CSF flow dynamics has been known to have a key role the pathogenesis of syringomyelia. Our purpose was to evaluate the CSF flow pattern in syringomyelia with spatial modulation of magnetization (SPAMM) that can depict directional flow, and to determine the relationship between flow dynamics and clinical outcome after decompress surgery. We performed pre- and post-operative MRI in 9 patients with syringomyelia with SPAMM technique. They showed caudal shift of tagging bands in the syrinx cavity in systolic phase while stagnation of CSF flow was seen in diastolic phase. The degree of band shift in syrinx was well correlated with the degree of shrinkage in size of syrinx after operation. Evaluation of syringomyelia by SPAMM technique can predict postsurgical outcome after decompress surgery.
Adult ; Cerebrospinal Fluid/*physiology ; Female ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Prognosis ; Syringomyelia/*cerebrospinal fluid/diagnosis/surgery

Idiopathic Normal Pressure Hydrocephalus (NPH) is a debilitating condition of the elderly. The patient is typically "wet, wobbly and wonky", to different degrees of the triad. The diagnosis is supported by the radiologic finding of dilated ventricles, determined by an elevated Evan's Index (EI) without a demonstrable cause. Patients with newly diagnosed NPH typically respond to ventriculo-peritoneal shunting (VPS). NPH-related dementia is possibly the only surgically reversible dementia. An elevated cerebrospinal fluid (CSF) fl ow rate (FR) is associated with a positive response to shunting. However, post-shunting EI and FRs are unpredictable. Of late, intracranial apparent diffusion coefficient (ADC) quantification via Diffusion Weighted Imaging (DWI) has been emerging as a possible marker in NPH diagnosis. A local study, conducted on a national level, to study the relationship of EI, FR and ADC to pre- and post-shunt clinical measurements has just ended. This review seeks to reconcile the current thinking of NPH, magnetic resonance imaging (MRI) quantification and clinical evaluation, and in the process shed some light on major pathophysiological determinants of the disease.
Biomarkers ; cerebrospinal fluid ; Cerebrospinal Fluid ; physiology ; secretion ; Diffusion Magnetic Resonance Imaging ; Humans ; Hydrocephalus, Normal Pressure ; diagnosis ; physiopathology

OBJECTIVE: To study the cerebrospinal fluid (CSF) flow through the aqueduct of sylvius in chronic tension-type headache patients with phase contrast magnetic resonance imaging. METHODS: Phase contrast magnetic resonance imaging (MRI) of the CSF flow through the aqueduct was obtained from 17 patients with chronic tension-type headache and 26 control subjects. A software for CSF flow was applied for MRI data analysis both qualitatively and quantitatively. RESULTS: The CSF through the aqueduct flew in the caudal and cranial directions with the rhythm of the heartbeat in both groups. There were 2 types of flow curves: the smooth "U" and the wave, which were 25 vs 1 in the controls and 11 vs 6 in the patients (P<0.05), respectively. The mean caudocranial flow rate through the aqueduct was (0.235±0.157) mL/s vs (0.133±0.106) mL/s (P<0.05) and the velocity was (6.023±2.654) cm/s vs (3.479±2.364) cm/s (P<0.05), and the mean craniocaudal flow rate was (-0.358±0.201) mL/s vs (-0.190±0.141) mL/s (P<0.05) and the velocity was (-8.263±3.020) cm/s vs (-4.788±2.862) cm/s (P<0.05), respectively. CONCLUSION The CSF flow curve, rate and velocity through the aqueduct in the patients with chronic tension-type headache is anomalous in comparison with the controls.
Case-Control Studies ; Cerebral Aqueduct ; Cerebrospinal Fluid ; physiology ; Humans ; Magnetic Resonance Imaging ; Tension-Type Headache ; cerebrospinal fluid

BACKGROUNDAlthough traumatic brain injury can lead to opening the blood-brain barrier and leaking of blood substances (including water) into brain tissue, few studies of brain antigens leaking into the blood and the pathways have been reported. Brain antigens result in damage to brain tissues by stimulating the immune system to produce anti-brain antibodies, but no treatment has been reported to reduce the production of anti-brain antibodies and protect the brain tissue. The aim of the study is to confirm the relationship between immune injury and arachnoid granulations following traumatic brain injury, and provide some new methods to inhibit the immune injury.

METHODSIn part one, methylene blue was injected into the rabbits' cisterna magna after traumatic brain injury, and concentrations of methylene blue and tumor necrosis factor (TNF)-α in blood were detected to determine the permeability of arachnoid granulations. In part two, umbilical cord mesenchymal stem cells and immature dendritic cells were injected into veins, and concentrations of interleukin 1 (IL-1), IL-10, interferon (IFN)-γ, transforming growth factor (TGF)-β, anti-brain antibodies (ABAb), and IL-12 were measured by ELISA on days 1, 3, 7, 14 and 21 after injury, and the numbers of leukocytes in the blood were counted. Twenty-one days after injury, expression of glutamate in brain tissue was determined by immunohistochemical staining, and neuronal degeneration was detected by H&E staining.

