Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2007
ReviewThe role of erythropoietin in central and peripheral nerve injury.
Erythropoietin (Epo) is a cytokine which controls red cell production. Apart from the red cell surface, erythropoietin's receptor (Epo-R) is also expressed in a large variety of normal tissues. Erythropoietin, as well as its receptor, is present in the central and peripheral nervous system. ⋯ After injury of the central as well as the peripheral nervous system, Epo presents an anti-apoptotic action. In combination with its anti-apoptotic effect, Epo, by reducing the inflammatory response plays a crucial role in neuroprotection in many types of injury in the central and the peripheral nervous system. Epo's administration contributes to the recovery of mechanical allodynia and may be effective in peripheral nerve regeneration after neurorrhaphy.
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Clin Neurol Neurosurg · Oct 2007
Usefulness of silicone elastomer sheet as another option of adhesion preventive material during craniectomies.
We describe the use of a silicone elastomer sheet (SILASTIC) to prevent peridural fibrosis in patients who underwent a craniectomy and a subsequent cranioplasty. ⋯ The use of a SILASTIC sheet to prevent peridural scarring and to facilitate cranioplasty in patients who have previously undergone a craniectomy is a good technique, regardless of the procedural indication.
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Clin Neurol Neurosurg · Oct 2007
Case ReportsBlood patch for spontaneous intracranial hypotension caused by cerebrospinal fluid leak at C1-2.
A case of spontaneous intracranial hypotension (SIH) caused by a cerebrospinal fluid (CSF) leak at C1-2 is described. The patient, a 46-year-old gentleman, presented to the emergency department with a severe, orthostatic neck pain and occipital headache of sudden onset. He was diagnosed with SIH and admitted, but failed to respond to conservative management. ⋯ His neck pain disappeared a day after the procedure, and he remains free of symptom for more than a year. SIH with a CSF leak at the upper cervical spine may be least amenable to conventional epidural blood patch delivered from the lumbar spine. Delivery of autologous blood patch via an epidural catheter inserted from the lower cervical spine can be a safe and effective method for such patients.