scholarly journals Metronidazole and Hydroxymetronidazole Central Nervous System Distribution: 2. Cerebrospinal Fluid Concentration Measurements in Patients with External Ventricular Drain

2013 ◽  
Vol 58 (2) ◽  
pp. 1024-1027 ◽  
Author(s):  
Denis Frasca ◽  
Claire Dahyot-Fizelier ◽  
Christophe Adier ◽  
Olivier Mimoz ◽  
Bertrand Debaene ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
External Ventricular Drain ◽  
Noncompartmental Analysis ◽  
Liquid Chromatograph ◽  
Blood Samples ◽  
Brain Injured ◽  
Fluid Concentration ◽  
High Pressure Liquid Chromatograph ◽  
Injured Patients ◽  
First Time

ABSTRACTThis study explored metronidazole and hydroxymetronidazole distribution in the cerebrospinal fluid (CSF) of brain-injured patients. Four brain-injured patients with external ventricular drain received 500 mg of metronidazole over 0.5 h every 8 h. CSF and blood samples were collected at steady state over 8 h, and the metronidazole and hydroxymetronidazole concentrations were assayed by high-pressure liquid chromatograph. A noncompartmental analysis was performed. Metronidazole is distributed extensively within CSF, with a mean CSF to unbound plasma AUC0–τratio of 86% ± 16%. However, the concentration profiles in CSF were mostly flat compared to the plasma profiles. Hydroxymetronidazole concentrations were much lower than those of metronidazole both in plasma and in CSF, with a corresponding CSF/unbound plasma AUC0–τratio of 79% ± 16%. We describe here for the first time in detail the pharmacokinetics of metronidazole and hydroxymetronidazole in CSF.

Cerebral Blood Flow, Cerebral Metabolism and Cerebrospinal Fluid Biochemistry in Brain-Injured Patients after Exposure to Hyperbaric Oxygen

1976 ◽  
Vol 14 (5) ◽  
pp. 351-364 ◽  
Author(s):  
François Artru ◽  
Bernard Philippon ◽  
Françoise Gau ◽  
Michel Berger ◽  
Raymond Deleuze
Keyword(s):  
Blood Flow ◽  
Cerebrospinal Fluid ◽  
Cerebral Blood Flow ◽  
Hyperbaric Oxygen ◽  
Cerebral Metabolism ◽  
Brain Injured ◽  
Injured Patients

scholarly journals 750. Isavuconazole Cerebrospinal Fluid Concentration in Refractory Coccidioidal Meningitis - A Three-Patient Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S422-S422
Author(s):  
Matthew R Davis ◽  
Sandy Chang ◽  
Pryce Gaynor ◽  
Erin K McCreary ◽  
Paul R Allyn
Keyword(s):  
Cerebrospinal Fluid ◽  
External Ventricular Drain ◽  
Treatment Success ◽  
Case Series ◽  
Serum Levels ◽  
Published Data ◽  
Cerebrospinal Fluid Concentration ◽  
Fluid Concentration ◽  
Csf Levels ◽  
Paired Serum

Abstract Background Coccidioidal meningitis (CM) causes life-threatening infection with limited treatment options. Small series have reported variable treatment success with isavuconazole. An absence of published data exists on cerebrospinal fluid (CSF) penetration of this agent. Methods Paired serum and CSF levels were measured on three patients with refractory CM treated on salvage isavuconazole therapy. Results 11 CSF levels were sent on 3 patients; 7 from ventricular sources (Ommaya reservoir or external ventricular drain) and 4 from lumbar punctures at 6-44 days after treatment initiation, 2-24.6 hours after oral or intravenous dose. All levels sent from ventricular sources were undetectable < 25µg/mL despite adequate paired serum levels (mean 2.45 µg/mL, range 1.25-6.38 µg/mL; n = 7 levels). Mean lumbar CSF levels were 1.00 µg/mL (range 0.45-1.72 µg/mL; n = 4 levels) with adequate serum levels (mean 3.57 µg/mL, range 1.78-5.63 µg/mL; n = 4 levels). Table 1. Isavuconazole serum and cerebrospinal fluid concentration measurements Conclusion Isavuconazole was detected in lumbar, but not ventricular CSF in three patients treated for CM. Disclosures All Authors: No reported disclosures

