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71.
Frequency and causes of shunt revisions in different cerebrospinal fluid shunt types 总被引:3,自引:0,他引:3
B. M. Borgbjerg F. Gjerris M. J. Albeck J. Hauerberg S. E. Børgesen 《Acta neurochirurgica》1995,136(3-4):189-194
Summary Shunt complications and revisions are common in hydrocephalic patients treated with a ventriculo-atrial or a ventriculo-peritoneal shunt. The reported revision rate differs very much but the rate of revision is close to 50% in many papers. Data from 884 hydrocephalic patients treated with various shunt types in the period 1958–1989 were recorded retrospectively in order to evaluate the frequency of revision for various shunt types and secondly to analyse the specific reasons for the shunt revisions.The rate of shunt revision was 45%. The Pudenz shunt was revised more often (62%) than the remaining shunt types. The Hakim and the Orbis-Sigma shunts had fewer revisions (35% and 27%, respectively) than the other observed shunt types. A defect of or an obstruction in the ventricular catheters was a frequent cause of revision followed by a defect or an obstruction of the distal catheter, a displacement of the distal catheter and an acute infection. Because of the higher rate of revision for the Pudenz shunt the rate of the above mentioned specific complications is also higher in most of the subgroups for that specific shunt type. Driven by these experiences it is reasonable to seek to develop and introduce new shunt types in an attempt to reduce the complication rate. 相似文献
72.
以羧甲基纤维素钠(CMC)水溶液模拟非牛顿型发酵介质,在内径为0.15m,高为0.975m的环隙气升式反应器内,考察了液体流变性质和导流筒结构对气液传质的影响,提出了体积氧传递系数(KLa)的经验关联式。实验表明:对于较高粘度的假塑性流体,反应器内部采用整体式导流筒结构,将有利于传质和混合,其性能优于采用开窗式导流筒或无导流筒的反应器。 相似文献
73.
急性颅脑损伤患者脑脊液中兴奋性和抑制性氨基酸含量改变及其临床意义 总被引:1,自引:0,他引:1
采用氨基酸自动分析仪检测了18例急性颅脑损伤患者脑脊液中谷氨酸、天门冬氨酸、牛磺酸、甘氨酸、丙氨酸、γ-氨基丁酸、脯氨酸含量的动态变化。结果发现,伤情越重、预后越差的患者,脑脊液中牛磺酸、γ-氨基丁酸、丙氨酸含量伤后早期升高越明显,恢复至正常的时间也越长;其中2例早期死于急性弥漫性脑肿胀、脑水肿的患者,伤后当天脑脊液中牛磺酸含量分别为92.6和51.5μmol/L,是对照值的9.6倍和5.4倍,γ-氨基丁酸含量分别为119.8和246.2μmol/L,是对照值的2.7倍和5.5倍。表明伤后脑脊液中牛磺酸、γ-氨基丁酸和丙氨酸含量的动态变化可初步反映颅脑损伤的严重程度及颅脑损伤患者的脑功能恢复状况,并可能与急性脑水肿、脑肿胀的病理生理过程有关。 相似文献
74.
Granulocytic sarcoma (GS) is a localized tumour of immature granulocytes that is usually associated with myelogenous leukaemia. We report an unusual case of mastoid GS with meningeal extension but no bone marrow involvement on presentation. Histological examination of the surgical specimen and the characteristic cerebrospinal fluid (CSF) cytology showing cytoplasmic granulations and Auer bodies led to the diagnosis of GS. Positive cytochemical staining of the immature CSF cells for naphtol-ASD chloroacetate esterase and myeloperoxidase confirmed their myeloid origin. Immunophenotyping did not reveal common acute lymphoblastic leukaemia antigen, cytokeratin, T or B-cell antigens. The patient underwent surgical resection of the localized tumour, followed by radiation therapy, intrathecal and systemic chemotherapy, as if he had acute myelogenous leukaemia (AML). He did not develop AML in the 21 months after the tumour resection. This case emphasizes the value of CSF cytological examination of tumour cells and the use of an immumocytochemical marker for differentiating GS from malignant lymphoma. 相似文献
75.
