Intracranial Pressure

2019 ◽  
pp. 69-73
Author(s):  
Eelco F. M. Wijdicks ◽  
William D. Freeman
Keyword(s):  
Cerebrospinal Fluid ◽  
Smooth Muscle ◽  
Choroid Plexus ◽  
Blood Cells ◽  
White Blood Cells ◽  
Ependymal Cells ◽  
Cerebral Aqueduct ◽  
Epithelial Surface ◽  
The Brain ◽  
Route Of Delivery

Cerebrospinal fluid (CSF) fills the subarachnoid space, spinal canal, and ventricles of the brain. CSF is enclosed within the brain by the pial layer, ependymal cells lining the ventricles, and the epithelial surface of the choroid plexus, where it is largely produced. Choroid plexus is present throughout the ventricular system with the exception of the frontal and occipital horns of the lateral ventricle and the cerebral aqueduct. The vascular smooth muscle and the epithelium of the choroid plexus receive both sympathetic and parasympathetic input. In an adult, CSF is normally acellular. A normal spinal sample may contain up to 5 white blood cells (WBCs) or red blood cells (RBCs). CSF allows for a route of delivery and removal of nutrients, hormones, and transmitters for the brain.

Infections of the Central Nervous System

2012 ◽  
pp. 319-340
Author(s):  
Michael R. Keating
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Blood Cells ◽  
White Blood Cells ◽  
Chronic Encephalitis ◽  
System P ◽  
The Central Nervous System ◽  
The Brain ◽  
Shunt Infections

Infections of the central nervous system include meninigitis (acute and chronic), encephalitis, myelitis, abscesses, and cerebrospinal fluid shunt infections. Meningitis is diagnosed by the presence of white blood cells in the cerebrospinal fluid. Encephalitis is inflammation of the brain caused by infection. Myelitis is infection or inflammation of the spinal cord. The diagnosis and treatment of various types of central nervous system infections are reviewed.

Cephalosporium Meningitis

PEDIATRICS ◽  
1970 ◽  
Vol 46 (1) ◽  
pp. 161-162
Author(s):  
Walter T. Hughes
Keyword(s):  
Cerebrospinal Fluid ◽  
Newborn Infant ◽  
Blood Cells ◽  
Chemical Constituents ◽  
White Blood Cells ◽  
Patient Reported ◽  
Physical Findings

I find it necessary to comment on the paper "Cephalosporium Meningitis" (Pediatrics, 44:749, 1969) in order to emphasize a word of caution to physicians who may encounter patients under circumstances similar to those described by Drs. Papadatos, Pavlatou, and Alexiou. The patient reported was a newborn infant who on day 15 of life became irritable, listless, and refused feedings. In the absence of abnormal physical findings, the cerebrospinal fluid was examined and found to be slightly xanthochromic with 20 white blood cells per cu mm, and with normal chemical constituents.

scholarly journals High Blood Pressure Effects on the Blood to Cerebrospinal Fluid Barrier and Cerebrospinal Fluid Protein Composition: A Two-Dimensional Electrophoresis Study in Spontaneously Hypertensive Rats

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Ibrahim González-Marrero ◽  
Leandro Castañeyra-Ruiz ◽  
Juan M. González-Toledo ◽  
Agustín Castañeyra-Ruiz ◽  
Hector de Paz-Carmona ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Protein Composition ◽  
Pressure Effects ◽  
Apolipoprotein A1 ◽  
Spontaneously Hypertensive ◽  
Barrier Disruption ◽  
Cerebrospinal Fluid Proteins ◽  
The Brain ◽  
Cerebrospinal Fluid Protein

The aim of the present work is to analyze the cerebrospinal fluid proteomic profile, trying to find possible biomarkers of the effects of hypertension of the blood to CSF barrier disruption in the brain and their participation in the cholesterol andβ-amyloid metabolism and inflammatory processes. Cerebrospinal fluid (CSF) is a system linked to the brain and its composition can be altered not only by encephalic disorder, but also by systemic diseases such as arterial hypertension, which produces alterations in the choroid plexus and cerebrospinal fluid protein composition. 2D gel electrophoresis in cerebrospinal fluid extracted from the cistern magna before sacrifice of hypertensive and control rats was performed. The results showed different proteomic profiles between SHR and WKY, thatα-1-antitrypsin, apolipoprotein A1, albumin, immunoglobulin G, vitamin D binding protein, haptoglobin andα-1-macroglobulin were found to be up-regulated in SHR, and apolipoprotein E, transthyretin,α-2-HS-glycoprotein, transferrin,α-1β-glycoprotein, kininogen and carbonic anhidrase II were down-regulated in SHR. The conclusion made here is that hypertension in SHR produces important variations in cerebrospinal fluid proteins that could be due to a choroid plexus dysfunction and this fact supports the close connection between hypertension and blood to cerebrospinal fluid barrier disruption.

