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The term hydrocephalus is commonly used to indicate increased volume of the cerebral ventricles, particularly the lateral ventricles. The disease is characterized by increased accumulation of cerebrospinal fluid (CSF) in the skull, and can occur in any animal, more frequently in puppies, although considered a rare congenicity in felines. Diagnosis is based on history, clinical examination, ultrasound examination, tomography or magnetic resonance imaging of the skull. The treatment of hydrocephalus is based on the patient's clinical condition and age and can be performed clinically or surgically. The surgical method consists of promoting a diversion of CSF flow from the lateral ventricle to the jugular vein or peritoneal cavity, while drug treatment is based on medications that reduce CSF production. The present study aimed to report a clinical case of congenital hydrocephalus diagnosed in adulthood in a feline. We opted for clinical treatment, with systemic drug therapy. The therapeutic choice was in line with recommended practices in the literature, aiming to stabilize the case and minimize patient discomfort. Although the animal presented relapses, pharmacological therapy was effective in managing the disease. [ABSTRACT FROM AUTHOR]

Background Oligoclonal bands (OCBs) and Kappa free light chains (FLCs) in the cerebrospinal fluid (CSF) are sensitive markers of intrathecal immunoglobulin (Ig)G synthesis in patients with multiple sclerosis.

Dengue, zika, and chikungunya are arboviruses of great epidemiological relevance worldwide. The emergence and re-emergence of viral infections transmitted by mosquitoes constitute a serious human public health problem. The neurological manifestations caused by these viruses have a high potential for death or sequelae. The complications that occur in the nervous system associated with arboviruses can be a challenge for diagnosis and treatment. In endemic areas, suspected cases should include acute encephalitis, myelitis, encephalomyelitis, polyradiculoneuritis, and/or other syndromes of the central or peripheral nervous system, in the absence of a known explanation. The confirmation diagnosis is based on viral (isolation or RT-PCR) or antigens detection in tissues, blood, cerebrospinal fluid, or other body fluids, increase in IgG antibody titers between paired serum samples, specific IgM antibody in cerebrospinal fluid and serological conversion to IgM between paired serum samples (non-reactive in the acute phase and reactive in the convalescent). The cerebrospinal fluid examination can demonstrate: 1. etiological agent; 2. inflammatory reaction or protein-cytological dissociation depending on the neurological condition; 3. specific IgM, 4. intrathecal synthesis of specific IgG (dengue and chikungunya); 5. exclusion of other infectious agents. The treatment of neurological complications aims to improve the symptoms, while the vaccine represents the great hope for the control and prevention of neuroinvasive arboviruses. This narrative review summarizes the updated epidemiology, general features, neuropathogenesis, and neurological manifestations associated with dengue, zika, and chikungunya infection.

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Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A meningoencefalite bacteriana é uma afecção neurológica que acomete cães e gatos e se dá pela migração de bactérias de focos infecciosos próximos ou distantes do sistema nervoso central através da corrente sanguínea, atravessando a Barreira hemato-encefálica e atingindo o encéfalo e meninges. Nesse contexto, o presente trabalho tem por objetivo relatar um caso de Meningoencefalite bacteriana secundária à vaginite em um canino, fêmea, sem raça definida, de 3 anos de idade, atendida no Hospital Veterinário Dr. Vicente Borelli localizado em Aracaju, Sergipe. O animal apresentava incoordenação motora, inclinação da cabeça para o lado direito e andar em círculos. Foram realizados exame físico, hemograma, perfil renal, perfil hepático e fração proteica, cistocentese guiada por ultrassom, análise físico-química, cultura da urina, coleta de LCR para realização de citologia e cultura bacteriana e coleta da secreção vaginal para cultura bacteriana e antibiograma. Por fim realizou-se laparotomia exploratória para descarte de coto uterino. Ao exame físico constatou-se presença de nistagmo horizontal bilateral, rigidez cervical, ausência de resposta a dor profunda, ausência de reflexo tibial cranial, déficit proprioceptivo no membro posterior direito além de secreção vulvar enegrecida. No hemograma, constatou-se discreta anemia normocítica normocrômica, trombocitopenia e monocitopenia. Os perfis renal e hepático e a fração proteica não apresentaram alterações. A urianálise apresentou aspecto turvo, pH alcalino, presença de hemácias e leucócitos, além de cristais como fosfato amorfo e triplo. Na urocultura obteve-se crescimento, isolamento e identificação do microrganismo Streptococcus spp. Os resultados encontrados no exame citológico do líquor foram pequena quantidade de material proteico eosinofílico, amorfo, finamente granular, densidade e proteínas pouco aumentados. A ultrassonografia e laparotomia exploratória auxiliaram no descarte dos diagnósticos diferenciais da vaginite. Quanto aos exames microbiológicos das amostras de LCR e secreção vaginal obteve-se em ambas o crescimento do gênero de bactérias gram-positivas Staphylococcus. Dessa forma o presente relato permitiu concluir que a vaginite pode desencadear meningoencefalite por conta da translocação bacteriana através da circulação sanguínea.

