Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)after cervical surgery.Methods Medical records of 642 patients who underwent cervical surgery between December 1999 and December ...Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)after cervical surgery.Methods Medical records of 642 patients who underwent cervical surgery between December 1999 and December 2005 at our hospital were retrospectively reviewed.Five patients complicated by CSFL after surgery were enrolled,of which 4 cases were complicated after ossified posterior longitudinal ligament or posterior vertebral osteophyte resection directly injuring the dura,and 1 case after posterior cervical double-door laminoplasty without observed dural injury during surgery.Of the 5 CSFL cases,4 cases occurred at 1-3 days after operation and 1 case at 9 days after operation.All 5 postoperative CSFL cases were treated through wound drainage removal,wound sutures,prophylactic antibiotics,and continuous subarachnoid drainage in the elevated head position.Results All 5 CSFL cases experienced leakage cessation within 1-3 days and wound healing within 4-8 days,and subarachnoid drainage lasted 11-16 days with an average volume of 320 mL(range,150-410 mL).Four cases experienced headache,nausea and vomiting,1 case suffered from somnolence and hyponatremia,and symptoms subsided after symptomatic treatment and intravenous fluid administration.All patients were followed up for an average of 32 months(range,22-50 months).No occurrence of cerebrospinal fluid cyst or wound infection was observed.CSFL produced no significant negative effects upon neuromuscular function recovery.Conclusion Continuous subarachnoid cavity drainage in combination with elevated head position is a simple and safe non-surgical method in treatment of CSFL following cervical surgery.展开更多
BACKGROUND Meningitis is a life-threatening clinical condition associated with high mortality and morbidity.Early diagnosis and specific treatment may improve outcomes.Lack of specific clinical signs or tests make the...BACKGROUND Meningitis is a life-threatening clinical condition associated with high mortality and morbidity.Early diagnosis and specific treatment may improve outcomes.Lack of specific clinical signs or tests make the diagnosis challenging.AIM To assess the efficacy of cerebrospinal fluid(CSF)lactate in diagnosing meningitis in critically ill patients.METHODS A prospective,observational cohort study was carried out in a neuro-medical intensive care unit(ICU)over a 22 mo period.Adult patients,with suspected meningitis admitted in ICU,were serially recruited.Patients who refused consent,those with peripheral sensorineural deficit,or with any contraindication to lumber puncture were excluded.CSF cytology,bio-chemistry,lactates,culture and polymerase chain reaction based meningo-encephalitis panel were evaluated.Patients were divided in two groups based on clinical diagnosis of meningitis.The efficacy of CSF lactate in diagnosing meningitis was evaluated and compared with other tests.RESULTS Seventy-one patients were included and 23 were diagnosed with meningitis.The mean values of CSF total leucocyte count(TLC),proteins and lactates were significantly higher in meningitis group.There was a significant correlation of CSF lactate levels with CSF cultures and meningo-encephalitis panel.CSF lactate(>2.72 mmol/L)showed good accuracy in diagnosing meningitis with an area under the curve of 0.81(95% confidence interval:0.69-0.93),sensitivity of 82.6%,and specificity 72.9%.These values were comparable to those of CSF TLC and protein.Twelve patients with bacterial meningitis had significantly higher CSF lactate(8.9±4.7 mmol/L)than those with non-bacterial meningitis(4.2±3.8 mmol/L),P=0.006.CONCLUSION CSF lactate may be used to aid in our diagnosis of meningitis in ICU patients.CSF lactate(>2.72 mmol/L)showed good accuracy,sensitivity,and specificity in diagnosing meningitis and may also help to differentiate between bacterial and non-bacterial meningitis.展开更多
<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resecti...<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. <strong>Methods:</strong> The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. <strong>Results:</strong> Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. <strong>Conclusion: </strong>For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.展开更多
