Neuroprotective effect of magnesium on lipid peroxidation and axonal function after experimental spinal cord injury

Study design: An experimental study examining the neuroprotective effect of magnesium on axonal function and lipid peroxidation in a rat model of acute traumatic spinal cord injury. Objective: To determine the effectiveness of postinjury treatment with magnesium on evoked potentials and lipid peroxidation after spinal cord injury (SCI). Setting: Pamukkale University, Denizli, Turkey. Methods: Spinal cord injury occurred in 30 rats with an aneurysm clip at T9 and the rats were randomly assigned to undergo subcutaneous administration of one of the following at 1 h after injury: (1) Physiological saline (n = 10); (2) MgSO4, 300 mg/kg (n = 10) and (3) MgSO4, 600 mg/kg (n = 10). Spinal somatosensory evoked potentials (SSEPs) were recorded before injury, 30 min after injury and 3 h after injections. Rats were killed 24 h after the injury, and malondialdehyde (MDA) levels were measured. Results: Following SCI, there were significant decreases in the amplitudes of P1 and N1 (P 0.001) and only high-dose magnesium improved the SSEPs (P < 0.01). On the other hand, there was significant difference in lipid peroxide content between high-dose magnesium treated group and both of saline treated and low-dose magnesium treated groups (P < 0.01). Conclusion: These results suggest that magnesium has a dose-dependent neuroprotective effect on SSEPs and lipid peroxidation after experimental spinal cord injury

Clinical Results of Anterior Odontoid Screw Fixation for Type II Odontoid Fractures

AmAÇ: Çalışmada, Tip II odontoid fraktürü tanısı alan 31 olgu bildirilmiştir. Olguların hepsi anterior transodontoid vida fiksasyonu ile tedavi edilmiş ve klinik sonuçları bildirilmiştir. yÖNTEm ve GEREÇLER: Çalışma, VKV Amerikan Hastanesi Nöroşirürji Bölümü'nde 1998-2012 yılları arasında travmatik tip II odontoid kırığı nedeniyle anterior transodontoid fiksasyon ile cerrahi tedavi uygulanan 31 hastanın retrospektif klinik analizleri yapılmıştır. Tüm olguların yaş, cinsiyet, travma nedeni, teşhis zamanı, cerrahi girişim öncesi ve sonrasında nörolojik muayeneleri, takip süresi değerlendirilmiştir. Olguların nörolojik durumları Frankel skalasına göre sınıflandırılmıştır. BuLGuLAR: Dört hastaya 2 adet transodontoid vidası yerleştirildi. Hastanede kalış süresi ortalama 3,35 gün idi. 1 hastada postop takibinde füzyon oluşmaması nedeniyle ikinci bir operasyon ile posteriordan oksipitoservikal füzyon yapıldı. İşlem sırasında ve sonrasında damar yaralanması, vida malpozisyonu, enfeksiyon, nörolojik bozulma gibi komplikasyonlar izlenmedi. Hastalar ameliyat sonrasında ortalama 36 ay takip edildi. Hastaların erken ve geç dönemde radyolojik görüntülemeleri yapıldı. soNuÇ: Postoperatif dönemde hastaların takiplerinde tatmin edici füzyon oranı ve hasta konforunun daha iyi olduğunu saptadık. Tip II odontoid kırıklarının cerrahi tedavisinde minimal invaziv yöntem olan transodontoid vida ile fiksasyonun yüksek avantajlarından dolayı ilk seçenek olabileceğini düşünüyoruz.AIm: In this study, 31 patients with a diagnosis of Type II odontoid fractures were reported. All patients were treated with anterior transodontoid screw fixation and clinical outcomes were reported. mATERIAL and mETHods: In this study, the retrospective clinical analysis of 31 patients with traumatic type II odontoid fractures who were treated through anterior transodontoid fixation in Neurosurgery Department at VKV American Hospital between 1998 and 2012 was performed. The age, sex, cause of injury, diagnosis time, neurological examination before and after surgery, follow-up period were evaluated. The neurological status of patients was classified according to the Frankel scale. REsuLTs: In 4 patients, 2 transodontoid screws were inserted. The mean hospital stay was 3.35 days. Posterior occipito-cervical fusion was done in 1 patient due to the lack of fusion in the first operation. No vascular injury, screw malposition, infection, neurologic deterioration, or complications were observed during the peroperative and postoperative stage. The mean postoperative follow-up period was 36 months after surgery. Radiological imaging of patients were performed at the early and late postoperative stage. CoNCLusIoN: We found satisfying fusion rates and better patient comfort during the postoperative period. We think that stabilization and fusion through a transodontoid screw is a minimal invasive method

Intraradicular lumbar disc herniation: Case report and review of the literature

OBJECTIVE AND IMPORTANCE: Intradural or intraradicular herniation of a lumbar disc is a rare complication of disc disease. The mechanism of the tearing of the dura mater by a herniated disc is not known with certainty. Only six cases of intraradicular disc herniation have been reported. By reporting the seventh case of this rare neurosurgical entity, we emphasize its importance and review the literature on intraradicular disc herniation. CLINICAL PRESENTATION: A 41-year-old man was admitted with a 3-year history of low back pain and sciatica. A neurological examination revealed motor weakness during plantar flexion, positive Lasegue's sign, sensory deficit on the S1 dermatoma, and loss of Achilles reflex. Magnetic resonance imaging revealed disc protrusion at the L5-S1 level. Therefore, we decided to operate on the patient having made a diagnosis of lumbar disc disease. INTERVENTION: The patient underwent a standard hemilaminotomy and foraminotomy for a removal of the L5-S1 disc. There was no disc protrusion or extruded fragment. The left S1 nerve root was observed to be swollen and immobile. A longitudinal incision was made on the radicular sheet of the S1 root, and a free disc fragment, approximately 2 x 1 x 1 cm, was extirpated in one piece. CONCLUSION: The patient was immediately relieved of pain and was discharged on the 7th day after the operation with normal muscle strength. It seems probable that in some patients with 'failed back syndrome,' intraradicular or intradural disc herniation is the cause of failure

