Diseases of the central nervous system (CNS) mean for the human organism a potentially dangerous situation. An investigation of cerebrospinal fluid (CSF) provides important information about a character of CNS impairment in the decision-making diagnostic and therapeutic algorithm. The authors present a brief overview of available cerebrospinal fluid assays, shortened indication criteria, a recommended algorithm of CSF assessment in different suspected diseases, and a view of the external quality system. The whole portfolio of obtainable CSF methodology is further subdivided according to the adequate choice into the first and inevitable basic routine panel, and following complicated analyses of highly specialized character. The basic panel is considered for standard laboratories, the complete specialized assessment should be provided by a super-consulting laboratory.

• MeSH
• algoritmy MeSH
• cytologické techniky MeSH
• klinické laboratorní techniky MeSH
• lidé MeSH
• makrofágy MeSH
• mozkomíšní mok chemie   cytologie   MeSH
• proteiny v mozkomíšním moku analýza   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• proteiny v mozkomíšním moku MeSH

In addition to its nutritive and protective effects, the basic function of the cerebrospinal fluid space resides in dynamic equilibration of pressure fluctuations caused by volume changes in three compartments contained within the rigid skull cavity: brain tissue, blood and cerebrospinal fluid. An increase in volume in one of them brings about a compliant withdrawal in volume in the other two. The degree of cerebrospinal fluid compliance can be expressed by means of the pressure/volume index which is directly proportional to this compliance. On the other hand an expansion of fluid space which forces the brain to withdraw its tissue, brings about the dilatation of brain ventricles. The degree of their dilatation depends on the effective pressure of cerebrospinal fluid which counteracts with the resistance of brain venous collectors. The blood in the venous network of the brain and cerebral extracellular fluid play a reversible role in cerebral mass restoration and reduction. These facts explain the reason why, from the physical point of view, the brain is considered to represent a viscous and elastic spongious matter. (Ref. 21.)

• MeSH
• absorpce MeSH
• lebka fyziologie   MeSH
• lidé MeSH
• mozek fyziologie   MeSH
• mozkomíšní mok fyziologie   MeSH
• poddajnost MeSH
• subarachnoidální prostor fyziologie   MeSH
• tlak mozkomíšního moku fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Cytological examination of cerebrospinal fluid (CSF) has some specifics. In the pre-analytical phase, due to collection into a tube without fixation and hypooncotic nature with rapid cell degradation, processing is required within 2-3 hours. In the subsequent analytical phase it is necessary to take into account the quantitative limit of the sample due to regular parallel cytological processing and non-morphological methods. A regular entry step of cytological examination is the quantification of cellularity. Even oligocellular samples may exhibit severe cytological findings. In the category of inflammatory processes, the cytological diagnosis of purulent meningitis within a few hours has a fundamental influence on prognosis of the disease. Non-purulent inflammations with a broad differential diagnosis are specified not only by cytological images, but also by parallel non-morphological examinations aimed at detecting an infectious agent or autoimmune nature of inflammation. Neoplastic processes in the intermeningeal space generally require immunocytochemical verification. The minimum amount of CSF for immunocytochemical examinations is 3-5 ml. The requirement for these examinations resulting from the baseline assessment may indicate the need for another sample. If the appropriate procedures and interpretations are followed in the context of parallel non-morphological examinations, the cytological examination of MM can contribute significantly to the diagnosis of pathological conditions in CSF spaces.

• Klíčová slova
• Meningitis, cytology of the cerebrospinal fluid, intracranial bleeding, meningeal carcinosis, multiple sclerosis,
• MeSH
• diferenciální diagnóza MeSH
• lidé MeSH
• mozkomíšní mok cytologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

This case report presents a 54-year-old Parkinson´s disease patient who underwent a DBS implantation to the subthalamic nuclei bilaterally. Shortly after the operation, the subcutaneous pocket of the generator filled with a liquid. Repeated aspirations did not show any bacterial contamination, and an infection was not found. In the sample, a beta-trace protein was detected that proved the presence of cerebrospinal fluid. A lumbar drain was immediately placed, and a chest compression bandage was fastened for 7 days. After removing the lumbar drain and the compression bandage, no additional liquid was observed, and the wound healed without any other complication. We present an unusual adverse event related to DBS surgery and suggest an effective treatment that has led to uncomplicated healing.

