CEREBELLOPONTINE ANGLE CEREBELLUM METENCEPHALON RHOMBENCEPHALON BRAIN STEM BRAIN CENTRAL NERVOUS SYSTEM NERVOUS SYSTEM NEOPLASMS

This study was undertaken to identify acute changes and mechanism of traumatic brain edema in the rabit by measuring the regional specific gravities and water content with Evans blue dye staining. After delivery of brain injury on the frontal area, animals were sacrificed at 30 minutes, 2, 4 and 6 hours. Specific gravity data collection of regional brain tissue was taken in the serial copper sulfate gravity solution. The regions tested included frontal lobe, occipital lobe, basal ganglia, cerebellum, pons and medulla. Specific gravity data and Evans blue dye staining with spread were compared with those from similar areas in the uninjured anesthetized rabbits to test for brain edema. The results obtained were as follows: 1) Immediately following brain impact, almost all animals in this study demonstrated temporary respiratory arrest. The mean duration of respiratory arrest in experimental animals was 15+/-3 seconds. There was no correlation between length of respiratory arrest and either gross intracranial pathology or brain edema data. 2) The specific gravities in both hemispheres were same in control animals and were not affected by the duration of anesthesia. 3) Significant decrease of specific gravity was identified in the both supratentorial regions at 30 minutes, 2 and 4 hours after trauma. This finding was more prominent in the contused side. No significant changes occurred in the cerebellum but significant decrease of specific gravity occurred in medulla at 6 hours. 4) Almost brain water content was increased as the time course and arrived on peak value at 4 hours and decreased at 6 hours after trauma in the supratentorial regions. 5) Evans blue dye staining occurred in the contusion area at 30 minutes after trauma and spread to surrounding cortex and subcortex but dye density was decreased with time. These results suggest that traumatic brain edema may originate from vasogenic mechanism due to dysfunction of blood-brain barrier and this edema may spread to both cerebral hemispheres and brain stem.
Anesthesia ; Animals ; Basal Ganglia ; Blood-Brain Barrier ; Brain Edema* ; Brain Injuries* ; Brain Stem ; Brain* ; Cerebellum ; Cerebrum ; Contusions ; Copper Sulfate ; Data Collection ; Edema ; Evans Blue ; Frontal Lobe ; Gravitation ; Occipital Lobe ; Pathology ; Pons ; Rabbits ; Specific Gravity

Among the various routes of drug administration, perhaps the least studied is intracerebroventricular (ICV) administration. This route has been shown to be particularly useful in administering to the central nervous system (CNS) drugs that do not cross the blood-brain barrier readily. As such, the ICV route is a valuable option for providing therapeutic CNS drug concentrations to treat patients with CNS infectious and neoplastic diseases. This route of drug administration also has the advantage of minimizing systemic toxicity.
Blood-Brain Barrier ; Central Nervous System ; Humans ; Meningitis ; Pharmacokinetics

OBJECTIVE: Central nervous system has unique inflammatory responses to the exposure to the endotoxin and immature brain may have a different response with that of the mature. The authors conduct this experiment to elucidate the characteristics of inflammatory response in immature brain. METHODS: Lipopolysaccharide(LPS) was injected in the right caudate nucleus in 7-day-old and adult Sprague-Dawley rats. The doses were 1 microliter of 0.1, 0.5, and 2.0mg/ml of LPS and the same amount of saline for controls. The rats were sacrificed 24hours after injections. Light microscopic examination was performed to evaluate the leukocyte recruitment, and reverse transcriptase-polymerase chain reaction(RT-PCR) to measure the expression of interleukin-1beta(IL-1beta) and tumor necrosis factor-alpha(TNF-alpha) mRNA. RESULTS: Light microscopic examination revealed more pronounced leukocyte infiltration in neonatal brain than in adult, even though lower than in peripheral tissue. RT-PCR revealed dose dependent expression of IL-1beta and TNF-alpha mRNA in both neonatal and adult brain as in peripheral tissue. CONCLUSION: These results support that the immature brain is more vulnerable to the LPS induced inflammation in terms of leukocyte infiltration and possibly resultant brain damage. However, the mechanism of inflammatory response in immature brain should be studied further in association with the research of the activity of microglia, astrocyte, blood brain barrier, chemokine, and adhesion molecule in immature brain.
Adult ; Animals ; Astrocytes ; Blood-Brain Barrier ; Brain* ; Caudate Nucleus ; Central Nervous System ; Humans ; Inflammation ; Interleukin-1beta ; Leukocytes ; Microglia ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy. METHODS: The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients with isolated VA and patients with normal MRI were compared in terms of the prevalence of epilepsy. RESULTS: In total, 2,385 pediatric patients who underwent brain MRI were enrolled. Isolated VA was identified in 26 patients (VA group). Among the patients with normal MRI findings, 225 age- and sex-matched patients to the VA-group were assigned to the control group. Nine patients in the VA group (9 of 26, 34.6%) and 27 patients in the control group (26 of 225, 11.5%; P<0.001) had epilepsy. In the VA group, 20 patients (76.9%) had the VA in the cerebral hemispheres, and 6 patients (23.1%) had the VA in the brainstem and cerebellum. The latter showed a higher prevalence of epilepsy (5 of 6, 83.3%) than the former (4 of 20, 20.0%; P=0.004). Among the nine patients who had epilepsy with VA, patients whose VA involved the brainstem and cerebellum showed a significantly higher frequency of abnormal Electroencephalographic findings than patients whose VA involved the cerebral hemispheres (P=0.016). CONCLUSION: VA, especially in the brainstem and cerebellum, might be associated with epilepsy.
Brain ; Brain Stem ; Busan ; Central Nervous System Venous Angioma ; Cerebellum ; Cerebrum ; Child* ; Congenital Abnormalities ; Epilepsy* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies

Disseminated tuberculosis occurs through lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The exact incidence of disseminated tuberculosis is still unknown and its diagnosis presents a challenge since the symptoms are not specific of the disease. Brain tuberculoma is one of the complications of tuberculosis. The literary review of brain tuberculoma shows that it mainly occurs in the cerebrum and cerebellum, whereas involvement of the brainstem is rare. Recently, we have experienced a case of 46-year-old man with fever of 2 months duration who was diagnosed with disseminated tuberculosis with miliary central nervous system (CNS) tuberculomas; brain tuberculomas were found even in the brainstem and the spinal cord. Pulmonary, intestinal, renal, and choroidal involvements were also noted.
Brain ; Brain Stem ; Central Nervous System ; Cerebellum ; Cerebrum ; Choroid ; Fever ; Fever of Unknown Origin ; Humans ; Incidence ; Middle Aged ; Mycobacterium tuberculosis ; Spinal Cord ; Tuberculoma ; Tuberculosis ; Tuberculosis, Miliary

Disseminated tuberculosis occurs through lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The exact incidence of disseminated tuberculosis is still unknown and its diagnosis presents a challenge since the symptoms are not specific of the disease. Brain tuberculoma is one of the complications of tuberculosis. The literary review of brain tuberculoma shows that it mainly occurs in the cerebrum and cerebellum, whereas involvement of the brainstem is rare. Recently, we have experienced a case of 46-year-old man with fever of 2 months duration who was diagnosed with disseminated tuberculosis with miliary central nervous system (CNS) tuberculomas; brain tuberculomas were found even in the brainstem and the spinal cord. Pulmonary, intestinal, renal, and choroidal involvements were also noted.
Brain ; Brain Stem ; Central Nervous System ; Cerebellum ; Cerebrum ; Choroid ; Fever ; Fever of Unknown Origin ; Humans ; Incidence ; Middle Aged ; Mycobacterium tuberculosis ; Spinal Cord ; Tuberculoma ; Tuberculosis ; Tuberculosis, Miliary