RESULTSIn part one, blood concentrations of methylene blue and TNF-α in the traumatic brain injury group were higher than in the control group (P < 0.05). Concentrations of methylene blue and TNF-α in the trauma cerebrospinal fluid (CSF) injected group were higher than in the control cerebrospinal fluid injected group (P < 0.05). In part two, concentrations of IL-1, IFN-γ, ABAb, IL-12, expression of glutamate (Glu), neuronal degeneration and number of peripheral blood leukocytes were lower in the group with cell treatment compared to the control group. IL-10 and TGF-β were elevated compared to the control group.

CONCLUSIONSTraumatic brain injury can lead to stronger arachnoid granulations (AGs) permeability; umbilical cord mesenchymal stem cells and immature dendritic cells can induce immune tolerance and reduce inflammation and anti-brain antibodies to protect the brain tissue.

Adipocytes ; cytology ; Animals ; Antigens ; blood ; metabolism ; Brain Injuries ; blood ; cerebrospinal fluid ; metabolism ; Cell Differentiation ; physiology ; Cells, Cultured ; Dendritic Cells ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Interleukin-1 ; blood ; cerebrospinal fluid ; Interleukin-10 ; blood ; cerebrospinal fluid ; Interleukin-12 ; blood ; cerebrospinal fluid ; Mesenchymal Stromal Cells ; cytology ; Methylene Blue ; metabolism ; Osteoblasts ; cytology ; Rabbits ; Transforming Growth Factor beta ; blood ; cerebrospinal fluid ; Tumor Necrosis Factor-alpha ; blood ; cerebrospinal fluid

OBJECTIVEVascular endothelial cell injury contributes to the pathogenesis of viral encephalitis. This study was designed to investigate the roles of vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule-1(VCAM-1) in cerebral spinal fluid (CSF) in the pathogenesis of viral encephalitis and in the evaluation of the severity and the prognosis of viral encephalitis in children.

METHODSCSF VEGF and VCAM-1 levels were measured using ELISA in 65 children with viral encephalitis and 20 age-matched controls (10 cases of epilepsy and 10 cases of congenital abnormality).

RESULTSCSF levels of VEGF and VCAM-1 in the viral encephalitis group in the acute phase were significantly elevated compared with those in the congenital abnormality (P<0.01) and the epilepsy groups (P<0.05). CSF levels of VEGF and VCAM-1 in the viral encephalitis group in the recovery phase decreased significantly and were similar to the levels of the epilepsy group, but remained higher than those in the congenital abnormality group (P<0.05). There was a positive correlation between CSF levels of VEGF and VCAM-1 in the viral encephalitis group in the acute and recovery phases. CSF levels of VEGF and VCAM-1 were positively correlated to CSF protein contents and the degree of MRI abnormality in the viral encephalitis group.

CONCLUSIONSVEGF and VCAM-1 may participate in the pathogenesis of viral encephalitis. Detection of the two parameters may be helpful to the evaluation of the severity and prognosis of viral encephalitis.

Adolescent ; Child ; Child, Preschool ; Electroencephalography ; Encephalitis, Viral ; cerebrospinal fluid ; etiology ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Vascular Cell Adhesion Molecule-1 ; cerebrospinal fluid ; physiology ; Vascular Endothelial Growth Factor A ; cerebrospinal fluid ; physiology

OBJECTIVE:To evaluate the normal figure of intracranial and intraspinal cerebrospinal fluid(CSF) dynamics, we report the results of the various parameters of cine phase contrast(PC) magnetic resonance(MR) CSF flow images throughout the whole neuraxis. METHODS: The MR images were obtained with 1.5T unit using the cine PC sequence with cardiac gating and gradient echo imaging in 10 normal persons(mean age, 30.4 years). The temporal velocity information from the anterior and posterior cervical pericord subarachnoid spaces, third and fourth ventricles, aqueduct, and lumbar cistern were plotted as wave forms. The wave forms were analyzed for configurations, amplitude parameters, and temporal parameters. The statistical significance of each parameter was examined with paired t-test. RESULTS: The actual flow of CSF were clearly visible with cine MR images. Throughout the whole neuraxis, the distinct reproducible configuration features were not obtained at ventricular or lumbar cistern, but at aqueduct and cervical pericord spaces. The temporal parameters were more important than the amplitude parameters. CONCLUSION: In this study, the authors demonstrated normal CSF dynamics and obtained further precision by plotting the temporal velocity information from the images as a waveform. This important basic information may be useful for understanding altered physiology in disease states such as syringomyelia and hydrocephalus.
Cerebrospinal Fluid* ; Fourth Ventricle ; Hydrocephalus ; Magnetic Resonance Imaging ; Physiology ; Subarachnoid Space ; Syringomyelia

OBJECTIVEAcute Transverse myelitis (ATM) is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic nerve dysfunction. There is often a clearly defined rostral border of sensory dysfunction. Nowadays, the pathogenesis of ATM is not clear. The present study aimed to understand possible relationship between ATM and infection with Coxsackievirus B.

