Based on preliminary experiences from the early 1970s, a patient with chronic and severe communicating hydrocephalus has been successfully treated with transposition of an omental pedicle to the lumbar subarachnoidal space. This patient, who suffered from congenital toxoplasmosis, at the age of 29 years had undergone no fewer than 82 shunt revisions. In the 5-year follow-up after treatment, she has had no further surgery or other treatment.
View Article and Find Full Text PDFVagus nerve stimulation (VNS) is widely used to treat refractory epilepsy. It is usually safe and has few side effects. Cardiac arrhythmia has been reported during lead tests performed during implantation of the device, but never during regular treatment.
View Article and Find Full Text PDFObjective: The discovery of stem cells in the adult human brain and developing stem cell technology open a possible future scenario of autotransplantation, where stem cells are harvested from the patient and propagated in vitro before they are used as transplants. The objectives of this study were: 1) to investigate the feasibility of harvesting tissue containing neural stem cells by endoscopy; 2) to study the possibility of propagating and multiplying stem cells from this tissue efficiently in vitro; and 3) to examine whether the stem cells differentiate into functional neurons.
Methods: In 13 patients with hydrocephalus undergoing routine neurosurgical procedures, we used an endoscope and a 3-mm biopsy forceps (Medtronic) to harvest the small piece of the ventricular wall that is detached by the introduction of the endoscope.
We sought to study the time course of the distribution of valproate (VPA) to subdural cerebrospinal fluid (CSF) in relation to subcutaneous extracellular fluid (ECF) and plasma after a single oral dose and to study the distribution to these three compartments under steady-state conditions. Microdialysis was used to estimate unbound VPA concentrations in subdural CSF and subcutaneous ECF, and blood samples were drawn for estimation of total and unbound VPA plasma concentrations in four patients with drug-resistant partial epilepsy undergoing presurgical evaluation with subdural EEG monitoring. Three patients were given a single oral dose of VPA, and one patient was receiving regular VPA treatment.
View Article and Find Full Text PDFNew neurons are continuously generated in certain regions of the adult brain. Studies in rodents have shown that new neurons are generated from self-renewing multipotent neural stem cells. Here we demonstrate that both the lateral ventricle wall and the hippocampus of the adult human brain harbor self-renewing cells capable of generating neurons, astrocytes, and oligodendrocytes in vitro, i.
View Article and Find Full Text PDFThe early effect of 1-100 microM roscovitine, a purine analogue and cyclin-dependent kinase inhibitor, was studied on tissue specimens from eight human malignant gliomas. The tissue was incubated immediately after resection with DMEM containing [3H]methylthymidine plus vehicle alone or the proper concentration of roscovitine for 30-90 min. The DNA synthesis rate was assessed by measurement of [3H]methylthymidine incorporation into trichloroacetic acid insoluble material/mg protein/min.
View Article and Find Full Text PDFPurpose: To estimate topiramate (TPM) concentrations in subdural cerebrospinal fluid (CSF), subcutaneous extracellular fluid (ECF), and plasma and to study the correlation of TPM concentrations in these three different compartments.
Methods: In this single case study of a patient with drug-resistant partial epilepsy undergoing presurgical evaluation with subdural EEG monitoring, we used microdialysis to estimate concentrations of unbound TPM in CSF of the subdural space and ECF of abdominal subcutaneous tissue. Blood samples were drawn for estimation of TPM concentrations in plasma.
Purpose: Vagus nerve stimulation (VNS) has been reported to produce >90% reduction in the number of seizures in children with intractable epilepsy. These encouraging results need confirmation.
Methods: Sixteen children, 10 boys and 6 girls aged 4-19 years, were treated with VNS (Cyberonics, Webster, TX, U.
A case of thrombosis of the straight sinus and the left transverse sinus in an 11 year old boy is described. The patient had a history of slight trauma followed by infection of the upper airways and presented with severe impressive and expressive dysphasia and stupor. He was treated with in situ fibrinolysis.
View Article and Find Full Text PDFIt was possible from a geographically well-defined region to detect all patients sustaining an aneurysmal subarachnoid haemorrhage. Different outcomes were measured and compared with other published series. Twenty-one per cent of all our patients at risk were never seen by a neurosurgeon.
View Article and Find Full Text PDFMonitoring the activity of the central nervous system with the 14C-2-deoxyglucose method of Sokoloff was utilized to explore the possibility to develop a model for the study of central nervous system reaction to peripheral trauma. Preliminary evidence indicates that the activation caused by tactile stimuli to one hindlimb nerve is that expected from earlier physiologic studies. However, an increase of stimulation intensity to recruit nociceptive (pain) fibers seems to abolish the changes, indicating that inhibitory systems have been activated.
View Article and Find Full Text PDFIn this study we examined the effect of pretreatment with the cyclo-oxygenase inhibitor indomethacin (10 mg . kg-1) on local cerebral blood flow (DBF) in the immediate recirculation period following complete and incomplete ischemia. Ischemia of 15 min duration was induced in lightly anaesthetized and artificially ventilated rats, and local CBF was measured with a 14C-iodoantipyrine autoradiographic technique after recirculation periods of 5 min.
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