• Klíčová slova
• Adverse events, Cerebrospinal fluid leak, Deep brain stimulation, Neurosurgery, Subcutaneous pocket,
• MeSH
• drenáž metody   MeSH
• hluboká mozková stimulace škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nucleus subthalamicus chirurgie   MeSH
• Parkinsonova nemoc diagnóza   chirurgie   MeSH
• pooperační komplikace etiologie   chirurgie   MeSH
• retrospektivní studie MeSH
• únik mozkomíšního moku etiologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

PURPOSE: The lack of reliable diagnostic and/or prognostic biomarkers for multiple sclerosis (MS) is the major obstacle to timely and accurate patient diagnosis in MS patients. To identify new proteins associated with MS we performed a detailed proteomic analysis of cerebrospinal fluid (CSF) of patients newly diagnosed with relapsing-remitting MS (RRMS) and healthy controls. MATERIAL: Reflecting significantly higher prevalence of MS in women we included only women patients and controls in the study. To eliminate a potential effect of therapy on the CSF composition, only the therapy-naïve patients were included. METHODS: Pooled CSF samples were processed in a technical duplicate, and labeled with stable-isotope coded TMT tags. To maximize the proteome coverage, peptide fractionation using 2D-LC preceded mass analysis using Orbitrap Fusion Tribrid Mass Spectrometer. Differential concentration of selected identified proteins between patients and controls was verified using specific antibodies. RESULTS: Of the identified 900 CSF proteins, we found 69 proteins to be differentially abundant between patients and controls. In addition to several proteins identified as differentially abundant in MS patients previously, we observed several linked to MS for the first time, namely eosinophil-derived neurotoxin and Nogo receptor. CONCLUSIONS: Our data confirm differential abundance of several previously proposed protein markers, and provide indirect support for involvement of copper-iron disbalance in MS. Most importantly, we identified two new differentially abundant CSF proteins that seem to be directly connected with myelin loss and axonal damage via TLR2 signaling and Nogo-receptor pathway in women newly diagnosed with RRMS.

• Klíčová slova
• Multiple sclerosis, Nogo, TLR2, cerebrospinal fluid, copper, iron, markers, proteomics,
• MeSH
• biologické markery mozkomíšní mok   MeSH
• lidé MeSH
• mozkomíšní mok chemie   metabolismus   MeSH
• proteiny v mozkomíšním moku mozkomíšní mok   MeSH
• proteom analýza   metabolismus   MeSH
• proteomika MeSH
• relabující-remitující roztroušená skleróza * diagnóza   MeSH
• roztroušená skleróza * diagnóza   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• proteiny v mozkomíšním moku MeSH
• proteom MeSH

The choroid plexus (CP) forming the blood-cerebrospinal fluid (B-CSF) barrier is among the least studied structures of the central nervous system (CNS) despite its clinical importance. The CP is an epithelio-endothelial convolute comprising a highly vascularized stroma with fenestrated capillaries and a continuous lining of epithelial cells joined by apical tight junctions (TJs) that are crucial in forming the B-CSF barrier. Integrity of the CP is critical for maintaining brain homeostasis and B-CSF barrier permeability. Recent experimental and clinical research has uncovered the significance of the CP in the pathophysiology of various diseases affecting the CNS. The CP is involved in penetration of various pathogens into the CNS, as well as the development of neurodegenerative (e.g., Alzheimer´s disease) and autoimmune diseases (e.g., multiple sclerosis). Moreover, the CP was shown to be important for restoring brain homeostasis following stroke and trauma. In addition, new diagnostic methods and treatment of CP papilloma and carcinoma have recently been developed. This review describes and summarizes the current state of knowledge with regard to the roles of the CP and B-CSF barrier in the pathophysiology of various types of CNS diseases and sets up the foundation for further avenues of research.