Neurogenesis from inner brain neural stem cells (NSCs) is a process which takes place continuously in mammals through- out their life. However, the main ontogenic difference is the intensity of neurogenesis, which c...Neurogenesis from inner brain neural stem cells (NSCs) is a process which takes place continuously in mammals through- out their life. However, the main ontogenic difference is the intensity of neurogenesis, which commences as a very intensive and global activity in the early embryonic brain (neural tube), persists in fetal and newborn stages, and declines significantly in adulthood, becoming restricted to specific places with low neurogenic activity such as the subventricular zone (SVZ) and the subgranular zone (SGZ) in the dentate gyrus (DG) of the hippocampus.展开更多
To establish the microarray technique with 16S rRNA probe for the rapid detection of pathogenic bacteria in cerebrospinal fluid, a set of Digoxin labelling universal primers were designed, and used to amplify the 16S ...To establish the microarray technique with 16S rRNA probe for the rapid detection of pathogenic bacteria in cerebrospinal fluid, a set of Digoxin labelling universal primers were designed, and used to amplify the 16S rRNA gene, and 2 specific probes for each bacterium designed were spotted onto nylon membrane to make a microarray, followed by hybridization to PCR products of bacteria, which set up a microarray technique for parallel detection of bacteria in cerebrospinal fluid (CSF). Twenty-nine CSF specimens from 16 patients that were proved to be positive by bacterial cultures and by using Vitek AMA-32 automated system were examined in the present investigation. It was found that positive fragment with length of 168?bp were amplified from 45 strains of 20 bacterial species, and amplifications also detected in 29 CSF specimens. The method of universal PCR could detect as few as 1 pg of bacterial DNA, and this microarray could identify all the bacterial species in CSF except Mycobacterium tuberculosis and Proteus mirabilis , satisfying the direct detection of bacteria in CSF specimens including a case of mixed bacterial infection. The positive and negative predictive value as well as the diagnostic index of this microarray were 100%, 94.67%, and 180.88 respectively, and the time of performance spent only for 5?h. It was concluded the method described in the present investigation can be used to detect and identify the pathogenic bacteria in CSF.展开更多
BACKGROUND: Guillain-Barre syndrome (GBS) is an autoimmune disease which is characterized by demyelination of peripheral nerve and nerve root, and inflammatory reaction of lymphocyte and macrophage. Neuroelectrophy...BACKGROUND: Guillain-Barre syndrome (GBS) is an autoimmune disease which is characterized by demyelination of peripheral nerve and nerve root, and inflammatory reaction of lymphocyte and macrophage. Neuroelectrophysiological examination and cerebrospinal fluid (CSF) analysis are of significance for its diagnosis. OBJECTIVE: To study the association of neuroelectrophysiology and cerebrospinal fluid immunoglobulin (CSF-lg) with pathogenetic conditions of patients with GBS. DESIGN: Case control study SETTING: Department of Neurology, Shenzhen Municipal Shekou Group Hospital; Department of Neuroelectrophysiology, People's Hospital of Guangdong Province. PARTICIPANTS: A total of 32 GBS patients including 18 males and 14 females who aged from 17 to 72 years were selected as experimental group from the Department of Neurology, People's Hospital of Guang- dong Province from January 2004 to December 2005. All cases conformed with GBS diagnostic criteria established by Asbury in 1990 and they were divided into three types according to neurological criteria established by Chinese Neurology and Psychology Journal in 1993: mild, moderate and severe types. Another 30 patients with vascular headache were selected as control group from the same hospital including 14 males and 16 females who aged from 17 to 79 years. METHODS: ① Neuroelectrophysiological examination: Multiple-functional electromyography device provided by Nicolet Company, USA was used to measure nerve conduction velocity (NCV), including motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV); meanwhile, electromyologram (EMG), somatosensory evoked potential (SEP) and electroencephalogram (EEG) were also measured. ② Detection of CSF-lg: Concentrations of IgG, IgA and IgM were measured with immunofixation electrophoresis. ③Follow-up: Among 32 GBS patients, 14 cases received follow-up