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Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: Síndrome Inflamatória da Reconstituição Imune (SIRI) se apresenta como uma resposta imune exagerada que ocorre durante uma restauração imune desregulada em pacientes imunocomprometidos em estágio avançado da infecção pelo HIV quando iniciam tratamento com antirretrovirais. Qualquer patógeno oportunista pode provocar este tipo de desordem durante a restauração imune. Objetivo: Identificar os recentes avanços nos fatores de risco e nos biomarcadores moleculares de prognóstico e diagnóstico da Síndrome Inflamatória da Reconstituição Imune associada à meningite criptococócica para melhor compreender sua imunopatogênese. Método: Revisão de escopo conforme a proposta de Joana Briggs Institute. A busca foi realizada por dois pesquisadores independentes, nas bases de dados PubMed e do Google Acadêmico, por meio de descritores e/ou seus sinônimos. Resultados: A busca resultou em 240 artigos. Destes, 36 foram excluídos por serem repetidos; 1 utilizou modelos animais; 3 eram sobre pacientes soronegativos para o HIV; 8 não eram sobre Cryptococcus; 3 falavam sobre tuberculose e 1 sobre criptococose pulmonar. Foram destacados estudos que analisaram fatores de risco e biomarcadores, no sangue / plasma e líquido cefalorraquidiano, que podem esclarecer a imunopatogênese da Síndrome Inflamatória da Reconstituição Imune associada à criptococose. Conclusão: Apresentamos uma revisão dos estudos realizados sobre fatores de risco em biomarcadores no sangue e líquido cefalorraquidiano que podem auxiliar no diagnóstico de Síndrome Inflamatória da Reconstituição Imune na meningite criptococócica. Esses fatores de risco e biomarcadores podem ser usados para identificar pacientes que seriam submetidos a um monitoramento clínico mais rigoroso e com ajuste dos protocolos de tratamento em pacientes com AIDS coinfectados com Cryptococcus.

Objective: To compare fetuses with intrauterine growth restriction (IUGR) and those with normal growth, in terms of skull and brain measurements obtained by magnetic resonance imaging (MRI). Materials and Methods: This was a prospective cohort study including 26 single fetuses (13 with IUGR and 13 with normal growth), evaluated from 26 to 38 weeks of gestation. Using MRI, we measured skull and brain biparietal diameters (BPDs); skull and brain occipitofrontal diameters (OFDs); corpus callosum length and area; transverse cerebellar diameter; extracerebral cerebrospinal fluid (eCSF); and right and left interopercular distances (IODs). Results: The following were significantly smaller in IUGR fetuses than in control fetuses: skull BPD (76.9 vs. 78.2 mm; p = 0.0029); brain BPD (67.8 vs. 71.6 mm; p = 0.0064); skull OFD (93.6 vs. 95 mm; p = 0.0010); eCSF (5.5 vs. 8.2 mm; p = 0.0003); right IOD (9.8 vs. 13.9 mm; p = 0.0023); and left IOD (11.8 vs. 16.3 mm; p = 0.0183). The skull BPD/eCSF, brain BPD/eCSF, skull OFD/eCSF, and brain OFD/eCSF ratios were also lower in IUGR fetuses. Conclusion: IUGR fetuses had smaller OFD and BPD, both skull and brain, and less eCSF when compared to normal growth fetuses. [ABSTRACT FROM AUTHOR]