Thiopental attenuates energetic impairment but fails to normalize cerebrospinal fluid glutamate in brain-injured patients

1999 ◽  
Vol 27 (7) ◽  
pp. 1351-1357 ◽  
Author(s):  
John F. Stover ◽  
Ulrike E. Pleines ◽  
Maria C. Morganti-Kossmann ◽  
Reto Stocker ◽  
Thomas Kossmann
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Injured ◽  
Injured Patients

scholarly journals Glutamate and Taurine Are Increased in Ventricular Cerebrospinal Fluid of Severely Brain-Injured Patients

1999 ◽  
Vol 16 (2) ◽  
pp. 135-142 ◽  
Author(s):  
JOHN F. STOVER ◽  
MARIA C. MORGANTI-KOSSMANN ◽  
PHILIPP M. LENZLINGER ◽  
RETO STOCKER ◽  
OLIVER S. KEMPSKI ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Injured ◽  
Injured Patients

More than Cell Dust: Microparticles Isolated from Cerebrospinal Fluid of Brain Injured Patients Are Messengers Carrying mRNAs, miRNAs, and Proteins

2013 ◽  
Vol 30 (14) ◽  
pp. 1232-1242 ◽  
Author(s):  
Silke Patz ◽  
Christa Trattnig ◽  
Gerda Grünbacher ◽  
Birgit Ebner ◽  
Christian Gülly ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Injured ◽  
Injured Patients

scholarly journals Altered methylation pattern of the SRD5A2 gene in the cerebrospinal fluid of post-finasteride patients: a pilot study

2019 ◽  
Vol 8 (8) ◽  
pp. 1118-1125 ◽  
Author(s):  
Roberto Cosimo Melcangi ◽  
Livio Casarini ◽  
Marco Marino ◽  
Daniele Santi ◽  
Samantha Sperduti ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Control Clinical Trial ◽  
Methylation Pattern ◽  
Androgenic Alopecia ◽  
Blood Samples ◽  
Srd5a2 Gene ◽  
Liquid Chromatography Tandem Mass ◽  
Csf Levels ◽  
Prospective Longitudinal ◽  
First Time

Context Post-finasteride syndrome (PFS) occurs in patients with androgenic alopecia after suspension of the finasteride treatment, leading to a large variety of persistent side effects. Despite the severity of the clinical picture, the mechanism underlying the PFS symptoms onset and persistence is still unclear. Objective To study whether epigenetic modifications occur in PFS patients. Methods Retrospective analysis of a multicentric, prospective, longitudinal, case–control clinical trial, enrolling 16 PFS patients, compared to 20 age-matched healthy men. Main outcomes were methylation pattern of SRD5A1 and SRD5A2 promoters and concentration of 11 neuroactive steroids, measured by liquid chromatography-tandem mass spectrometry, in blood and cerebrospinal fluid (CSF) samples. Results SRD5A1 and SRD5A2 methylation analysis was performed in all blood samples (n = 16 PFS patients and n = 20 controls), in 16 CSF samples from PFS patients and in 13 CSF samples from controls. The SRD5A2 promoter was more frequently methylated in CSF of PFS patients compared to controls (56.3 vs 7.7%). No promoter methylation was detected in blood samples in both groups. No methylation occurred in the SRD5A1 promoter of both groups. Unmethylated controls compared to unmethylated SRD5A2 patients showed higher pregnenolone, dihydrotestosterone and dihydroprogesterone, together with lower testosterone CSF levels. Andrological and neurological assessments did not differ between methylated and unmethylated subjects. Conclusions For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients. Although we cannot conclude whether this pattern is prenatally established or induced by finasteride treatment, it could represent an important mechanism of neuroactive steroid levels and behavioural disturbances previously described in PFS.