after treatment and the longest fol- low-up time was 1 year after onset. Among them, 8 cases were reexaminined with neuroelectrophysiological and CSF examinations. MAIN OUTCOME MEASURES: Results of NCV, EMG, SEP and EEG; comparison of CSF-lg content; results of follow-up examinations. RESULTS: All 32 GBS cases and 30 patients with vascular headache were involved in the final analysis. ① Abnormal rate of neuroelectrophysiological test: 75% of NCV, 88% of F-wave, 53% of MCV, 25% of SEP, 47% of EMG and 31% of EEG. There were no significant differences among various types (P 〉 0.05). ② Results of CSF-lg test: There were no significant differences among various types (P 〉 0.05); however, abnormalities in experimental group was higher than those in control group (P 〈 0.01). CONCLUSION : Results of follow-up study suggest that improvement of clinical symptom is earlier than neuroelectrophysiological recovery; MCV and EMG recoveries are faster than that of NCV; the earlier the abnormality of EMG, the poorer the recovery. CSF4g recovers normally along improvement of clinical symptoms. It is of significance for neuroelectrophysiology and abnormality of CSF-Ig to determine degree of peripheral nerve demyelination and prognosis.展开更多
Objective To analyze the causes and prevention and treatment of cerebrospinal fluid leak during transsphenoidal pituitary adenoma surgery. Methods Retrospective study of 260 cases of microscopic transsphenoidal surger...Objective To analyze the causes and prevention and treatment of cerebrospinal fluid leak during transsphenoidal pituitary adenoma surgery. Methods Retrospective study of 260 cases of microscopic transsphenoidal surgery and 274 cases of endoscopic surgery for resection of the pituitary adenomas was performed. CSF leak occurred展开更多
BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningit...BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported,the mechanism remains uncertain.Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism.CASE SUMMARY A 45-year-old man underwent cervical laminoplasty for cervical spondylotic myelopathy at a local hospital.Ten days postoperatively,a high fever occurred and magnetic resonance imaging(MRI)showed cerebrospinal fluid(CSF)leakage.Pseudomeningocele liquid test showed high levels of protein and white blood cell(WBC)count with negative bacterial culture.The patient was treated with shortterm intravenous antibiotic and discharged with normal body temperature.The patient was uneventful during the first 8 mo follow-up although repeated MRI showed persistent pseudomeningocele.At the 9th mo postoperatively,the patient gradually presented with dizziness and headache accompanied by recurrent weakness of his left arm.Imaging examinations demonstrated hydrocephalus and a cystic lesion around the cervical spinal cord.CSF test from lumbar puncture indicated chronic meningitis.MRI on 1 d after pseudomeningocele drainage showed a significant decrease in the cystic volume,suggesting that the cystic lesion would be subdural fluid collection rather than adhesive arachnoiditis.After dural defect repair,the patient’s symptoms completely resolved and hydrocephalus gradually disappeared.CSF analysis at the 21-mo follow-up revealed significantly decreased protein level and WBC count.CONCLUSION Subdural fluid collection rather than meningitis contributes to the hydrocephalus formation after cervical laminoplasty.展开更多
In vertebrates, early brain development takes place at the expanded anterior end of the neural tube, which is filled with embryonic cerebrospinal fluid (E-CSF). We have recently identified a transient blood–CSF barri...In vertebrates, early brain development takes place at the expanded anterior end of the neural tube, which is filled with embryonic cerebrospinal fluid (E-CSF). We have recently identified a transient blood–CSF barrier that forms between embryonic days E3 and E4 in chick embryos and that is responsible for the transport of proteins and control of E-CSF homeostasis, including osmolarity. Here we examined the presence of glucose transporter GLUT-1 as well the presence of caveolae-structural protein Caveolin1 (CAV-1) in the embryonic blood-CSF barrier which may be involved in the transport of glucose and of proteins, water and ions respectively across the neuroectoderm. In this paper we demonstrate the presence of GLUT-1 and CAV-1 in endothelial cells of blood vessels as well as in adjacent neuroectodermal cells, located in the embryonic