Neurology

2021 ◽  
pp. 383-444
Author(s):  
Nguyen Thi Hoang Mai ◽  
Mary Warrell ◽  
Charles Newton ◽  
Diana Lockwood
Keyword(s):  
Spinal Cord ◽  
Status Epilepticus ◽  
Peripheral Neuropathy ◽  
Intracranial Pressure ◽  
Bacterial Meningitis ◽  
Viral Meningitis ◽  
Acute Bacterial Meningitis ◽  
Extradural Haematoma ◽  
Raised Intracranial Pressure ◽  
Subdural Haemorrhage

Impaired consciousness, Headache, Raised intracranial pressure, Acute bacterial meningitis, Epidemic meningococcal disease, Viral meningitis, Chronic meningitis, Encephalitis, Rabies, Tetanus, Stroke, Subarachnoid haemorrhage, Subdural haemorrhage, Extradural haematoma, Blackouts/syncope, Space-occupying lesions (SOL), Brain abscess, Hydrocephalus, Epilepsy, Status epilepticus, Cysticercosis, Weak legs and spinal cord disease, Guillain-Barré syndrome, Poliomyelitis (polio), Peripheral neuropathy, Leprosy, Dementia

scholarly journals Phosphatidylcholine PC ae C44:6 in cerebrospinal fluid is a sensitive biomarker for bacterial meningitis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Leonardo Silva de Araujo ◽  
Kevin Pessler ◽  
Kurt-Wolfram Sühs ◽  
Natalia Novoselova ◽  
Frank Klawonn ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Cell Count ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Viral Meningitis ◽  
Acute Bacterial Meningitis ◽  
Membrane Phospholipids ◽  
Cns Disorders

Abstract Background The timely diagnosis of bacterial meningitis is of utmost importance due to the need to institute antibiotic treatment as early as possible. Moreover, the differentiation from other causes of meningitis/encephalitis is critical because of differences in management such as the need for antiviral or immunosuppressive treatments. Considering our previously reported association between free membrane phospholipids in cerebrospinal fluid (CSF) and CNS involvement in neuroinfections we evaluated phosphatidylcholine PC ae C44:6, an integral constituent of cell membranes, as diagnostic biomarker for bacterial meningitis. Methods We used tandem mass spectrometry to measure concentrations of PC ae C44:6 in cell-free CSF samples (n = 221) from patients with acute bacterial meningitis, neuroborreliosis, viral meningitis/encephalitis (herpes simplex virus, varicella zoster virus, enteroviruses), autoimmune neuroinflammation (anti-NMDA-receptor autoimmune encephalitis, multiple sclerosis), facial nerve and segmental herpes zoster (shingles), and noninflammatory CNS disorders (Bell’s palsy, Tourette syndrome, normal pressure hydrocephalus). Results PC ae C44:6 concentrations were significantly higher in bacterial meningitis than in all other diagnostic groups, and were higher in patients with a classic bacterial meningitis pathogen (e.g. Streptococcus pneumoniae, Neisseria meningitidis, Staphylococcus aureus) than in those with less virulent or opportunistic pathogens as causative agents (P = 0.026). PC ae C44:6 concentrations were only moderately associated with CSF cell count (Spearman’s ρ = 0.45; P = 0.009), indicating that they do not merely reflect neuroinflammation. In receiver operating characteristic curve analysis, PC ae C44:6 equaled CSF cell count in the ability to distinguish bacterial meningitis from viral meningitis/encephalitis and autoimmune CNS disorders (AUC 0.93 both), but had higher sensitivity (91% vs. 41%) and negative predictive value (98% vs. 89%). A diagnostic algorithm comprising cell count, lactate and PC ae C44:6 had a sensitivity of 97% (specificity 87%) and negative predictive value of 99% (positive predictive value 61%) and correctly diagnosed three of four bacterial meningitis samples that were misclassified by cell count and lactate due to low values not suggestive of bacterial meningitis. Conclusions Increased CSF PC ae C44:6 concentrations in bacterial meningitis likely reflect ongoing CNS cell membrane stress or damage and have potential as additional, sensitive biomarker to diagnose bacterial meningitis in patients with less pronounced neuroinflammation.

