Pub Date : 2015-11-01DOI: 10.1097/WNQ.0000000000000088
C. Yaldiz, D. Ceylan, M. Sayin, T. Kaçıra, F. Dilek
Purpose:This study aims to demonstrate the effects of therapeutic and high doses of Levetiracetam on neural tube development in early-stage chick embryos. Materials and Methods:The embryos were divided into 3 groups: control (n=20), treatment (n=20), and high-dose Levetiracetam (n=20). After 24 hours of incubation, the eggs were opened under ×4 optical magnification. The control group dosed by0.045 mL normal saline, the treatment group dosed by 0.045 mL normal saline with 4.5 &mgr;L Levetiracetam, and the high-dose group dosed by 0.045 mL normal saline with 45 &mgr;L Levetiracetam. At the end of 72 hours, all eggs were opened and the embryos were taken out for hematoxylin and eosin and immunohistochemistry (Bcl-2, Bax) stainings in order to examine microscopically and macroscopically. Results:Fifty-seven of 60 incubated embryos were evaluated. Neural tube closure was found in all embryos in all of the 3 groups (examined with hematoxylin and eosin and Bcl-2 and Bax) and no pathologic findings were detected. The development of chorda dorsalis, dorsal aorta, mesenchymal connective tissue, crista neuralis, and the somites were compatible for up to 72 hours. Microscopical examination showed that Levetiracetam causes no neural tube closure defects in the treatment or high-dose Levetiracetam groups. Conclusions:The apopytotic process was normal and no neural tube closing defects occurred with the used therapeutic agent, even when high doses were performed. It has been derived that Levatiracetam can be used as a safe antiepileptic drug in pregnant women.
{"title":"The Effects of Levetiracetam on Neural Tube Development of Chick Embryos","authors":"C. Yaldiz, D. Ceylan, M. Sayin, T. Kaçıra, F. Dilek","doi":"10.1097/WNQ.0000000000000088","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000088","url":null,"abstract":"Purpose:This study aims to demonstrate the effects of therapeutic and high doses of Levetiracetam on neural tube development in early-stage chick embryos. Materials and Methods:The embryos were divided into 3 groups: control (n=20), treatment (n=20), and high-dose Levetiracetam (n=20). After 24 hours of incubation, the eggs were opened under ×4 optical magnification. The control group dosed by0.045 mL normal saline, the treatment group dosed by 0.045 mL normal saline with 4.5 &mgr;L Levetiracetam, and the high-dose group dosed by 0.045 mL normal saline with 45 &mgr;L Levetiracetam. At the end of 72 hours, all eggs were opened and the embryos were taken out for hematoxylin and eosin and immunohistochemistry (Bcl-2, Bax) stainings in order to examine microscopically and macroscopically. Results:Fifty-seven of 60 incubated embryos were evaluated. Neural tube closure was found in all embryos in all of the 3 groups (examined with hematoxylin and eosin and Bcl-2 and Bax) and no pathologic findings were detected. The development of chorda dorsalis, dorsal aorta, mesenchymal connective tissue, crista neuralis, and the somites were compatible for up to 72 hours. Microscopical examination showed that Levetiracetam causes no neural tube closure defects in the treatment or high-dose Levetiracetam groups. Conclusions:The apopytotic process was normal and no neural tube closing defects occurred with the used therapeutic agent, even when high doses were performed. It has been derived that Levatiracetam can be used as a safe antiepileptic drug in pregnant women.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"468–471"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61881266","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000100
R. Shrestha, Yi Liu, C. You
Objective:Treatment of arteriovenous malformations (AVMs) remains a challenge in the neurosurgical entity. Our study aimed to review the procedures outcomes and complications of different strategies. Clinical Materials and Methods:We retrospectively reviewed 304 patients with AVMs treated with various combinations of radiosurgery (RS), surgery, and endovascular techniques between December 2010 and July 2012. Their presentation, preoperative neurological status, and postoperative outcome were analyzed. Results:During the study period, there were 65.1% male and 34.9% female patients. Mean age was 33.31 years, ranging from 0 months to 78 years. According to the Spetzler-Martin (SM) grading system, 2 patients had grade I lesions, 69 patients had grade II, 159 patients had grade III, 65 had grade IV lesions, and 9 had grade V lesions. Of the total 304 patients, 106 underwent surgery, 60 underwent RS, 47 underwent embolization, and underwent conservative 34 and 57 multimodal therapies. Of all the patients presenting with AVM, 187 (61.52%) demonstrated excellent outcome and 70 (23%) showed no significant disability despite symptoms according to the Modified Rankin scale score. Twelve patients experienced rebleeding after procedure, 6 in endovascular group, 4 in RS, and 2 in surgery group. Statistically, we compared each procedure in between with Modified Rankin scale in first 3 SM grade and last 2, which indicated significance (P<0.05). Conclusions:Successful treatment of brain AVMs requires extensive preoperative planning. Surgery intervention or combined procedure has good outcome for SM grade I to III AVMs. Multimodality therapy has favorable outcome with minimum morbidity and mortality for SM grade IV to V AVMs.
