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Cerebral Spinal Fluid

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161. Simultaneous Spinal and Intracranial Chronic Subdural Hematoma Cured by Craniotomy and Laminectomy: A Video Case Report Full Text available with Trip Pro

craniotomy, he complained of sensory disturbance on his buttocks. Lumbar MRI showed a space-occupying lesion behind the thecal sac at L5. CT with myelography showed a subdural mass lesion; there was no communication with the subarachnoid space. Fourteen days after craniotomy, L5 laminectomy was performed and the dura mater was incised carefully. The video shows that a liquid hematoma similar to the intracranial CSDH flowed out, followed by cerebrospinal fluid. His symptoms improved after the operation (...) Simultaneous Spinal and Intracranial Chronic Subdural Hematoma Cured by Craniotomy and Laminectomy: A Video Case Report Simultaneous spinal and intracranial chronic subdural hematoma (CSDH) is a rare entity. A 67-year-old man visited our hospital due to headache after diving into a river 2 weeks before. Non-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) revealed bilateral intracranial CSDH. The bilateral CSDH was evacuated and his symptoms improved. Three days after

2016 Case reports in neurology

162. Cerebral and Spinal Protection of Xenon Post-conditioning in Patients Undergoing Aortic Dissection Repair

Cerebral and Spinal Protection of Xenon Post-conditioning in Patients Undergoing Aortic Dissection Repair Cerebral and Spinal Protection of Xenon Post-conditioning in Patients Undergoing Aortic Dissection Repair - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Cerebral and Spinal Protection of Xenon Post-conditioning in Patients Undergoing Aortic Dissection Repair The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02774096 Recruitment Status : Unknown Verified May 2016 by WeiPing Cheng, Beijing Anzhen

2016 Clinical Trials

163. Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report. Full Text available with Trip Pro

Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report. Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes, and leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable biopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some characteristics, it is limited, and atypical cases are especially difficult to identify (...) with intracranial tumours and other diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected of having PCNSL.This report documents a woman who presented with a three-month history of numbness and weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed demyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of Nerve Infection and Immunology at Tiantan Hospital. Head magnetic

2019 BMC Neurology

164. Oxycodone concentrations in the central nervous system and cerebrospinal fluid after epidural administration to the pregnant ewe. Full Text available with Trip Pro

Oxycodone concentrations in the central nervous system and cerebrospinal fluid after epidural administration to the pregnant ewe. The main sites of the analgesic action of oxycodone are the brain and spinal cord. The present study describes the concentrations of oxycodone and its metabolites in the brain and spinal cord after epidural administration to the ewe. Twenty pregnant ewes undergoing laparotomy were randomized into two groups to receive epidural oxycodone: infusion group (n = 10, 0.1 (...) concentrations of oxycodone were 9.0 and 14.2 ng·mL-1 after infusion and 0.4 and 1.1 ng·mL-1 after repeated boluses. In the infusion group, the cortex, thalamus and cerebellum oxycodone concentrations were 4-8 times higher and in the spinal cord 1310 times higher than in plasma. In the repeated boluses group, brain tissue concentrations were similar in the three areas, and in the spinal cord were 720 times higher than in plasma. Oxymorphone was the main metabolite detected, which accumulated in the brain

2019 Basic & clinical pharmacology & toxicology Controlled trial quality: uncertain

165. Cerebrospinal fluid drainage complications during first stage and completion fenestrated-branched endovascular aortic repair. (Abstract)

graded as severe to moderate in 17 patients (9%). There were 12 patients (6%) with intracranial hypotension, including three (2%) who had intracranial hemorrhage and nine (5%) with post dural puncture headache requiring blood patches in six. Another six patients (3%) developed spinal hematomas resulting in paraplegia in two (1%) and transient paraparesis in two (1%). One patient had CSF leakage from the puncture site (no intervention required). Four patients had bleeding during attempted drain (...) Cerebrospinal fluid drainage complications during first stage and completion fenestrated-branched endovascular aortic repair. To determine the rates and risk factors of complications related to cerebrospinal fluid drainage (CSFD) during first stage and completion fenestrated-branched endovascular aortic repair (F-BEVAR) of pararenal and thoracoabdominal aortic aneurysms.We reviewed the outcomes of 293 consecutive patients enrolled in a prospective, nonrandomized study to investigate outcomes

