Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000185
A. Rahmanian, F. Malekpour, S. M. Rakei, F. Ghaffarpasand, G. Mehrabani
Patients undergoing lumbar laminectomy experience severe pain in the postoperative period, which may increase the incidence of postoperative morbidity and complications. This study determined the effect of bupivacaine on postoperative back pain after lumbar laminectomy. Sixty consecutive patients who underwent posterior approach laminectomy were randomly allocated to control and study groups. Anesthesia was induced with intravenous midazolam, fentanyl, and morphine. Tracheal intubation was facilitated by Atra, and patients’ lungs were ventilated with a mixture of 66% nitrous oxide and 0.5% to 1% halothane in oxygen. Anesthesia was continued with panthotal. Before wound closure in the study group, the surgeon injected 30 mL of 0.25% bupivacaine in paravertebral muscle and 30 mL of normal saline at the same site in the control group. Pain was assessed at rest on a linear visual analog scale at 6 and 12 hours after surgery. Also, the size of incision was recorded in all patients. No difference was noticed for pain intensity scores in different age groups. Level of education did not influence the pain tolerance and there was no relation between increases in size of incision and pain intensity. In the study group, after 6 and 12 hours postoperatively, female patients had more visual analog scale values than male patients, which was more significant statistically after 6 hours postoperatively when compared with 12 hours postoperatively. Regarding education and pain perception, there was no significant correlation. There was no statistical difference for age between groups. As injection of bupivacaine in paravertebral muscles did not diminish the postoperative back pain experienced by the patients and no difference was noticed in pain intensity scores between groups, our findings denote to ineffectiveness of local bupivacaine in postoperative back pain.
{"title":"The Effects of Bupivacaine on Postoperative Back Pain After Lumbar Laminectomy: A Randomized Clinical Trial","authors":"A. Rahmanian, F. Malekpour, S. M. Rakei, F. Ghaffarpasand, G. Mehrabani","doi":"10.1097/WNQ.0000000000000185","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000185","url":null,"abstract":"Patients undergoing lumbar laminectomy experience severe pain in the postoperative period, which may increase the incidence of postoperative morbidity and complications. This study determined the effect of bupivacaine on postoperative back pain after lumbar laminectomy. Sixty consecutive patients who underwent posterior approach laminectomy were randomly allocated to control and study groups. Anesthesia was induced with intravenous midazolam, fentanyl, and morphine. Tracheal intubation was facilitated by Atra, and patients’ lungs were ventilated with a mixture of 66% nitrous oxide and 0.5% to 1% halothane in oxygen. Anesthesia was continued with panthotal. Before wound closure in the study group, the surgeon injected 30 mL of 0.25% bupivacaine in paravertebral muscle and 30 mL of normal saline at the same site in the control group. Pain was assessed at rest on a linear visual analog scale at 6 and 12 hours after surgery. Also, the size of incision was recorded in all patients. No difference was noticed for pain intensity scores in different age groups. Level of education did not influence the pain tolerance and there was no relation between increases in size of incision and pain intensity. In the study group, after 6 and 12 hours postoperatively, female patients had more visual analog scale values than male patients, which was more significant statistically after 6 hours postoperatively when compared with 12 hours postoperatively. Regarding education and pain perception, there was no significant correlation. There was no statistical difference for age between groups. As injection of bupivacaine in paravertebral muscles did not diminish the postoperative back pain experienced by the patients and no difference was noticed in pain intensity scores between groups, our findings denote to ineffectiveness of local bupivacaine in postoperative back pain.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"293–297"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000201
H. Chon, Han Yu Seong, J. H. Park
A 43-year-old man presented with a 1-week history of progressive weakness of left leg and voiding difficulty. T2-weighted sagittal magnetic resonance image (MRI) showed large size disk extrusion on L4 to L5 level. T1-weighted sagittal MRI with gadolinium enhancement showed rim-enhanced irregularly oval-shaped mass. We performed surgery and removed a large disk particle immediately after partial hemilaminectomy and ligament flavectomy. Disk particles were removed piecemeal. Most common presentation of this pathology was cauda equina syndrome. MRI usually shows rim-enhanced mass-like lesion and partial hemilaminectomy seems to be enough to treat this pathology.
