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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MR imaging is the premier imaging modality for diagnosing the various forms and causes of hydrocephalus. Although CT is satisfactory for imaging in the axial plane, MR imaging is capable of imaging in any plane to better demonstrate any cause of observation. MR imaging also is more sensitive than CT to interstitial edema (transependymal flow of cerebrospinal fluid [CSF]) and to the hyperdynamic CSF flow seen with shunt-responsive normal-pressure hydrocephalus (NPH). MR imaging also is sensitive to the presence of deep white matter ischemia that may contribute to the cause of the idiopathic form of NPH.
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PMID:Diagnostic tools in hydrocephalus. 1152 88

The authors report an unusual case of low intracranial pressure (ICP) syndrome that was successfully treated by the placement of an anti-siphon device (ASD). This 36-year-old male had suffered suprasellar germinoma with hydrocephalus and had had a V-P shunt following radiotherapy. Sixteen years later he developed gait disturbance and somnolence and MRI demonstrated a small lateral ventricle as well as a diffuse dural enhancement. A lumbar tap revealed a low ICP of 12 mmH2O. Because of this, an ASD was placed in the patient. Postoperatively, his symptoms of gait and consciousness disturbance improved. Typical clinical findings of low ICP syndrome such as headache were not observed in this case. To our knowledge, no symptom of gait disturbance with low ICP has been reported previously. We present an interesting case of low ICP syndrome with gait disturbance and discuss the mechanism of the symptoms. Symptoms of this patient were due at first to brain ischemia. After convulsion and consciousness disturbance due to low intracranial pressure, the symptoms increased in strength until gait disturbance occurred. The possibility is suggested that gait disturbance in this patient was due both to brain ischemia and low intracranial pressure.
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PMID:[Successful treatment of a patient with low pressure syndrome associated with gait disturbance]. 1159 68

Whether or not neuron death plays a major role in pathophysiology during hydrocephalus is not well known. The goals of this study were to determine if neural degeneration occurred during hydrocephalus, and to determine if neuron tolerance developed during this pathophysiologic procedure.Neural damage as visualized by a sensitive staining technique, silver impregnation, was observed in three experimental groups: (1) adult hydrocephalic rats induced by kaolin injection into the cisterna magna, (2) adult rats with chronic hydrocephalus for 10 weeks subjected to acute forebrain ischemia induced by four-vessel occlusion, and (3) adult rats without hydrocephalus subjected to acute forebrain ischemia. The magnitude of hydrocephalus was also evaluated during this time. In mild or moderate hydrocephalus, little cell death was found. In severe hydrocephalus, axon and neuropil degeneration was extensively distributed, but cell death was still rarely observed. Although some neuron degeneration was found after acute forebrain ischemia in hydrocephalic rats, the extensive cell death in cortical layers III and V, and in hippocampal areas CA1 and CA4 that is commonly observed in the ischemic brain without hydrocephalus, was not seen. This study suggests that neuron death was not a major pathological change in the brain during hydrocephalus, with cerebral ventricles being enlarged during the development of hydrocephalus. Less neuron death in hydrocephalic rats after acute forebrain ischemia suggests that neuronal tolerance to ischemia occurs during hydrocephalus.
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PMID:Neuron tolerance during hydrocephalus. 1168 53

We report a newborn infant girl, born to consanguineous parents, with recurrent intracranial hemorrhage secondary to congenital factor V deficiency with factor V inhibitor. Repeated transfusions of fresh-frozen plasma (FFP) and platelet concentrates, administrations of immunosuppressive therapy (prednisolone and cyclophosphamide), and intravenous immunoglobulin failed to normalize the coagulation profiles. Exchange transfusion followed-up by administrations of activated prothrombin complex and transfusions of FFP and platelet concentrates caused a temporary normalization of coagulation profile, enabling an insertion of ventriculoperitoneal (VP) shunt for progressive hydrocephalus. The treatment was complicated by thrombosis of left brachial artery and ischemia of left middle finger. The child finally died from another episode of intracranial hemorrhage 10 days after insertion of the VP shunt.
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PMID:Factor V inhibitor in neonatal intracranial hemorrhage secondary to severe congenital factor V deficiency. 1184 4

The infants' brain during the prenatal, perinatal and neonatal periods is susceptible to injury. Many problems in the perinatal period often result in bleeding, ischemia and other pathological changes in the infant brain. Which can subsequently cause cerebral palsy or developmental disorders. Unless they are discovered early and measures are taken, permanent brain damage may remain. Although neurological examinations at this stage is very difficult, it is very important to be familiar with neurological signs and assessment of extremely and very low birth weight infants and to discover early any abnormal findings of diseases such as neonatal asphyxia, intraventricular haemorrhage, periventricular leukomalacia, neonatal seizures and hydrocephalus.
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PMID:[Neurological signs and assessment of extremely and very low birth weight infants]. 1190 9