PURPOSE: Neonatal cranial sonongraphy performed through the mastoid fontanelle is more useful to evaluate the peripheral structures at the convexity of the cerebral hemispheres and brainstem rather than that performed through the anterior fontanelle. The purpose of this study is to demonstrate the anatomy of the extracerebral CSF space and brainstem and to suggest appropriate scan planes for performing neonatal cranial sonography through the mastoid fontanelle using MRI and multiplanar reconstruction programs. MATERIALS AND METHODS: A neonate with normal features on ultrasonography and good image quality on MRI, including the 3D-SPGR axial scans, was selected. We made the reconstructed MR images corresponding to the sonongraphic planes and the anatomic models of the neonatal cranial sonographic images by using axial MRI as the standard reference on the same screen. We demonstrated the sonographic images at the levels of the body of the caudate nucleus and lentiform nucleus, the head of the caudate nucleus and thalamus, the third ventricle and midbrain, and the midbrain and cerebellar vermis on the oblique axial scans. Four oblique coronal images at the levels of the periventricular white matter, basal ganglia, thalamus and tentorium were also obtained. RESULTS: We illustrated the anatomic atlas with including four oblique axial scans and four oblique coronal scans that corresponded to the neonatal cranial sonographic images through the mastoid fontanelle. CONCLUSION: We objectively analyzed the anatomy of the extracerebral CSF space and brainstem by using MRI and multiplanar reconstruction programs and we provided the standardized sonographic scan planes through the mastoid fontanelle. This study will be very helpful for evaluating the abnormalities of the peripheral structures at the convexity of the cerebral hemispheres and brainstem.
Basal Ganglia ; Brain ; Brain Stem ; Caudate Nucleus ; Cerebrum ; Corpus Striatum ; Cranial Fontanelles ; European Continental Ancestry Group ; Head ; Humans ; Infant, Newborn ; Mastoid ; Mesencephalon ; Models, Anatomic ; Thalamus ; Third Ventricle

Infections of the central nervous system (CNS) can be rapidly progressive, RESULTing in death or permanent neurological damage in a short period of time, because of focal immunocompromised milieu with few complements and immunoglobulins in the cerebrospinal fluid. In order to provide effective antimicrobial therapy in a timely manner, all clinicians need to have a basic understanding of the antimicrobial agents and epidemiological data of the disease. It takes time to reveal the causative organisms of the infection. One should start antimicrobial treatment empirically as soon as possible after collecting the specimens from the patient. Many factors influence the choice of antimicrobial agents in the treatment of the infection which include microorganisms, environmental factors, and host factors such as age, sex, site of infection, and the underlying disease of the patient. Especially, in CNS infections, the efficacy of an antimicrobial agent depends upon its ability to penetrate the blood-brain barrier. The antimicrobial agent should also be active in purulent cerebrospinal fluid and demonstrate rapid bactericidal activity against the offending pathogen. The recent emergence of resistant pathogens, (also seen in Korea), has posed a challenge to the antimicrobial therapy. Therefore, the guidelines of antimicrobial therapy should be suitable for these considerations. This article reviews the basic therapeutic principles for the treatment of infections of the CNS and gives recommendations for the treatment of specific infections.
Anti-Infective Agents* ; Blood-Brain Barrier ; Central Nervous System Infections* ; Central Nervous System* ; Cerebrospinal Fluid ; Complement System Proteins ; Humans ; Immunoglobulins

Laminin-1 is biologically active and can effect cellular proliferation, differentiation, migration, and apoptosis. In the central nervous system, neuronal cells are rarely reported to give positive reaction by laminin antibody staining. However, the original cell type which can produce the laminin molecule has not been well established. Since the neuronal cells of brain are derived from neuroectoderm, we thought that the neuronal cells should be able to produce the laminin molecules as other epithelial cells. In this study we aimed to explore whether the neuronal cells express the laminin chain mRNAs, and further to identify which types of laminin isoform are expressed at the specific sites of the brain structure. We found that neuronal cell was the important cell type in mouse brain, which could produce laminin isoforms. Although immunostainings disclosed reactivity of laminins in the basement membrane of capillaries as well as neuronal cells, mRNA expressions of laminins were intense only in the neuronal cells. It was relatively weak in the endothelial cells. Among neuronal cells the cortical cells of cerebrum, pyramidal cells of hippocampus, and Purkinje cells of cerebellum showed pronounced expression of laminin chain mRNA. Glial cells, especially astrocytes, were negative for laminin subtypes both in immunohistochemistry and in situ hybridization. Taken together, our data indicate that the neuronal cells of mouse brain actively produce laminin isoforms, and the resultant polymerized laminins are accumulated mainly in the basement membrane of capillaries. In conclusion, the results indicate that neuronal cells produce and utilize the different laminin chains to maintain the neurovascular environment of brain.
Animals ; Apoptosis ; Astrocytes ; Basement Membrane ; Brain* ; Capillaries ; Cell Proliferation ; Central Nervous System ; Cerebellum ; Cerebrum ; Endothelial Cells ; Epithelial Cells ; Hippocampus ; Immunohistochemistry ; In Situ Hybridization ; Laminin* ; Mice* ; Neural Plate ; Neuroglia ; Neurons* ; Polymers ; Protein Isoforms ; Purkinje Cells ; Pyramidal Cells ; RNA, Messenger