.1 mcg/ml. 2) After intravenous injection of 2 g of CET, lumbar CSF was obtained in 6 cases. In two cases out of these 6 cases, CET concentration in CSF was higher than 0.7 mcg/ml. 3) In 13 cases 2 g of CET with 200ml of 20% Mannitol was injected intravenously and lumbar CSF was examined. CET concentrations in CSF between 0.7 mcg/ml and 6.0 mcg/ml were observed in 9 cases of this group. 4) According to the results it is strongly suggested that the administration of Monnitol and CET is very effective for penetration of CET into CSF.


Assuntos
Cefalotina/administração & dosagem , Manitol/administração & dosagem , Adolescente , Adulto , Idoso , Cefalotina/líquido cefalorraquidiano , Criança , Combinação de Medicamentos , Feminino , Humanos , Injeções Intravenosas , Aneurisma Intracraniano/sangue , Aneurisma Intracraniano/líquido cefalorraquidiano , Malformações Arteriovenosas Intracranianas/sangue , Malformações Arteriovenosas Intracranianas/líquido cefalorraquidiano , Embolia e Trombose Intracraniana/sangue , Embolia e Trombose Intracraniana/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade
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