• Klíčová slova
• Autoimmune disease, Blood–cerebrospinal fluid barrier, Carcinoma, Choroid plexus, Inflammatory diseases, Neurodegenerative disease, Stroke,
• MeSH
• homeostáza fyziologie   MeSH
• lidé MeSH
• mozkomíšní mok metabolismus   MeSH
• nemoci centrálního nervového systému * imunologie   metabolismus   patofyziologie   MeSH
• plexus chorioideus anatomie a histologie   fyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS: This study compared the results obtained by basic immunophenotyping of cerebrospinal fluid (CSF) cells by flow cytometry (FC) to the results of conventional cytology and evaluated the possibility of detailed analyses of CSF B-cell subpopulations. METHODS: Samples from 42 patients were examined by conventional cytology (native and/or pre-centrifuged CSF) and FC. The results from 15 patients without evidence of organic neurological disease were used to estimate reference ranges. RESULTS: Pre-centrifugated CSF had significantly higher cell yield on the cytologic slide, but cell subpopulation percentages were altered; the percentage of lymphocytes was significantly higher and monocytes significantly lower compared to both native CSF slides and FC. The percentage of granulocytes was higher in FC compared to cytology. For leukocyte count, the following reference ranges were estimated for Fuchs-Rosenthal chamber (FR) counting and FC, respectively: leukocytes ≤4.7/μL and ≤2.5/μL, lymphocytes ≤4.1/μL and ≤1.8/μL, monocytes ≤1.2/μL and ≤0.9/μL, and granulocytes 0/μL and ≤0.2/μL. The following reference ranges were estimated for basic subpopulations: T-lymphocytes 84.1-100%, B lymphocytes 0.0-1.5%, NK cells 0.0-6.3%, NKT cells 0-9.5%, and CD3+CD4+/CD3+CD8+ 0.8-4.9. Using a volume of 1.2-2.4 mL, the number of B lymphocytes was too low (<20) in samples with ≤2.7 cells/μL in the FR. CONCLUSIONS: Even normal CSF samples are amenable to basic mononuclear cell subpopulation analysis by FC. However, analysis of the B-cell subpopulations requires either a larger sample volume or selection of samples with ≥ 3 cells/μL.

• Klíčová slova
• B lymphocytes, cerebrospinal fluid, cytology, flow cytometry,
• MeSH
• imunofenotypizace MeSH
• leukocyty * MeSH
• lidé MeSH
• lymfocyty * MeSH
• mozkomíšní mok MeSH
• průtoková cytometrie metody   MeSH
• T-lymfocyty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Transethmoidal encephalocele is a rare condition in adult patients. It is usually diagnosed during childhood by cerebrospinal fluid (CSF) rhinorrhea, meningitis, a nasal mass, or seizures. We present a case of an adult woman with CSF rhinorrhea following resection of an occipital meningioma. The cribriform plate defect containing the encephalocele was diagnosed by computed tomography and magnetic resonance imaging. Transcranial surgery using a patch was performed successfully. We also discuss the possible pathophysiologic mechanisms of encephalocele and treatment options.

• MeSH
• encefalokéla komplikace   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• meningeální nádory chirurgie   MeSH
• meningeom chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační komplikace etiologie   MeSH
• rinorea mozkomíšního moku etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The author describes postsurgical formation of a cerebrospinal fluid (CSF) pseudocyst after anterior decompression and stabilization for cervical spine injury. The CSF pseudocyst was caused by extensive lacerations to the spinal dura mater. A further contributory factor was a circulation blockage of CSF in the spinal canal, brought about by edema of the contused spinal cord. Ventricular drainage caused rapid collapse of the pseudocyst and its subsequent healing.

• MeSH
• cysty diagnóza   etiologie   MeSH
• dospělí MeSH
• dura mater zranění   MeSH
• edém komplikace   MeSH
• krční obratle zranění   chirurgie   MeSH
• lidé MeSH
• mozkomíšní mok fyziologie   MeSH
• nemoci míchy komplikace   MeSH
• páteřní kanál patofyziologie   MeSH
• shunty pro odvod mozkomíšního moku * MeSH
• ventrikulostomie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Three children with primary intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea were operated on at the Department of Neurosurgery, Hradec Králové. In two children, aged 4 and 9.5 years, freeze-dried allogeneic costal cartilage was glued into the skull base defect. This plugging was covered up with deep frozen allogeneic fascia lata. In the third child, an only 1-year-old boy, after transection of the neck of the encephalomeningocele freeze-dried allogeneic dura mater was glued on extradurally and deep-frozen allogeneic fascia lata applied intradurally. The cerebrospinal fluid rhinorrhea ceased immediately after surgery. Spontaneous atrophy of the intranasal portion of the encephalomeningocele was demonstrated respectively 11, 1, and 7 years postoperatively on computed tomography. To evaluate cartilage healing histologically, the extracted allogeneic cartilage used for orbital roof plasty after 4 months was examined. The extent of spotty regressions represented about 7% of the tissue volume. It is stressed that, once diagnosed, intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea should be operated on for prevention of meningitis as soon as possible.

• MeSH
• chrupavka chirurgie   MeSH
• homologní transplantace * MeSH
• lebka chirurgie   MeSH
• lidé MeSH
• mozek patofyziologie   chirurgie   MeSH
• nemoci mozku komplikace   patofyziologie   chirurgie   MeSH
• nosní přepážka abnormality   chirurgie   MeSH
• nosní sliznice patofyziologie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační komplikace MeSH
• předškolní dítě MeSH
• rinorea mozkomíšního moku komplikace   diagnóza   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH