Intraventricular hemorrhage is a common cause of morbidity and mortality in premature infants. The rupture of the germinal zone into the ventricles entails loss of neural stem cells and disturbs the normal cytoarchitecture of the region, compromising late neurogliogenesis. Here we demonstrate that neural stem cells can be easily and robustly isolated from the hemorrhagic cerebrospinal fluid obtained during therapeutic neuroendoscopic lavage in preterm infants with severe intraventricular hemorrhage. Our analyses demonstrate that these neural stem cells, although similar to human fetal cell lines, display distinctive hallmarks related to their regional and developmental origin in the germinal zone of the ventral forebrain, the ganglionic eminences that give rise to interneurons and oligodendrocytes. These cells can be expanded, cryopreserved, and differentiated in vitro and in vivo in the brain of nude mice and show no sign of tumoral transformation 6 months after transplantation. This novel class of neural stem cells poses no ethical concerns, as the fluid is usually discarded, and could be useful for the development of an autologous therapy for preterm infants, aiming to restore late neurogliogenesis and attenuate neurocognitive deficits. Furthermore, these cells represent a valuable tool for the study of the final stages of human brain development and germinal zone biology.
Endoscopy-assisted surgery for correction of craniosynostosis in children under 4 months represents a valid and safe management option. Early treatment may contribute to prevent the development of associated ventriculomegaly and Chiari I malformation.
Introduction: Many brain processes that cause death are mediated by intracranial hypertension (ICH). The natural course of this condition inevitably leads to brain death. The objective of this study is to carry out a systematic review of cerebral pathophysiology and intracranial pressure (ICP) monitoring.Development: Studying, monitoring, and recording ICP waves provide data about the presence of different processes that develop with ICH.Conclusions: Correct monitoring of ICP is fundamental for diagnosing ICH, and even more importantly, providing appropriate treatment in a timely manner. Fisiopatología cerebral; Líquido cefalorraquídeo; Monitorización; Presión intracraneal Conceptos básicos sobre la fisiopatología cerebral y la monitorización de la presión intracraneal Resumen Introducción: Muchos procesos encefálicos que causan la muerte de los pacientes que los presentan están mediados por hipertensión intracraneal (HIC). La historia natural de la misma conduce inexorablemente a esta muerte encefálica. El objetivo de este trabajo estriba en realizar una revisión de la fisiopatología cerebral y de la monitorización de la presión intracraneal (PIC).Desarrollo: El estudio de las ondas de PIC, su monitorización y el registro de las mismas nos informan sobre la existencia de procesos que tienen como común denominador la HIC.ଝ Please cite this article as: Rodríguez-Boto G, Rivero-Garvía M, Gutiérrez-González R, Márquez-Rivas J. Conceptos básicos sobre la fisiopatología cerebral y la monitorización de la presión intracraneal. Neurología. 2015;30:16-22. Brain pathophysiology and intracranial pressure monitoring 17 Conclusiones: El correcto registro de la PIC es fundamental para diagnosticar la HIC y, lo que resulta aún más importante, poder instaurar un tratamiento adecuado a tiempo.
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