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The Prominent Subarachnoid Space in Children: How has a Normal Variant Become Medicolegally Life-Threatening Pathology?
J Med Imaging Radiat Oncol
January 2025
Department of Pediatric, Royal Children's Hospital, Melbourne, Victoria, Australia.
A prominent subarachnoid space (SAS) in infants under 24 months is a very common finding and is a normal variant that can be associated with macrocephaly. This must be differentiated from various pathological conditions that also cause a prominent SAS, including a reduction in brain volume, obstruction to the cerebrospinal fluid (CSF) or malformations of the skull. The inappropriate labelling of normal SAS prominence as enlargement due to pathology and misrepresentation of published literature by some author groups has created confusion medicolegally, contributing to inappropriate conclusions that a normal prominent SAS may cause subdural haemorrhage (SDH) and brain injury.
View Article and Find Full Text PDFPatient stratification by genetic risk in Alzheimer's disease is only effective in the presence of phenotypic heterogeneity.
PLoS One
January 2025
Washington University School of Medicine, NeuroGenomics and Informatics Center, St. Louis, MO, United States of America.
Case-only designs in longitudinal cohorts are a valuable resource for identifying disease-relevant genes, pathways, and novel targets influencing disease progression. This is particularly relevant in Alzheimer's disease (AD), where longitudinal cohorts measure disease "progression," defined by rate of cognitive decline. Few of the identified drug targets for AD have been clinically tractable, and phenotypic heterogeneity is an obstacle to both clinical research and basic science.
View Article and Find Full Text PDFImpaired macroscopic CSF flow by sevoflurane in humans - both during and after anesthesia.
Anesthesiology
January 2025
Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, Germany.
Background: According to the model of the glymphatic system, the directed flow of cerebrospinal fluid (CSF) is a driver of waste clearance from the brain. In sleep, glymphatic transport is enhanced, but it is unclear how it is affected by anesthesia. Animal research indicates partially opposing effects of distinct anesthetics but corresponding results in humans are lacking.
View Article and Find Full Text PDFA field resource for the glioma cerebrospinal fluid proteome: impacts of resection and location on biomarker discovery.
Neuro Oncol
December 2024
Department of Neurological Surgery, Mayo Clinic; Rochester, MN, USA.
Background: While serial sampling of glioma tissue is rarely performed prior to recurrence, cerebrospinal fluid (CSF) is an underutilized longitudinal source of candidate glioma biomarkers for understanding therapeutic impacts. However, the impact of key variables to consider in longitudinal CSF samples for monitoring biomarker discovery, including anatomical location and post-surgical changes, remains unknown.
Methods: Aptamer-based proteomics was performed on 147 CSF samples from 74 patients, 71 of whom had grade 2-4 astrocytomas or grade 2-3 oligodendrogliomas.
A Hitchhiker's Guide Toward CSF Biomarkers for Neuro-Oncology.
Neuro Oncol
December 2024
Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Cerebrospinal fluid (CSF) has emerged as a valuable liquid biopsy source for glioma biomarker discovery and validation. CSF produced within the ventricles circulates through the subarachnoid space, where the composition of glioma-derived analytes is influenced by the proximity and anatomical location of sampling relative to tumor, in addition to underlying tumor biology. The substantial gradients observed between lumbar and intracranial CSF compartments for tumor-derived analytes underscore the importance of sampling site selection.
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