{"title":"Management of Intracranial Arteriovenous Malformations (AVMs) at a Tertiary Center","authors":"R. Shrestha, Yi Liu, C. You","doi":"10.1097/WNQ.0000000000000100","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000100","url":null,"abstract":"Objective:Treatment of arteriovenous malformations (AVMs) remains a challenge in the neurosurgical entity. Our study aimed to review the procedures outcomes and complications of different strategies. Clinical Materials and Methods:We retrospectively reviewed 304 patients with AVMs treated with various combinations of radiosurgery (RS), surgery, and endovascular techniques between December 2010 and July 2012. Their presentation, preoperative neurological status, and postoperative outcome were analyzed. Results:During the study period, there were 65.1% male and 34.9% female patients. Mean age was 33.31 years, ranging from 0 months to 78 years. According to the Spetzler-Martin (SM) grading system, 2 patients had grade I lesions, 69 patients had grade II, 159 patients had grade III, 65 had grade IV lesions, and 9 had grade V lesions. Of the total 304 patients, 106 underwent surgery, 60 underwent RS, 47 underwent embolization, and underwent conservative 34 and 57 multimodal therapies. Of all the patients presenting with AVM, 187 (61.52%) demonstrated excellent outcome and 70 (23%) showed no significant disability despite symptoms according to the Modified Rankin scale score. Twelve patients experienced rebleeding after procedure, 6 in endovascular group, 4 in RS, and 2 in surgery group. Statistically, we compared each procedure in between with Modified Rankin scale in first 3 SM grade and last 2, which indicated significance (P<0.05). Conclusions:Successful treatment of brain AVMs requires extensive preoperative planning. Surgery intervention or combined procedure has good outcome for SM grade I to III AVMs. Multimodality therapy has favorable outcome with minimum morbidity and mortality for SM grade IV to V AVMs.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"529–535"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61881628","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000092
Y. Oh, Jong-pil Eun
Spontaneous spinal subdural hematoma (SSDH) is even rarer, and it may occur in patients with coagulation abnormalities whose underlying diseases include neoplasm or arteriovenous malformation. Moreover, there are extremely rare cases of spontaneous SSDH without detectable structural lesion or coagulopathy. We experienced a rare case of a 27-year-old man with spontaneous acute SSDH without coagulopathy who presented with transient paraparesis. The patient received a conservative treatment and then achieved a complete recovery of the neurologic symptoms. To discuss the possible mechanism of spontaneous resolution in patients with SSDH, we report our case with a review of the literature.
{"title":"Idiopathic Spontaneous Spinal Subdural Hematoma Causing Transient Paraparesis: Case Report With a Review of the Literature","authors":"Y. Oh, Jong-pil Eun","doi":"10.1097/WNQ.0000000000000092","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000092","url":null,"abstract":"Spontaneous spinal subdural hematoma (SSDH) is even rarer, and it may occur in patients with coagulation abnormalities whose underlying diseases include neoplasm or arteriovenous malformation. Moreover, there are extremely rare cases of spontaneous SSDH without detectable structural lesion or coagulopathy. We experienced a rare case of a 27-year-old man with spontaneous acute SSDH without coagulopathy who presented with transient paraparesis. The patient received a conservative treatment and then achieved a complete recovery of the neurologic symptoms. To discuss the possible mechanism of spontaneous resolution in patients with SSDH, we report our case with a review of the literature.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"484-487"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61881719","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000111
K. Song, Young-Jae Moon, Kwang-Bok Lee
Cervical osteochondroma is a rare tumor. However, because minor trauma in patients with a history of cervical osteochondroma can lead to serious neurological damage, spinal evaluation using computed tomography in hereditary multiple exostosis patients including patients with no presenting symptoms is required; in addition, sufficient explanation of the possibility of neurological damage after minor trauma to the head should be given to the patient and guardians.
