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

Effect of Coenzyme Q10 on ischemia and neuronal damage in an experimental traumatic brain-injury model in rats

<p>Abstract</p> <p>Background</p> <p>Head trauma is one of the most important clinical issues that not only can be fatal and disabling, requiring long-term treatment and care, but also can cause heavy financial burden. Formation or distribution of free oxygen radicals should be decreased to enable fixing of poor neurological outcomes and to prevent neuronal damage secondary to ischemia after trauma. Coenzyme Q₁₀(CoQ₁₀), a component of the mitochondrial electron transport chain, is a strong antioxidant that plays a role in membrane stabilization. In this study, the role of CoQ₁₀in the treatment of head trauma is researched by analyzing the histopathological and biochemical effects of CoQ₁₀administered after experimental traumatic brain injury in rats. A traumatic brain-injury model was created in all rats. Trauma was inflicted on rats by the free fall of an object of 450 g weight from a height of 70 cm on the frontoparietal midline onto a metal disc fixed between the coronal and the lambdoid sutures after a midline incision was carried out.</p> <p>Results</p> <p>In the biochemical tests, tissue malondialdehyde (MDA) levels were significantly higher in the traumatic brain-injury group compared to the sham group (<it>p </it>< 0.05). Administration of CoQ₁₀after trauma was shown to be protective because it significantly lowered the increased MDA levels (<it>p </it>< 0.05). Comparing the superoxide dismutase (SOD) levels of the four groups, trauma + CoQ₁₀group had SOD levels ranging between those of sham group and traumatic brain-injury group, and no statistically significant increase was detected. Histopathological results showed a statistically significant difference between the CoQ₁₀and the other trauma-subjected groups with reference to vascular congestion, neuronal loss, nuclear pyknosis, nuclear hyperchromasia, cytoplasmic eosinophilia, and axonal edema (<it>p </it>< 0.05).</p> <p>Conclusion</p> <p>Neuronal degenerative findings and the secondary brain damage and ischemia caused by oxidative stress are decreased by CoQ₁₀use in rats with traumatic brain injury.</p

A pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report

Hipofiz adenomları, sıklıkla hipofiz ön lobundan kaynaklanan, hormonal bozukluklarla ya da kitle etkisi ile kendini gösteren tümörlerdir. Kitle etkisi genellikle işlevsel olmayan tümörlerde olur. Hipofiz adenomları karşımıza görme alanı defektleri "görme alanında eksiklik" ile çıkabildiği gibi ender olarak göz kaslarının tam felci şeklinde de bulgu verebilir. Görme alanı eksikliği en sık bitemporal hemianopsi ve superior temporal görme alanı eksikliği şeklindedir. Ani görme kaybı, papilla ödemi ve göz felci görülebilir. Hipofiz apopleksisi baş ağrısı, kusma, görme kaybı, göz felci ve bilinç bulanıklığı ile seyreden akut klinik durumu tanımlamaktadır. Hipofiz apopleksisine neden olan sorun adenom içinde kanlanmanın azalması, bu azalmayı izleyerek kanama olması ya da yalnız kanama olması olabilir. Bu yazıda, travma sonrası ateş yüksekliği, kusma, ani görme kaybı ve sol gözde dışa bakış kısıtlılığı ile başvuran, kafa ve hipofiz manyetik rezonans görüntülemede, solda optik kiyazmaya ve sol optik sinire bası yapan hipofiz makroadenomu saptanan bir olgu sunulmuştur.Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apoplexy is defined as an acute clinical syndrome characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness. The problem leading to pituitary apoplexy may be decreased blood supply in the adenoma and hemorrhage following this decrease or hemorrhage alone. In this article, we present a patient who presented with fever, vomiting and sudden loss of vision and limited outward gaze in the left eye following trauma and who was found to have pituitary macroadenoma causing compression of the optic chiasma and optic nerve on the left side on cranial and pituitary magnetic resonance imagin

Ewing's Sarcoma: Dural Metastases after Intracranial Hemorrhage

Ewing's sarcoma (ES) is a primary malignant tumor of the mesenchymal tissue of bone in children and young adults. Central nervous system metastases of ES are rarely seen. In this paper, we report a case of ES that progressed with dural metastases after spontaneous intracerebral hemorrhage.</jats:p

Decompressive craniectomy for acute subdural haematoma: an overview of current prognostic factors and a discussion about some novel prognostic parametres.

To identify specific factors that can be used to predict functional outcome and to assess the value of decompressive craniectomy in patients with acute subdural haematoma.The retrospective study was done at the Zonguldak Karaelwas University Practice and Research Hospital, Turkey, and included 34 trauma patients who had undergone decompressive craniectomy for acute subdural haematoma from 2001 to 2009. At the 30th day of the operation, the patients were grouped as survivors and non-survivors. Besides, based on their Glasgow Outcome Scale, which was calculated 6 months postoperatively, the patients were divided into two functional groups: favourable outcomes (4-5 on the scale), and unfavourable outcomes (1-3 on the scale). The characteristics of the groups were compared using SPSS 15 for statistical analysis.One-month mortality was 38.2% (n = 13) and 6-month total mortality reached 47% (n = 16). Patients with higher pre-operative revised trauma score, Glasgow coma scale, partial anterial pressure of carbon dioxide, arterial oxygen pressure, Charlson co-morbidity index score, blood glucose level, blood urea nitrogen, and lower age had a higher rate of survival and consequently a favourable outcome. Higher platelet values were only found to be a determinant of higher survival at the end of the first month without having any significant effect on the favourable outcome.In patients of traumatic acute subdural haematoma whose Glasgow coma scale on arrival was < or = 8, a massive craniectomy along with the evacuation of the haematoma, may be considered as a treatment option for intra-operative and post-operative brain swelling. But in patients with a score of 3 on arrival and bilaterally fixed and dilated pupils, decompressive craniectomy is unnecessary

Decompressive craniectomy for acute subdural haematoma: An overview of current prognostic factors and a discussion about some novel prognostic parametres

Objective: To identify specific factors that can be used to predict functional outcome and to assess the value of decompressive craniectomy in patients with acute subdural haematoma

Ischemia modified albumin increase indicating cardiac damage after experimental subarachnoid hemorrhage

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.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.The results revealed that increased serum IMA may be related to myocardial stress after SAH