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当脑室脑脊液评估产生误导时：基底脑膜炎及腰椎穿刺采样的重要性

When Ventricular Cerebrospinal Fluid Assessment Misleads: Basal Meningitis and the Importance of Lumbar Puncture Sampling.

作者信息

Khan Sadid F, Macauley Thornton, Tong Steven Y C, Xie Ouli, Hughes Carly, Hall Nicholas D P, Mahanty Siddhartha, Jennens Ian, Street Alan C

机构信息

Victorian Infectious Disease Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Doherty Department University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Australia.

出版信息

Open Forum Infect Dis. 2019 Jul 1;6(7). doi: 10.1093/ofid/ofz324.

DOI:10.1093/ofid/ofz324
PMID:31363769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6667712/
Abstract

The diagnosis of central nervous system (CNS) infection relies upon analysis of cerebrospinal fluid (CSF). We present 4 cases of CNS infections associated with basal meningitis and hydrocephalus with normal ventricular CSF but grossly abnormal lumbar CSF. We discuss CSF ventricular-lumbar composition gradients and putative pathophysiological mechanisms and highlight clinical clues for clinicians.

摘要

中枢神经系统（CNS）感染的诊断依赖于脑脊液（CSF）分析。我们报告4例与基底脑膜炎和脑积水相关的CNS感染病例，其脑室CSF正常，但腰椎CSF明显异常。我们讨论了CSF脑室-腰椎成分梯度及可能的病理生理机制，并为临床医生强调临床线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a6/6667712/053d1cf79dfb/ofz324f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a6/6667712/053d1cf79dfb/ofz324f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a6/6667712/053d1cf79dfb/ofz324f0001.jpg

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Unusual case of tuberculous meningitis with discordant ventricular and lumbar cerebrospinal fluid; lessons in the era of world-wide migration.结核性脑膜炎伴脑室与腰椎脑脊液不一致的罕见病例；全球移民时代的经验教训
J Paediatr Child Health. 2018 Jan;54(1):93-95. doi: 10.1111/jpc.13665. Epub 2017 Aug 14.
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The differential diagnosis of hypoglycorrhachia in adult patients.成人低血糖性脑脊液的鉴别诊断。
Am J Med Sci. 2014 Sep;348(3):186-90. doi: 10.1097/MAJ.0000000000000217.
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Normal ventricular-CSF may comfound the diagnosis of tuberculous meningitis hydrocephalus.
关于脑脊液细胞外囊泡研究可重复性的建议。
J Extracell Vesicles. 2024 Jan;13(1):e12397. doi: 10.1002/jev2.12397.
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Cerebrospinal Fluid-Basic Concepts Review.脑脊液——基本概念回顾
Biomedicines. 2023 May 17;11(5):1461. doi: 10.3390/biomedicines11051461.
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J Neuroinflammation. 2022 Jul 6;19(1):174. doi: 10.1186/s12974-022-02538-3.
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Cerebrospinal fluid osmolality cannot predict development or surgical outcome of idiopathic normal pressure hydrocephalus.脑脊髓液渗透压不能预测特发性正常压力脑积水的发展或手术结果。
Fluids Barriers CNS. 2022 Jun 27;19(1):52. doi: 10.1186/s12987-022-00349-5.
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