{"title":"Incomplete Cord Injury by Minor Trauma in C1 Osteochondroma: A Case Report","authors":"K. Song, Young-Jae Moon, Kwang-Bok Lee","doi":"10.1097/WNQ.0000000000000111","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000111","url":null,"abstract":"Cervical osteochondroma is a rare tumor. However, because minor trauma in patients with a history of cervical osteochondroma can lead to serious neurological damage, spinal evaluation using computed tomography in hereditary multiple exostosis patients including patients with no presenting symptoms is required; in addition, sufficient explanation of the possibility of neurological damage after minor trauma to the head should be given to the patient and guardians.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"550–554"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882308","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000112
F. Donmez
Intramedullary spinal cord metastasis is the rarest type of central nervous system involvement from breast cancer. Only a few cases have been reported in the literature. Most commonly, it is a late manifestation of the disease and survival after the diagnosis of intramedullary metastasis is unfortunately not good. Herein, we present a case with no metastasis other than the neuroaxis, relatively newly diagnosed, an aggressive inflammatory infiltrative intraductal carcinoma, having multiple metastatic intramedullary masses and leptomeningeal involve-
{"title":"Intramedullary Metastasis of Breast Carcinoma","authors":"F. Donmez","doi":"10.1097/WNQ.0000000000000112","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000112","url":null,"abstract":"Intramedullary spinal cord metastasis is the rarest type of central nervous system involvement from breast cancer. Only a few cases have been reported in the literature. Most commonly, it is a late manifestation of the disease and survival after the diagnosis of intramedullary metastasis is unfortunately not good. Herein, we present a case with no metastasis other than the neuroaxis, relatively newly diagnosed, an aggressive inflammatory infiltrative intraductal carcinoma, having multiple metastatic intramedullary masses and leptomeningeal involve-","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"555-557"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882485","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000113
G. Tsaousi, D. Kanyamibwa, C. Pourzitaki, D. Vasilakos
We report a unique case of recurrent asystolic episodes arising from carotid sinus hypersensitivity (CSH), during surgical intervention for cervical disk prolapse under general anesthesia. As the patient’s neck was positioned for optimal surgical exposure, an incidence of cardiac arrest lasting 5.8 seconds was detected that was restored to normal sinus rhythm by cessation of any manipulation in the neck and intravenous administration of atropine 0.5 mg. The incidence recurred twice and it was again elicited from light manipulations at the right side of the neck, where the surgical procedure was going to be performed. An extremely sensitive carotid sinus reflex was suspected, but as the surgical procedure could not be postponed owing to its urgent nature, a temporary pacing establishment was decided. Thereafter, having the temporary pacemaker in situ at demand function, surgical intervention was completed uneventfully. Recurrent episodes of bradycardia were recorded at several time-points throughout the surgical procedure, which was effectively managed by the ventricular pacing. The postoperative course was uneventful. Our case comes to highlight the importance of heightened awareness of CSH as this syndrome constitutes an unexpected but potentially lethal entity during positioning for cervical spine surgery. Considering that, the intraoperative period itself poses significant challenges, high clinical suspicion, early identification of the signs of possible CSH, close hemodynamic monitoring, and immediate availability of vagolytic drugs, b-1 stimulators, and intraoperative cardiac pacing are the key elements for an early diagnosis, timely management, and a favorable outcome.
