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Cerebrospinal fluid proteins and cells in normal-pressure hydrocephalus

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Summary

A total of 21 patients with normal-pressure hydrocephalus were examined. Cerebrospinal fluid (CSF) was collected before and after operation with a ventriculoperitoneal shunt. A slight plasma-like protein pattern indicating a blood-brain barrier (BBB) dysfunction was seen in 38% of the patients before operation. No characteristic changes could be found in the “CSF-specific” protein fraction. After the shunt operation 65% of the patients had a BBB dysfunction to macromolecules and 70% had two additional acidic protein bands in the CSF-specific fraction. Ventricular CSF protein content was 73% of lumbar CSF content when shunts were patent. Isotope encephalography showed a radionuclide accumulation at the intracranial part of the shunt system, indicating that the BBB damage might be located round the shunt catheter.

Zusammenfassung

21 Patienten mit Hydrozephalus mit normalem Druck wurden untersucht. Liquor wurde vor und nach dem Anlegen eines ventrikuloperitonealen Shunts untersucht. 38% der Patienten wies vor der Operation eine dem Plasma ähnliche Verteilung der Proteine auf, was auf eine defekte Bluthirnschranke hindeutete. Charakteristische Veränderungen der “liquorspezifischen” Eiweißfraktion ließen sich nicht feststellen. Nach der Shuntoperation hatten 65% der Patienten einen Schaden der Bluthirnschranke, und 70% zeigten 2 zusätzliche saure Proteinbänder in der “liquorspezifischen” Fraktion. Das ventrikuläre Liquorprotein betrug 73% der lumbalen Liquorproteinmenge bei intaktem Shunt. Die Isotopenenzephalographie zeigte eine Anreicherung von Radionuklid entsprechend dem intrakraniellen Teil des Shuntsystems. Dies deutet darauf hin, daß der Schaden der Bluthirnschranke möglicherweise in der Nachbarschaft des Shuntkatheters gelegen ist.

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Authors and Affiliations

  1. Department of Neurology, Sahlgren Hospital, University of Göteborg, Göteborg, Sweden

    C. Wikkelsø & C. Blomstrand

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  1. C. Wikkelsø
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  2. C. Blomstrand
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Wikkelsø, C., Blomstrand, C. Cerebrospinal fluid proteins and cells in normal-pressure hydrocephalus. J Neurol 228, 171–180 (1982). https://doi.org/10.1007/BF00313729

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  • DOI: https://doi.org/10.1007/BF00313729

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