{"title":"Dorsal Cauda Equina Compression by the Sequestral Lumbar Disk Herniation: A Case Report and the Literature Review","authors":"H. Chon, Han Yu Seong, J. H. Park","doi":"10.1097/WNQ.0000000000000201","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000201","url":null,"abstract":"A 43-year-old man presented with a 1-week history of progressive weakness of left leg and voiding difficulty. T2-weighted sagittal magnetic resonance image (MRI) showed large size disk extrusion on L4 to L5 level. T1-weighted sagittal MRI with gadolinium enhancement showed rim-enhanced irregularly oval-shaped mass. We performed surgery and removed a large disk particle immediately after partial hemilaminectomy and ligament flavectomy. Disk particles were removed piecemeal. Most common presentation of this pathology was cauda equina syndrome. MRI usually shows rim-enhanced mass-like lesion and partial hemilaminectomy seems to be enough to treat this pathology.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"358–360"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000193
H. Yi, H. Hwang, K. Kim, I. Shin, I. Choi, In Bok Jang
Objective:The subsequent hemorrhage risk for intracranial arteriovenous malformations (AVMs) has previously been studied according to angiographical findings. We propose to concentrate on the AVMs venous structure. Methods:Between 2004 and 2010, 50 intracranial AVM patients were followed at the Hallym University Medical Center. Angiographic characteristics were retrospectively reviewed, including the number of venous drainage, venous kinking, venous stenosis, venous recruitment, exclusive deep venous drainage, venous reflux, venous obstacles, nidus size, and aneurysms. Results:Cerebral AVMs caused bleeding in 38 patients. Venous recruitment was a valuable protective factor against hemorrhage (odds ratio, 0.165; 95% confidence interval, 0.046-0.586; P=0.0053). Venous kinking, venous stenosis, deep venous drainage, nidus size, venous obstacles, and venous locations did not show meaningful differences in bleeding risk on univariate analysis. Conclusions:In our study, except for venous recruitment, no factor had any significant bleeding difference. We postulate that venous structures may be inconsistent and dependent on individual explanation of angiography characteristics.
{"title":"Angioarchitectural Characteristics Associated With the Risk of Hemorrhage in Intracranial Arteriovenous Malformations","authors":"H. Yi, H. Hwang, K. Kim, I. Shin, I. Choi, In Bok Jang","doi":"10.1097/WNQ.0000000000000193","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000193","url":null,"abstract":"Objective:The subsequent hemorrhage risk for intracranial arteriovenous malformations (AVMs) has previously been studied according to angiographical findings. We propose to concentrate on the AVMs venous structure. Methods:Between 2004 and 2010, 50 intracranial AVM patients were followed at the Hallym University Medical Center. Angiographic characteristics were retrospectively reviewed, including the number of venous drainage, venous kinking, venous stenosis, venous recruitment, exclusive deep venous drainage, venous reflux, venous obstacles, nidus size, and aneurysms. Results:Cerebral AVMs caused bleeding in 38 patients. Venous recruitment was a valuable protective factor against hemorrhage (odds ratio, 0.165; 95% confidence interval, 0.046-0.586; P=0.0053). Venous kinking, venous stenosis, deep venous drainage, nidus size, venous obstacles, and venous locations did not show meaningful differences in bleeding risk on univariate analysis. Conclusions:In our study, except for venous recruitment, no factor had any significant bleeding difference. We postulate that venous structures may be inconsistent and dependent on individual explanation of angiography characteristics.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"329–335"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61887139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000174
N. Tatarlı, B. Güçlü, H. Süslü, Özgür Şenol, D. Yavuzer, T. Hiçdönmez
Intracranial tuberculoma, a form of central nervous system tuberculosis, is a space-occupying mass of granulomatous tissue. Dural tuberculoma mimicking an en plaque meningioma is very rare. We report on a 64-year-old male patient who underwent surgery for a dural tuberculoma mimicking en plaque meningioma.
