Background: Spinal extradural arachnoid cysts are rare expanding lesions in the spinal canal. Enlargement may cause progressive signs and symptoms caused by spinal cord compression. They are associated with trauma, surgery, arachnoiditis, and neural tube defects. Most nontraumatic spinal extradural arachnoid cysts are thought to be congenital. Design: Case report and literature review. Findings: A 9-year-old boy with mild paraparesis was found to have an extradural multiloculated arachnoid cyst with fibrous septa at T4-L3 levels and anterior compression and displacement of the spinal cord. Conclusions: Definitive treatment of arachnoid cyst entails radical cyst removal and dura cleft repair. Formation of a postoperative cerebrospinal fluid fistula may require external lumbar drainage.
Spontaneous spinal epidural hematoma (SSEH) is a rare condition requiring urgent diagnosis and treatment. Patients with SSEH typically present with acute onset of severe back pain and rapidly develop signs of compression of the spinal cord. The authors present a case with spontaneous resolution of SSEH which is extremely rare. We discuss a man who presented to our clinic with mild paraparesis at the seventh day of his symptoms. He had a history of poorly controlled hypertension and hypercholestrolemia requiring an antihyperlipidemic agent and anticoagulation. His upper level of hypoesthesia was at the third thoracic segment. Cervicothoracic SSEH was diagnosed by magnetic resonance imaging. Since there was a gradual recovery of the neurological deficits beginning 12 hours after the onset of symptoms, surgery was obviated and strict bed rest, serial neurological examinations, and pain controls with opiates were instituted. The neurological deficits showed complete recovery on the 25th day of the clinical course. SSEH is rare and immediate surgical decompression is suggested. Rapid neurological deterioration followed by early and progressive neurological recovery, confirmed by radiological resolution of the lesion, may indicate nonoperative treatment.
The authors describe the key-hole laminectomy technique (KHLT) for application of syringosubarachnoid shunts. This technique was used in 29 patients with noncommunicating syringomyelia. In all cases the shunts were inserted successfully without any peri- or late postoperative complications. The late follow-up magnetic resonance examinations revealed the clear collapse of syrinx in all cases. The authors advocate use of the KHLT because it is associated with less surgery-related trauma, epidural fibrosis, infection, and spinal instability.
The clinical study consisted of 27 patients and 30 hands that were operated on with the biportal endoscopic carpal tunnel release technique between 2000 and 2002. The mean follow-up time was 28 months. The time to return to work or complete recovery was found to average 12 days. The rate of functional recovery was 93% (27 hands), and 90% of hands (26 hands) were free of symptoms at the time of publication. According to our study, we conclude that the biportal endoscopic technique is an effective method to attain patient comfort; it is a minimally invasive method with a low complication rate in experienced hands for surgical treatment of carpal tunnel syndrome. Military persons can return to work quickly, without deficits in hand skills, with the use of this technique.
Traumatic brain injury (TBI) is a common consequence of accidents, and apoptosis is now recognized as one of its important pathophysiological factors. The primary hypothesis of this study was to show the early antineuroapoptotic effects of propofol and dexmedetomidine by showing the small number of apoptotic cells after mild TBI. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Forty five rats, anesthetized with intraperitoneal 50mg/kg ketamine hydrocloride and 5mg/kg xylazine, were randomly assigned into 5 groups. Groups 1 (trauma) and 2 (no trauma) were applied propofol while Groups 3 (trauma) and 4 (no trauma) were applied dexmedetomidine. No additional anesthetics were applied to Group 5 (trauma). The mean arterial pressure (MAP), rectal temperature and blood glucose levels were monitored for 2 hours. Then, the brains of the rats were removed after sacrification and craniectomy, and the apoptotic cell analysis was done in midsagital, parasagittal and hippocampal regions. R Re es su ul lt ts s: : The median values for mean body weight, MAP, and temperature were similar(p>0.05), but glucose levels were significantly higher in Group 5 in the first 45 min (p<0.05). Among the trauma groups, the apoptotic cell number was significantly higher in Group 5 in all regions (p<0.05). In contrary, there was no significant difference in the number of apoptotic cells in any of the region in groups without trauma (Groups 2 and 4) (p>0.05). C Co on n-c cl lu us si io on n: : The number of apoptotic cells in rat brains with mild TBI, in which propofol and dexmedetomidine applied, was smaller. However, these two agents had no superiority to each other in terms of antineuroapoptotic effect. These agents were thought to be protective against the early phase brain damage. K Ke ey y W Wo or rd ds s: : Brain injuries; propofol; dexmedetomidine; apoptosis Ö ÖZ ZE ET T A Am ma aç ç: : Travmatik beyin hasarı (TBH) kazaların sık karşılaşılan bir sonucudur, ve son zamanlarda apoptozun TBH'nin önemli patofizyolojik faktörlerinden biri olduğu anlaşılmıştır. Bu çalışmanın primer hipotezi; hafif TBH sonrası propofol ve deksmedetomidinin erken antinöroapoptik etkinliğini rat beyinlerindeki düşük apoptotik hücre sayısı ile göstermekti. G Ge er re eç ç v ve e Y Yö ön n-t te em ml le er r: : İntraperitoneal 50mg/kg ketamin hidroklorür ve 5 mg/kg ksilazin ile anestetize edilen 45 rat, randomize edilerek 5 gruba ayrıldı. Grup 1 (travmalı) ve Grup 2'ye (travmasız) propofol, Grup 3 (travmalı) ve Grup 4'e (travmasız) deksmedetomidin uygulandı. Grup 5 (travmalı) ratlara ise ek anestetik kullanılmadı. Ratların iki saat süresince ortalama arter basınçları (OAB), rektal ısı ve kan glukoz seviyeleri monitörize edildi. Sakrifikasyon ve kraniektomiden sonra ratların beyinleri çıkartıldı ve midsagittal, parasagittal ve hipokampal bölgelerde apoptotik hücre analizleri yapıldı. B Bu ul lg gu ul la ar r: : Tüm ratların ortalama vücut ağırlıkları, OAB ve ısı değerleri benzer (p>0,05) iken, ilk 45 dakikada Grup 5'te glukoz seviyeleri anlamlı olarak yüks...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.