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The present study aimed to describe epidemiological, clinical, laboratorial, and pathological findings of polioencephalomalacia (PEM) in ruminants from the semi-arid region of Rio Grande do Norte, Brazil. A total of seven ruminants (five sheep, one cattle, and one goat) with pathological diagnosis of PEM were included. Four cases were associated with thiamine deficiency, on account of chronic ruminal acidosis caused by diets rich in carbohydrate, with mainly concentrates, ground soybean hulls, and melon. Three ruminants from an outbreak of petroleum poisoning presented macro and microscopic lesions consistent with changes of malacia and edema in deep structures of the brain, as described in ruminants with PEM associated with sulfur intoxication. Major macroscopic changes included congestion of cerebral vessels, edema, and herniation of the cerebellum. The most observed microscopic lesions, among all assessed cases, were laminar and segmental neuronal necrosis at different regions of the brain, spongiosis, nuclear pyknosis, and red nucleus neurons. Cerebrospinal fluid analysis revealed nonspecific alterations, requiring its association with epidemiological, clinical, and pathological findings, as the results described here are similar to those reported in toxic diseases with neurological manifestations, such as botulism.

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Acute Transverse Myelitis (MTA) is an inflammatory condition that affects the spinal cord. The disease evolve with clusters of monocytes and lymphocytes and activation of microglia and astroglia in the medullary and perivascular region. Generally, the clinic starts with pain, and may have paresthesias, ataxic gait and sphincter dysfunction. The diagnosis is based on inclusion and exclusion criteria, and the examination of cerebrospinal fluid and magnetic resonance imaging is essential to confirm spinal cord inflammation. The treatment is not well established; can be used: corticosteroids, cyclophosphamide, immunomodulators, cerebrospinal fluid filtration, plasma exchange, diet and physiotherapy. Its prognosis ranges from complete healing to total paraplegia or death. the recognition of the disease is necessary to institute early treatment, avoiding more serious damage, including death. For obtaining scientific information, was used databases as of scientific information, will be SciELO, MEDLINE, PubMed and LILACS, in addition to access to periodicals and reference sites related to the health area. [ABSTRACT FROM AUTHOR]

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RESUMO A COVID-19 foi declarada pandemia pela Organização Mundial de Saúde no dia 11 de março de 2020. O quadro clínico apresenta predominantemente sintomatologia respiratória, no entanto, na literatura atual, têm sido descritas diversas manifestações neurológicas associadas à infeção por SARS-CoV-2. Os autores apresentam o caso clínico de um homem de 45 anos internado por pneumonia com resultado positivo para SARS-CoV-2, sem antecedentes neurológicos, que, ao décimo sexto dia de internamento, apresentou alteração súbita do estado de consciência acompanhada de desvio conjugado do olhar para a direita e mioclonias da face e da região torácica à esquerda, seguidas de crise convulsiva tônico-clônica generalizada, associadas à hemiparesia esquerda persistente. Do estudo realizado salienta-se a existência de RT-PCR para SARS-CoV-2 no líquido cefalorraquidiano positiva. O doente apresentou evolução clínica com melhoria gradual, tendo o desfecho sido favorável.