2019 Journal of Vascular Surgery

166. Continuous lumbar drainage and the postoperative complication rate of open anterior skull base surgery. (Abstract)

Continuous lumbar drainage and the postoperative complication rate of open anterior skull base surgery. Anterior skull base operations pose the risk for postoperative cerebrospinal fluid (CSF) leak. Routine lumbar continuous drainage catheter (LD) placement is intended to decrease CSF leaks and central nervous system (CNS) complications, but there are no sound evidence-based data on its efficacy. The primary goal of this study was to review CNS complications following anterior open skull base (...) not. Delayed complications were defined as those occurring more than 30 days after the index operation. Thirty-one (26%) patients in the LD group had early CNS complications compared with only two (1.6%) in the non-LD group, whereas 13 (11%) of the former patients had late CNS complications compared with four (3%) of the latter patients. Early systemic and late wound complications were also significantly more numerous in the LD group. On multivariate analysis, elective LD insertion and intracranial tumor

2018 Laryngoscope

167. Central Nervous System Bleeding After a Lumbar Puncture: Still an Ongoing Complication Full Text available with Trip Pro

Central Nervous System Bleeding After a Lumbar Puncture: Still an Ongoing Complication BACKGROUND A lumbar puncture is a procedure performed to uncover the state of the central nervous system by analysis of the cerebrospinal fluid. It is done also to infuse medications in the subdural space. A lumbar puncture should not cause central nervous system bleeding, but this complication is still occurring in certain cases. CASE REPORT We present 2 cases where a lumbar puncture was performed (...) in the emergency department. The first patient had severe inflammatory lower back pain and received epidural steroids through a lumbar puncture and the second case presented with the clinical picture of meningitis and a lumbar puncture was performed for diagnostic purposes. In both cases, major complications arose secondary to bleeding in the cerebrospinal fluid. The first case developed a bleeding tendency because the patient had acute renal failure and was on low molecular weight heparin. The second case had

2018 The American journal of case reports

168. Improved lumbar infusion test analysis for normal pressure hydrocephalus diagnosis Full Text available with Trip Pro

Improved lumbar infusion test analysis for normal pressure hydrocephalus diagnosis Constant infusion lumbar infusion test (LIT) is an important way to find which patients, of those with signs and symptoms corresponding to normal pressure hydrocephalus (NPH) who will improve from shunt operation. LIT is a stress test on the ability for cerebrospinal fluid re-absorbtion. The aim of this study is to show how the information from LIT can be improved by quantitative analysis and avoidance (...) of methodological pitfalls.The potential pitfalls, and the analysis method, are described in detail. The analysis was applied on pre-operative constant infusion LIT from 31 patients operated for NPH, with known outcome. The pre- and post-operative walking speed was used to grade pathology progression or improvement.The maximal, plateau, intra-spinal pressure at constant infusion LIT is an ambivalent indicator for NPH: while low maximal pressure indicates no cerebrospinal fluid (CSF) absorbtion pathology, too

2018 Brain and behavior

169. Bowel perforation by lumbar-peritoneal (LP) shunt: A rare complication of neurosurgery Full Text available with Trip Pro

Bowel perforation by lumbar-peritoneal (LP) shunt: A rare complication of neurosurgery Lumbar-peritoneal (LP) and ventriculo-peritoneal (VP) shunt placement is the treatment of choice for diversion of cerebrospinal fluid (CSF) from the subarachnoid space into the peritoneal cavity. This invasive procedure has been associated with several complications, most commonly infection and obstruction. Perforation of the bowel is an extremely rare complication.We report a case of a 72 old female patient (...) with LP shunt for raised intracranial pressure, who presented with LP shunt catheter protruding from anus. This was due to bowel perforation in the recto-sigmoid junction by the distal tip of lumbar-peritoneal shunt. She was surgically treated with removal of the distal part of the shunt, external drainage of the proximal part and primary closure of the perforation.The mortality after perforation is relatively high, approaching 15-18%, and it is further increased when infection is present up to 22

2018 International journal of surgery case reports

170. Bedside Ultrasound for the Evaluation of Epidural Hematoma After Infant Lumbar Puncture. (Abstract)

with EH formation.We enrolled infants younger than 6 months who underwent LP in the emergency department. The primary investigator performed a bedside US of the lumbar spine, which was reviewed and interpreted by a pediatric radiologist. Treating clinicians performed the procedure and were asked to classify each attempt as "traumatic" or "atraumatic." Cerebral spinal fluid RBC counts were recorded.Thirty-one percent of patients had evidence of post-LP EH, 17% of which completely effaced the thecal sac (...) Bedside Ultrasound for the Evaluation of Epidural Hematoma After Infant Lumbar Puncture. Unsuccessful lumbar puncture (LP) attempts may lead to epidural hematoma (EH) formation within the spinal canal at the site of needle insertion, which can affect subsequent attempts. We aimed to determine the rate of EH formation after infant LP using bedside ultrasound (US). Furthermore, we aimed to correlate both perceived trauma during LP and cerebral spinal fluid (CSF) red blood cell (RBC) counts

2018 Pediatric Emergency Care

171. Real time optic nerve sheath diameter measurement during lumbar puncture. (Abstract)

Real time optic nerve sheath diameter measurement during lumbar puncture. Measurement of optic nerve sheath diameter (ONSD) using point of care ultrasound has been used to indirectly assess the intracranial pressure (ICP) particularly in conditions where it is raised. Direct pressure measurements using probes reaching the ventricle system correlated with ONSD using ultrasound. Attempts were made to measure the ONSD pre and post lumbar puncture (LP) after draining cerebrospinal fluid (CSF (...) ) as well as post ventricular shunt placement. We report ONSD measurement and demonstrate dynamic changes during LP in a patient with known idiopathic intracranial hypertension (IIH).Copyright © 2018 Elsevier Inc. All rights reserved.

