scholarly journals Opportunistic Disease or Metastatic Lesions: A Rare Finding in a Patient with Bladder Cancer

2019 ◽  
Vol 13 (1) ◽  
pp. 54-56
Author(s):  
Michael Simon ◽  
Natalie Elkayam ◽  
Jonathan Smerling ◽  
Michael Marcelin ◽  
Stephan Kamholz
Keyword(s):  
Bladder Cancer ◽  
Metastatic Disease ◽  
Cerebral Spinal Fluid ◽  
Vasogenic Edema ◽  
Brain Biopsy ◽  
Spinal Fluid ◽  
Cd4 Count ◽  
Frontal Horn ◽  
The Right ◽  
The Brain

A 66-year-old male with a history of human immunodeficiency virus infection and metastatic bladder cancer presented to our hospital for a further workup of a focal seizure involving the patients left upper extremity. The patient was undergoing active chemotherapy at the time of admission and had a CD4 count of 111. Magnetic resonance imaging of the brain revealed multiple ring-enhancing lesions in the right frontal lobe associated with vasogenic edema, and mass effect at the right frontal horn of the lateral ventricles. As the imaging was not consistent with typical metastatic disease of the bladder, further testing was performed. A lumbar puncture was performed to assist in differentiating between malignant and infectious causes in the setting of a low CD4 count. The cerebral spinal fluid was sterile and no malignant cells were identified. Protein and glucose levels of the cerebral spinal fluid were within normal range. To confirm the presence of metastatic disease, a brain biopsy was performed and found to be consistent with metastatic carcinoma with a bladder primary. The patient subsequently underwent radiation therapy to the site of the brain metastasis.

scholarly journals A history of the path towards imaging of the brain: From skull radiography through cerebral angiography

2021 ◽  
Author(s):  
Haris Kamal ◽  
Edward J. Fine ◽  
Banafsheh Shakibajahromi ◽  
Ashkan Mowla
Keyword(s):  
Contrast Agent ◽  
Carotid Arteries ◽  
Cerebral Arteries ◽  
X Ray ◽  
Spinal Subarachnoid Space ◽  
Frontal Horn ◽  
History Of ◽  
The Right ◽  
Occipital Lobes ◽  
The Brain

This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified tumors, shifts in midline position of a calcified pineal gland due to a mass in the cranium, or foreign metallic objects within the skull. Walter Dandy reported in 1918 that he visualized cerebral ventricles by introducing air as a contrast agent through a trocar into one of the occipital lobes or the right frontal horn of the ventricular system. Dandy localized lesions that distorted or shifted the ventricles. In 1920, Dandy placed air by lumbar puncture into the spinal subarachnoid space that could visualize the brain and entire ventricles. Antonio Egas Moniz with the assistance of his neurosurgeon colleague, Almeida Lima, obtained X-ray images of cerebral arteries of dogs and decapitated human heads from corpses after injecting strontium bromide into their carotid arteries. Satisfied by these experiments, Moniz injected strontium bromide directly into carotid arteries of five patients which failed to show intracranial vessels. In the sixth patient, intracranial arteries were outlined but that patient died of cerebral thrombosis presumably due to the hyper- osmolality of that contrast agent. Finally, on June 18, 1927, Moniz injected 22% sodium iodine into a 20-year-old man and obtained clear visualization of his carotid artery and intracerebral branches after temporarily occluding the artery with a ligature. 

Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder

2011 ◽  
Vol 18 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Ju-Hong Min ◽  
Byoung Joon Kim ◽  
Kwang Ho Lee
Keyword(s):  
Neuromyelitis Optica ◽  
Vasogenic Edema ◽  
Brain Mri ◽  
Brain Lesions ◽  
Steroid Treatment ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Parietal Lobes ◽  
The Right ◽  
The Brain

We report the case of a patient who developed extensive brain lesions during fingolimod (FTY720) treatment in the TRANSFORMS study. His initial diagnosis was multiple sclerosis, but after encephalopathy anti-aquaporin4 antibody (anti-AQP4 Ab) was detected, it was changed to neuromyelitis optica spectrum disorder. After treatment with fingolimod, he developed bilateral extensive brain lesions. The brain MRI showed lesions predominantly involving the right frontal and parietal lobes, with vasogenic edema and enhancement. He had residual encephalomalacia and no recurrence with steroid treatment over 3 years following withdrawal of fingolimod.

