No abstract

This study is the first report on human intracranial temperature in conscious patients during and after an upper respiratory bypass. Temperatures were measured in four subjects subdurally between the frontal lobes and cribriform plate (T(cr)) and on the vault of the skull (T(sd)). Further measurements were taken in the esophagus (T(es)) and on the tympanic membrane. Reinstitution of airflow in the upper respiratory tract under conditions of mild hyperthermia gave a rapid drop in T(cr) of 0.4-0.8 degrees C. In three patients the intracranial temperature at the basal aspect of the frontal lobes fell below T(es). Thus local selective cooling of the brain surface below that of the trunk temperature was shown to occur. Intensive breathing by the patients after extubation for a 3-min period produced a cooling at the site of T(cr) measurement at a rate of up to 0.1 degrees C/min, and this response could be evoked on demand. The results support the view that cooling of the upper airway can directly influence human brain temperature.

Background and Purpose-Recent evidence suggests that physiological changes in the concentration of endogenous estrogens may influence stroke outcome. The purpose of this study was to determine a menstrual cycle-related profile of blood flow through the carotid arteries and its correlation with estrogen concentration. Methods-The flow velocity and cross-sectional area of the common carotid artery, internal carotid artery (ICA), and external carotid artery (ECA) were measured with duplex Doppler sonography throughout the menstrual cycle in 14 healthy women. Concentration of plasma 17␤-estradiol, progesterone, hematocrit, hemoglobin, and blood pressure were also determined. Results-In the follicular phase, the concentration of estrogen increased to reach a peak on day 14, whereas concentration of progesterone remained low. The mean and end-diastolic velocities in the ICA increased on average by 15% of their base values, along with increasing concentrations of estrogen (rϭ0.59 and 0.65, respectively). The profile of flow velocity changes in this artery corresponded to the profile of estrogen concentration. In contrast to the ICA, flow velocities in the ECA decreased from their base value, reaching their minimum in the luteal phase. The mean flow velocity in the common carotid artery increased on day 14 by just 2% of its base value. The lumen of the carotid arteries was stable throughout the cycle. Hematocrit, hemoglobin, and systolic blood pressure also remained unchanged. Conclusions-Increased

The present study was performed to investigate the relationship between noninvasive measurements of core temperature and intracranial temperature measurements in humans. At 2-3 weeks following minor subarachoid haemorrhage, five patients were studied during open brain surgery. All patients were fully conscious and free of neurological symptoms at the time of surgery. During craniotomies in the frontotemporal region, temperatures between the dura and brain surface were on average 0.58 (SD 0.51) degrees C lower than those near the mesencephalon. During the 60-90 min following the initial exposure of the brain surface to the ambient temperature of 24 degrees C, subdural temperature at the convexity decreased by 0.72 (SD 0.43) degrees C and subdural temperature at the basis decreased by 0.36 (SD 0.17) degrees C. During the same period, mesencephalon temperature decreased by 0.22 (SD 0.10) degrees C. The decreases of cerebral temperatures were followed by a similar decrease in tympanic temperature of 0.28 (SD 0.10) degrees C but by an increase in rectal temperature of 0.22 (SD 0.13) degrees C and an increase in oesophageal temperature of 0.20 (SD 0.20) degrees C. The maximal shift of frontal skin temperature during the same period amounted to +0.04 (SD 0.21) degrees C. The findings would seem to support the thesis that a direct relationship does exist between tympanic and brain temperatures in humans and that of the externally accessible body temperatures, tympanic temperatures giving the best approximation of average cerebral temperature.

Meningiomas constitute up to 13% of all intracranial tumors. The predictive factors for meningioma have not been unambiguously defined; however some limited data suggest that the expression of matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) may be associated with the presence of peritumoral brain edema (PTBE) and worse clinical outcome. The aim of this study was to analyze the expressions of MMP-9 and VEGF in a group of meningiomas of various grades and to study associations between these two markers and PTBE. The study included patients with supratentorial meningiomas. The patients were divided into low- (G1) and high-grade meningiomas (G2 and G3). PTBE was assessed on MRI. The expressions of VEGF and MMP-9 were determined immunohistochemically. The expression of MMP-9 was observed significantly more often in G3 meningiomas than in lower grade tumors. The presence of stage II or III PTBE was associated with a significant increase in MMP-9 expression. The expression of VEGF did not differ across the PTBE stages. Our findings point to a significant role of MMP-9 and VEGF in the pathogenesis of peritumoral brain edema in low- and high-grade meningiomas.