METHODSIgM antibody against Coxsackievirus B was detected in cerebrospinal fluid of 33 patients with ATM.

RESULTSIn 7 of the 33 cases with ATM, the IgM andtibody Coxsackievirus B (CVB) was positive. No infections with other pathogens were found at the onset of the disease.

CONCLUSIONThe pathogenesis of ATM may involve infection with Coxsackievirus B.

Adult ; Antibodies, Viral ; cerebrospinal fluid ; immunology ; Enterovirus B, Human ; immunology ; pathogenicity ; physiology ; Female ; Humans ; Immunoglobulin M ; cerebrospinal fluid ; immunology ; Male ; Middle Aged ; Myelitis, Transverse ; cerebrospinal fluid ; immunology ; pathology ; virology ; Retrospective Studies

OBJECTIVE: To evaluate whether the results of cerebrospinal fluid (CSF) flow quantification differ according to the anatomical location of the cerebral aqueduct that is used and the background baseline region that is selected. MATERIALS AND METHODS: The CSF hydrodynamics of eleven healthy volunteers (mean age = 29.6 years) were investigated on a 1.5T MRI system. Velocity maps were acquired perpendicular to the cerebral aqueduct at three different anatomical levels: the inlet, ampulla and pars posterior. The pulse sequence was a prospectively triggered cardiac-gated flow compensated gradient-echo technique. Region-of-interest (ROI) analysis was performed for the CSF hydrodynamics, including the peak systolic velocity and mean flow on the phase images. The selection of the background baseline regions was done based on measurements made in two different areas, namely the anterior midbrain and temporal lobe, for 10 subjects. RESULTS: The mean peak systolic velocities showed a tendency to increase from the superior to the inferior aqueduct, irrespective of the background baseline region, with the range being from 3.30 cm/sec to 4.08 cm/sec. However, these differences were not statistically significant. In the case of the mean flow, the highest mean value was observed at the mid-portion of the ampulla (0.03 cm3/sec) in conjunction with the baseline ROI at the anterior midbrain. However, no other differences were observed among the mean flows according to the location of the cerebral aqueduct or the baseline ROI. CONCLUSION: We obtained a set of reference data of the CSF peak velocity and mean flow through the cerebral aqueduct in young healthy volunteers. Although the peak systolic velocity and mean flow of the CSF differed somewhat according to the level of the cerebral aqueduct at which the measurement was made, this difference was not statistically significant.
Adult ; Cerebral Aqueduct/anatomy & histology/*physiology ; Cerebrospinal Fluid/*physiology ; Female ; Human ; *Magnetic Resonance Imaging, Cine ; Male ; Reference Values ; Rheology

The purpose of this research is to explore the distribution and expression of MAP kinase phosphatase-1 (MKP-1) in cerebrospinal fluid (CSF)-contacting nucleus in depression, and provide experimental evidence to reveal the biological function and regulatory mechanisms of CSF-contacting nucleus in depression. Depression model was produced by chronic forced swimming stress (CFSS) in Sprague-Dawley (SD) rats. Intracerebroventricular injection of cholera toxin subunit B (CTb) labeled with horseradish peroxidase (CB-HRP) was used to specifically mark distal CSF-contacting nucleus. The rate of animal growth and behavioral tests including sucrose preference test (SPT) and open field test (OFT) were used to validate the model of depression. The expressions of MKP-1 and fos proteins in CSF-contacting nucleus were detected by immunofluorescence. Software Image-Pro Plus version 6.0 was used to count the positive neurons. The results showed that, the distributions of MKP-1 were found in the CSF-contacting nucleus. After 28 days of swimming, the rats in stress group had a lower growth rate, a less consumption of sucrose and lower scores of OFT compared to control group. The number of neurons double labeled with CB-HRP/fos or CB-HRP/MKP-1 in stress group was significantly higher than that in control group (P < 0.01). These results suggest that the CSF-contacting nucleus may be involved in the process of depression via the MKP-1.
Animals ; Cerebrospinal Fluid ; Depression ; enzymology ; Dual Specificity Phosphatase 1 ; physiology ; Neurons ; physiology ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological

It is very important to probe into the axonal regeneration and functional recovery of central nervous system (CNS) after implantation of cells into cerebrospinal fluid (CSF) for spinal cord injury (SCI). Transplantation of cells via CSF poses great potentials for SCI in clinic. Studies on administration of cells via CSF indicate that the method is safe and convenient. The method is more suitable to treating multiple lesions of the CNS since it does not produce open lesions. However, there are disputes over its promotion effects on axonal regeneration and functional recovery of spinal cord after injury; and some questions, such as the mechanisms of functional recovery of spinal cord, the proper time window of cell transplantation, and cell types of transplantation, still need to be handled. This review summarized the method of cell transplantation via CSF for treatment of SCI.
Animals ; Cell Transplantation ; methods ; Cerebrospinal Fluid ; cytology ; physiology ; Humans ; Nerve Regeneration ; physiology ; Spinal Cord Injuries ; pathology ; surgery