Pulmonary hemodynamic responses to elevated cerebral spinal fluid pressure in the dog

1979 ◽  
Vol 46 (1) ◽  
pp. 84-88 ◽  
Author(s):  
M. B. Maron ◽  
T. S. Hakim ◽  
C. A. Dawson
Keyword(s):  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Cerebral Spinal Fluid ◽  
Stellate Ganglion ◽  
Fluid Pressure ◽  
Lower Lobe ◽  
Spinal Fluid ◽  
Left Lower Lobe ◽  
Pulmonary Hemodynamic ◽  
The Right

To investigate the possibility that a pulmonary vasomotor reflex contributes to the pulmonary hemodynamic response to elevated cerebral spinal fluid pressure (PCSF), we studied 10 chloralose-anesthetized dogs in which the left lower lobe (LLL) perfusion was isolated to eliminate the influence of passive factors and of circulating vasoactive agents. Left lower lobe neural integrity was tested by electrically stimulating the stellate ganglion. This resulted in a 35.5% increase in lobar vascular resistance and a 29.1% increase in systemic vascular resistance. Elevating the PCSF to 137 Torr caused the systemic vascular resistance to increase 33.0%, but resulted in no change in LLL vascular resistance. In the intact right lung, this PCSF elevation resulted in increases in pulmonary artery and left atrial pressures, but no change in right lung vascular resistance. Because the neurally intact LLL did not respond to PCSF elevation and the responses of the right lung could be accounted for by passive mechanisms, we conclude that no pulmonary vascular reflex was elicited by PCSF elevation in this preparation.

Effects of Anisotonicity in the Cisterna Magna and Fourth Ventricle of Cats

1958 ◽  
Vol 193 (1) ◽  
pp. 207-212 ◽  
Author(s):  
John Andrew ◽  
Julien Taylor
Keyword(s):  
Fourth Ventricle ◽  
Cerebral Spinal Fluid ◽  
Autonomic Function ◽  
Spinal Fluid ◽  
Distilled Water ◽  
Neural Pathways ◽  
Cisterna Magna ◽  
The Central Nervous System ◽  
Series Of Experiments ◽  
The Brain

Following the observation that distilled water, when introduced into the cisterna magna of a cat, produced marked disturbances of autonomic function, a series of experiments was carried out to determine the effect of altering the tonicity of the cerebral spinal fluid. Observations were made on 20 cats under general anesthesia. Precautions were taken to eliminate undesirable effects from raised intracranial pressure. An increase in osmotic tension was found consistently to stimulate respiration and cause marked changes in the electrocardiogram. Reduction of the osmotic tension depressed respiratory function and could cause death. Evidence obtained from a) recording electrical activity in different parts of the brain, b) applying distilled water and hypertonic sodium chloride directly to various parts of the central nervous system, and c) interruption of neural pathways, suggests that an area of special sensitivity to alterations of tonicity in the cerebral spinal fluid exists, and that it is located in the floor of the fourth ventricle.

scholarly journals Mother’s voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation

2015 ◽  
Vol 112 (10) ◽  
pp. 3152-3157 ◽  
Author(s):  
Alexandra R. Webb ◽  
Howard T. Heller ◽  
Carol B. Benson ◽  
Amir Lahav
Keyword(s):  
Brain Plasticity ◽  
Environmental Noise ◽  
Sound Exposure ◽  
Early Life Programming ◽  
Frontal Horn ◽  
Neural Processes ◽  
The Right ◽  
Mother’S Voice ◽  
Auditory Plasticity ◽  
The Brain

