Aim: To present clinical, radiological, and follow-up features of 34 cases with spinal split cord malformation (SCM) treated in a tertiary referral center between April 2000 and March 2012. Methods: A total of 59 patients were treated due to SCM between April 2000 and March 2012 at the Gazi University Faculty of Medicine, Division of Pediatric Neurosurgery. Data for each patient were evaluated retrospectively, and age, sex, clinical findings, radiological findings, complications, and surgical results were recorded. Patients with a follow-up period of less than 6 months, patients harboring an open spinal dysraphism, and patients who had had their index surgery in another clinic were excluded, thus leaving a total of 34 patients for further analysis. Results: There were 19 females and 15 males ranging in age from 2 months to 15 years (mean 5.04 years). In this cohort, skin stigma was the most common reason (76.5%) to seek medical care. Of the cases, 22 (64.7%) had lumbar SCM and 12 (35.3%) had thoracic SCM. There were no cervical SCM. Twenty-one (61.8%) of the cases had type 1 SCM and 13 (38.2%) had Type 2 SCM. Of the patients, 21 (61.8%) had a detectable neurological deficit at initial evaluation. There were no differences between patients with and without a neurological deficit regarding age, sex, type, and level of SCM. Overall evaluation of patients regarding their final neurological status revealed that 16 (47.1%) patients improved, 4 (11.8%) deteriorated, and 14 (41.2%) remained stable. Conclusions: In our opinion, all patients diagnosed with either type of SCM should be surgically treated to prevent further neurological deterioration. The results of this study, together with previously published data, confirm the effectiveness and safety of surgical intervention in SCM.

Embryologic studies revealed that it is common to encounter different histological subtypes of FT pathology. However, the presence of peripheral nerve cells in the FT is important for neurosurgical practice due to the risk of sectioning a functional structure during surgery. In our analysis, we demonstrated the high frequency of PNF in FT pathology. However, since none of the patients showed any symptoms of neurologic deterioration, we considered that these fibers were probably not functional. Our findings emphasize the importance of neuromonitoring in TCS surgery. Although we consider that most of the fibers are probably not functional, neuromonitoring after surgery may prevent serious complications.

No abstract

clinicopathological condition that can lead to permanent deficit in the cord's normal motor, sensory, and autonomic functions and decrease life quality. Unfortunately, there is no known effective treatment for SCI acquired after trauma. The pathophysiological mechanism of acute SCI can be █

No abstract

ObjectiveTumor necrosis factor alpha (TNF-α) have proven effects in pathogenesis of neuroinflammation after spinal cord injury (SCI). Current study is designed to evaluate the effects of an anti-TNF-α agent, adalimumab, on spinal cord clip compression injury in rats.MethodsThirty two male adult Wistar rats were divided into four groups (sham, trauma, infliximab, and adalimumab groups) and SCI was introduced using an aneurysm clip. Animals in treatment groups received 5 mg/kg subcutaneous adalimumab and infliximab right after the trauma. Malondialdehyde (MDA) levels were studied in traumatized spinal cord tissues 72 hours after the injury as a marker of lipid peroxidation.ResultsAnimals that received anti-TNF-α agents are found to have significantly decreased MDA levels. MDA levels were significantly different between the trauma and infliximab groups (p<0.01) and trauma and adalimumab groups (p=0.022). There was no significant difference in neurological evaluation of the rats using Tarlov scale.ConclusionThese results suggest that, like infliximab, adalimumab has favorable effects on lipid peroxidation induced by spinal cord trauma in rats.

Object. The purpose of this retrospective study is to demonstrate the effectiveness of Gamma Knife radiosurgery for essential trigeminal neuralgia (TGN) and assess the long-term outcome in a cohort from Turkey. Methods. From 2004 to 2011, 93 cases of essential TGN were treated with single radiosurgery (RS). Female:male ratio was 45:48 and the mean age of the population was 57.06 years. Mean suffering time before treatment was 88.26 months. V2 + V3 was the most effected branch. 38.7% of the cases had no previous invasive procedures. Each case received doses ranging from 70 to 90 Gy in a target located at the pontine trigeminal root entry zone of the trigeminal nerve. Statistical analyses were performed to evaluate the outcome and factors leading to outcome status. Results. The median follow-up period was 28 months. Of the cases 31.2% had poor outcome related to treatment failure after single RS session. The excellent and good outcomes were achieved in 29% and 39.8% of patients, respectively. The probability of maintaining pain relief was calculated as 67% at 36 months and 58% at 72 months. The only complication encountered was facial dysesthesia and was positive in 68.8% of patients. The presence of facial dysesthesia was significantly correlated with better outcomes. In this study, no other factor was determined to have significant influence on outcome. Conclusion. RS treatment for TGN is safe and effective. A multicenter, prospective, randomized controlled trial is needed to determine a guideline for better treatment protocols.

No abstract