Neurology

2013 ◽  
Author(s):  
Martin Beed ◽  
Richard Sherman ◽  
Ravi Mahajan
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Subarachnoid Haemorrhage ◽  
Metabolic Disorders ◽  
Raised Intracranial Pressure ◽  
Thromboembolic Stroke ◽  
Neurological State

Decreased consciousnessSeizures and status epilepticusStroke/thromboembolic strokeIntracerebral haemorrhageSubarachnoid haemorrhageTraumatic brain injuryRaised intracranial pressureMeningitis and encephalitisAgitation/confusion/aggressionAlcohol withdrawalNeuromuscular weakness and paralysisGuillain–Barré syndromeMyasthenia gravis↓consciousness occurs in many diseases requiring admission to intensive care, and is often a cause for admission in its own right. Changes in neurological state may be related to intracranial pathology, or may occur in response to respiratory, circulatory, or metabolic disorders....

A child with spinal cord AVM presenting with raised intracranial pressure

Neurology ◽  
2003 ◽  
Vol 60 (10) ◽  
pp. 1724-1725 ◽  
Author(s):  
A. G. Bassuk ◽  
D. M. Burrowes ◽  
B. Velimirovic ◽  
J. Grant ◽  
G. F. Keating
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Raised Intracranial Pressure

scholarly journals Cerebrospinal fluid proteome maps detect pathogen-specific host response patterns in meningitis

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Anahita Bakochi ◽  
Tirthankar Mohanty ◽  
Paul Theodor Pyl ◽  
Carlos Alberto Gueto-Tettay ◽  
Lars Malmström ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Host Response ◽  
Viral Meningitis ◽  
Acute Bacterial Meningitis ◽  
Tissue Cell ◽  
Response Patterns ◽  
Lasso Regression ◽  
Specific Host

Meningitis is a potentially life-threatening infection characterized by the inflammation of the leptomeningeal membranes. Many different viral and bacterial pathogens can cause meningitis, with differences in mortality rates, risk of developing neurological sequelae and treatment options. Here we constructed a compendium of digital cerebrospinal fluid (CSF) proteome maps to define pathogen-specific host response patterns in meningitis. The results revealed a drastic and pathogen-type specific influx of tissue-, cell- and plasma proteins in the CSF, where in particular a large increase of neutrophil derived proteins in the CSF correlated with acute bacterial meningitis. Additionally, both acute bacterial and viral meningitis result in marked reduction of brain-enriched proteins. Generation of a multi-protein LASSO regression model resulted in an 18-protein panel of cell and tissue associated proteins capable of classifying acute bacterial meningitis and viral meningitis. The same protein panel also enabled classification of tick-borne encephalitis, a subgroup of viral meningitis, with high sensitivity and specificity. The work provides insights into pathogen specific host response patterns in CSF from different disease etiologies to support future classification of pathogen-type based on host response patterns in meningitis.

Thoracic disc herniation associated with papilledema

1984 ◽  
Vol 61 (6) ◽  
pp. 1132-1134 ◽  
Author(s):  
Shalom D. Michowiz ◽  
Harry Z. Rappaport ◽  
Itzchak Shaked ◽  
Allon Yellin ◽  
Abraham Sahar
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Intervertebral Disc ◽  
Spastic Paraparesis ◽  
Raised Intracranial Pressure ◽  
Thoracic Disc Herniation ◽  
Spinal Cord Lesions ◽  
Content Type ◽  
Thoracic Disc ◽  
Fine Print

✓ The occurrence of papilledema in a patient with progressive spastic paraparesis due to herniation of the T11–12 intervertebral disc is reported. The papilledema resolved following discectomy. The association and possible pathogenetic mechanisms between spinal cord lesions and signs of raised intracranial pressure are reviewed.

scholarly journals New onset headache caused by histiocytic sarcoma of the spinal cord and leptomeninges: a case report

2021 ◽  
Vol 3 (1) ◽  
pp. e000147
Author(s):  
Matthew Silsby ◽  
Winny Varikatt ◽  
Steve Vucic ◽  
Parvathi Menon
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Diagnostic Delay ◽  
Cauda Equina ◽  
Histiocytic Sarcoma ◽  
Raised Intracranial Pressure ◽  
Limb Weakness ◽  
Cerebral Pathology ◽  
Pressure Headache ◽  
New Onset