{"title":"Recurrent Episodes of Asystolia Induced by Carotid Sinus Manipulation During Cervical Spine Surgery Without Preceding Clinical Symptoms","authors":"G. Tsaousi, D. Kanyamibwa, C. Pourzitaki, D. Vasilakos","doi":"10.1097/WNQ.0000000000000113","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000113","url":null,"abstract":"We report a unique case of recurrent asystolic episodes arising from carotid sinus hypersensitivity (CSH), during surgical intervention for cervical disk prolapse under general anesthesia. As the patient’s neck was positioned for optimal surgical exposure, an incidence of cardiac arrest lasting 5.8 seconds was detected that was restored to normal sinus rhythm by cessation of any manipulation in the neck and intravenous administration of atropine 0.5 mg. The incidence recurred twice and it was again elicited from light manipulations at the right side of the neck, where the surgical procedure was going to be performed. An extremely sensitive carotid sinus reflex was suspected, but as the surgical procedure could not be postponed owing to its urgent nature, a temporary pacing establishment was decided. Thereafter, having the temporary pacemaker in situ at demand function, surgical intervention was completed uneventfully. Recurrent episodes of bradycardia were recorded at several time-points throughout the surgical procedure, which was effectively managed by the ventricular pacing. The postoperative course was uneventful. Our case comes to highlight the importance of heightened awareness of CSH as this syndrome constitutes an unexpected but potentially lethal entity during positioning for cervical spine surgery. Considering that, the intraoperative period itself poses significant challenges, high clinical suspicion, early identification of the signs of possible CSH, close hemodynamic monitoring, and immediate availability of vagolytic drugs, b-1 stimulators, and intraoperative cardiac pacing are the key elements for an early diagnosis, timely management, and a favorable outcome.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"558–561"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882618","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000087
R. Draghi, M. Pluderi, N. Grimoldi, A. Gobbo, D. Spagnoli
Intradural spine teratoma is a rare neoplasm (0.1% to 0.5% of spinal tumors). Its incidence is even lower in adults and in patients without any history of spine traumas/surgical procedures or split cord malformations. We present a case of adult lumbar extramedullary mature cystic teratoma that belongs to this particular group. A 52-year-old woman presented to our attention with a long-standing, progressive, and worsening history of urinary incontinence and lower limb weakness. The lesion was known since she was 28 years old, when she underwent MRI for low back pain. Images revealed a cystic lesion at L1 level, nodular in shape, isointense to spinal roots, and iperintense to cerebrospinal fluid in T1 and T2 sequences, respectively. Afterwards the patient suffered episodic low back pain, responsive to analgesic drugs till 2007, when neurological symptoms started progressively. A new MRI confirmed the tumor, compressing the cauda equina roots. Surgical removal of the lesion was performed, with subsequent improvement of the patient. Histology on surgery specimen revealed mature cystic teratoma. Although teratoma is rare in adulthood, this condition has to be considered in differential diagnosis for lumbar spine root pathology. MRI is the gold standard diagnosis technique. The low growth rate of the tumor, lumbar location, and age-related lumbar spine degenerative processes can contribute to late, slow, and progressive appearance of clinical symptoms, which can sometimes be misinterpreted, creating a diagnostic challenge.
{"title":"Lumbar Spine Extramedullary Mature Cystic Teratoma Presenting With Neurogenic Claudication and Urinary Incontinence: Case Report and Review of Literature","authors":"R. Draghi, M. Pluderi, N. Grimoldi, A. Gobbo, D. Spagnoli","doi":"10.1097/WNQ.0000000000000087","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000087","url":null,"abstract":"Intradural spine teratoma is a rare neoplasm (0.1% to 0.5% of spinal tumors). Its incidence is even lower in adults and in patients without any history of spine traumas/surgical procedures or split cord malformations. We present a case of adult lumbar extramedullary mature cystic teratoma that belongs to this particular group. A 52-year-old woman presented to our attention with a long-standing, progressive, and worsening history of urinary incontinence and lower limb weakness. The lesion was known since she was 28 years old, when she underwent MRI for low back pain. Images revealed a cystic lesion at L1 level, nodular in shape, isointense to spinal roots, and iperintense to cerebrospinal fluid in T1 and T2 sequences, respectively. Afterwards the patient suffered episodic low back pain, responsive to analgesic drugs till 2007, when neurological symptoms started progressively. A new MRI confirmed the tumor, compressing the cauda equina roots. Surgical removal of the lesion was performed, with subsequent improvement of the patient. Histology on surgery specimen revealed mature cystic teratoma. Although teratoma is rare in adulthood, this condition has to be considered in differential diagnosis for lumbar spine root pathology. MRI is the gold standard diagnosis technique. The low growth rate of the tumor, lumbar location, and age-related lumbar spine degenerative processes can contribute to late, slow, and progressive appearance of clinical symptoms, which can sometimes be misinterpreted, creating a diagnostic challenge.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"465–467"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61881691","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000103
Qiufeng Ma, Wen Zhang, Min Yang, Wen-xiang Zhong, Guo Li, Jun Shi, Chenlong Liao
Objective:The aim of this study is to investigate the clinical characteristics, outcomes, and complications of patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of gasserian ganglion with and without previous herpes zoster. Materials and Methods:The authors analyzed 269 patients with trigeminal neuralgia treated by radiofrequency thermocoagulation of gasserian ganglion in Xinhua hospital between January 1, 2010 and December 31, 2012. A total of 37 patients were secondary to herpes zoster (group I), and 232 patients were primary to trigeminal neuralgia (group II). Clinical outcome data evaluated by visual analogue scale (VAS) scoring and postoperative complications were obtained immediate postoperative, 3 months after operation, and 6 months after operation. Follow-up data were collected from patients when they received reexamination at clinic. Results:In group I and group II, the pain VAS scoring were 0.82±1.26, 0.64±1.52 immediately postoperative, 2.26±2.42, 1.35±2.25 3 months postoperative, 3.85±2.11, and 2.02±1.83 6 months postoperative, respectively. No significant difference in satisfaction score between the 2 groups was observed at the immediate postoperative (P>0.05), 3 months after operation (P<0.05), significant difference was observed at 6 months after operation (P<0.05). No significant differences in postoperative complications were noted between the 2 groups. Conclusions:Radiofrequency thermocoagulation of the gasserian ganglion is an effective and safe procedure for patients of trigeminal neuralgia. Secondary trigeminal neuralgia is inferior to primary in long-term curative effect.
{"title":"Effect of Previous Herpes Zoster on Radiofrequency Thermocoagulation of Gasserian Ganglion for Trigeminal Neuralgia","authors":"Qiufeng Ma, Wen Zhang, Min Yang, Wen-xiang Zhong, Guo Li, Jun Shi, Chenlong Liao","doi":"10.1097/WNQ.0000000000000103","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000103","url":null,"abstract":"Objective:The aim of this study is to investigate the clinical characteristics, outcomes, and complications of patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of gasserian ganglion with and without previous herpes zoster. Materials and Methods:The authors analyzed 269 patients with trigeminal neuralgia treated by radiofrequency thermocoagulation of gasserian ganglion in Xinhua hospital between January 1, 2010 and December 31, 2012. A total of 37 patients were secondary to herpes zoster (group I), and 232 patients were primary to trigeminal neuralgia (group II). Clinical outcome data evaluated by visual analogue scale (VAS) scoring and postoperative complications were obtained immediate postoperative, 3 months after operation, and 6 months after operation. Follow-up data were collected from patients when they received reexamination at clinic. Results:In group I and group II, the pain VAS scoring were 0.82±1.26, 0.64±1.52 immediately postoperative, 2.26±2.42, 1.35±2.25 3 months postoperative, 3.85±2.11, and 2.02±1.83 6 months postoperative, respectively. No significant difference in satisfaction score between the 2 groups was observed at the immediate postoperative (P>0.05), 3 months after operation (P<0.05), significant difference was observed at 6 months after operation (P<0.05). No significant differences in postoperative complications were noted between the 2 groups. Conclusions:Radiofrequency thermocoagulation of the gasserian ganglion is an effective and safe procedure for patients of trigeminal neuralgia. Secondary trigeminal neuralgia is inferior to primary in long-term curative effect.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"432–435"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61881807","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000109
S. Dundar, E. Kalkan, F. Keskin, B. Kaya, Fatih Erdi, F. Yerlikaya, H. Esen
Spinal cord injury effects social and economical life negatively with its high mortalitiy and morbidity. Paraplegia which occurs due to spinal ischemia, during thoracic and thorocoabdominal aorta surgery is still a serious complication. In this study, we investigate the possible neuroprotective effects of a strong antioxidant, free radical scavenger; octreotide acetate on a rabbit spinal ischemia/reperfusion (I/R) injury model. A total of 18 rabbits were divided into 3 groups of 6 rabbits each, as follows: group 1 (n=6) sham, laparotomy only; group 2 (n=6) I/R group; group 3 (n=6) I/R+ octreotide group. I/R was established in groups 2 and 3. All rabbits were followed up neurologically for 24 hours. After 24 hours, the rabbits were killed and spinal cord tissue samples examined. Neurological examinations score, tissue malondialdehyde (MDA), glutathione peroxidase (GPx), xanthine oxidase (XO), tissue nitrite and nitrate levels and myeloperoxidase (MPO) levels, neuronal and glial degeneration, and apoptosis. Neurological examinations scores were significantly better in the treatment group than I/R group (P<0.05). Biochemically, XO and MPO enzyme activities were significantly decresed in the treatment group than the I/R group (P<0.05). Immunohistopathologically, apoptotic cell count in white matter were statistically reduced in the treatment group than I/R group (P<0.05). This experimental study shows the benefical effects of octreotide acetate on spinal cord I/R injury. Octreotide acetate have neuroprotective effects by inhibiting XO and MPO enzyme activity and reducing white matter apopitotic cell count. Neurological examination scores were also better in the treatment group than I/R only group.
