Journal of neurosurgery
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Journal of neurosurgery · Jul 2000
Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats.
Local spinal cord cooling (LSCC) is associated with beneficial effects when applied following ischemic or traumatic spinal cord injury (SCI). However, the clinical application of LSCC is associated with many technical difficulties such as the requirement of special cooling devices, emergency surgery, and complicated postoperative management. If hypothermia is to be considered for future application in the treatment of SCI, alternative approaches must be developed. The objectives of the present study were to evaluate 1) the relationship between systemic and epidural temperature after SCI; 2) the effects of modest systemic hypothermia on histopathological damage at 7 and 44 days post-SCI; and 3) the effects of modest systemic hypothermia on locomotor outcome at 44 days post-SCI. ⋯ The results showed that 1) modest changes in the epidural temperature of the spinal cord can be produced using systemic hypothermia; 2) modest systemic hypothermia (32-33 degrees C) significantly protects against locomotor deficits following traumatic SCI; and 3) modest systemic hypothermia (32-33 degrees C) reduces the area of tissue damage at both 7 and 44 days postinjury. Although additional research is needed to study the therapeutic window and long-term benefits of systemic hypothermia, these data support the possible use of modest systemic hypothermia in the treatment of acute SCI.
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Journal of neurosurgery · Jul 2000
Case ReportsTranscranial-transdural real-time ultrasonography during transsphenoidal resection of a large pituitary tumor. Case report.
Ultrasonography has been used in neurosurgical operative procedures for several decades. The authors report the case of a large pituitary tumor that was subtotally resected using endoscopy via the transnasal-transsphenoidal approach, with the aid of transcranial real-time ultrasound. To our knowledge, this is the first reported case in which intraoperative transcranial-transdural real-time ultrasound was used to facilitate the resection of a skull base tumor.
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Journal of neurosurgery · Jul 2000
Possible origin of suprasellar arachnoid cysts: neuroimaging and neurosurgical observations in nine cases.
In this study the authors identify and investigate two new classifications of suprasellar arachnoid cysts. ⋯ The authors postulate two different types of suprasellar arachnoid cysts: a noncommunicating intraarachnoid cyst of the diencephalic membrane of Liliequist and a communicating cyst that is a cystic dilation of the interpeduncular cistern.
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Journal of neurosurgery · Jul 2000
Effects of cervical spinal cord stimulation on cerebral blood flow in the rat.
Spinal cord stimulation (SCS) is frequently used for the treatment of chronic pain. Although the mechanisms by which SCS alleviates pain are unclear, they are believed to involve changes within the dorsal horn of the spinal cord. Spinal cord stimulation has also been found to cause significant vasodilation in the peripheral vasculature. The mechanisms underlying this effect are thought to involve sympathetic blockade. A rostral vasodilatory effect has also been described, but changes in cerebral blood flow (CBF) have been poorly delineated. Using laser Doppler flowmetry (LDF), the authors examined the effects of cervical SCS on CBF in rats. ⋯ These results indicate that cervical SCS may induce cerebral vasodilation and that this effect may involve indirect effects on vasomotor centers in the brainstem as well as an alteration in sympathetic tone.