2018 American Journal of Emergency Medicine

172. The Effectiveness and Safety of Human Lumbar Puncture Assist Device (LPat)

of performing lumbar puncture (LP), avoid side effects from multiple punctures, avoid excess radiation if the LP need to be done under fluoroscopy, and need to obtain none traumatic tap for better CSF analysis. Condition or disease Intervention/treatment Meningitis Encephalitis Guillain-Barré Subarachnoid Hemorrhage Intracranial Neoplasm Intracranial CNS Disorder Device: LPat Device Detailed Description: "Human Lumbar Puncture Assist Device (LPat)" was invented as an assist tool to be utilized to improve (...) Method: Non-Probability Sample Study Population Any patient 12 years or older Criteria Inclusion Criteria: Patients age 12 years and older who need lumbar puncture (LP) for diagnostic purposes or patients already underwent LP but failed to obtain Cerebrospinal Fluids i.e. "Unsuccessful Tap" Exclusion Criteria: Patients younger than 12 years of age Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study

2018 Clinical Trials

173. Erythrophages do not develop when lumbar CSF and blood samples are mixed in vitro Full Text available with Trip Pro

Erythrophages do not develop when lumbar CSF and blood samples are mixed in vitro Cerebrospinal fluid (CSF) analysis is a crucial method in the diagnostic process for suspected subarachnoid hemorrhage (SAH), especially when cerebral imaging is negative or inconclusive. CSF cytology (detection of erythrophages or siderophages) is used to determine whether a bloodstained CSF resembles a genuine SAH. Whether erythrophages may develop in vitro after a traumatic puncture in case of delayed CSF (...) analysis is unclear. An in vitro development of erythrophages after traumatic puncture would diminish the diagnostic properties of CSF analysis. We assessed whether erythrophagocytosis is detectable in CSF after an imitated traumatic lumbar puncture.We mimicked a traumatic lumbar puncture by mixing surplus CSF with whole blood from the same patient. From this mixture, cytological specimens were obtained immediately and repeatedly at time intervals of 1 h, until 7 h after mixing, or until the mixture

2018 Fluids and barriers of the CNS

174. SubArachnoid Hemorrhage HEadache Treated by Lumbar Puncture

. Hemorrhagic cerebrospinal fluid (CSF) removal by a lumbar puncture (LP), is well tolerated, reduces intracranial pressure and accelerates the clearance of the blood products from CSF. Nonetheless it has never been tested in a randomized trial. The investigators aim to compare in patients who experienced a low grade aSAH, the variation of headache intensity after CSF removal by LP vs. Sham LP in addition to predefined analgesic protocol management. Condition or disease Intervention/treatment Phase (...) from the prolonged increased intracranial pressure and meningeal inflammation related to the accumulation of blood products in the subarachnoid space. Preliminary studies, suggest that hemorrhagic cerebrospinal fluid (CSF) removal by lumbar puncture (LP) or lumbar drain, is safe and decreases intracranial pressure. However its impact on headache control has never been tested. A reliable headache evaluation has to be performed among conscious patients experiencing a "low-grade" aSAH. The objective

2018 Clinical Trials

175. Intracranial complications associated with spinal surgery. (Abstract)

Intracranial complications associated with spinal surgery. Though rare, intracranial complications have been reported as a result from spinal surgery. Most if not all of these are a result of intracranial hypotension from durotomy and cerebrospinal fluid (CSF) leak. We aimed to characterize these complications across a large postoperative population at our institution.We conducted a retrospective review of all patients who underwent spinal surgery at our institution by four neurosurgeons from (...) July 2008 to August 2013.Our review yielded 1113 consecutive patients who underwent spinal surgery for a total of 1396 procedures. Intracranial imaging using either computed tomography or magnetic resonance imaging was obtained on 59 (4.2%) patients after a procedure due to neurologic change. Six patients (0.4%) were found to have intracranial findings of subdural hygroma (4 patients), remote cerebellar hemorrhage (1 patient), or subdural hematoma (1 patient).Intracranial complications from spinal

