Neurological research
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Neurological research · Oct 2001
Case ReportsOsteochondroma of the cervical spine causing occipital nerve neuralgia. Case report.
Osteochondroma is a rare tumor of the cervical spine. The authors present a rare case of osteochondroma narrowing the C 1/2 foramen and causing occipital neuralgia. Complete removal of the tumor was performed with release of the pain. The literature is reviewed and etiology, diagnosis, treatment and differential diagnosis are discussed.
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Neurological research · Oct 2001
Inflammatory cytokine cascade released by leukocytes in cerebrospinal fluid after subarachnoid hemorrhage.
Subarachnoid hemorrhage (SAH) elicits an inflammatory response in the subarachnoid space, which is mediated by the release of various cytokines. To assess their involvement in post-hemorrhagic complications, we determined the source and time-course of the release of inflammatory cytokines and acute-phase proteins in cerebrospinal fluid (CSF) following SAH. Concentrations of interleukin (IL)- 1beta, IL-6, transforming growth factor-beta1 (TGF-beta1) and C-reactive protein (CRP) in CSF of 36 patients with SAH were measured by enzyme-linked immunoabsorbent assay (ELISA). ⋯ CRP levels in CSF peaked on day 2-3. The present results suggest that leukocytes induced by SAH play an important role in post-hemorrhagic inflammation in the subarachnoid space by releasing IL-6 and TGF-beta1. The CRP and TGF-beta1 levels in CSF are strongly concerned with communicating hydrocephalus after SAH.
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Neurological research · Oct 2001
Case ReportsDermatomal somatosensory evoked potential demonstration of nerve root decompression after VAX-D therapy.
Reductions in low back pain and referred leg pain associated with a diagnosis of herniated disc, degenerative disc disease or facet syndrome have previously been reported after treatment with a VAX-D table, which intermittently distracts the spine. The object of this study was to use dermatomal somatosensory evoked potentials (DSSEPs) to demonstrate lumbar root decompression following VAX-D therapy. Seven consecutive patients with a diagnosis of low back pain and unilateral or bilateral L5 or S1 radiculopathy were studied at our center. ⋯ Seventeen nerve root responses were improved, eight remained unchanged and three deteriorated. The significance of DSSEP improvement contralateral to the symptomatic leg is emphasized. Direct compression of a nerve root by a disc herniation is probably not the sole explanation for referred leg pain.
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Neurological research · Jul 2001
Extracellular levels of glucose and lactate measured by quantitative microdialysis in the human brain.
The aim of this study was to use quantitative microdialysis to estimate the true extracellular concentrations of glucose and lactate in minimally disturbed human brain. These values are important as criteria for microdialytical monitoring in critical care patients and for determining therapy. Microdialysis procedures were carried out during tumor operations, the probe being inserted distant from the site of manipulation in minimally disturbed tissue. ⋯ Glucose levels correspond with those measured by other methods in humans, allowing for the fact that our patients were anesthetised. Extracellular glucose levels were positively correlated with blood glucose values measured before the operation, and with extracellular lactate. Results confirm that extracellular glucose is zero when blood glucose is about 2 mM.
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Neurological research · Jun 2001
Microsurgical anatomy of the ophthalmic artery and the distal dural ring for the juxta-dural ring aneurysms via the pterional approach.
Microsurgical anatomy for the pterional approach was studied regarding the origin and the course of the ophthalmic artery and the distal dural ring using human cadaveric specimens, with special reference to the surrounding bony structures. In 50 human adult formalin-fixed cadaveric cerebral hemispheres and 10 block specimens of the skull base region including the ophthalmic artery and the carotid dural ring were examined under magnification using an operating microscope. The ophthalmic artery originated from the intradural portion of the internal carotid artery (ICA), except in 5% where the ophthalmic artery originated extradurally. ⋯ The ophthalmic artery was commonly taking an S-shaped course in the intradural portion and entered the optic canal over the optic strut. The distal dural ring was tightly adherent to the internal carotid artery; circumferential sectioning of the dural ring is required to mobilize the internal carotid artery. When approaching juxtadural ring ICA aneurysms via the pterional route, it is important to recognize the extradural origin, especially the trans-optic strut type, and to precisely understand the microsurgical anatomy around the dural ring.