The Effect of Intravenous L-Carnitine on the Vasospasm Process in the Experimental Subarachnoid Hemorrhage Model

AIM: Cerebral vasospasm after subarachnoid hemorrhage (SAH) is an important cause of morbidity and mortality. In this study, we examined the effects of L-carnitine on the cerebral vasospasm process. MATERIAL and METHODS: Twenty male New Zealand white rabbits were randomly divided into 4 groups. Group 1 served as control; group 2 was not subjected to SAH and received intravenous L-carnitine 3 times; group 3 was subjected to SAH and group 4 was subjected to SAH and treated with 100 mg/kg intravenous L-carnitine at 0, 24, and 48 hours after SAH. All animals were euthanized by perfusion-fixation 72 hours after SAH induction. The brains were then removed and stored in fixative +4 degrees C overnight. The subjects' basilar arteries were sectioned from four separate zones. Basilar artery cross-sectional areas and thicknesses of vessels were measured by using the SPOT for Windows Version 4.1 computer programme. Statistical comparisons were performed by using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: Basilar artery wall thicknesses in group 4 were significantly lower than in group 3 (p=0.009). Basilar artery cross-sectional areas in group 4 were higher than in group 3 and the difference was statistically significant (p=0.008). CONCLUSION: L-carnitine was shown to be potentially beneficial on the resolution of cerebral vasospasm following SAH.WoSScopu

The Added Value of Diffusion Magnetic Resonance Imaging in the Diagnosis and Posttreatment Evaluation of Skull Base Chordomas

Objectives To determine the use of diffusion-weighted imaging (DWI) in the pre- and posttreatment evaluation of skull base chordomas. Design Retrospective study. Setting Tertiary care university hospital. Participants In total, 17 patients with histopathological diagnosis of chordoma who had magnetic resonance (MR) imaging and DWI were evaluated. Of them, 13 patients had posttreatment MR imaging including DWI. Main Outcome Measures Three apparent diffusion coefficient (ADC) values were obtained from tumor, and an ADC value was measured from pons for the purpose of normalization. ADC values of the subtypes of chordomas (typical and chondroid chordomas) were compared. Results Ten (59%) masses had increased signal on trace DWI at pretreatment evaluation. The mean ADC(entire) (tumor)/ADC(pons) was calculated as 1.55 +/- 0.44. The mean ADC(entire) (tumor) values of typical and chondroid chordomas were 1.26 +/- 0.29 x 10(-3) mm(2)/s and 0.99 +/- 0.46 x 10(-3) mm(2)/s, respectively. There was no statistically significant difference between ADC values of the subtypes (p > 0.05). For posttreatment evaluation, DWI enabled detection of residual tumor in the majority (85%) of cases. Conclusions DWI is useful in diagnosis and posttreatment evaluation of skull base chordomas. However, ADC values in our series did not distinguish the subtypes of chordomas.Wo

A case of idiopathic granulomatous hypophysitis

WOS: 000418562600014PubMed ID: 2927852

Gliosarcoma of the Optic Nerves 15 years After Radiation Treatment For Hypophyseal Adenoma

"Gliosarcoma is a very rare mixed tumor in the central nervous system, consisting of glial and malignant mesenchymal elements. Gliosarcoma is considered a subtype of glioblastoma and termed as primary gliosarcoma. Secondary gliosarcoma is detected at subsequent surgery for previously resected and irradiated glioblastoma multiforme. We describe an unusual case with vision loss due to gliosarcoma, probably radiotheraphy-induced,15 years after radiation treatment for hypophyseal adenoma.

Thyrotropinoma And Multinodular Goiter: A Diagnostic Challenge For Hyperthyroidism

Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.PubMe

Pharmacoresistant seizures in neurofibromatosis type 1 related to hippocampal sclerosis: Three case presentation and review

Neurofibromatosis type 1 (NF1) is an autosomal dominantly inherited disorder, with an estimated prevalence of 1 in 3000-4000 people. Seizures occur 4-7% of individuals with NF1, mostly due to associated brain tumors or cortical malformations. Hippocampal sclerosis (HS) in the patients with NF1 has been reported very rarely and only 15 patients were found in review of English literature. We presented here 3 additional patients with NF1 and intractable seizures due to hippocampal sclerosis; in whom one of them underwent epilepsy surgery and he is seizure free for 5 years after right temporal lobectomy.Wo

Is the Knowledge Pertaining to Adult Glioblastomas Enough for Pediatric Cases? Prognostic Factors in Childhood

AIM: Pediatric glioblastoma (GBM) is still a topic obscurity. The aim of this study was to explore clinical, radiological and pathological features, and prognostic factors affecting the outcomes. MATERIAL and METHODS: We retrospectively reviewed our database for prognostic factors for 42 consecutive pediatric patients with histologically proven GBM treated in our hospital. RESULTS: The study reached at 20 boys and 22 girls, with a mean age of 10.2 years. Almost all patients (97.6%) had supratentorial tumors; lobar/hemispheric (68.3%), thalamic (26.8%) and suprasellar-hypothalamic region (4.8%). Total of 11/42 children had seeding metastases (mean 11.5 months) either preoperatively or postoperatively. Gross total resection (GTR) was achieved in 13 patients (30.9%) in the first surgery. Perioperative mortality and morbidity rates were 4.7% and 19%, respectively. Patients were followed for an average of 18.1 months. The median progression-free and overall survivals were 7.0 (95% CI: 5.9-8.0) and 11.0 (95% CI: 8.9-13.1) months, respectively. 1-year, 2-year and 5-year progression-free survival and overall survivals were 30.9% vs. 50.0%, 11.9% vs. 19.0%, 4.8% vs. 9.5%; respectively. CONCLUSION: Gross total resection should be safely attempted in pediatric GBM. In addition, a thorough and frequent radiological evaluation of the entire neuraxis for seeding metastases is recommended both at diagnosis and follow-ups.WoSScopu