We analyzed the cranial computerized tomography scans (CT) of 1000 consecutive patients with the history of seizures. The seizures were classified in generalized tonic-clonic seizures (GS) and partial seizures (PS) on the basis of the clinical semiology, as it was described by the patients and family members. Seizure types were correlated with age group, sex and CT findings. GS were observed in 70.7% of the patients and PS in 29.3 %. An increased incidence of GS was noted among the age groups 0 to 10 yrs (31%) and 11 to 20 yrs (21.8%). For PS the 0 to 10 yrs (24.5 %), 21 to 30 yrs (16.7%) and 31 tp 40 yrs (18.5%) age groups were the most prevalent groups. The CT scan findings for the GS group were the following: normal studies 48.8 % of the patients, calcifications/cysticercosis (14.0%), neurocysticercosis/cysts (9.6 %), hydrocephalus (4.3%), ischemia (4.2 %), non-definite lesions (4.1 %), tumor (2.5%), and others (12.5%). In the PS group we found 37.4% of normal studies, calcifications/cysticercosis (11.2%), neurocysticercosis/cysts (12.2%), tumor (10.5%), ischemia (5.4%), hydrocephalus (3.7%), non-definite lesions (8.1%) and others (11.6%). We emphasize the importance of CT scan imaging in patients presenting with seizures, particularly in the diagnosis of cysticercosis.
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PMID:[Tomographic findings in 1000 consecutive patients with antecedents of epileptic seizures]. 1213 43

Recent studies have demonstrated that antibodies against the calcium-binding proteins (CaBPs) parvalbumin (PV), calbindin (CB), and calretinin (CR) are appropriate tools for demonstrating transient features and developmental changes of human fetal brain organization as well as for detecting specific alterations in pathologically altered specimens. CB and CR are abundantly expressed in various nerve cell types of the subplate in the second half of gestation. The subplate being an outstandingly wide zone subjacent to the cortical plate, it is a "waiting compartment" for various cortical afferents that reside here prior to entering the cortical plate. The cortical plate (future layers II-VI of the cerebral cortex) contains only CR-ir neurons until the 6th gestational month. In the 7th and 8th month, cortical CB- and PV-ir interneurons are observed in deeper portions of the cortical plate. Cajal-Retzius cells of layer I are CR-immunolabeled from the 4th month onwards. Fetal hydrocephalus causes severe alterations of CB- and PV-ir neurons in the subplate and the cortical plate: shrinkage of ir neurons, loss of process labeling and in most severe cases, entire loss of immunolabeling. Such alterations, which cannot be detected in Nissl-stained sections, indicate distinct impairment of neuronal function. The ganglionic eminence being a prominent part of the telencephalic proliferative zone persists nearly throughout the entire fetal period. Between 16 and 24 weeks of gestation, CR-ir cells are found in the center and, in a higher number, in the periphery, i.e., the mantle zone, of the ganglionic eminence. The mantle zone also exhibits CB-ir cells. These observations support experimental data showing that CR-ir precursor cells leave the ganglionic eminence to migrate towards the cerebral cortex. The CR- and CB-ir neurons of the mantle zone most probably represent an intermediate target for outgrowing axons. This notion is supported by the observation that SNAP (synaptosomal associated protein) 25-ir fibers coming from the intermediate zone terminate upon CR-ir cells in the mantle zone. Within the amygdaloid complex, immature, migrating CR- or CB-ir neurons are observed in the 5th and 6th gestational month. In the 8th and 9th month, anti-CR and anti-CB mark different subsets of interneurons as well as a small proportion of pyramidal projection neurons. The different subsets of interneurons are likely to be functionally different with regard to their connectivities. Considering studies in the literature, it is obvious that CR is transiently expressed in pyramidal cells. Moreover, diffuse (neuropil) CB and CR immunolabeling, which is found in different intensities in the various amygdaloid subdivisions, displays distinct redistribution during development, an observation indicating reorganization of afferent inputs. The sequential arrival of various afferent fiber systems in the two compartments of the striatum (patch and matrix compartment) is reflected by changing patterns of diffuse CB immunolabeling: During the second half of gestation, the patches are labeled and postnatally a changeover to matrix labeling is seen. The thalamic reticular complex reveals prominent transient features seen in PV and CR immunopreparations. Four subdivisions become obvious: the main portion, the perireticular nucleus, the medial subnucleus, and the pregeniculate nucleus. The PV- and CR-ir perireticular nucleus, not visible in the mature brain, is a distinct fetal entity located within the internal capsule. The main portion of the reticular complex is much more prominent in the fetus than in the adult and displays transitory CR expression. The most probable developmental role of the reticular complex is to provide guiding cues for outgrowing axons from or into the dorsal thalamus. The basal nucleus of Meynert and the hypothalamic tuberomamillary nucleus both provide extrathalamic projections to the cerebral cortex. The sequential differentiation of the two nuclei can be demonstrated using anti-CB and anti-PV. The basal nucleus strongly expresses CB and appears to be mature distinctly earlier than the PV-ir tuberomamillary nucleus. Antisera against CaBPs clearly demonstrate that the magnocellular part of the red nucleus located in the mesencephalic tegmentum is outstanding in the fetal and perinatal brain and inconspicuous in the adult. In particular, CB is the most abundant CaBP in this portion of the red nucleus. The dominance of the magnocellular part over the parvocellular part may be a substrate for a specific transitory pattern of motor behavior. On the whole, CaBPs mark the transient architectonic organization of the brain, which is involved in the establishment of transitory neuronal circuitries. The latter are essential for the formation of mature projections. Detailed data on the normal organization of the transient structures are required for the evaluation of alterations occurring in the fetal and perinatal brain. The transient structures are sites of predilection for alteration caused by hypoxia-ischemia, hemorrhage, or hydrocephalus.
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PMID:Calcium-binding proteins in the human developing brain. 1223 93