Introduction: Hydrocephalus is a common complication among neurological patients whose treatment in acute cases is done through an external ventricular drain catheter which allows monitoring and controlling intracranial hypertension. This study aimed at describing the knowledge retention by nurses after an educational intervention on nursing care for an external ventricular drain. Materials and Methods: A quasi-experimental study with nurses at an adult intensive care unit was conducted in which knowledge retention on the topic was evaluated at different three times: before, one week and three months after training. Results: After one week, significant retention was observed but not after three months, given that after this period the question success rate was significantly low with respect to the previous phases. Participants' performance was better in those questions related to system management. Discussion: Time is a factor that interferes with learning since studies show that knowledge at three months significantly decreases and is almost completely gone after six months and a year. Practical behaviors based on assistance guidelines have better retention among professionals, underlining that it is easier to learn technical skills that are associated with professional experience. Conclusions: A significant knowledge retention was observed among professionals in the first week after training but not after three months. [ABSTRACT FROM AUTHOR]

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Copyright of Jornal Brasileiro de Patologia e Medicina Laboratorial is the property of Sociedade Brasileira de Patologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jornal Brasileiro de Patologia e Medicina Laboratorial is the property of Sociedade Brasileira de Patologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jornal Brasileiro de Patologia e Medicina Laboratorial is the property of Sociedade Brasileira de Patologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Ciências Veterinárias e Zoologia da Unipar is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT The physiological and biophysical knowledge base for interpretations of cerebrospinal fluid (CSF) data and reference ranges are essential for the clinical pathologist and neurochemist. With the popular description of the CSF flow dependent barrier function, the dynamics and concentration gradients of blood-derived, brain-derived and leptomeningeal proteins in CSF or the specificity-independent functions of B-lymphocytes in brain also the neurologist, psychiatrist, neurosurgeon as well as the neuropharmacologist may find essentials for diagnosis, research or development of therapies. This review may help to replace the outdated ideas like “leakage” models of the barriers, linear immunoglobulin Index Interpretations or CSF electrophoresis. Calculations, Interpretations and analytical pitfalls are described for albumin quotients, quantitation of immunoglobulin synthesis in Reibergrams, oligoclonal IgG, IgM analysis, the polyspecific ( MRZ- ) antibody reaction, the statistical treatment of CSF data and general quality assessment in the CSF laboratory. The diagnostic relevance is documented in an accompaning review.

ABSTRACT The analysis of intrathecal IgG, IgA and IgM synthesis in cerebrospinal fluid (CSF) and evaluation in combined quotient diagrams provides disease-related patterns. The compilation with complementary parameters (barrier function, i.e., CSF flow rate, cytology, lactate, antibodies) in a cumulative CSF data report allows a knowledge-based interpretation and provides analytical and medical plausibility for the quality assessment in CSF laboratories. The diagnostic relevance is described for neurological and psychiatric diseases, for which CSF analysis can’t be replaced by other diagnostic methods without loss of information. Dominance of intrathecal IgM, IgA or three class immune responses give a systematic approach for Facial nerve palsy, Neurotrypanosomiasis, Opportunistic diseases, lymphoma, Neurotuberculosis, Adrenoleucodystrophy or tumor metastases. Particular applications consider the diagnostic power of the polyspecific antibody response (MRZ-antibodies) in multiple sclerosis, a CSF-related systematic view on differential diagnostic of psychiatric diseases and the dynamics of brain- derived compared to blood-derived molecules in CSF for localization of paracytes.

Resumo Objetivo: descrever um protocolo simplificado para abordagem de casos suspeitos de meningite. Métodos: relato de experiência na abordagem diagnóstica das meningites no serviço de referência em doenças tropicais do estado do Piauí, Brasil, no período de 2007-2016; extraíram-se informações do Sistema de Informação de Agravos de Notificação (Sinan) e do livro de registro do laboratório; utilizou-se o teste do qui-quadrado para comparar os indicadores da vigilância epidemiológica baseados na classificação final dos casos de meningite; utilizou-se o teste de concordância Phi para verificar a correlação entre os diagnósticos etiológicos presumidos pelo protocolo e aqueles confirmados laboratorialmente. Resultados: considerando-se 4.096 casos de meningite estudados, houve redução na classificação genérica desses casos, de 72 para 47% (p