scholarly journals Cerebrospinal Fluid Total Protein Reference Intervals Derived from 20 Years of Patient Data

2017 ◽  
Vol 63 (12) ◽  
pp. 1856-1865 ◽  
Author(s):  
Christopher R McCudden ◽  
John Brooks ◽  
Priya Figurado ◽  
Pierre R Bourque
Keyword(s):  
Cerebrospinal Fluid ◽  
Quantile Regression ◽  
Total Protein ◽  
Blood Cells ◽  
White Blood Cells ◽  
Age Groups ◽  
Reference Intervals ◽  
Patient Data ◽  
Age Dependence ◽  
Data Set

Abstract BACKGROUND Reference intervals are vital for interpretation of laboratory results. Many existing reference intervals for cerebrospinal fluid total protein (CSF-TP) are derived from old literature because of the invasive nature of sampling. The objective of this study was to determine reference intervals for CSF-TP using available patient data. METHODS Twenty years of hospital database information was mined for previously reported CSF-TP results. Associated demographic, laboratory, and clinical diagnosis (International Classification of Diseases 9/10 codes) details were extracted. CSF-TP results included 3 different analytical platforms: the Siemens Vista 1500, Beckman Lx20, and Roche Hitachi 917. From an initial data set of 19591 samples, the following exclusion criteria were applied: incomplete data, white blood cells (WBCs) >5 × 106/L, red blood cells (RBCs) >50 × 106/L, and glucose <2.5 mmol/L. Patient charts were reviewed in detail to exclude 60 different conditions for which increases in CSF-TP would be expected. A total of 6068 samples were included; 63% of the samples were from females. Continuous reference intervals were determined using quantile regression. Age- and sex-partitioned intervals were established using the quantile regression equation and splitting age-groups into 5-year bins. RESULTS CSF-TP showed a marked age dependence, and males had significantly higher CSF-TP than females across all ages. CSF-TP results from the 3 different instruments and manufacturers showed small (approximately 0.04 g/L), but statistically significant, differences. CSF-TP showed weak, but again statistically significant, correlation with WBC and RBC but was independent of serum total protein and creatinine. CONCLUSIONS The age dependence of CSF-TP supports that age-partitioned reference intervals will be more accurate than a single cutoff, particularly in patients with advancing age.

scholarly journals ZFP423 regulates early patterning and multiciliogenesis in the hindbrain choroid plexus

2020 ◽  
Author(s):  
Filippo Casoni ◽  
Laura Croci ◽  
Francesca Vincenti ◽  
Paola Podini ◽  
Luca Massimino ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Cell Fate ◽  
Third Ventricle ◽  
Joubert Syndrome ◽  
Ependymal Cells ◽  
Cerebral Aqueduct ◽  
Cell Fate Specification ◽  
Stem Cell Maintenance ◽  
Roof Plate ◽  
Secretory Tissue

ABSTRACTThe choroid plexus (ChP) is a secretory tissue that produces cerebrospinal fluid (CSF) and secretes it into the ventricular system. CSF flows from the lateral to the third ventricle, and then to the fourth ventricle through the cerebral aqueduct. Recent studies have uncovered new, active roles for this structure in the regulation of neural stem cell maintenance and differentiation into neurons. Zfp423, encoding a Kruppel-type zinc finger transcription factor essential for cerebellar development and mutated in rare cases of cerebellar vermis hypoplasia / Joubert syndrome and other ciliopathies, is expressed in the hindbrain roof plate (RP), from which the IV ventricle ChP arises, and in mesenchymal cells giving rise to the stroma and leptomeninges. Zfp423 mutants display a marked reduction of the hindbrain ChP (hChP), which fails to express key markers of its secretory function and genes implicated in its development and maintenance (Lmx1a, Otx2). The mutant hChP displays a complete lack of multiciliated ependymal cells. A transcriptome analysis conducted at the earliest stages of hChP development and subsequent validations demonstrate that the mutant hChp displays a strong deregulation of pathways involved in early hindbrain patterning and multiciliated cell fate specification. Our results propose Zfp423 as a master gene and one of the earliest known determinants of hChP development.

scholarly journals Spontaneous Ectopic Choroid Plexus with Sclerosis in Adult Beagle Dogs