2015 European Spine Journal

176. Acute visual loss in a patient with spinal cord injury Full Text available with Trip Pro

tract infections. On hospital day 4, he developed acute bilateral vision loss. The next morning he had a generalized-tonic-clonic seizure followed by cardiac arrest, with return of spontaneous circulation following resuscitation. Magnetic resonance imaging brain demonstrated multifocal areas of hyperintensity on T2 fluid-attenuated inversion recovery sequence, most pronounced in the occipital lobes. Systolic blood pressures (SBP) were under 180 mmHg throughout hospital stay but above his baseline (...) Acute visual loss in a patient with spinal cord injury Patients with spinal cord injury (SCI), especially those with injury at and above T6, are prone to transient episodes of hypertension induced by noxious triggers below the level of SCI, known as autonomic dysreflexia (AD). An uncommonly reported presentation of AD is posterior reversible encephalopathy syndrome (PRES).A 50-year-old male with the history of paraplegia from SCI presented with sepsis secondary to baclofen pump and urinary

2017 Spinal cord series and cases

177. Intrathecal baclofen for treating spasticity in children with cerebral palsy. (Abstract)

Intrathecal baclofen for treating spasticity in children with cerebral palsy. Cerebral palsy is a disorder of movement and posture arising from a non-progressive lesion in the developing brain. Spasticity, a disorder of increased muscle tone, is the most common motor difficulty and is associated with activity limitation to varying degrees in mobility and self care.Oral baclofen, a gamma-aminobutyric acid (GABA) agonist, has been used in oral form to treat spasticity for some time, but it has (...) a variable effect on spasticity and the dose is limited by the unwanted effect of excessive sedation. Intrathecal baclofen produces higher local concentrations in cerebrospinal fluid at a fraction of the equivalent oral dose and avoids this excessive sedation.To determine whether intrathecal baclofen is an effective treatment for spasticity in children with cerebral palsy.We searched the CENTRAL, MEDLINE, EMBASE and CINAHL databases, handsearched recent conference proceedings, and communicated

2015 Cochrane

178. Cerebrospinal fluid mitochondrial DNA – a novel DAMP in pediatric traumatic brain injury Full Text available with Trip Pro

lead to the release of mtDNA into the cerebrospinal fluid (CSF) and has the potential to predict the outcome after trauma. Cerebrospinal fluid was collected from children with severe TBI who required intracranial pressure monitoring with Glasgow Coma Scale (GCS) scores of 8 or less via an externalized ventricular drain. Control CSF was obtained in children without TBI or meningoencephalitis who demonstrated no leukocytes in the diagnostic lumbar puncture. The median age for patients with TBI (...) Cerebrospinal fluid mitochondrial DNA – a novel DAMP in pediatric traumatic brain injury Danger-associated molecular patterns (DAMPs) are nuclear or cytoplasmic proteins that are released from the injured tissues and activate the innate immune system. Mitochondrial DNA (mtDNA) is a novel DAMP that is released into the extracellular milieu subsequent to cell death and injury. We hypothesized that cell death within the central nervous system in children with traumatic brain injury (TBI) would

2014 Shock (Augusta, Ga.)

179. Lumbar Spine, Trauma

). Lumbar spine trauma. Sagittal multiplanar reformatted CT scan demonstrates a compression fracture of the L1 vertebral body (white arrow). A large fragment of bone projects into the spinal canal (yellow arrow). Although not yet at the point of clinical application, traumatic vertebral body fracture detection software has been reported. The software digitally strips the vertebral body cortex and looks for fractures in the cortical shell and is able to differentiate isolated Denis anterior column (...) image in a patient with a burst fracture injury to the upper lumbar spine. The posterior margin of the vertebral endplate has been displaced into the spinal canal (arrow). Cerebrospinal fluid is seen as bright signal anterior to the conus and upper cauda equina. Lumbar spine trauma. A 35-year-old man presented to the emergency department after a motor vehicle accident. He complained of back pain without paresthesias or weakness of his lower extremities. Findings on the sagittal T2-weighted MRI

2014 eMedicine Radiology

180. Antibiotic Prophylaxis in Spine Surgery (Revised 2013)

of recommendations, these recommendations will be operation- alized into performance measures. Multidisciplinary Collaboration With the goal of ensuring the best possible care for adult patients suffering with spinal disorders, NASS is committed to multidis - ciplinary involvement in the process of guideline and perfor- mance measure development. To this end, NASS has ensured that representatives from medical, interventional and surgical spine specialties have participated in the development and re- view of all (...) in answering different questions within this guideline. How a given question was asked might influence how a study was evaluated and interpreted as to its level of evidence in answer- ing that particular question. For example, a randomized control trial reviewed to evaluate the differences between the outcomes of surgically treated versus untreated patients with lumbar spinal stenosis might be a well designed and implemented Level I ther- apeutic study. This same study, however, might be classified

2013 North American Spine Society

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