ABSTRACT Introduction: Several studies have been conducted in order to validate cerebrospinal fluid biomarkers for the diagnosis of Alzheimer’s disease (AD), aiming primarily to facilitate the early diagnosis. Objective: To evaluate CSF biomarkers on patients with probable AD and the applicability of the international references values in this population. Methods: 46 individuals were recruited and classified as probable AD (n = 19), mild cognitive impairment (MCI) (n = 5) and other dementias (n = 22). The cerebrospinal fluid (CSF) biomarkers were measured using the INNOTEST kits for enzyme-linked immunosorbent assay (ELISA). Higher Tau protein values and lower Aβand Innotest Amyloid Tau Index (IATI) values were observed in AD group when compared with MCI; higher levels of Tau and phosphorylated Tau (P-Tau), and lower Aβand IATI values were observed in AD group when compared to patients with other dementias. No biomarker or IATI was able to distinguish between MCI and other dementias. The kappa index between biomarkers and the clinical diagnosis was regular to Tau and IATI, and weak to Aβand P-tau. Conclusion: The cut-off values for each biomarker that showed better combined sensibility and specificity differ from the reference values suggested by the manufacturer. The CSF biomarkers represent important resources that can help with the AD diagnosis, although the results interpretation must be made based on the analysis of the three analytes together. The cut-off values must be established to address the specificities and characteristics of each population.

ABSTRACT INTRODUCTION: Intrathecal fluorescein has been effective for topographic diagnosis of rhinoliquorrhea. Nonetheless, there are no reports on the study of cerebral spinal fluid (CSF) after use of intrathecal fluorescein. OBJECTIVE: A prospective study attempting to evaluate CSF through chemical and cytological analysis, after injection of fluorescein. METHODS: Prospective analysis of 24 samples of CSF after intrathecal injection of fluorescein for topographic diagnosis of CSF fistulae, collected at the time of puncture and after 24 and 48 h, divided by cellularity: Group 1, up to five cells, and Group 2, with more than five cells. RESULTS: The yellow-greenish color of CSF remained after 48 h in 36%, evidencing permanence of fluorescein. No changes in protein and glucose levels were observed between 0-24 h and 0-48 h. In group 2, an increase in cell count was observed between 24 h and 48 h (p = 0.019). In both groups, there was an increase of neutrophils between 0 and 48 h (p = 0.048) and a decrease between 24 and 48 h (p = 0.05). CONCLUSION: Intrathecal fluorescein provoked discreet meningeal reactions, such as an increase of cells between 24 and 48 h and an increase of neutrophils at 24 h, with a subsequent decrease at 48 h with no correlation with symptomatology.

The nervous system plays an important role in HIV infection. The purpose of this review is to discuss the indications for cerebrospinal fluid (CSF) analysis in HIV infection in clinical practice. CSF analysis in HIV infection is indicated for the diagnosis of opportunistic infections and co-infections, diagnosis of meningitis caused by HIV, quantification of HIV viral load, and analysis of CNS HIV compartmentalization. Although several CSF biomarkers have been investigated, none are clinically applicable. The capacity of HIV to generate genetic diversity, in association with the constitutional characteristics of the CNS, facilitates the generation of HIV quasispecies in the CNS that are distinct from HIV in the systemic circulation. CSF analysis has a well-defined and valuable role in the diagnosis of CNS infections in HIV/AIDS patients. Further research is necessary to establish a clinically applicable biomarker for the diagnosis of HIV-associated neurocognitive disorders.