blood–CSF barrier. In blood vessels, these proteins were detected as early as E4 in chick embryos and E12.7 in rat embryos, i.e. the point at which the embryonic blood–CSF barrier acquires this function. In the neuroectoderm of the embryonic blood-CSF barrier, GLUT-1 was also detected at E4 and E12.7 respectively, and CAV-1 was detected shortly thereafter in both experimental models. These experiments contribute to delineating the extent to which the blood–CSF embryonic barrier controls E-CSF composition and homeostasis during early stages of brain development in avians and mammals. Our results suggest the regulation of glucose transport to the E-CSF by means of GLUT-1 and also suggest a mechanism by which proteins are transported via transcellular routes across the neuroectoderm, thus reinforcing the crucial role of E-CSF in brain development.展开更多
文摘Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)after cervical surgery.Methods Medical records of 642 patients who underwent cervical surgery between December 1999 and December 2005 at our hospital were retrospectively reviewed.Five patients complicated by CSFL after surgery were enrolled,of which 4 cases were complicated after ossified posterior longitudinal ligament or posterior vertebral osteophyte resection directly injuring the dura,and 1 case after posterior cervical double-door laminoplasty without observed dural injury during surgery.Of the 5 CSFL cases,4 cases occurred at 1-3 days after operation and 1 case at 9 days after operation.All 5 postoperative CSFL cases were treated through wound drainage removal,wound sutures,prophylactic antibiotics,and continuous subarachnoid drainage in the elevated head position.Results All 5 CSFL cases experienced leakage cessation within 1-3 days and wound healing within 4-8 days,and subarachnoid drainage lasted 11-16 days with an average volume of 320 mL(range,150-410 mL).Four cases experienced headache,nausea and vomiting,1 case suffered from somnolence and hyponatremia,and symptoms subsided after symptomatic treatment and intravenous fluid administration.All patients were followed up for an average of 32 months(range,22-50 months).No occurrence of cerebrospinal fluid cyst or wound infection was observed.CSFL produced no significant negative effects upon neuromuscular function recovery.Conclusion Continuous subarachnoid cavity drainage in combination with elevated head position is a simple and safe non-surgical method in treatment of CSFL following cervical surgery.
文摘BACKGROUND Meningitis is a life-threatening clinical condition associated with high mortality and morbidity.Early diagnosis and specific treatment may improve outcomes.Lack of specific clinical signs or tests make the diagnosis challenging.AIM To assess the efficacy of cerebrospinal fluid(CSF)lactate in diagnosing meningitis in critically ill patients.METHODS A prospective,observational cohort study was carried out in a neuro-medical intensive care unit(ICU)over a 22 mo period.Adult patients,with suspected meningitis admitted in ICU,were serially recruited.Patients who refused consent,those with peripheral sensorineural deficit,or with any contraindication to lumber puncture were excluded.CSF cytology,bio-chemistry,lactates,culture and polymerase chain reaction based meningo-encephalitis panel were evaluated.Patients were divided in two groups based on clinical diagnosis of meningitis.The efficacy of CSF lactate in diagnosing meningitis was evaluated and compared with other tests.RESULTS Seventy-one patients were included and 23 were diagnosed with meningitis.The mean values of CSF total leucocyte count(TLC),proteins and lactates were significantly higher in meningitis group.There was a significant correlation of CSF lactate levels with CSF cultures and meningo-encephalitis panel.CSF lactate(>2.72 mmol/L)showed good accuracy in diagnosing meningitis with an area under the curve of 0.81(95% confidence interval:0.69-0.93),sensitivity of 82.6%,and specificity 72.9%.These values were comparable to those of CSF TLC and protein.Twelve patients with bacterial meningitis had significantly higher CSF lactate(8.9±4.7 mmol/L)than those with non-bacterial meningitis(4.2±3.8 mmol/L),P=0.006.CONCLUSION CSF lactate may be used to aid in our diagnosis of meningitis in ICU patients.CSF lactate(>2.72 mmol/L)showed good accuracy,sensitivity,and specificity in diagnosing meningitis and may also help to differentiate between bacterial and non-bacterial meningitis.