Lipid peroxidation and glutathione levels after cortical injection of ferric chloride in rats: Effect of trimetazidine and deferoxamine

Intracortical injection of iron salts causes seizures. Oxidation of lipids in neural membranes by reactive oxygen species is involved in the mechanism responsible for iron-induced seizures as a model of posttraumatic epilepsy. In this study, we examined the effect of trimetazidine (TMZ) and deferoxamine (DFO) on lipid peroxidation after cortical injection of 5 μl of an aqueous solution containing 100 mM of ferric chloride (FeC13) in rats. Animals were divided into four groups (n = 7 each) and treated as follows: group 1, saline injection into the cortex (control group); group 2, iron injection into the cortex (injury group); group 3, iron injection into the cortex plus TMZ; group 4, iron injection into the cortex plus DFO. The animals were killed 3 h after injections, and the levels of malondialdehyde (MDA), a lipid peroxidation product, and reduced glutathione (GSH) were measured. A significant elevation of MDA was observed in group 2 (P < 0.05). MDA levels were found to be lower in both the TMZ-treated (P < 0.05) and DFO-treated (P < 0.05) groups than in the injury group. Tissue GSH levels were significantly decreased in group 2 (P < 0.05). GSH levels were increased in the TMZ-treated (P < 0.05) and DFO-treated (P < 0.05) groups compared to the injury group. The results of our study suggest that lipid peroxidation is a critical event in iron-induced epilepsy and that treatment with TMZ and DFO is effective in preventing the formation of free radicals and reducing lipoperoxides in brain tissue

Lipid peroxidation and glutathione levels after cortical injection of ferric chloride in rats: Effect of trimetazidine and deferoxamine

Intracortical injection of iron salts causes seizures. Oxidation of lipids in neural membranes by reactive oxygen species is involved in the mechanism responsible for iron-induced seizures as a model of posttraumatic epilepsy. In this study, we examined the effect of trimetazidine (TMZ) and deferoxamine (DFO) on lipid peroxidation after cortical injection of 5 μl of an aqueous solution containing 100 mM of ferric chloride (FeC13) in rats. Animals were divided into four groups (n = 7 each) and treated as follows: group 1, saline injection into the cortex (control group); group 2, iron injection into the cortex (injury group); group 3, iron injection into the cortex plus TMZ; group 4, iron injection into the cortex plus DFO. The animals were killed 3 h after injections, and the levels of malondialdehyde (MDA), a lipid peroxidation product, and reduced glutathione (GSH) were measured. A significant elevation of MDA was observed in group 2 (P < 0.05). MDA levels were found to be lower in both the TMZ-treated (P < 0.05) and DFO-treated (P < 0.05) groups than in the injury group. Tissue GSH levels were significantly decreased in group 2 (P < 0.05). GSH levels were increased in the TMZ-treated (P < 0.05) and DFO-treated (P < 0.05) groups compared to the injury group. The results of our study suggest that lipid peroxidation is a critical event in iron-induced epilepsy and that treatment with TMZ and DFO is effective in preventing the formation of free radicals and reducing lipoperoxides in brain tissue

Spinal extradural compression caused by granuloma of brucellosis

A rare case of extradural brucellosis granuloma in the thoracic region is presented. In spite of medical treatment, total paraplegia with sphincter disturbance developed. Delayed neurosurgical intervention resulted in significant clinical recovery. Magnetic resonance imaging was useful in obtaining detailed information and to decide on surgery

Whipple's disease confined to the central nervous system: Case report and review of the literature

Whipple's disease confined exclusively to the CNS without systemic involvement appears to be very rare, with only 8 cases reported in the literature. We present here a further case of primary cerebral Whipple's disease in which the neurological symptoms were seen in the absence of systemic involvement and emphasize the importance of diagnosing this treatable disease

Brain stem abscesses in childhood

Background: Solitary brain stem abscess is a rare condition with high mortality and morbidity. These lesions were considered to be invariably fatal before 1974 when advanced diagnostic tools were not available. Recently, the diagnosis and prognosis of brain stem abscesses have been modified by the introduction of modern radiological tools, and several patients with a favorable outcome have been reported since then. Because the pons is the most common site of the abscesses, involvement of the sixth and seventh nerves is frequent. The midbrain is the second most likely location, and medullary abscesses are distinctly rare. Treatment of a brain stem abscess includes medical therapy alone, open microsurgical intervention, or stereotactic aspiration. Case report: We report a case of a 7-year-old girl with a solitary brain stem abscess. Her neurological examination revealed involvement of the cranial nerves and pyramidal tracts. Microsurgical exposure and aspiration of the abscess resulted in rapid improvement in her neurological condition and radiological resolution of the lesion. We discuss this uncommon case to draw attention to the importance of early diagnosis and adequate treatment, and we review the relevant literature. © Springer-Verlag 2005