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Objective: The present study is to describe the clinical impact of S100 and S100β for the evaluation of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass (CPB). Methods: Quantitative results of S100 and S100β reported in the literature of the year range 1990-2014 were collected, screened and analyzed. Results: Cerebrospinal fluid and serum S100 levels showed a same trend reaching a peak at the end of CPB. The cerebrospinal fluid/serum S100 ratio decreased during CPB, reached a nadir at 6 h after CPB and then increased and kept high untill 24 h after CPB. Serum S100 at the end of CPB was much higher in infant than in adults, and in on-pump than in off-pump coronary artery bypass patients. ∆S100 increased with age and CPB time but lack of statistical significances. Patients receiving an aorta replacement had a much higher ∆S100 than those receiving a congenital heart defect repair. Serum S100β reached a peak at the end of CPB, whereas cerebrospinal fluid S100 continued to increase and reached a peak at 6 h after CPB. The cerebrospinal fluid/serum S100β ratio decreased during CPB, increased at the end of CPB, peaked 1 h after CPB, and then decreased abruptly. The increase of serum S100β at the end of CPB was associated with type of operation, younger age, lower core temperature and cerebral damages. ∆S100β displayed a decreasing trend with age, type of operation, shortening of CPB duration, increasing core temperature, lessening severity of cerebral damage and the application of intervenes. Linear correlation analysis revealed that serum S100β concentration at the end of CPB correlated closely with CPB duration. Conclusion: S100 and S100β in cerebrospinal fluid can be more accurate than in the serum for the evaluations of cerebral damage in cardiac surgery. However, cerebrospinal fluid biopsies are limited. But serum S100β and ∆S100β seem to be more sensitive than serum S100 and ∆S100. The cerebral damage in cardiac surgery might be associated with younger age, lower core temperature and longer CPB duration during the operation. Effective intervenes with modified CPB circuit filters or oxygenators and supplemented anesthetic agents or priming components may alleviate the cerebral damage.

Increased plasma lactate levels can indicate the presence of metabolic disorders in HIV infected individuals. Objective: To determine whether a portable analyzer is valid for measuring cerebrospinal fluid (CSF) and plasma lactate levels in HIV infected individuals. Method: CSF and plasma were collected from 178 subjects. Samples tested by the Accutrend® portable analyzer were compared to those tested by a reference device (SYNCHRON LX® 20). Results: The portable analyzer had in plasma sensitivity of 0.95 and specificity 0.87. For CSF the specificity was 0.95; the sensitivity 0.33; the negative predictive value was 95% and the positive predictive value 33%. Conclusions: These findings support the validity of the portable analyzer in measuring lactate concentrations in CSF that fall within the normal range. The relatively poor positive predictive value indicates that a result above the reference range may represent a “false positive test”, and should be confirmed by the reference device before concluding abnormality.

Blood plasma specimens are the clinical standard for HIV-1 pol gene genotyping from viral populations; however, it is not always successful, often from low viral loads or the presence of polymerase chain reaction (PCR) inhibitors. Objective To describe the successful of HIV-1 genotyping in two samples of cerebrospinal fluid (CSF), after genotype procedures failed from blood. Method Two HIV-infected patients enrolled in a neurocognitive research study were evaluated when standard HIV-1 genotyping failed from blood plasma samples. Genotyping was performed using the commercial system TRUGENE® HIV-1 Genotyping Kit and the OpenGene® DNA Sequencing System (Siemens Healthcare Diagnostics, Tarrytown, NY, USA). Results CSF genotyping was performed via the same commercial platform and was successful in both cases. Conclusion This report demonstrates that CSF could be used as an alternate clinical specimen for HIV-1 genotyping when it fails from blood.

To describe a series of 129 consecutive patients submitted to the resection of pituitary tumors using the endoscopic transsphenoidal approach in a public medical center. Method: Retrospective analysis based on the records of patients submitted to the resection of a pituitary tumor through the endoscopic transsphenoidal approach between 2004 and 2009. Results: One hundred and twenty-nine records were analyzed. The tumor was non-secreting in 96 (74.42%) and secreting in 33 patients (22.58%). Out of the secretory tumors, the most prevalent was the growth hormone producer (7.65%), followed by the prolactinoma, (6.98%). Eleven patients developed cerebral spinal fluid (CSF) fistulas, and four of them developed meningitis. One patient died due to intracerebral hemorrhage in the postoperative period. Conclusion: The endoscopic transsphenoidal approach to sellar tumors proved to be safe when the majority of the tumors were non-secreting. The most frequent complication was CSF. This technique can be done even in a public hospital with financial limits, since the health professionals are integrated.