{"title":"Dural Tuberculoma Mimicking En Plaque Meningioma: Case Report","authors":"N. Tatarlı, B. Güçlü, H. Süslü, Özgür Şenol, D. Yavuzer, T. Hiçdönmez","doi":"10.1097/WNQ.0000000000000174","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000174","url":null,"abstract":"Intracranial tuberculoma, a form of central nervous system tuberculosis, is a space-occupying mass of granulomatous tissue. Dural tuberculoma mimicking an en plaque meningioma is very rare. We report on a 64-year-old male patient who underwent surgery for a dural tuberculoma mimicking en plaque meningioma.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"340–342"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61885275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000184
R. Mohammadi, Abolhasan Alijanpour, Kamran Alijanpour, A. Hajili, K. Amini
The objective was to assess the effect of locally administered flunarizine (FNZ) on transected peripheral nerve regeneration and functional recovery. Sixty male healthy white Wistar rats were divided into 4 experimental groups (n=15), randomly: in transected group, left sciatic nerve was transected and stumps were fixed in the adjacent muscle. In treatment group, defect was bridged using an inside-out vein graft (IOVG/FNZ) filled with 10 &mgr;L FNZ (100 ng/mL). In vein graft group (IOVG), the graft was filled with phosphate-buffered saline alone. In sham-operated group (SHAM), sciatic nerve was exposed and manipulated. Each group was subdivided into 3 subgroups of 5 animals each and regenerated nerve fibers were studied 4, 8, and 12 weeks after surgery. Behavioral testing, biomechanical studies, sciatic nerve functional study, electrophysiological, gastrocnemius muscle mass, and morphometric indices confirmed faster recovery of regenerated axons in IOVG/FNZ than IOVG group (P<0.05). In immunohistochemistry, location of reactions to S-100 in IOVG/FNZ was clearly more positive than that in IOVG group. When loaded in a vein graft FNZ accelerated and improved functional recovery and morphometric indices of sciatic nerve. This may have clinical implications for the surgical management of patients after facial nerve transection.
{"title":"Flunarizine, Calcium Channel Blocker, Locally Improves Functional Recovery of the Transected Sciatic Nerve After Bridging With Inside-Out Vein Graft","authors":"R. Mohammadi, Abolhasan Alijanpour, Kamran Alijanpour, A. Hajili, K. Amini","doi":"10.1097/WNQ.0000000000000184","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000184","url":null,"abstract":"The objective was to assess the effect of locally administered flunarizine (FNZ) on transected peripheral nerve regeneration and functional recovery. Sixty male healthy white Wistar rats were divided into 4 experimental groups (n=15), randomly: in transected group, left sciatic nerve was transected and stumps were fixed in the adjacent muscle. In treatment group, defect was bridged using an inside-out vein graft (IOVG/FNZ) filled with 10 &mgr;L FNZ (100 ng/mL). In vein graft group (IOVG), the graft was filled with phosphate-buffered saline alone. In sham-operated group (SHAM), sciatic nerve was exposed and manipulated. Each group was subdivided into 3 subgroups of 5 animals each and regenerated nerve fibers were studied 4, 8, and 12 weeks after surgery. Behavioral testing, biomechanical studies, sciatic nerve functional study, electrophysiological, gastrocnemius muscle mass, and morphometric indices confirmed faster recovery of regenerated axons in IOVG/FNZ than IOVG group (P<0.05). In immunohistochemistry, location of reactions to S-100 in IOVG/FNZ was clearly more positive than that in IOVG group. When loaded in a vein graft FNZ accelerated and improved functional recovery and morphometric indices of sciatic nerve. This may have clinical implications for the surgical management of patients after facial nerve transection.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"78 1","pages":"285–292"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000194
Selcuk Ozdogan, Yusuf Emrah Gergin, O. Senol, Mehmet Tiryaki, H. Suslu, N. Tatarlı, T. Hıcdonmez
The incidence of intervertebral disk herniation in the thoracic region of the spine is very rare when compared with cervical and lumbar regions. The sequestered disk fragments mimic spinal mass lesions because of lack of noticeable clinical features. The common symptoms are unilateral radicular pain and pain radiating from the upper or middle back to the chest. The differential diagnosis includes not only diverse neoplasms but also other epidural processes such as synovial cysts, hematomas, and inflammatory lesions. Magnetic resonance imaging and computed tomography can be used for diagnosis; however, histologic examination is the exact technique. A variety of surgical approaches have been described to reach these anatomically challenging lesions. We describe a 43-year-old female patient with a sequestrated disk fragment in the thoracic spine that mimics a mass lesion of the spinal canal. We will discuss systematic diagnostic approach, differential diagnosis, and treatment modalities of these lesions.
