Chemodectoma presenting with dorsal vertebral metastasis

Tumors of the paraganglionic system include pheochromocytomas, carotid body tumors (chemodectoma), jugulotympanic paragangliomas (glomus jugulare tumors), and the rare aorticopulmonary and aorticosympathetic paragangliomas. Paragangliomas are generally well-differentiated tumors, with only a minority (7% to 10%) behaving in a malignant fashion by causing distant spread. The case report of a 37-year-old male patient, with a medical history of glomus jugulare tumor resected 1 year ago, attending with a spinal column metastasis is presented. Surgical resection of the metastases, combined with radiotherapy, was performed on the patient. Paragangliomas have the potential to be malignant and although rare, the spinal column is one of the targets of spread

Retrospective Analysis of Patients Undergoing Video-EEG Monitoring

Objective:Video-electroencephalography (EEG) monitoring (VEM) is an essential tool in diagnosing and treating epilepsy as it enables real-time monitoring and recording of electrical activity in the brain. We investigated the role of VEM in the diagnosis and treatment of epilepsy and recurrent paroxysmal events.Methods:We retrospectively examined patients monitored in our VEM unit between 2008-2016. We registered demographic and clinical information from the patients’ files. The VEM was performed until at least three typical seizures were recorded or the predetermined recording period ended. An experienced neurologist reviewed and interpreted all video-EEG recordings and compared them to the initial diagnoses. Any changes in the diagnoses and treatment plans were recorded.Results:A total of 252 patients were included in this study. VEM was performed for pre-surgical planning or vagal nerve stimulation in 170 (67.46%), diagnosis/differantial diagnosis in 54 (21.42%), seizure classification in 18 (7.14%), and treatment follow-up in 10 patients (3.96%). A total of 187 patients (74.2%) had seizures [11 of whom had both epileptic seizures and psychogenic non-epileptic seizures (PNES)], 14 (5.55%) had only PNES, and one (0.39%) had a sleep attack due to idiopathic hypersomnia. VEM provided an additional contribution in diagnosis in 197 patients (78.17%). Diagnosis and management were changed in 26 (10.31%) and 175 patients (69.16%), respectively, following VEM.Conclusion:VEM plays a crucial role in the diagnosis and management of epilepsy, particularly when used in presurgical planning. In additionally, VEM, the gold standard in diagnosing PNES, may change the diagnosis, especially in patients with PNES or PNES plus epilepsy

Acute ethanol intoxication in a model of traumatic brain injury: The protective role of moderate doses demonstrated by immunoreactivity of synaptophysin in hippocampal neurons

Although ethanol intoxication is reported to be a complicating factor in traumatic brain injury, some recent studies are indicating its possible protective role especially at lower doses. Ethanol inhibition of NMDA-mediated excitotoxicity which predominates at lower doses is believed to be responsible for this protection. The aim of this study was to demonstrate this neuroprotective role of alcohol using immunoreactivity for synaptophysin as an indirect marker for severity of injury. Acute ethanol intoxication at moderate doses was performed 2 h prior to trauma. Severe traumatic brain injury was administrated using an impact acceleration model in Sprague-Dawley rats. At post-traumatic 48th hour, immunorectivity for synapthophysin in the rat hippocampi was evaluated under light microscopy. According to our results there were slight increases in immunoreactivity for synaptophysin in the stratum oriens and striatum radiatum of CA1 subfield of hippocampus when ethanol was administered prior to trauma comparing to moderate increase in the trauma-only group. On the other hand vacuolar degeneration and red neuron formation was more prominent in the pyramidal cell layer of CA1 and CA3 when ethanol was not administered. Ethanol may have a neuroprotective role when administered at moderate doses prior to traumatic brain injury. This effect of ethanol may primarily be due to inhibition of NMDA receptors

Cerebrospinal fluid and serum levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in patients with severe head injury

Coskun, Abdurrahman/0000-0002-1273-0604; Uzan, Mustafa/0000-0001-7214-380X; Sanus, Galip Zihni/0000-0001-6539-7254WOS: 000256795800004PubMed: 17978909BACKGROUND The aim of this study is to present time course of insulin like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in both cerebrospinal fluid (CSF) and serum of patients after severe head injury (SHI) and to compare with controls. METHODS Our trauma and control groups included 11 consecutive patients with isolated SHI and 9 patients with hydrocephalus (one with normotensive and eight with hydrocephalus due to aqueduct stenosis), respectively. Both serum and cerebrospinal fluid levels of IGF-1 and IGFBP-3 were measured during post-traumatic days and we compared the levels with controls. RESULTS Patients and controls showed undetectable levels of both IGF-1 and IGFBP-3 in their CSF. When considering serum levels, patients with SHI had always lower levels of both molecules than that of controls. CONCLUSION Administration of IGF-1 during acute, as well as chronic phase of severe head trauma may provide beneficial effects and may decrease both mortality and morbidity in humans with SHI