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Cerebrospinal fluid proteomics reveals the innate immunity and blood-brain barrier dysregulation in a patient with multidrug-resistant ventriculitis treated with intrathecal and intravenous polymyxin B.
Heliyon
December 2024
Department of Critical Care Medicine, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China.
is a major pathogen of nosocomial meningitis and ventriculitis. Due to very limited antibiotic treatment options, polymyxins are often used as a last-line therapy. To optimise polymyxin use in the intraventricular environment, cerebrospinal fluid (CSF) proteomics was employed to investigate host-pathogen-polymyxin interactions in a 69-year-old patient with multidrug-resistant ventriculitis treated with a combination of intrathecal (ITH; 50,000 IU q24h/q48h), intraventricular (IVT; 50,000 IU q48h), and intravenous (500,000 IU, q12h) polymyxin B.
View Article and Find Full Text PDFIntraventricular baclofen for the treatment of pediatric spasticity in cerebral palsy: technique and outcomes.
J Neurosurg Pediatr
January 2025
Departments of1Neurosurgery and.
Objective: Intraventricular baclofen (IVB) administration is used for the treatment of secondary dystonia associated with cerebral palsy (CP), but it has not been reported as a first-line infusion technique for spasticity. In this study, the authors report outcomes of patients with mixed or isolated spasticity treated with IVB administration.
Methods: A retrospective analysis was performed of consecutive patients treated with IVB between 2019 and 2023.
Intrathecal Nicardipine After Aneurysmal Subarachnoid Hemorrhage: A Scoping Review.
Neurocrit Care
December 2024
Department of Neurology, Albany Medical Center, Albany, NY, USA.
Intrathecal nicardipine (ITN) is an investigational therapy for cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The objective of this scoping review was to characterize the current state of the literature and map the current available evidence, examine research methodology, clarify key concepts and definitions in the literature, report procedural characteristics, identify and analyze knowledge gaps, and serve as a precursor for future systematic reviews, meta-analyses, and randomized controlled trials. An electronic search for studies on ITN for the treatment of CVS and DCI in patients with aSAH was conducted in accordance with published standards.
View Article and Find Full Text PDFMultiple drug resistance to infection treatment is a great challenge for neuro-intensivists due to poor drug penetration through the blood-brain barrier (BBB). Fortunately, the intraventricular administration of polymyxin-B and tigecycline seems to be effective; there are few case reports demonstrating the effectiveness of such treatments. Here, we report the case of a 24-year-old male who presented with fever and neck rigidity after intracranial drainage following lung infection caused by MDR .
View Article and Find Full Text PDFIntraventricular antibiotics for severe central nervous system infections: a case series.
Sci Rep
November 2024
Neurocritical Care Unit, Institute for Intensive Care, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Article Synopsis
- * A study analyzed 27 patients over 10 years to assess clinical features, outcomes, and antibiotic use, finding that gram-positive bacteria were more common in community-acquired infections, while healthcare-associated infections had more gram-negative bacteria.
- * The results showed that 64% of patients had favorable outcomes, which were linked to a rapid decline in white blood cell count in cerebrospinal fluid after starting IVT, indicating that faster recovery rates could lead to better long-term results despite initial severe symptoms. *
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