聚合酶链反应(PCR)对单纯疱疹病毒性脑炎的临床诊断价值 总被引:2,自引:1,他引:1
应用聚合酶链反应(PCR)检测技术对118例颅内感染性疾病患者及37例无神神经系统疾病患者脑脊液(CSF)中的单纯疱疹病毒DNA(HSV-DNA)进行了检测及分型。结果提示:“散发性脑炎”组的阳性率为38.46%(20/52),细菌、真菌性脑膜炎、其它病毒性脑炎组以及无神经系统疾病组均为阴性。作者认为:①本检测是目前单纯疹病毒性脑炎(HSE)较为简便而准确的早期诊断方法之一;②HSV分型检测,对病原诊断更具有全面性;③两型单纯疱疹病毒均可引起HSE。 相似文献
76.
用改良的ELISA检测25例正常对照组和32例急性脑血管病患者的血清和脑脊液(CSF)中的脑型肌酸激酶同功酶BB(creatine kinase isoenzyme BB)浓度。32例急性脑血管病患者CSF CKBB平均水平为16.62±8.3ng/ml,明显高于对照组(7.5—4.8ng/ml)。发病24h内CSFCKBB轻微增高,24~48h达高峰,以后下降,7天左右尚未恢复正常。病初CSF CKBB水平明显高于恢复期。9例高血压性脑出血的血肿出血量(按CT片上血肿大小计算)与患者CSF CKBB有密切关系(r=0.8127,P<0.01)。血肿体积(X)与CSF CKBB浓度(y)的回归方程y—7.945±0.872X。 相似文献
77.
78.
Ch. W. Wong 《Acta neurochirurgica》1995,137(1-2):38-43
Summary In this report we describe 3 patients with syringomyelia in association with tumours of the posterior fossa. In each patient the syrinx was demonstrated on pre-operative magnetic resonance imaging (MRI). After total or partial removal of the tumour the syrinx collapsed. It is concluded that the pathogenesis of syrinx formation in this entity requires interference with normal cerebrospinal fluid (CSF) flow at the foramen magnum. We suggest that the obstruction to the flow of CSF causes alterations in the passage of extracellular fluid (ECF) in the spinal cord which lead to syringomyelia. 相似文献
79.
B. Pfausler G. Grubwieser S. Bsch H. Vollert M. Herald E. Schmutzhard 《European journal of neurology》1995,2(6):570-572
A 37 year old male was admitted with the diagnosis of bacterial meningitis. Pneumococci were seen in the Gram stain of the cerebrospinal fluid. The clinical condition did not suggest severely raised intracranial pressure, there were no localizing signs and symptoms. CSF was turpid, with 20.100/3/mm3, mainly polymorphonuclear cells. Tumor necrosis factor alpha in CSp was greatly increased with 813 pg/ml. Parallel to the application of intravenous Penicillin G a CSF filtration was carried out. Within 214 h 225 ml CSF were filtrated through a Pall-filter, using a bidirectional pump. Cell count dropped to 720/3 cells/mm3, TNF-alpha to 39 pg/ml. The clinical course was uneventful, on day 12 the patient could be discharged without sequelae. CSF filtration may be a highly effective method to reduce from the CSF pathogenetically important cytokines, such as TNF-alpha, being responsible for intrathecal/meningeal inflammatory processes and triggered by cell-wall components of bacteria, e.g. pneumococci. 相似文献
80.
The neurochemistry of Alzheimer's disease 总被引:1,自引:0,他引:1
Our knowledge of the neurochemical pathology of AD has increased immensely the last years. Although it is now clear that mutations in the APP gene can cause some rare hereditary forms of AD, and that ApoE4 is a prominent risk factor for AD, we at present know little about the underlying cause of AD in the general population and the biochemical mechanisms by which the apolipoprotein E4 isoform affects AD pathogenesis. It is hoped that the near future will see a resolution of the current controversies in AD research, including: 1) whether APP mutations cause Alzheimer's disease by affecting Aβ deposition or the function of APP itself; 2) whether abnormal phosphorylation of tau is a central pathogenetic event, or whether it occurs as epiphenomena that reflect general neurodegeneration in a variety of disease processes; 3) Whether Aβ deposition in the brain is the central event in AD or whether it occurs as epiphenomena in a variety of brain disorders such as head trauma; and 4) whether altered tau phosphorylation occurs secondary to Aβ deposition or vice versa, and what the link is (if any) between the two processes. 相似文献