2018 ◽  
Vol 46 (5) ◽  
pp. 608-609
Author(s):  
Ingrid D. Pardo ◽  
Ahmed M. Shoieb ◽  
Robert Garman ◽  
Michael Mirsky ◽  
Rosemary Santos ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Choroid Plexus ◽  
Neural Development ◽  
Clinical Signs ◽  
Ependymal Cells ◽  
Tubular Structures ◽  
Beagle Dogs ◽  
The Brain ◽  
Morphologic Appearance ◽  
Adjacent Brain

Microscopic examination of the brain of adult Beagle dogs from four different general toxicity studies revealed the presence of ectopic choroid plexus tissue in six individual dogs (4 females and 2 males) with ages ranging from 12 to 18 months. In each dog, this finding was characterized by a well-circumscribed mass localized to a region above and along the corpus callosum without any apparent compression of adjacent brain tissue. Each mass was composed of columnar ependymal cells forming tubular structures surrounded by variable amounts of fibrovascular connective tissue and had the appearance of small rests of ependymal cells that had been penetrated by the leptomeninges during neural development. There were no associated clinical signs or macroscopic correlates. Based on morphologic appearance, a diagnosis of spontaneous ectopic choroid plexus with secondary sclerosis was made. To the authors’ knowledge, ectopic choroid plexus has not been reported in Beagle dogs and is rare in humans and horses.

Fine Structure of the Lateral Area of the Posterior Rhombencephalic Tela of the Bullfrog, Rana Catesbiana

1980 ◽  
Vol 38 ◽  
pp. 522-523
Author(s):  
J. E. Michaels ◽  
P. A. Tornheim
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Subarachnoid Space ◽  
Fourth Ventricle ◽  
Essential Feature ◽  
Ventricular System ◽  
Ependymal Cells ◽  
Open Communication ◽  
Tela Choroidea ◽  
Lateral Area

In mammals, the caudal roof of the fourth ventricle consists of an inner layer of ependymal cells and an outer layer of leptomeningeal cells. It contains specializations in the form of tufts of choroid plexus for the elaboration of cerebrospinal fluid (CSF) as well as gross apertures that permit open communication between the ventricular system and the subarachnoid space, an essential feature for mammalian CSF circulation. In the bullfrog, as in most submammals, the roof of the fourth ventricle contains a rostral rhombencephalic choroid plexus with no gross evidence of fourth ventricular apertures. Communication between the ventricular system and the subarachnoid space in this animal, however, has been demonstrated to occur by way of microscopic openings or pores in the caudal roof of the hindbrain or the posterior rhombencephalic tela choroidea.

A Man With Recurrent Headache and Focal Neurologic Deficits

2021 ◽  
pp. 222-224
Author(s):  
Jaclyn R. Duvall ◽  
Jerry W. Swanson
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Angiography ◽  
Blood Cells ◽  
White Blood Cells ◽  
Severe Headache ◽  
First Episode ◽  
Benign Condition ◽  
Left Hand ◽  
Neurologic Deficits ◽  
Symptomatic Management

A 42-year-old healthy man sought care for transient episodes of neurologic deficits followed by severe headache. The first episode began with left hand weakness, numbness, and dysarthria, followed approximately 1 hour later by a right temporal headache. His symptoms spontaneously resolved after 8 hours. He had a second episode 2 days later manifested by confusion and bilateral lower extremity numbness, again followed by severe headache with symptoms resolving within 12 hours. A total of 8 episodes occurred over 3 weeks, each lasting 8 to 24 hours, with spontaneous resolution each time. His most recent episode occurred during cerebral angiography. Cerebrospinal fluid evaluation showed opening pressure, 190 mm H2O; white blood cells, 205/μ‎L, 97% lymphocytes; protein, 95 mg/dL; and glucose, 40 mg/dL. Electroencephalography demonstrated right greater than left generalized slowing, with increased-voltage rhythmic delta wave activity, in the frontal regions predominantly. Conventional cerebral angiography findings were normal, but the test appeared to provoke the patient’s previous episode. Neurologic examination was normal after his most recent episode resolved, and no further episodes were reported. This case highlights a typical presentation of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis. Because the disorder was self-limited, treatment was aimed at symptomatic management of headache. In this case patient with a secure diagnosis of headache and neurologic deficits with cerebrospinal fluid lymphocytosis and stereotypical episodes limited to 3 months after the initial presentation, additional testing was not indicated. Headache and neurologic deficits with cerebrospinal fluid lymphocytosis is a rare, self-limited, benign condition with migrainelike headache episodes accompanied by transient neurologic deficits usually lasting more than 4 hours, with some deficits lasting more than 24 hours.

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