Brain development is largely shaped by early sensory experience. However, it is currently unknown whether, how early, and to what extent the newborn’s brain is shaped by exposure to maternal sounds when the brain is most sensitive to early life programming. The present study examined this question in 40 infants born extremely prematurely (between 25- and 32-wk gestation) in the first month of life. Newborns were randomized to receive auditory enrichment in the form of audio recordings of maternal sounds (including their mother’s voice and heartbeat) or routine exposure to hospital environmental noise. The groups were otherwise medically and demographically comparable. Cranial ultrasonography measurements were obtained at 30 ± 3 d of life. Results show that newborns exposed to maternal sounds had a significantly larger auditory cortex (AC) bilaterally compared with control newborns receiving standard care. The magnitude of the right and left AC thickness was significantly correlated with gestational age but not with the duration of sound exposure. Measurements of head circumference and the widths of the frontal horn (FH) and the corpus callosum (CC) were not significantly different between the two groups. This study provides evidence for experience-dependent plasticity in the primary AC before the brain has reached full-term maturation. Our results demonstrate that despite the immaturity of the auditory pathways, the AC is more adaptive to maternal sounds than environmental noise. Further studies are needed to better understand the neural processes underlying this early brain plasticity and its functional implications for future hearing and language development.

Republished: Targeted epidural patch with n-butyl cyanoacrylate (n-BCA) through a single catheter access site for treatment of a cerebral spinal fluid leak causing spontaneous intracranial hypotension

2015 ◽  
Vol 8 (7) ◽  
pp. e26-e26 ◽  
Author(s):  
Sean Woolen ◽  
Joseph J Gemmete ◽  
Aditya S Pandey ◽  
Neeraj Chaudhary
Keyword(s):  
Intracranial Hypotension ◽  
Cerebral Spinal Fluid ◽  
Spontaneous Intracranial Hypotension ◽  
Transverse Sinus ◽  
Spinal Fluid ◽  
Csf Leak ◽  
Flow Void ◽  
Dural Enhancement ◽  
Fluid Collections ◽  
The Right

Spontaneous intracranial hypotension (SIH) usually occurs in the setting of a spontaneous cerebral spinal fluid (CSF) leak. We report the first description of a case of SIH caused by a CSF leak which improved after a targeted epidural patch with n-butyl cyanoacrylate (n-BCA) at the right T1–T2 level. An 81-year-old woman presented with an orthostatic headache for 6 days. MRI of the brain with contrast demonstrated low lying cerebellar tonsils, an engorged transverse sinus flow void, bifrontal small subdural fluid collections, and diffuse dural enhancement. CT myelography showed extravasation of intrathecal contrast at the right T1–T2 level. A targeted epidural patch was performed by injection of n-BCA through a catheter at the right T1–T2 level. After treatment, the patient's symptoms immediately improved and she was without a headache at 1-year follow-up.

scholarly journals Leptin acts in the brain to influence hypoglycemic counterregulation: disparate effects of acute and recurrent hypoglycemia on glucagon release

2015 ◽  
Vol 309 (12) ◽  
pp. E960-E967 ◽  
Author(s):  
Candace M. Reno ◽  
Yuyan Ding ◽  
Robert Sherwin
Keyword(s):  
Cerebral Spinal Fluid ◽  
Glucagon Secretion ◽  
Spinal Fluid ◽  
Glucagon Release ◽  
Basal Plasma ◽  
Acute Hypoglycemia ◽  
Plasma Leptin ◽  
The Brain ◽  
Recurrent Hypoglycemia