Introducción: El Síndrome HaNDL (Headache and neurologic deficits with cerebroespinal fluid lymphocytosis) por sus siglas en inglés, es una patología que cursa con cefalea, focalización neurológica y linfocitosis en el líquido cefalorraquídeo. Objetivo: este artículo busca presentar un caso de Síndrome de HaNDL, puesto que esta condición nosológica implica un reto diagnóstico. Resultados y conclusiones: Se presenta el caso de un paciente con diagnóstico de síndrome de HaNDL los hallazgos al examen físico y del líquido cefalorraquídeo. [Barros-Gutiérrez CE, Silva-Monsalve E, Gualtero-Trujillo S. Síndrome HaNDL. MedUNAB 2015; 17(3): xx-xx]. Introduction: The syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis, is a pathology that presents cephalalgia, neurological focalization and lymphocytes in the cerebrospinal fluid. Objective: This article presents a HaNDL Syndrome case, since this nosological condition implies a diagnostic challenge. Results and conclusions: A case of a patient with HaNDL syndrome diagnosis, physical examination findings and cerebrospinal fluid are presented. [Barros-Gutiérrez CE, Silva-Monsalve E, Gualtero-Trujillo S. HaNDL Syndrome. MedUNAB 2015; 17(3): xx-xx]. Introdução: A síndrome de HaNDL (Headache and neurologic déficits with cerebrospinal fluid lymphocytosis) por sua sigla em inglês é uma doença que causa dor de cabeça, foco neurológico e linfocitose no líquido cefalorraquidiano. Objetivo: Este artigo tem como objetivo apresentar um caso de Síndrome de HaNDL, uma vez que esta condição nosológica envolve um desafio diagnóstico. Resultados e conclusões: Apresenta-se o caso de um paciente diagnosticado com a síndrome de HaNDL, o encontrado no exame físico e o líquido cefalorraquidiano. [Barros-Gutiérrez CE, Silva-Monsalve E, Gualtero-Trujillo S. Síndrome HaNDL. MedUNAB 2015; 17(3): xx-xx].

Liquoric fistula (LF) is defined as the communication of the subarachnoid space with the external environment, which main complication is the development of infection in the central nervous system. We reported the case of a patient with non-traumatic eyelid liquoric fistula secondary to orbital meningocele (congenital lesion), which main clinical manifestation was unilateral eyelid edema. Her symptoms and clinical signs appeared in adulthood, which is uncommon. The patient received surgical treatment, with complete resolution of the eyelid swelling. In conclusion, eyelid cerebrospinal fluid (CSF) fistula is a rare condition but with great potential deleterious to the patient. It should be considered in the differential diagnosis of unilateral eyelid edema, and surgical treatment is almost always mandatory.

