Alzheimer' s disease (AD) is associated with an increase in cerebrospinal fluid (CSF) levels of the isoprostane 8,12iso-iPF2α-VI, a specific marker of in vivo lipid peroxidation. Poor cerebral clearance of end products of oxidative reactions via CSF circulation may contribute to and sustain ongoing stress. CSF drainage via a low-flow ventriculoperitoneal (VP) shunt may improve removal of these products, reducing oxidative stress. We quantified this biomarker in patients with AD undergoing to VP shunt placement at baseline and after one-year period. CSF sampling occurred at baseline and quarterly visits for one year. Levels of this isoprostane were determined simultaneously at the end of the study by gas chromatography negative ion chemical ionization mass spectrometry. Over one-year, CSF 8,12-iso-iPF2α-VI levels consistently decreased versus baseline (51% of initial level), while CSF protein, glucose, cell count and IgG concentrations remained within normal limits. This finding supports the hypothesis that improving CSF drainage enhances extra-cellular clearance of end products of oxidative reactions and lowers brain lipid peroxidation.

Ultrasound images of the brain were obtained intraoperatively and on an outpatient basis through a burr hole. The patient's tumor was well visualized, prior to biopsy, after biopsy, and during radiation therapy treatment. The ultrasound images correlated closely to the CT scan findings.

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We present a method to reduce the geometric distortion in fast spin echo (FSE) images to levels appropriate for guiding stereotactic pallidotomy. We quantified the accuracy of FSE-guided target localization before and after correction using a cadaver head model. These results strongly suggest that stereotactic pallidotomy can be performed using MR and stimulation responses alone, thus avoiding the morbidity associated with pallidotomy and the costs of x-ray apparatus and personnel during surgery. This method, however, must be tested further and validated clinically before it can be applied.