Spinal Lesions and Cerebrospinal Fluid

2016 ◽  
pp. 279-296
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Cerebrospinal Fluid ◽  
Dural Arteriovenous Fistula ◽  
Cell Protein ◽  
Spinal Dural Arteriovenous Fistula ◽  
Protein Ratio ◽  
Protein Levels ◽  
Fluid Analysis ◽  
Low Glucose ◽  
Specific Disorders ◽  
Lesion Localization

This chapter expounds on the major lesions of the spinal cord, whether from within the cord or from outside it, with particular emphasis on syringomyelia. Points from the history and examination that aid lesion localization are detailed, together with tips that might lead to a speedy diagnosis. Diagnostic clues for specific disorders are listed, such as spinal dural arteriovenous fistula and claudication. Detail is supplied on infectious myelopathies, in particular recurrent myelopathy and recurrent meningitis. Clues are given that would allow rapid interpretation of cerebrospinal fluid analysis, including high or low cell–protein ratio, cell and protein levels, chronic polymorphonuclear reaction, eosinophilia, and low glucose. The causes of a dry spinal tap are also outlined.

Spinal Lesions and Cerebrospinal Fluid

2019 ◽  
pp. 297-314
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Recurrent Meningitis ◽  
Spinal Dural Arteriovenous Fistula ◽  
Fluid Analysis ◽  
Specific Disorders ◽  
Lesion Localization ◽  
Brown Sequard Syndrome

This chapter explains the major lesions of the spinal cord with emphasis on myelopathies, Brown-Sequard syndrome and syringomyelia. Points from the history and examination that aid lesion localization are detailed. Handles for specific disorders are listed, such as spinal dural arteriovenous fistula and claudication. Detail is supplied on infectious myelopathies, in particular recurrent myelopathy and recurrent meningitis. Clues are given that would allow rapid interpretation of cerebrospinal fluid analysis and the causes of a dry spinal tap.

scholarly journals A Cluster of Neurobrucellosis at King Hussein Medical Center, Jordan - A Comprehensive Analysis And Review.

2020 ◽  
pp. 349-358
Author(s):  
Al Dhomour Aktham ◽  
Al Shyyab Awni ◽  
Al Etan Shaher ◽  
Al Adamat Mohammed ◽  
Amin Bani Salamah ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Center ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Close Monitoring ◽  
Animal Products ◽  
Fluid Analysis ◽  
Clinical Presentations ◽  
Low Glucose

In this retrospective review, we describe the neurological clinical manifestations in five cases diagnosed with neurobrucellosis over two years between 2018 and 2020, and the application of different proposed criteria for establishing the diagnosis and treatment of neurobrucellosis. All cases were confirmed to have brucellosis with laboratory tests, and all were living in Jordan, which is considered part of a highly endemic area within the Middle East. The neurobrucellosis proposed criteria was applied, which requires signs and symptoms consistent with neurobrucellosis, presence of anti-Brucella antibodies in cerebrospinal fluid and serum with or without isolation of Brucella species in CSF and serum, cerebrospinal fluid analysis shows: lymphocytosis, high protein level, and low glucose level and radiological findings on MRI or CT. In all five cases, we have confirmed direct contact with animals or animal products either as a consumer or as a farmworker. Their signs and symptoms were consistent with brucellosis. In all cases, haematological and CSF results, in addition to imaging findings using magnetic resonance and computed tomography, were highly coherent with neurobrucellosis. Neurobrucellosis can present with different clinical manifestations, either as a sole site of infection like acute or subacute meningitis or myelitis, or in context of a multi variable systemic disease. In patients with unusual neurological clinical presentations, and those with persistent chronic symptoms like headache, malaise, or depression, neurobrucellosis should be highly suspected, especially in endemic areas. Such patients must have a prolonged course of antibiotics between 6 to 18 months with close monitoring of their serum and CSF examination

scholarly journals Cerebrospinal fluid cannot be used to distinguish inflammatory myelitis from congestive myelopathy due to spinal dural arteriovenous fistula: case series

2019 ◽  
Vol 1 (1) ◽  
pp. e000019
Author(s):  
Vinojini Vivekanandam ◽  
Vivien Li ◽  
Teddy Wu ◽  
Richard Dowling ◽  
Richard H Roxburgh ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Case Series ◽  
Spinal Dural Arteriovenous Fistula ◽  
Motor Disturbance ◽  
Inappropriate Treatment ◽  
Signal Change ◽  
Spinal Mri ◽  
Csf Findings

Patients with congestive myelopathy due to spinal dural arteriovenous fistula (SDAVF) typically present with progressive sensory and motor disturbance in association with sphincter dysfunction. Spinal MRI usually shows longitudinally extensive T2 signal change. Here, we report four patients with progressive myelopathy due to SDAVF who also presented with findings on cerebrospinal fluid (CSF) examination suggestive of an inflammatory aetiology. Such CSF findings in SDAVF are important to recognise, to avoid the erroneous diagnosis of an inflammatory myelitis and inappropriate treatment with immunosuppression. SDAVF can be difficult to detect and may require repeated investigation, with formal angiography as the gold standard.