BackgroundHeadache due to raised intracranial pressure is rarely caused by spinal lesions. We describe a patient with primary histiocytic sarcoma who presented with a new onset headache with features of raised intracranial pressure and subtle signs of cauda equina syndrome due to predominant lower spinal cord infiltration and minimal intracranial involvement.CaseA previously well 54-year-old man presented with a 2-month history of new onset headache with features of raised intracranial pressure. Progression of lower limb weakness was delayed and mild with diagnostic delay resulting from the primary presentation with headache leading to an initial focus on cerebral pathology. Subsequent investigations revealed a previously unreported presentation of primary histiocytic sarcoma infiltrating the cauda equina causing raised intracranial pressure headache.ConclusionThis case highlights the importance of a broad search in the investigation of new onset raised intracranial pressure headache, including imaging of the lower spinal cord. Primary histiocytic sarcoma should be considered in the differential diagnosis of this rare syndrome.

scholarly journals Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

2020 ◽  
Vol 10 (3) ◽  
pp. 120-123
Author(s):  
Marouane Hammoud ◽  
Fayçal Lakhdar ◽  
Mohammed Benzagmout ◽  
Khalid Chakour, ◽  
Mohammed El Faiz Chaou
Keyword(s):  
Spinal Cord ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Contralateral Side ◽  
Acute Bacterial Meningitis ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Abscess ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Central Nervous System

Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. Untreated, it may result in significant morbidity and mortality. We describe the case of a 34-year-old man, who initially was admitted for bacterial meningitis. 3 days after initiation of antibiotic therapy, a gradually and progressive weakness appeared on the left side of his body with numbness on the contralateral side. MRI of the spine demonstrated an ISCA at level of C4. A myelotomy and surgical drainage was performed. Postoperatively, the patient had improved significantly his neurological deficit. ISCA is still a life-threatening condition, we point out that the diagnosis should be highly suspected, if a cystic spinal cord lesion is surrounded by significant medullar edema associated with fast onset of symptoms, especially in a context of sepsis or acuate meningitis. Prompt surgical evacuation followed by adequate antibiotic therapy, are the mainstays of treatment.

scholarly journals Cerebrospinal fluid proteome maps detect pathogen-specific host response patterns in meningitis

2020 ◽  
Author(s):  
Anahita Bakochi ◽  
Tirthankar Mohanty ◽  
Paul Theodor Pyl ◽  
Lars Malmström ◽  
Adam Linder ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Host Response ◽  
Viral Meningitis ◽  
Acute Bacterial Meningitis ◽  
Tissue Cell ◽  
Response Patterns ◽  
Lasso Regression ◽  
Specific Host

AbstractMeningitis is a potentially life-threatening infection characterized by the inflammation of the leptomeningeal membranes. Many different viral and bacterial pathogens can cause meningitis, with differences in mortality rates, risk of developing neurological sequelae and treatment options. Here we constructed a compendium of digital cerebrospinal fluid (CSF) proteome maps to define pathogen-specific host response patterns in meningitis. The results revealed a drastic and pathogen-type specific influx of tissue-, cell- and plasma proteins in the CSF, where in particular a large increase of neutrophil derived proteins in the CSF correlated with acute bacterial meningitis. Additionally, both acute bacterial and viral meningitis result in marked reduction of brain-enriched proteins. Generation of a multi-protein LASSO regression model resulted in an 18-protein panel of cell and tissue associated proteins capable of classifying acute bacterial meningitis and viral meningitis. The same protein panel also enabled classification of tick-borne encephalitis, a subgroup of viral meningitis, with high sensitivity and specificity. The work provides insights into pathogen specific host response patterns in CSF from different disease etiologies to support future classification of pathogen-type based on host response patterns in meningitis.

scholarly journals Anterior spinal cord syndrome as a rare complication of acute bacterial meningitis in an adult

2018 ◽  
pp. bcr-2018-226082 ◽  
Author(s):  
Kwang Sheng Ng ◽  
Sanihah Abdul Halim
Keyword(s):  
Spinal Cord ◽  
Bacterial Meningitis ◽  
Daily Living ◽  
Rare Complication ◽  
Central Nervous System Infection ◽  
Acute Bacterial Meningitis ◽  
Spinal Cord Infarction ◽  
Adequate Treatment ◽  
Systemic Complications ◽  
Spinal Cord Dysfunction

Acute bacterial meningitis is not an uncommon central nervous system infection. In severe cases, it can be associated with various neurological or systemic complications. However, acute spinal cord dysfunction rarely occurs. We report a case of bacterial meningitis complicated with spinal cord infarction despite adequate treatment with antibiotics and corticosteroid therapy. He had residual paraplegia and was fully dependent in the activity of daily living.

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