文摘<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. <strong>Methods:</strong> The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. <strong>Results:</strong> Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. <strong>Conclusion: </strong>For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.
文摘Neurogenesis from inner brain neural stem cells (NSCs) is a process which takes place continuously in mammals through- out their life. However, the main ontogenic difference is the intensity of neurogenesis, which commences as a very intensive and global activity in the early embryonic brain (neural tube), persists in fetal and newborn stages, and declines significantly in adulthood, becoming restricted to specific places with low neurogenic activity such as the subventricular zone (SVZ) and the subgranular zone (SGZ) in the dentate gyrus (DG) of the hippocampus.
文摘To establish the microarray technique with 16S rRNA probe for the rapid detection of pathogenic bacteria in cerebrospinal fluid, a set of Digoxin labelling universal primers were designed, and used to amplify the 16S rRNA gene, and 2 specific probes for each bacterium designed were spotted onto nylon membrane to make a microarray, followed by hybridization to PCR products of bacteria, which set up a microarray technique for parallel detection of bacteria in cerebrospinal fluid (CSF). Twenty-nine CSF specimens from 16 patients that were proved to be positive by bacterial cultures and by using Vitek AMA-32 automated system were examined in the present investigation. It was found that positive fragment with length of 168?bp were amplified from 45 strains of 20 bacterial species, and amplifications also detected in 29 CSF specimens. The method of universal PCR could detect as few as 1 pg of bacterial DNA, and this microarray could identify all the bacterial species in CSF except Mycobacterium tuberculosis and Proteus mirabilis , satisfying the direct detection of bacteria in CSF specimens including a case of mixed bacterial infection. The positive and negative predictive value as well as the diagnostic index of this microarray were 100%, 94.67%, and 180.88 respectively, and the time of performance spent only for 5?h. It was concluded the method described in the present investigation can be used to detect and identify the pathogenic bacteria in CSF.
文摘BACKGROUND: Guillain-Barre syndrome (GBS) is an autoimmune disease which is characterized by demyelination of peripheral nerve and nerve root, and inflammatory reaction of lymphocyte and macrophage. Neuroelectrophysiological examination and cerebrospinal fluid (CSF) analysis are of significance for its diagnosis. OBJECTIVE: To study the association of neuroelectrophysiology and cerebrospinal fluid immunoglobulin (CSF-lg) with pathogenetic conditions of patients with GBS. DESIGN: Case control study SETTING: Department of Neurology, Shenzhen Municipal Shekou Group Hospital; Department of Neuroelectrophysiology, People's Hospital of Guangdong Province. PARTICIPANTS: A total of 32 GBS patients including 18 males and 14 females who aged from 17 to 72 years were selected as experimental group from the Department of Neurology, People's Hospital of Guang- dong Province from January 2004 to December 2005. All cases conformed with GBS diagnostic criteria established by Asbury in 1990 and they were divided into three types according to neurological criteria established by Chinese Neurology and Psychology Journal in 1993: mild, moderate and severe types. Another 30 patients with vascular headache were selected as control group from the same hospital including 14 males and 16 females who aged from 17 to 79 years. METHODS: ① Neuroelectrophysiological examination: Multiple-functional electromyography device provided by Nicolet Company, USA was used to measure nerve conduction velocity (NCV), including motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV); meanwhile, electromyologram (EMG), somatosensory evoked potential (SEP) and electroencephalogram (EEG) were also measured. ② Detection of CSF-lg: Concentrations of IgG, IgA and IgM were measured with immunofixation electrophoresis. ③Follow-up: Among 32 GBS patients, 14 cases received follow-up after treatment and the longest fol- low-up time was 1 year after onset. Among them, 8 cases were reexaminined with neuroelectrophysiological and CSF examinations. MAIN OUTCOME MEASURES: Results of NCV, EMG, SEP and EEG; comparison of CSF-lg content; results of follow-up examinations. RESULTS: All 32 GBS cases and 30 patients with vascular headache were involved in the final analysis. ① Abnormal rate of neuroelectrophysiological test: 75% of NCV, 88% of F-wave, 53% of MCV, 25% of SEP, 47% of EMG and 31% of EEG. There were no significant differences among various types (P 〉 0.05). ② Results of CSF-lg test: There were no significant differences among various types (P 〉 0.05); however, abnormalities in experimental group was higher than those in control group (P 〈 0.01). CONCLUSION : Results of follow-up study suggest that improvement of clinical symptom is earlier than neuroelectrophysiological recovery; MCV and EMG recoveries are faster than that of NCV; the earlier the abnormality of EMG, the poorer the recovery. CSF4g recovers normally along improvement of clinical symptoms. It is of significance for neuroelectrophysiology and abnormality of CSF-Ig to determine degree of peripheral nerve demyelination and prognosis.