{"title":"The Effects of Octreotide Acetate on Spinal Cord Ischemia/Reperfusion Injury","authors":"S. Dundar, E. Kalkan, F. Keskin, B. Kaya, Fatih Erdi, F. Yerlikaya, H. Esen","doi":"10.1097/WNQ.0000000000000109","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000109","url":null,"abstract":"Spinal cord injury effects social and economical life negatively with its high mortalitiy and morbidity. Paraplegia which occurs due to spinal ischemia, during thoracic and thorocoabdominal aorta surgery is still a serious complication. In this study, we investigate the possible neuroprotective effects of a strong antioxidant, free radical scavenger; octreotide acetate on a rabbit spinal ischemia/reperfusion (I/R) injury model. A total of 18 rabbits were divided into 3 groups of 6 rabbits each, as follows: group 1 (n=6) sham, laparotomy only; group 2 (n=6) I/R group; group 3 (n=6) I/R+ octreotide group. I/R was established in groups 2 and 3. All rabbits were followed up neurologically for 24 hours. After 24 hours, the rabbits were killed and spinal cord tissue samples examined. Neurological examinations score, tissue malondialdehyde (MDA), glutathione peroxidase (GPx), xanthine oxidase (XO), tissue nitrite and nitrate levels and myeloperoxidase (MPO) levels, neuronal and glial degeneration, and apoptosis. Neurological examinations scores were significantly better in the treatment group than I/R group (P<0.05). Biochemically, XO and MPO enzyme activities were significantly decresed in the treatment group than the I/R group (P<0.05). Immunohistopathologically, apoptotic cell count in white matter were statistically reduced in the treatment group than I/R group (P<0.05). This experimental study shows the benefical effects of octreotide acetate on spinal cord I/R injury. Octreotide acetate have neuroprotective effects by inhibiting XO and MPO enzyme activity and reducing white matter apopitotic cell count. Neurological examination scores were also better in the treatment group than I/R only group.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"25 1","pages":"541–546"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882597","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 : 2015-11-01DOI: 10.1097/WNQ.0000000000000096
M. Khani, S. Jahanbin
Objective:Physiotherapy is one of the popular modalities in the conservative management of disk herniation; however, the costs of physiotherapy programs are high and they are time consuming. Therefore, we were curious to investigate an easy and home-based way to reduce the size of herniated lumbar disk material and its pain, “the use of a door-mounted pull-up bar.” Materials and Methods:In this prospective randomized controlled single-blind clinical trial, 50 patients with lumbar disk herniation were included, and randomized into 2 groups: the traction group (25 patients) and the control group (25 patients). The traction group experienced a program of frequent (20 times a day) suspension (each 30 s) from a door-mounted pull-up bar for 2 months. The control group was given the same medication, but without traction. Data for the pain symptoms (visual analog scale) were collected before and after the treatment together with calculation of a herniation index from MRI images that reflected the size of the herniated disk material. Data analysis and comparison followed. Results:Means comparison of the posttreatment visual analog scale in both groups showed a significant difference (P=0.0004). In the traction group, the herniation index decreased from 156.8 pretreatment value to 106.5 (P<0.01) after the exercise. In the control group, pretreatment value was 204.7, and it decreased to 194.1 after treatment (P>0.1). Conclusions:Use of a simple pull-up bar at home as a way of traction in the conservative management of lumbar disk herniation is quite effective, considering that it is very cost effective and time sparing.
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