{"title":"Thoracic Disk Herniation Mimicking Spinal Mass Lesion: An Illustrative Case and Review of the Literature","authors":"Selcuk Ozdogan, Yusuf Emrah Gergin, O. Senol, Mehmet Tiryaki, H. Suslu, N. Tatarlı, T. Hıcdonmez","doi":"10.1097/WNQ.0000000000000194","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000194","url":null,"abstract":"The incidence of intervertebral disk herniation in the thoracic region of the spine is very rare when compared with cervical and lumbar regions. The sequestered disk fragments mimic spinal mass lesions because of lack of noticeable clinical features. The common symptoms are unilateral radicular pain and pain radiating from the upper or middle back to the chest. The differential diagnosis includes not only diverse neoplasms but also other epidural processes such as synovial cysts, hematomas, and inflammatory lesions. Magnetic resonance imaging and computed tomography can be used for diagnosis; however, histologic examination is the exact technique. A variety of surgical approaches have been described to reach these anatomically challenging lesions. We describe a 43-year-old female patient with a sequestrated disk fragment in the thoracic spine that mimics a mass lesion of the spinal canal. We will discuss systematic diagnostic approach, differential diagnosis, and treatment modalities of these lesions.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"354–357"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000200
M. Vaish, R. Patir, A. Dhar, R. Prasad, Sumit Goel, M. Marda
Colloid cysts are benign space-occupying lesions that account for 0.5% to 1.0% of brain tumors and arise from the velum interpositum or the choroid plexus of the third ventricle. We are describing a modified surgical technique that combines the positive attributes of being minimalistic while retaining the effectiveness of microsurgery. In all 20 consecutive symptomatic patients with a preoperative magnetic resonance imaging diagnosis of colloid cyst who came to the senior author between 2008 and 2011 were included in the study. The patient was kept supine with the head positioned neutrally in the saggital plane and neck flexed at 20 degrees. The tube of a 5-mL plastic syringe having an external diameter of 13 mm and an internal diameter of 12.6 mm was cut towards the nozzle end to an appropriate length depending upon the cortical thickness measured on the preoperative magnetic resonance imaging. Microsurgical excision using tubular retractor was performed in all the cases. Average operative time was around 90 minutes with maximum of 120 minutes. None of the patients had seizures preoperatively or postoperatively and in all cases antiepileptic medication could be stopped after 3 to 6 months of surgery. Two patients had short-term memory impairment which returned to near-normal by 1 year after surgery.