文摘Objective To analyze the causes and prevention and treatment of cerebrospinal fluid leak during transsphenoidal pituitary adenoma surgery. Methods Retrospective study of 260 cases of microscopic transsphenoidal surgery and 274 cases of endoscopic surgery for resection of the pituitary adenomas was performed. CSF leak occurred
文摘BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported,the mechanism remains uncertain.Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism.CASE SUMMARY A 45-year-old man underwent cervical laminoplasty for cervical spondylotic myelopathy at a local hospital.Ten days postoperatively,a high fever occurred and magnetic resonance imaging(MRI)showed cerebrospinal fluid(CSF)leakage.Pseudomeningocele liquid test showed high levels of protein and white blood cell(WBC)count with negative bacterial culture.The patient was treated with shortterm intravenous antibiotic and discharged with normal body temperature.The patient was uneventful during the first 8 mo follow-up although repeated MRI showed persistent pseudomeningocele.At the 9th mo postoperatively,the patient gradually presented with dizziness and headache accompanied by recurrent weakness of his left arm.Imaging examinations demonstrated hydrocephalus and a cystic lesion around the cervical spinal cord.CSF test from lumbar puncture indicated chronic meningitis.MRI on 1 d after pseudomeningocele drainage showed a significant decrease in the cystic volume,suggesting that the cystic lesion would be subdural fluid collection rather than adhesive arachnoiditis.After dural defect repair,the patient’s symptoms completely resolved and hydrocephalus gradually disappeared.CSF analysis at the 21-mo follow-up revealed significantly decreased protein level and WBC count.CONCLUSION Subdural fluid collection rather than meningitis contributes to the hydrocephalus formation after cervical laminoplasty.
文摘In vertebrates, early brain development takes place at the expanded anterior end of the neural tube, which is filled with embryonic cerebrospinal fluid (E-CSF). We have recently identified a transient blood–CSF barrier that forms between embryonic days E3 and E4 in chick embryos and that is responsible for the transport of proteins and control of E-CSF homeostasis, including osmolarity. Here we examined the presence of glucose transporter GLUT-1 as well the presence of caveolae-structural protein Caveolin1 (CAV-1) in the embryonic blood-CSF barrier which may be involved in the transport of glucose and of proteins, water and ions respectively across the neuroectoderm. In this paper we demonstrate the presence of GLUT-1 and CAV-1 in endothelial cells of blood vessels as well as in adjacent neuroectodermal cells, located in the embryonic blood–CSF barrier. In blood vessels, these proteins were detected as early as E4 in chick embryos and E12.7 in rat embryos, i.e. the point at which the embryonic blood–CSF barrier acquires this function. In the neuroectoderm of the embryonic blood-CSF barrier, GLUT-1 was also detected at E4 and E12.7 respectively, and CAV-1 was detected shortly thereafter in both experimental models. These experiments contribute to delineating the extent to which the blood–CSF embryonic barrier controls E-CSF composition and homeostasis during early stages of brain development in avians and mammals. Our results suggest the regulation of glucose transport to the E-CSF by means of GLUT-1 and also suggest a mechanism by which proteins are transported via transcellular routes across the neuroectoderm, thus reinforcing the crucial role of E-CSF in brain development.