scholarly journals Cisternal Cerebrospinal Fluid Concentrations of Morphine following Intrathecal and Epidural Administration in the Baboon

1987 ◽  
Vol 15 (4) ◽  
pp. 445-450 ◽  
Author(s):  
W. A. Hampton ◽  
N. G. Lavies ◽  
J. W. Downing ◽  
J. G. Brock-Utne ◽  
R. T. Salisbury ◽  
...  
Keyword(s):  
High Pressure ◽  
Cerebrospinal Fluid ◽  
Respiratory Depression ◽  
Intrathecal Injection ◽  
Maximum Level ◽  
Epidural Administration ◽  
Epidural Group ◽  
Liquid Chromatograph ◽  
Lumbar Level ◽  
High Pressure Liquid Chromatograph

Eleven baboons, anaesthetised with ketamine, had catheters introduced into the cisterna magna. Morphine was injected at lumbar level intrathecally in six and epidurally in five. Cisternal CSF was sampled hourly and the morphine concentration measured using a high pressure liquid chromatograph. In two cases following intrathecal injection peaks of 180 ng/ml at 4 hours, and 2,200 ng/ml at 3 hours were detected. In the latter case there was associated error in sampling therefore this baboon had a repeat injection four weeks later. The maximum level of morphine obtained then was 139 ng/ml at 4 hours. In the epidural group peaks of 113 ng/ml and 53 ng/ml at 1 hour were measured in 2 baboons and 27 ng/ml at 6 hours in a third. In all six other baboons following either procedure no morphine was detected in the cisterna. We conclude that morphine injected either intrathecally or epidurally in primates does migrate centrally in varying quantities. This finding would seem to have some bearing on the unpredictability of reported episodes of respiratory depression following intraspinal morphine.

Osteoinductive Effect of Cerebrospinal Fluid from Brain-Injured Patients

2007 ◽  
Vol 24 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Oliver P. Gautschi ◽  
Andrew M. Toffoli ◽  
Karen A. Joesbury ◽  
Allan P. Skirving ◽  
Luis Filgueira ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Injured ◽  
Injured Patients

Specific Computerized Attention Training in Stroke and Traumatic Brain-Injured Patients

2003 ◽  
Vol 14 (4) ◽  
pp. 283-292 ◽  
Author(s):  
W. Sturm ◽  
B. Fimm ◽  
A. Cantagallo ◽  
N. Cremel ◽  
P. North ◽  
...  
Keyword(s):  
Divided Attention ◽  
Single Case ◽  
Baseline Period ◽  
Specific Training ◽  
Attention Task ◽  
Baseline Phase ◽  
Computerized Training ◽  
Brain Injured ◽  
Divided Attention Task ◽  
Injured Patients

Abstract: In a multicenter European approach, the efficacy of the AIXTENT computerized training programs for intensity aspects (alertness and vigilance) and selectivity aspects (selective and divided attention) of attention was studied in 33 patients with brain damage of vascular and traumatic etiology. Each patient received training in one of two most impaired of the four attention domains. Control tests were performed by means of a standardized computerized attention test battery (TAP) comprising tests for the four attention functions. Assessment was carried out at the beginning and at the end of a four week baseline period and after the training period of 14 one-hour sessions. At the end of the baseline phase, there was only slight but significant improvement for the most complex attention function, divided attention (number of omissions). After the training, there were significant specific training effects for both intensity aspects (alertness and vigilance) and also for the number of omissions in the divided attention task. The application of inferential single case procedures revealed a high number of significant improvements in individual cases after specific training of alertness and vigilance problems. On the other hand, a non specific training addressing selectivity aspects of attention lead either to improvement or deterioration of alertness and vigilance performance. The results corroborate the findings of former studies with the same training instrument but in patients with different lesion etiologies.

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