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Resumo Justificativa e objetivo Investigar as diferenças no número de células epiteliais escamosas transportadas para o canal medular por três tipos diferentes de pontas de agulhas espinhais do mesmo tamanho. Métodos Os pacientes foram alocados em três grupos (Grupo I, Grupo II, Grupo III). Raquianestesia foi administrada aos pacientes do Grupo I (n = 50) com agulha Quincke de 25G, do Grupo II (n = 50) com agulha espinhal ponta de lápis de 25G e do Grupo III (n = 50) com agulha atraumática não cortante de curvatura especial. A primeira e terceira gotas de líquido cefalorraquidiano (LCR) foram colhidas de cada paciente para amostra e cada gota foi colocada em lâmina para exame citológico. As células epiteliais escamosas nucleadas e não nucleadas sobre as lâminas de esfregaço foram contadas. Resultados Houve diferença estatisticamente significativa entre os grupos em relação ao número de células epiteliais escamosas na primeira gota ( p < 0,05). O Grupo III apresentou um número menor de células epiteliais escamosas na primeira gota, em comparação com os grupos I e II, enquanto o Grupo I apresentou um número maior de células epiteliais escamosas na terceira gota, em comparação com os outros grupos. Os números de células epiteliais escamosas na primeira e terceira gotas foram estatisticamente semelhantes em cada grupo, respectivamente ( p > 0,05, para cada grupo). Conclusões Neste estudo de pontas de agulha diferentes, verificamos que com a agulha atraumática de curvatura especial o número de células transportadas foi significativamente menor, em comparação com as agulhas Quincke e ponta de lápis. Background and objectives To investigate the differences in the number of squamous epithelial cells carried to the spinal canal by three different types of spinal needle tip of the same size. Methods Patients were allocated into three groups (Group I, Group II, Group III). Spinal anesthesia was administered to Group I ( n = 50) using a 25G Quincke needle, to Group II ( n = 50) using a 25G pencil point spinal needle, and to Group III ( n = 50) using a non‐cutting atraumatic needle with special bending. The first and third drops of cerebral spinal fluid (CSF) samples were taken from each patient and each drop was placed on a slide for cytological examination. Nucleated and non‐nucleated squamous epithelial cells on the smear preparations were counted. Results There was statistically significant difference between the groups in respect to the number of squamous epithelial cells in the first drop ( p < 0.05). Group III had lower number of squamous epithelial cells in the first drop compared to that of Group I and Group II. Mean while Group I had higher number of squamous epithelial cells in the third drop compared to the other groups. The number of squamous epithelial cells in the first and third drops was statistically similar in each group respectively ( p > 0.05 for each group). Conclusions In this study of different needle tips, it was seen that with atraumatic needle with special bending a significantly smaller number of cells were transported when compared to the Quincke tip needles, and with pencil point needles. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods: A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results: The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion: Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone. [ABSTRACT FROM AUTHOR]

A presente pesquisa foi realizada com o objetivo de desenvolver e adaptar técnicas diagnósticas em neurologia para primatas não humanos, da espécie Alouatta guariba Geoffroy Saint-Hilaire, 1812 (bugio-ruivo) saudáveis e mantidos em cativeiro. Foram realizadas análises físico-químicas e citológicas do líquido cefalorraquidiano obtido na cisterna magna de oito bugios-ruivos. Para realização dos exames, todos os animais foram contidos quimicamente com associação de cetamina, xilazina e midazolam e anestesia inalatória com isoflurano. Os resultados das análises do líquido cefalorraquidiano demonstraram valores médios de proteína: 16,92mg/dL±9,84; glicose: 131,25mg/dL±106,7; pH: 8,37±0,69; células nucleadas: 0,5/mm³±0,75; hemácias: 49,37/mm³±111,76 e pressão: 7,37cm H2O±1,77. O trabalho demonstrou a segurança e a eficácia da colheita do líquido cefalorraquidiano na cisterna magna de Alouatta guariba e os valores de referência para a espécie.

Cognitive impairment and major depressive disorder (MDD) are common HIV-1 central nervous system (CNS) complications. Their frequencies in AIDS patients are 36% and 45%, respectively. The diagnoses of HIV cognitive impairment are made by clinical criteria, no single laboratory test or biomarker establishes the diagnosis. Factors of indirect neuronal injury related with the pathophysiology of the HIV infection in the CNS, are the factors studied as biomarkers. In the present no biomarker is established to the diagnosis of HIV cognitive impairment, much still needs to be done. We review in this paper some biomarkers in cerebrospinal fluid that could be valuable to the diagnosis of HIV cognitive impairment. Diagnosing depression in the context of HIV can be challenging, to identify a biomarker that could help in the diagnosis would be very important, although MDD risks and neurobiology are still poorly understood.

Analysis on cerebrospinal fluid (CSF) in neurological diagnosis has always been considered to be a strong point among the main complementary examinations in Brazil. The present paper reviews the main events in the history of CSF in the neurological sciences, with emphasis on the founders of several CSF schools in our country from the beginning of the 20th century to the present time.