Intraventricular

Anton RF, Pettinati H, Zweben A, et al A multi-site dose ranging study of nalmefene in the treatment of alcohol dependence. J Clin Psychopharmacol 24 421 28, 2004 Aragon CM, Stotland LM, Amit Z Studies on ethanol-brain catalase interaction evidence for central ethanol oxidation. Alcohol Clin Exp Res 15 165-169, 1991 Arizzi MN, Correa M, Betz AJ, et al Behavioral effects of intraventricular injections of low doses of ethanol, acetaldehyde, and acetate in rats studies with low and high rate operant schedules. Behav Brain Res 147 203—210, 2003 Azrin NH, Sisson RW, Meyers R, et al Alcoholism treatment by disulfiram and community reinforcement therapy. J Behav Ther Exp Psychiatry 13 105—112, 1982 Babor TF, Kranzler HR, Lauerman RL Social drinking as a health and psychosocial risk factor Anstie s limit revisited, in Recent Developments in Alcoholism, Vol 5. Edited by Galanter M. New York, Plenum, 1987, pp 373 02... 

Excess fluid may be harmful (i.e., shift intraventricular septum into left ventricle, increase right ventricular oxygen demand)... 

Empirical therapy for postoperative infections in neurosurgical patients (including patients with CSF shunts) should include vancomycin in combination with either cefepime, ceftazidime, or meropenem. Linezolid has been reported to reach adequate CSF concentrations and resolve cases of meningitis refractory to vancomycin.35 However, data with linezolid are limited. The addition of rifampin should be considered for treatment of shunt infections. When culture and sensitivity data are available, pathogen-directed antibiotic therapy should be administered. Removal of infected devices is desirable aggressive antibiotic therapy (including high-dose intravenous antibiotic therapy plus intraventricular vancomycin and/or tobramycin) may be effective for patients in whom hardware removal is not possible.36... 

Dexamethasone therapy may reduce antibiotic penetration, so antimicrobial drug dosing may have to be increased (especially vancomycin) to achieve adequate CSF levels. Serum levels of vancomycin should be measured and doses titrated to ensure adequate CNS concentrations. Evaluate whether intraventricular or intrathecal antibiotics are indicated. 

Laguzzi, R. F., Adrien, J., Bourgoin, S. Hamon, M. (1979). Effects of intraventricular injection of 6-hydroxydopamine in the developing kitten. 1. On the sleepwaking cycles. Brain Res. 160, 445-59. 

Histamine decarboxylase knockout mice are unable to produce histamine and these animals are unable to maintain wakefulness in a novel environment. Systemic or intraventricular administration of histamine or Hi receptor agonists induces wakefulness whereas systemic or intraventricular administration of Hi receptor antagonists induces sleep. Local administration of an H3 receptor agonist in the TMN induces sleep whereas local administration of an H3 receptor antagonist into the TMN induces wakefulness. 

The hypothesis of the role of HA in wakefulness stems from the observation that administration of the classical antihistamines (i.e. H3 receptor antagonists) induced sedation. These first-generation antihistamines, used to treat inflammatory reactions, could cross the blood-brain barrier and block the central Hi receptor (White Rumbold, 1988). The first study examining the effect of antihistamines on sleep-wakefulness in cats reported an increase in NREM sleep and a decrease in REM sleep (Jewett, 1968). Similar results were also obtained in dogs (Wauquier et ah, 1981) and humans (Risberg et ah, 1975 Bassano Caille, 1979 Nicholson et ah, 1985 Adam Oswald, 1986). Intraventricular application of HA in the anesthetized rat caused a dose-dependent decrease in the duration of narcosis, whereas intraventricular application of HA in conscious... 

Administration of HA and its effect on sleep-wakefulness Local application of HA (5, 30 and 60 pg) in the TMN region of cats increased the latency to sleep, increased arousal, and reduced NREM sleep in a site-specific, dose-dependent manner. The highest dose produced the maximal effect, which lasted for 6 h. The HA-induced arousal was completely blocked when the cats were pretreated intraperitoneally with the Hi receptor antagonist mepyramine (Lin et at, 1986, 1988). In rats, intraventricular administration of HA blocked the increase in delta and theta activity (0-6 Hz) in the EEG induced by repeated low-frequency stimulation of the midbrain reticular formation. This effect was blocked if specific thalamic nuclei were lesioned (Tasaka et at, 1993) or by simultaneous administration of an Hi receptor antagonist, but not by an H2 receptor antagonist (Tasaka et at, 1989). Application of HA... 