{"title":"Newer Technique of Using Indigenous Tubular Retractor (Tailored 5-mL Syringe) for Microscopic Excision of Third Ventricular Colloid Cysts","authors":"M. Vaish, R. Patir, A. Dhar, R. Prasad, Sumit Goel, M. Marda","doi":"10.1097/WNQ.0000000000000200","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000200","url":null,"abstract":"Colloid cysts are benign space-occupying lesions that account for 0.5% to 1.0% of brain tumors and arise from the velum interpositum or the choroid plexus of the third ventricle. We are describing a modified surgical technique that combines the positive attributes of being minimalistic while retaining the effectiveness of microsurgery. In all 20 consecutive symptomatic patients with a preoperative magnetic resonance imaging diagnosis of colloid cyst who came to the senior author between 2008 and 2011 were included in the study. The patient was kept supine with the head positioned neutrally in the saggital plane and neck flexed at 20 degrees. The tube of a 5-mL plastic syringe having an external diameter of 13 mm and an internal diameter of 12.6 mm was cut towards the nozzle end to an appropriate length depending upon the cortical thickness measured on the preoperative magnetic resonance imaging. Microsurgical excision using tubular retractor was performed in all the cases. Average operative time was around 90 minutes with maximum of 120 minutes. None of the patients had seizures preoperatively or postoperatively and in all cases antiepileptic medication could be stopped after 3 to 6 months of surgery. Two patients had short-term memory impairment which returned to near-normal by 1 year after surgery.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"336–339"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000190
N. Banihabib, M. Es.Haghi, S. Zare, F. Farrokhi
Introduction:Methylphenidate is a central nervous system stimulant drug that has become the primary drug of choice in treating attention-deficit/hyperactivity disorder in children. The aim of the present study was to investigate the short-term effect of oral administration of methylphenidate hydrochloride on the hippocampal tissue in adult rats. Methods:Twenty-eight male Wistar rats were divided to 4 groups (N=7): vehicle group, received distilled water; control groups, received no treatment; 2 experimental groups: received methylphenidate hydrochloride (3 and 10 mg/kg dissolved in distilled water) orally once daily for 6 days. On sixth day all rats were anesthetized and to study the tissue changes in hippocampus area of rats, tissue sections were prepared after a month and stained with hematoxylin-eosin staining. Results:In dose 3 mg, a dense cytoplasm and nucleus in cornus ammonis 3, 4 and dentate gyrus neurons of hippocampus were observed. The dose 10 mg, in addition to mentioned areas, caused necrosis in cornus ammonis 1 and 2 areas of hippocampus. In addition to the morphometric analysis indicated that the number of necrotic hippocampal cells in cornus ammonis and dentate gyrus areas was significantly increased in rats receiving methylphenidate. Conclusions:Our findings suggested that oral administration of methylphenidate hydrochloride can induce hippocampal necrosis in adult rats.
{"title":"The Effect of Oral Administration of Methylphenidate on Hippocampal Tissue in Adult Male Rats","authors":"N. Banihabib, M. Es.Haghi, S. Zare, F. Farrokhi","doi":"10.1097/WNQ.0000000000000190","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000190","url":null,"abstract":"Introduction:Methylphenidate is a central nervous system stimulant drug that has become the primary drug of choice in treating attention-deficit/hyperactivity disorder in children. The aim of the present study was to investigate the short-term effect of oral administration of methylphenidate hydrochloride on the hippocampal tissue in adult rats. Methods:Twenty-eight male Wistar rats were divided to 4 groups (N=7): vehicle group, received distilled water; control groups, received no treatment; 2 experimental groups: received methylphenidate hydrochloride (3 and 10 mg/kg dissolved in distilled water) orally once daily for 6 days. On sixth day all rats were anesthetized and to study the tissue changes in hippocampus area of rats, tissue sections were prepared after a month and stained with hematoxylin-eosin staining. Results:In dose 3 mg, a dense cytoplasm and nucleus in cornus ammonis 3, 4 and dentate gyrus neurons of hippocampus were observed. The dose 10 mg, in addition to mentioned areas, caused necrosis in cornus ammonis 1 and 2 areas of hippocampus. In addition to the morphometric analysis indicated that the number of necrotic hippocampal cells in cornus ammonis and dentate gyrus areas was significantly increased in rats receiving methylphenidate. Conclusions:Our findings suggested that oral administration of methylphenidate hydrochloride can induce hippocampal necrosis in adult rats.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"315–318"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000186
K. Asil, Birol Özkal, M. Ersavas
Dermoid cysts (DC) are originated from ectodermal cells, which stay in the intracranial region in the course of neural tube closure between 3 and 5 weeks of the embryonic period. They are benign, slowly growing, usually asymptomatic, quite rare inclusion cysts, and consist <0.5% of primary intracranial tumors. Hydrocephalus is a disease that goes with impairment in cerebrospinal fluid circulation and has a complex physiopathology. In this report, we present a DC patient who developed confusion on postoperative day 4, after spinal surgery caused by hydrocephalus following epidermoid rupture. Computed tomography of the brain revealed fat blisters caused by fat crystals in the right sylvian fissure, anterior interhemispheric fissure, and basal cisterns. There was minimal dilation in lateral ventricles. Computed tomography obtained a couple of weeks later revealed significant triventricular hydrocephalus. On cranial magnetic resonance imaging, there were hyperintense foci in T1A, T2A, and FLAIR series and significant triventricular hydrocephalus. An external ventricular drainage system was inserted because of progressive hydrocephalus developing due to rupture of epidermoid tumor. The patient whose confusion improved in the early postoperative period and the external ventricular drainage system was removed on day 5. In conclusion, DCs and their rupture have become a more commonly encountered condition with increased use of magnetic resonance imaging. Proper treatment planning may be done for this potentially fatal complication of hydrocephalus due to ruptured epidermoid cyst through radiologic imaging.
