Acta neurochirurgica. Supplement
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Intraoperative imaging technologies have improved surgical results in glioma and pituitary adenoma surgeries. With improvements and refinements 3T intraoperative MRI systems offer a potential of further improving these results. Hereby we describe the equipment and technique of a cost-effective shared-resource 3-T ultra-high field intraoperative magnetic resonance imaging system and report our continuing experience on surgical tumor resection. ⋯ Operation is performed using regular non-MRI compatible equipment and the patient is transferred to the MRI during the procedure using a custom designed floating table. Advanced sequences such as diffusion weighted and diffusion tensor imaging, MR angiography, MR venography, MR spectroscopy can be performed with no changes in the setup and result in image quality comparable to outpatient scans. The intraoperative 3-T ultra high field MRI unit with the twin room concept permits both diagnostic outpatient imaging and image guided surgery in the same setting and is a cost effective solution to afford a highly capable ioMRI system.
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Acta Neurochir. Suppl. · Jan 2011
Mechanism of action of oxygen ozone therapy in the treatment of disc herniation and low back pain.
In the low back syndrome the pain has a multifactorial origin and ozone can surprisingly display a number of beneficial effects ranging from the inhibition of inflammation, correction of ischemia and venous stasis, and finally inducing a reflex therapy effect by stimulating anti-nociceptor analgesic mechanisms. The intradiscal and intramuscular injection of oxygen-ozone is a successful approach comparable to other minimally invasive procedures, but the elucidation of the mechanisms of action remains elusive. This communication shortly reports the mechanisms of action of oxygen ozone therapy at the level of intervertebral disc and paravertebral muscles.
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Acta Neurochir. Suppl. · Jan 2011
Multiparametric characterisation of the perihemorrhagic zone in a porcine model of lobar ICH.
To describe early perihemorrhagic changes after lobar intracerebral hemorrhage (ICH) using multiparametric neuromonitoring [intracranial pressure (ICP), cerebral blood flow (CBF), tissue oxygenation (PbrO2), microdialysis (MD)]. ⋯ We established a reproducible cortical ICH model using multiparametric neuromonitoring. Subtle changes in ICP were observed. No evidence for the existence of a perihemorrhagic ischemic area was found, hypothetically because of the small hematoma size. Individual animals underwent critical PbrO2 and CBF decreases with consecutive metabolic derangement. The effect of larger hematoma volumes should be evaluated with this setup in future studies to study volume-dependent deterioration.
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Acta Neurochir. Suppl. · Jan 2011
Mucosal tolerance to brain antigens preserves endogenous TGFβ-1 and improves neurological outcomes following experimental craniotomy.
Intracranial surgery causes brain damage from cortical incisions, intraoperative hemorrhage, retraction, and electrocautery; collectively these injuries have recently been coined surgical brain injury (SBI). Inflammation following SBI contributes to neuronal damage. This study develops T-cells that are immunologically tolerant to brain antigen via the exposure of myelin basic protein (MBP) to airway mucosa. ⋯ Animals tolerized to MBP (SBI+MBP) had better postoperative neurological scores than SBI+Vehicle and SBI+OVA. SBI inhibited the cerebral expression TGFβ1 in PBS and OVA treated groups, whereas MBP treated-animals preserved preoperative levels. Mucosal tolerance to MBP leads to significant improvement in neurological outcome that is associated with the preservation of endogenous levels of brain TGFβ1.
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Acta Neurochir. Suppl. · Jan 2010
Serine protease inhibitor attenuates intracerebral hemorrhage-induced brain injury and edema formation in rat.
Our previous studies have demonstrated that thrombin plays an important role in intracerebral hemorrhage (ICH)-induced brain injury and edema formation. We, therefore, examined whether nafamostat mesilate (FUT), a serine protease inhibitor, can reduce ICH-induced brain injury. Anesthetized male Sprague-Dawley rats received an infusion of autologous whole blood (100 microL), thrombin (5U/50 microL) or type VII collagenase (0.4 U/2 microL) into the right basal ganglia, the three ICH models used in the present study. ⋯ FUT attenuated ICH-induced changes in 8-OHdG and thrombin-reduced brain edema. FUT did not increase collagenase-induced hematoma volume. FUT attenuates ICH-induced brain edema and DNA injury suggesting that serine protease inhibitor may be potential therapeutic agent for ICH.