Wolf, P. Monnier, M. (1973). Electroencephalographic, behavioural and visceral effects of intraventricular infusion of histamine in the rabbit. Agents Actions 3, 196. 

Feldberg W., Sherwood S. L. (1954). Behaviour of cats after intraventricular injections of eserine and DFO. J. Physiol. 125, 488-500. 

Giovanni, A., Liang, L.R, Hastings, T.G., Zigmond, M.J. Estimating hydroxyl radical content in rat brain using systemic and intraventricular salicylate impact of methamphetamine. J. Neurochem. 64 1819, 1995. 

About 40% of this population express markers of oligodendrocytes, and a similar proportion have astrocytic markers. To test the potential of these cells in vitro, ES cells propagated in this fashion were transplanted into the spinal cord or cerebral ventricles of myelin-deficient rats. Two weeks after transplantation, ES derived cells were present in the dorsal columns of the spinal cord both at the implant and several millimeters in both directions from that site. The mouse origin of the ES cells transplanted into rat was confirmed by analysis of mouse satellite DNA in the grafts. Similarly, intraventricular transplanted cells formed myelin in multiple brain regions [29]. These and other results support the further study of stimulated ES cells for potential therapies in the nervous system. 

Koketsu, N., Berlove, D. J., Moskowitz, M. A., Kowall, N. W., Caday, C. G. and Finklestein, S. P. Pretreatment with intraventricular basic fibroblast growth factor decreases infarct size following focal cerebral ischemia in rats. Ann. Neurol. 35 451-457,1994. 

The cardiac pump theory states that the active compression of the heart between the sternum and vertebrae creates an artificial systole in which intraventricular pressure increases, the atrioventricular valves... 

In subarachnoid hemorrhage due to a ruptured intracranial aneurysm or arteriovenous malformation, surgical intervention to clip or ablate the vascular abnormality substantially reduces mortality from rebleeding. The benefits of surgery are less well documented in cases of primary intracerebral hemorrhage. In patients with intracerebral hematomas, insertion of an intraventricular drain with monitoring of intracranial pressure is... 

A Cochrane metaanalysis shows the benefit of antenatal corticosteroids for fetal lung maturation to prevent respiratory distress syndrome, intraventricular hemorrhage, and death in infants delivered prematurely. 

With increased meningeal inflammation, there will be greater antibiotic penetration (Table 36-3). Problems ofCSF penetration maybe overcome by direct instillation of antibiotics by intrathecal, intracisternal, or intraventricular routes of administration (Table 36-4). 

The use of intrathecal amphotericin B is not recommended for the treatment of cryptococcal meningitis except in very ill patients or in those with recurrent or progressive disease despite aggressive IV amphotericin B therapy. The dosage of amphotericin B employed is usually 0.5 mg administered via the lumbar, cisternal, or intraventricular (via an Ommaya reservoir) route two or three times weekly. 

CNS disease Lipid formulation of amphotericin BIV 3-6 mg/kg/day x 6-10 weeks (Note Induction therapy with azoles alone is discouraged.) Amphotericin Brf IV 0.7-1 mg/kg/day + flucytosine 100 mg/kg/ day orally x 2 wk, followed by fluconazole 400 mg orally daily for a minimum of 10 weeks (in patients intolerant to fluconazole, substitute itraconazole 200-400 mg orally daily) or Amphotericin B IV 0.7-1 mg/kg/day + 5-flucytosine 100 mg/kj day orally x 6-10 weeks or Amphotericin Brf IV 0.7-1 mg/kg/day x 10 weeks Refractory disease Intrathecal or intraventricular amphotericin B (continued)... 

Using tactile startle, bufotenin, a hallucinogen that does not cross the blood-brain barrier readily, also produced biphasic dose-response effects when given intraventricularly (76). After systemic administration, however, low doses of indole hallucinogens have not been reported to increase tactile startle (73). Thus LSD (20-80 Mg/kg), DMT (0.25-1.0 mg/kg), and psilocin (2.5-5.0 mg/kg) did not increase tactile startle. A slightly higher dose of LSD (100 Mg/kg) did increase startle toward the end of the test session, perhaps because of blocking habituation (see below). 

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