Leptin has been shown to diminish hyperglycemia via reduced glucagon secretion, although it can also enhance sympathoadrenal responses. However, whether leptin can also inhibit glucagon secretion during insulin-induced hypoglycemia or increase epinephrine during acute or recurrent hypoglycemia has not been examined. To test whether leptin acts in the brain to influence counterregulation, hyperinsulinemic hypoglycemic (∼45 mg/dl) clamps were performed on rats exposed to or not exposed to recurrent hypoglycemia (3 days, ∼40 mg/dl). Intracerebroventricular artificial cerebral spinal fluid or leptin was infused during the clamp. During acute hypoglycemia, leptin decreased glucagon responses by 51% but increased epinephrine and norepinephrine by 24 and 48%, respectively. After recurrent hypoglycemia, basal plasma leptin levels were undetectable. Subsequent brain leptin infusion during hypoglycemia paradoxically increased glucagon by 45% as well as epinephrine by 19%. In conclusion, leptin acts within the brain to diminish glucagon secretion during acute hypoglycemia but increases epinephrine, potentially limiting its detrimental effects during hypoglycemia. Exposure to recurrent hypoglycemia markedly suppresses plasma leptin, whereas exogenous brain leptin delivery enhances both glucagon and epinephrine release to subsequent hypoglycemia. These data suggest that recurrent hypoglycemia may diminish counterregulatory responses in part by reducing brain leptin action.

scholarly journals Reversible Coma: A Rare Presentation of Spontaneous Intracranial Hypotension

2004 ◽  
Vol 31 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Jodi L. Kashmere ◽  
Michael J. Jacka ◽  
Derek Emery ◽  
Donald W. Gross
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypotension ◽  
Cerebral Spinal Fluid ◽  
Spontaneous Intracranial Hypotension ◽  
Spinal Fluid ◽  
Resonance Imaging ◽  
Rare Presentation ◽  
Blood Patch ◽  
The Brain

Background:Spontaneous intracranial hypotension (SIH) is a well-recognized neurologic disorder that typically presents with orthostatic headaches, low cerebral spinal fluid pressures and distinct abnormalities on magnetic resonance imaging.Methods:We present a case of a rare presentation of SIH.Results:A 49-year-old man presented with a two week history of orthostatic headaches that rapidly progressed to encephalopathy and coma, requiring intubation. Neuroimaging revealed abnormalities typical of SIH; diffusely enhancing pachymeninges, subdural fluid collections, and descent of the brain. Treatment with an epidural blood patch reversed his coma within minutes. Following a second blood patch, the patient became asymptomatic. No cerebral spinal leak could be identified on magnetic resonance imaging or on a nuclear medicine technetium cerebral spinal fluid flow study. At six month follow-up, he remained symptom free.Conclusion:The mechanism of coma in SIH is presumed to be compression of the diencephalon from downward displacement of the brain. Although it is very unusual for patients with SIH to present with coma, it is important to recognize since the coma may be reversible with epidural blood patches.

The brain structure and neurosecretory cells of noctuid moth Anadevidia peponis: Noctuidae

1990 ◽  
Vol 48 (3) ◽  
pp. 436-437
Author(s):  
M. Sato ◽  
Y. Ogawa ◽  
M. Sasaki ◽  
T. Matsuo
Keyword(s):  
Biological Clock ◽  
Virgin Female ◽  
Basic Structure ◽  
Fixed Time ◽  
Neurosecretory Cells ◽  
Nerve Cells ◽  
Noctuid Moth ◽  
The Right ◽  
20 Nm ◽  
The Brain

A virgin female of the noctuid moth, a kind of noctuidae that eats cucumis, etc. performs calling at a fixed time of each day, depending on the length of a day. The photoreceptors that induce this calling are located around the neurosecretory cells (NSC) in the central portion of the protocerebrum. Besides, it is considered that the female’s biological clock is located also in the cerebral lobe. In order to elucidate the calling and the function of the biological clock, it is necessary to clarify the basic structure of the brain. The observation results of 12 or 30 day-old noctuid moths showed that their brains are basically composed of an outer and an inner portion-neural lamella (about 2.5 μm) of collagen fibril and perineurium cells. Furthermore, nerve cells surround the cerebral lobes, in which NSCs, mushroom bodies, and central nerve cells, etc. are observed. The NSCs are large-sized (20 to 30 μm dia.) cells, which are located in the pons intercerebralis of the head section and at the rear of the mushroom body (two each on the right and left). Furthermore, the cells were classified into two types: one having many free ribosoms 15 to 20 nm in dia. and the other having granules 150 to 350 nm in dia. (Fig. 1).

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