Arachnoid cysts do not contain cerebrospinal fluid: A comparative chemical analysis of arachnoid cyst fluid and cerebrospinal fluid in adults

<p>Abstract</p> <p>Background</p> <p>Arachnoid cyst (AC) fluid has not previously been compared with cerebrospinal fluid (CSF) from the same patient. ACs are commonly referred to as containing "CSF-like fluid". The objective of this study was to characterize AC fluid by clinical chemistry and to compare AC fluid to CSF drawn from the same patient. Such comparative analysis can shed further light on the mechanisms for filling and sustaining of ACs.</p> <p>Methods</p> <p>Cyst fluid from 15 adult patients with unilateral temporal AC (9 female, 6 male, age 22-77y) was compared with CSF from the same patients by clinical chemical analysis.</p> <p>Results</p> <p>AC fluid and CSF had the same osmolarity. There were no significant differences in the concentrations of sodium, potassium, chloride, calcium, magnesium or glucose. We found significant elevated concentration of phosphate in AC fluid (0.39 versus 0.35 mmol/L in CSF; <it>p </it>= 0.02), and significantly reduced concentrations of total protein (0.30 versus 0.41 g/L; <it>p </it>= 0.004), of ferritin (7.8 versus 25.5 ug/L; <it>p </it>= 0.001) and of lactate dehydrogenase (17.9 versus 35.6 U/L; <it>p </it>= 0.002) in AC fluid relative to CSF.</p> <p>Conclusions</p> <p>AC fluid is not identical to CSF. The differential composition of AC fluid relative to CSF supports secretion or active transport as the mechanism underlying cyst filling. Oncotic pressure gradients or slit-valves as mechanisms for generating fluid in temporal ACs are not supported by these results.</p

Benign external hydrocephalus: a review, with emphasis on management

Benign external hydrocephalus in infants, characterized by macrocephaly and typical neuroimaging findings, is considered as a self-limiting condition and is therefore rarely treated. This review concerns all aspects of this condition: etiology, neuroimaging, symptoms and clinical findings, treatment, and outcome, with emphasis on management. The review is based on a systematic search in the Pubmed and Web of Science databases. The search covered various forms of hydrocephalus, extracerebral fluid, and macrocephaly. Studies reporting small children with idiopathic external hydrocephalus were included, mostly focusing on the studies reporting a long-term outcome. A total of 147 studies are included, the majority however with a limited methodological quality. Several theories regarding pathophysiology and various symptoms, signs, and clinical findings underscore the heterogeneity of the condition. Neuroimaging is important in the differentiation between external hydrocephalus and similar conditions. A transient delay of psychomotor development is commonly seen during childhood. A long-term outcome is scarcely reported, and the results are varying. Although most children with external hydrocephalus seem to do well both initially and in the long term, a substantial number of patients show temporary or permanent psychomotor delay. To verify that this truly is a benign condition, we suggest that future research on external hydrocephalus should focus on the long-term effects of surgical treatment as opposed to conservative management

A stellar overdensity associated with the Small Magellanic Cloud

We report the discovery of a stellar overdensity 8◦ north of the centre of the Small Magellanic Cloud (SMC; Small Magellanic Cloud Northern Over-Density; SMCNOD), using data from the first 2 yr of the Dark Energy Survey (DES) and the first year of theMAGellanic SatelLITEs Survey (MagLiteS). The SMCNOD is indistinguishable in age, metallicity and distance from the nearby SMC stars, being primarily composed of intermediate-age stars (6 Gyr, Z=0.001), with a small fraction of young stars (1 Gyr, Z=0.01). The SMCNOD has an elongated shape with an ellipticity of 0.6 and a size of 6◦ × 2◦. It has an absolute magnitude of MV = −7.7, rh = 2.1 kpc, and μV(r < rh) = 31.2 mag arcsec−2. We estimate a stellar mass of 105 M , following a Kroupa mass function. The SMCNOD was probably removed from the SMC disc by tidal stripping, since it is located near the head of the Magellanic Stream, and the literature indicates likely recent Large Magellanic Cloud-SMC encounters. This scenario is supported by the lack of significant HI gas. Other potential scenarios for the SMCNOD origin are a transient overdensity within the SMC tidal radius or a primordial SMC satellite in advanced stage of disruption