Lumbar extradural extraosseous schwannoma causing extensive compression of the vertebral body

Destroyed vertebral body and posterior bone elements of the spine by a schwannoma may cause unstability. Besides the removal of the tumour tissue, the surgeons have to correct these bone deformities using stabilization techniques. In this report we present a patient operated for a spinal schwannoma originating from L5 nerve root with involvement of nearly half of the L5 vertebra. During surgery, the internal cortical layer of the vertebral body was found intact so instrumentation and fusion were not performed in our case. The patient presented no tumour recurrence after more than three years of unproblematic follow-ups

A multilevel thoracolumbar meningioma in a young woman

Spinal meningiomas of five or more vertebral segment long are very rare and also less common in younger patients. Under 50 years of age these tumors are more commonly genetical and have worse prognosis. A 25-year-old woman presented with back pain and progressive walking difficulty. An intradural extramedullary tumor extending from thoracal 9th to lumbar 2nd vertebral body was detected. The patient was operated and the tumor was totally removed. The histopathological diagnosis was angiomatous meningioma. Neurological symptoms and signs partially improved postoperatively. Interestingly, magnetic resonance imaging of this patient might easily be confused with ependymoma. Although we performed laminectomy and instrumentation, to maintain stability laminoplasty should be the first treatment modality for such a young patient. © 2008 Springer-Verlag

Apoptosis and necrosis in the circumventricular organs after experimental subarachnoid hemorrhage as detected with annexin V and caspase 3 immunostaining

Objectives: The circumventricular organs (CVOs) are essential for most autonomic and endocrine functions. Trauma and bleeding can affect their function. The aim of this study was to investigate apoptosis and necrosis in CVOs in the early period after experimental subarachnoid hemorrhage (SAH) in rats, using annexin V affinity and caspase 3 immunostaining.Methods: Three experimental groups were used: Days 1 and 2 after SAH, and a control group, seven Wistar albino rats each. Subarachnoid hemorrhage was accomplished by transclival basilar artery puncture. Rats were perfused with 0.9%NaCl and 0.1M phosphate buffer pH 7.4 until heart stoppage. Apoptosis and necrosis in CVOs were measured by flow cytometry with annexin V staining, and by caspase 3 immunostaining.Results: Apoptosis in the organum vasculosum lamina terminalis (OVLT), median eminence (ME), and area postrema (AP) was significantly higher in the Day 1 group than in the control group. Apoptosis in the subfornicial organ (SFO), OVLT, ME, and AP was significantly higher in the Day 2 group than in the control group. There were significant differences between the Day 1 and Day 2 groups, except for AP. Necrosis in SFO and OVLT was significantly higher in the Day 2 group than in the Day 1 or control groups, whereas necrosis in the ME and AP did not differ between the three groups. Caspase 3-positive cell density was more intense in the Day 2 group than in the Day 1 and control groups.Discussion: Prevention of apoptosis may potentially improve impaired functions of CVOs after SAH. © W. S. Maney & Son Ltd 2014

Ischemia modified albumin increase indicating cardiac damage after experimental subarachnoid hemorrhage

Background: Cardiac complications are often developed after subarachnoid hemorrhage (SAH) and may cause sudden death of the patient. There are reports in the literature addressing ischemia modified albumin (IMA) as an early and useful marker in the diagnosis of ischemic heart events. The aim of this study is to evaluate serum IMA by using the albumin cobalt binding (ACB) test in the first, second, and seventh days of experimental SAH in rats.Twenty-eight Wistar albino rats were divided into four groups each consisting of seven animals. These were classified as control group, 1st, 2nd and 7th day SAH groups. SAH was done by transclival basilar artery puncture. Blood samples were collected under anesthesia from the left ventricles of the heart using the cardiac puncture method for IMA measurement. Histopathological examinations were performed on the heart and lung tissues. Albumin with by colorimetric, creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) were determined on an automatic analyser using the enzymatic method. IMA using by ACB test was detected with spectrophotometer.Results: Serum IMA (p = 0.044) in seventh day of SAH were higher compared to the control group. Total injury scores of heart and lung tissue, also myocytolysis at day 7 were significantly higher than control group (p = 0.001, p = 0.001, p = 0.001), day 1 (p = 0.001, p = 0.001, p = 0.001) and day 2 (p = 0.001, p = 0.007, p = 0.001). A positive correlation between IMA - myocytolysis (r = 0.48, p = 0.008), and between IMA - heart tissue total injury score (r = 0.41, p = 0.029) was found.Conclusion: The results revealed that increased serum IMA may be related to myocardial stress after SAH. © 2014 Açi{dotless}kgöz et al.; licensee BioMed Central Ltd

Cystain C and neuropeptid Y levels in brain tissues after experimental subarachnoid hemorrhage

The aim of this study was to investigate the changes in the levels of cystatin C, which protects neurodegeneration in the central nervous system with the inhibition of cysteine protease and by inducing autophagy in the pathogenesis of cerebral vasospasm and levels of vasoconstrictive neuropeptid Y (NPY) in the brain tissue homogenates of rat model of subarachnoid hemorrhage (SAH). Three experimental groups were used: Day 2 and Day 7 groups after SAH, and also a control group. There were seven Wistar albino rats in each group. SAH was accomplished by transclival basilar artery puncture. Rat cystatin C, rat NPY were determined with ELISA in brain tissue homogenates. Day 2 group showed significantly enhanced cystatin C values in comparision with the control group (P=0.048). NPY levels between the Day 2 and Day 7 groups and the control groups were not significantly different (P=0.315). In histopathological examination, there was less neuronal loss in the Day 2 group than in the Day 7 group. Regarding our results, it would be more valuable to measure NPY levels in specific brain areas. The increased cystatin C levels on the second day after SAH is probably a pathophysiologic mechanism to organize protease activity