The prognostic value of demyelinating electrophysiologic findings and cerebrospinal fluid protein levels in acute inflammatory demyelinating polyneuropathy

2020 ◽  
Vol 78 (8) ◽  
pp. 481-487
Author(s):  
Abdulkadir TUNÇ ◽  
Aysel TEKEŞİN ◽  
Vildan GÜZEL ◽  
Yonca ÜNLÜBAŞ ◽  
Meral SEFEROĞLU
Keyword(s):  
Cerebrospinal Fluid ◽  
Prognostic Value ◽  
Disease Onset ◽  
Demyelinating Polyneuropathy ◽  
Specific Criterion ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Protein Levels ◽  
Fluid Analysis ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Cerebrospinal Fluid Protein

ABSTRACT Background: Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. Objective: To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. Conclusions: The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice.

Spinal Dural Arteriovenous Fistula: Diagnosis and Treatment

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Nur Setiawan Suroto
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Vascular Malformation ◽  
Dural Arteriovenous Fistula ◽  
Motor Symptoms ◽  
Elderly Men ◽  
Spinal Dural Arteriovenous Fistula ◽  
Sensory Disturbances ◽  
Av Fistulas ◽  
Low Rate

Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive paraplegia or tetraplegia. They most commonly affected are elderly men and are classically found in the thoracolumbar region.Symptoms gradually progress or decline in a stepwise manner and are commonly associated with pain and sphincter disturbances. Surgical or endovascular disconnection of the fistula has a high success rate with a low rate of morbidity. Motor symptoms are most likely to improve after treatment, followed by sensory disturbances, and lastly sphincter disturbances.

scholarly journals Alterations of mesenchymal stromal cells in cerebrospinal fluid: insights from transcriptomics and an ALS clinical trial

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ashley A. Krull ◽  
Deborah O. Setter ◽  
Tania F. Gendron ◽  
Sybil C. L. Hrstka ◽  
Michael J. Polzin ◽  
...  
Keyword(s):  
Gene Expression ◽  
Cerebrospinal Fluid ◽  
Growth Factors ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Large Scale ◽  
Therapeutic Benefit ◽  
Protein Levels ◽  
Genes Encoding ◽  
Intrathecal Space

Abstract Background Mesenchymal stromal cells (MSCs) have been studied with increasing intensity as clinicians and researchers strive to understand the ability of MSCs to modulate disease progression and promote tissue regeneration. As MSCs are used for diverse applications, it is important to appreciate how specific physiological environments may stimulate changes that alter the phenotype of the cells. One need for neuroregenerative applications is to characterize the spectrum of MSC responses to the cerebrospinal fluid (CSF) environment after their injection into the intrathecal space. Mechanistic understanding of cellular biology in response to the CSF environment may predict the ability of MSCs to promote injury repair or provide neuroprotection in neurodegenerative diseases. Methods In this study, we characterized changes in morphology, metabolism, and gene expression occurring in human adipose-derived MSCs cultured in human (hCSF) or artificial CSF (aCSF) as well as examined relevant protein levels in the CSF of subjects treated with MSCs for amyotrophic lateral sclerosis (ALS). Results Our results demonstrated that, under intrathecal-like conditions, MSCs retained their morphology, though they became quiescent. Large-scale transcriptomic analysis of MSCs revealed a distinct gene expression profile for cells cultured in aCSF. The aCSF culture environment induced expression of genes related to angiogenesis and immunomodulation. In addition, MSCs in aCSF expressed genes encoding nutritional growth factors to expression levels at or above those of control cells. Furthermore, we observed a dose-dependent increase in growth factors and immunomodulatory cytokines in CSF from subjects with ALS treated intrathecally with autologous MSCs. Conclusions Overall, our results suggest that MSCs injected into the intrathecal space in ongoing clinical trials remain viable and may provide a therapeutic benefit to patients.

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