{"title":"A Rare Cause of Hydrocephalus: Dermoid Cyst Rupture","authors":"K. Asil, Birol Özkal, M. Ersavas","doi":"10.1097/WNQ.0000000000000186","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000186","url":null,"abstract":"Dermoid cysts (DC) are originated from ectodermal cells, which stay in the intracranial region in the course of neural tube closure between 3 and 5 weeks of the embryonic period. They are benign, slowly growing, usually asymptomatic, quite rare inclusion cysts, and consist <0.5% of primary intracranial tumors. Hydrocephalus is a disease that goes with impairment in cerebrospinal fluid circulation and has a complex physiopathology. In this report, we present a DC patient who developed confusion on postoperative day 4, after spinal surgery caused by hydrocephalus following epidermoid rupture. Computed tomography of the brain revealed fat blisters caused by fat crystals in the right sylvian fissure, anterior interhemispheric fissure, and basal cisterns. There was minimal dilation in lateral ventricles. Computed tomography obtained a couple of weeks later revealed significant triventricular hydrocephalus. On cranial magnetic resonance imaging, there were hyperintense foci in T1A, T2A, and FLAIR series and significant triventricular hydrocephalus. An external ventricular drainage system was inserted because of progressive hydrocephalus developing due to rupture of epidermoid tumor. The patient whose confusion improved in the early postoperative period and the external ventricular drainage system was removed on day 5. In conclusion, DCs and their rupture have become a more commonly encountered condition with increased use of magnetic resonance imaging. Proper treatment planning may be done for this potentially fatal complication of hydrocephalus due to ruptured epidermoid cyst through radiologic imaging.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"351–353"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000187
Hassan Reza Mohammadi, Z. Reihanian, S. Ramezani, S. A. Baneh
Background and Aims:This paper attempts to investigate the variation of craniosynostosis subtypes over time and comparison of surgical outcome in patients who underwent suturectomy versus cranioplasty at the Mofid Pediatric Surgery Center in Iran. Methods:In a retrospective investigation, personal, clinical, and paraclinical data were extracted from medical records of 250 infants/children with nonsyndromic craniosynostosis who underwent operation from 1996 to 2011 in Mofid Pediatric Hospital. Samples were separated into 2 groups according to surgical method type. The surgical outcome had been ranked using Haberl Scale by 2 neurologists 1 year after surgery. Using &khgr;2 test, suturectomy and cranioplasty outcomes were compared and the effective factors on the surgical outcome were also investigated. Results:Schaphocephaly (40%) and anterior plagiocephaly (28.8%) were prevalently delineated among phenotypes which gradually varied over time. The most prevalent age ranges at operation were 2 to 4 months for suturectomy and 6 to 12 months for cranioplasty. Patients mainly underwent suturectomy (61.2%). About 84% of operated cases demonstrated very good outcome. There was not significant difference between suturectomy and cranioplasty groups with respect to the surgical outcome. Age at operation exhibited a significant effect on the surgical outcome. Conclusions:It seems that age at surgery is an important factor to prognosticate surgical outcome versus type of surgical method and phenotype of craniosynostosis in operated patients with nonsyndrome craniosynostosis. Namely, operation of younger pediatric cases leads to a satisfactory outcome.
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