A case of parkinsonian syndrome caused by normal pressure hydrocephalus (NPH) accompanied by cauda equina neurinoma is reported. A 69-year-old woman presented with typical symptoms of parkinsonism, including akinesia, resting and postual tremor, and cog-wheel rigidity. CT scan of the brain revealed dilatation of ventricles, but she did not present dementia and urinary incontinence that are common symptoms in NPH. Her cerebrospinal fluid (CSF) pressure was normal, and her protein level was high at 2,970 mg/dl. An electroencephalogram (EEG) showed diffuse slow waves. An IMP-SPECT images of the brain showed diffuse reduction of radioisotope uptake. Levodopa was not effective in treating her parkinsonism. Removal of the tumor caused dramatic improvement in her parkinsonism. Her CSF protein level was normalized and EEG and SPECT images were improved after the operation. However, ventricular size on brain CT showed no change. It was considered that the causal mechanism of NPH was due to high protein levels in the CSF. The parkinsonism in this case was caused by dysfunction of the circuits linking the cortex, basal ganglia, and thalamus associated with metabolic disorder due to periventricular ischemia. Typical parkinsonism caused by NPH associated with spinal cord tumor has not been reported. When we examine a patient with parkinsonian syndrome caused by NPH, we should check the CSF protein level. And if that level is high, the possibility of spinal cord tumor should be considered.
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PMID:[A case of parkinsonian syndrome caused by normal pressure hydrocephalus accompanied by the cauda equina neurinoma]. 1242 62

A 58-year-old male presented with a dissecting aneurysm of the basilar artery manifesting as dysarthria, left hemiparesis, and numbness of the left side. Angiography revealed a double lumen at the midportion of the basilar artery which was consistent with a diagnosis of dissecting basilar artery aneurysm. The patient was treated conservatively, and remained neurologically stable for a 5-year period following initial presentation, but serial magnetic resonance imaging revealed growth of the aneurysm compressing the brain stem. His condition then worsened. Computed tomography revealed obstructive hydrocephalus. Ventriculoperitoneal shunting was performed and the patient's symptoms improved. However, he died of subarachnoid hemorrhage. Autopsy showed the patient had had a type 3 "dolichoectatic dissecting aneurysm." Surgical treatment should be seriously considered for treating the patients with dissecting basilar artery aneurysm causing brain stem ischemia, especially if the aneurysm is growing. High-flow bypass and proximal occlusion may be the choice in patients with poor collateral circulations.
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PMID:Dissecting basilar artery aneurysm growing during long-term follow up--case report. 1251 29

Hydrocephalus causes damage to periventricular white matter at least in part through chronic ischemia. Magnesium sulfate (MgSO4) has been shown to be protective in various models of neurologic injury. We hypothesized that this agent would ameliorate the effects of experimental childhood-onset hydrocephalus. Hydrocephalus was induced in 3- and 4-wk-old rats by injection of kaolin into the cisterna magna. Tests of cognitive and motor function were performed on a weekly basis. In a blinded and randomized manner, MgSO4 was administered in two separate experiments (s.c. injection 0.85, 4.1, or 8.2 mM/kg/d), supplemented by osmotic minipump infusion (0.03 mM/d) to prevent low trough levels for 2 wk, beginning 2 wk after induction of hydrocephalus. The brains were then subjected to histopathological and biochemical analyses. With the 4.1 mM/kg/d dose, serum Mg++ levels were elevated transiently from 1.3 to approximately 7 mM/L. We observed statistically significant improvement in gait performance and reduced astroglial reaction. There was also a trend to improved memory performance, but no evidence of increased myelin or synaptic protein content. The 8.2 mM/kg/d dose was associated with sedation and there was no evidence of improvement in any parameter. We conclude that MgSO4 might be mildly protective in experimental hydrocephalus.
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PMID:Magnesium sulfate therapy is of mild benefit to young rats with kaolin-induced hydrocephalus. 1262 Oct 98


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