The importance of evaluating all seven cervical vertebrae in the trauma patient: A case report

WOS: 000256792700016PubMed: 17935035The cervical spine is injured in approximately 3% of major trauma patients and 10% of patients with serious head injury We present a patient in whom an unstable cervical spine, without neurological deficit, resulting from a traffic accident was misdiagnosed as normal in the emergency room. Although cervical spine pain or tenderness and neurological deficit have a sensitivity of 93% for cervical spine injury, asymptomatic patients or patients with mild symptoms can have spine injury. All trauma patients with a complaint of mild neck pain require a standard three-view radiological evaluation of the cervical spine demonstrating all seven vertebrae and the top of first thoracic vertebra even if their neurologic examination is normal

Age-related and sex-related changes in the intervertebral discs and endplates of rats at all spinal levels

WOS: 000256162100007The intervertebral disc (IVD) and endplates change throughout life, eventually resulting in tissue degeneration, which may have clinical significance. In this study, we analyzed age-related changes in the IVD and endplate of newborn (1 mo), middle-aged (12 mo), and older (24 mo) male and female Sprague-Dawley rats. We evaluated the presence of embryonic disc cells, chondrocyte proliferation, cell death, appearance of clefts/tears, granular degeneration, cell proliferation, and cartilage disorganization in the IVD and endplate under light microscopy, according to age and sex Chondrocyte proliferation was greater in male rats than in female rats across all age groups in the cervical region and at 1, and 24 months in the thoracic region. A strong correlation between aging and cell death in female rats was observed.. In females, cell death was significantly elevated in 12 and 24-month-old rats compared with 1-month-old rats. Examining the histologic changes with aging in the IVD and endplates at all levels of the spine is obviously difficult in humans. Animal research is essential for making the transition from scientific concepts to clinical applications. The aging spine shows the greatest changes in the cervical and thoracic regions in male rats, whereas it mostly affects the lumbar region in females

Epidural extension of a lumbar vertebral haemangioma

alper, murat/0000-0001-7069-0623WOS: 000240160100018PubMed: 16815019Vertebral haemangiomas are relatively common, but those extending into the epidural space are rare. A 59-year-old man with severe lower back and right leg pain that did not resolve with conservative treatment was seen in an outpatient clinic. Magnetic resonance imaging of the lumbar spine identified an L3 vertebral corpus lesion with epidural extension. The diagnosis was unclear, so the patient underwent surgery. The pathologic diagnosis was capillary haemangioma, so angiography-guided embolization was performed postoperatively. Vertebral haemangioma must be considered when there is evidence of a vertebral corpus lesion with epidural extension on magnetic resonance imaging. (c) 2006 Published by Elsevier Ltd

A 13-year-old girl with a cystic cerebellar lesion: Consider the hydatid cyst

WOS: 000265223900025PubMed: 19264485We report a 13-year-old girl with a hydatid cyst located in the posterior fossa. The pre-operative diagnosis was a cerebellar turnout; the cyst was operated on using puncture, aspiration, irrigation and resection. Sixteen months post-operatively, the patient is in a good health. A hydatid cyst must always be considered in the differential diagnosis of cystic lesions of the cranium, especially for those children living in rural areas. (C) 2008 Elsevier Ltd. All rights reserved

Effects of anti-edema drugs on diffuse cerebral edema in rats: Experimental study

AMAÇ Travmatik beyin ödemi, nöroşirürji pratiğinde sık karşıla- şılan önemli sorunlardan biridir. Beyin ödemi, kafaiçi ba- sıncını yükseltmekte, morbidite ve mortalite artışına yol açmaktadır. Bu çalışmanın amacı travmatik beyin ödemi tedavisinde hiperozmolar tuzların tedavi etkinliğinin sap- tanması ve mannitole göre karşılaştırılmasıdır. GEREÇ VE YÖNTEM Bu deneysel çalışmada ağırlıkları 300-350 g arasında deği- şen 80 adet erkek erişkin Spraque-Dawley sıçanı kullanıldı. Sıçanlar kontrol; travma; sadece mannitol; travma sonrası mannitol; sadece %3 NaCl; travma sonrası %3 NaCl; sade- ce %7,5 NaCl; travma sonrası %7,5 NaCl; sadece %23,4 NaCl; travma sonrası %23.4 NaCl gruplarına ayrıldı. Tüm ilaçlar periton içine verildi. Travma ve ilaç uygulaması son- rası 24. saatte sıçanlar dekapite edildi, örnekler histopatolo- jik olarak incelendi. BULGULAR Travma grubu ile travma sonrası %23,4 NaCl verilen grup arasında kanama açısından bir fark olmadığı (p0,473), ödem açısından ise anlamlı fark (p0,003) olduğu saptan- dı. Gruplar plazma osmolaritesi ve serum sodyum değerleri açısından karşılaştırıldığında kontrollerle diğer tüm gruplar arasında anlamlı fark bulunmadı. SONUÇ Travma sonrası beyin ödemi önlemek amacıyla verilen %23,4 NaCl’nin diğer hipertonik salinlerden ve mannitol- den daha etkili olduğu görülmüştür. Bu bulgunun hipertonik salinlerin farklı doz, konsantrasyon ve sürelerde verildiği daha geniş klinik çalışmalarla desteklenmesi gerekmektedir.Traumatic brain edema is one of the most common problems encountered in neurosurgical practice and it leads to morbidity and mortality via increased intracranial pressure. The aim of this study was to examine the effect of hypertonic saline on traumatic brain edema in comparison to mannitol. METHODS Eighty adult male Sprauge-Dawley rats weighting 300- 350 g were used in this experimental study. Rats were randomly divided into control (C); trauma (T); mannitol only traumamannitol; NaCl 3% only; TraumaNaCl 3%; NaCl 7.5% only; traumaNaCl 7.5%; NaCl 23.4% only and traumaNaCl 23.4% groups. All medications were given intraperitoneally. Rats were sacrificed and decapitated 24 hours after trauma with or without medications and the brains were examined histopatologically. RESULTS Although no difference was observed with regard to hemorrhage between trauma only and traumaNaCl 23.4% groups, there was a statistically significant difference in brain edema within these two groups (p0.003). There were no statistically significant differences within groups with respect to plasma osmolarity and serum sodium levels. CONCLUSION This study demonstrates that 23.4% NaCl is more effective than other concentrations of hypertonic saline or mannitol in the prevention of posttraumatic brain edema. Further clinical studies with different dosages and concentrations of hypertonic saline are required

A 13-year-old girl with a cystic cerebellar lesion: Consider the hydatid cyst

WOS: 000265223900025PubMed: 19264485We report a 13-year-old girl with a hydatid cyst located in the posterior fossa. The pre-operative diagnosis was a cerebellar turnout; the cyst was operated on using puncture, aspiration, irrigation and resection. Sixteen months post-operatively, the patient is in a good health. A hydatid cyst must always be considered in the differential diagnosis of cystic lesions of the cranium, especially for those children living in rural areas. (C) 2008 Elsevier Ltd. All rights reserved

Evaluation of Different Surgical Techniques to Repair Iatrogenic Esophageal Injury; an Experimental Study

WOS: 000368518700014Objective: Esophageal perforation during anterior spine surgery is a rare but serious complication that may lead to death, if not managed properly. Optimal management of these injuries is still debated, which varies from conservative approach to different types of surgical repair. The purpose of this study was to evaluate and compare the healing process following various surgical techniques to repair experimentally induced esophageal injury in rodents. We hypothesized that repair techniques that involve flap rotation along with primary suture was superior to primary suture alone. Material and Methods: Fifty male Sprague-Dawley rats were used for this study. Esophageal injury was induced by a vertical incision through all layers of its wall. Groups were determined according to the repair techniques used, i.e., Group-1 (sham, no injury), Group-2 (primary suture), Group 3 (primary suture plus muscle flap), Group 4 (primary suture omental flap) and Group 5 (untreated). Esophageal segments repaired were obtained fourteen days after the injury/repair surgery for histopathological evaluation. Results: Total histopathological damage scores were highest in Group 5. Lower total scores were obtained in Group 3 than in Group 2 and 5, whereas total scores between Groups 2 and 4, 2 and 5, and 3 and 4 were similar. Infiltration and submucosal/muscular healing scores were higher in Group 2 than in 3. There was no difference in any of the parameters between groups 2 and 4, 2 and 5, and 3 and 4. Conclusions: Primary suture closure reinforced by a muscle flap provides better healing in a rat model of iatrogenic esophageal injury. Primary suture reinforced by omentum, or primary suture alone may be considered as second options for repair

Yings and Yangs of acute ethanol intoxication in experimental traumatic brain injury

Ulu, Mustafa Onur/0000-0002-6256-0869WOS: 000227291400009Although the deleterious effects of acute alcohol intoxication on traumatic brain injury (TBI) are well known, neuroprotective features of lower doses of ethanol (EtOH) before head trauma have been reported during recent years. Inhibition of N-methyl-D-aspartate receptor (NMDA)-mediated excitotoxicity by lower doses of EtOH has been believed to be responsible for this protection. The aim of this study was to show the neuroprotective effects of low and moderate doses of EtOH and to compare their efficacy in each group. Acute EtOH intoxication at low and moderate doses was induced 40 minutes before trauma. Severe TBI was administered in Sprague-Dawley rats using an impact acceleration model. At 24 hours after trauma, all the rats were decapitated and hippocampi were evaluated under light microscopy. According to our results, red neuron formation and vacuolar degeneration in the CA1 and CA3 sectors of the hippocampi were less prominent in the lowdose and moderate-dose EtOH plus trauma groups than in the trauma only group. In addition, edema formation was less prominent in the EtOH plus trauma group. When comparing the low-dose EtOH Plus trauma and moderate-dose EtOH Plus trauma groups, an almost normal appearance of the hippocampus was noted in the moderate-dose EtOH plus trauma group. EtOH may have a neuroprotective effect when administered at a lower dose, particularly a moderate dose, and this protection may be a result of the inhibition of NMDA receptor-mediated excitotoxicity