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ABSTRACT: The aim of this study is to determine the effects of a strong dithiol antioxidant, alpha lipoic acid (ALA) on cerebral vasospasm following subarachnoid hemorrhage in a rabbit model. MATERIAL and
Twenty-one New Zealand white rabbits were assigned to one of three groups: group 1 (control), group 2 (SAH only), group 3 (SAH+ALA). ALA was administered (100 mg/kg/day, single dose, intraperitoneally). The rabbits were sacrificed 72 hours after SAH. The basilar artery lumen areas, arterial wall thickness and endothelial apoptosis in a cross section of basilar artery were measured in all groups. The tissue MDA, SOD, GSH-Px levels were also determined.
The elevated tissue MDA levels after SAH were significantly reduced by ALA treatment. The reduced tissue SOD and GSH-Px levels after SAH were also elevated by ALA treatment. In the treatment group the average wall thickness and the mean percentages of apoptotic cells (apoptotic index) were reduced and the average cross-sectional areas of the basilar artery were increased statistically significantly.
ALA treatment attenuates the severity of cerebral vasospasm by its strong antioxidant, antivasospastic and antiapoptotic properties. ALA may potentially serve as agents in the prevention of cerebral vasospasm after SAH.
Turkish neurosurgery 01/2011; 21(4):527-33. · 0.62 Impact Factor
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ABSTRACT: Vasospasm is an important cause of morbidity and mortality with subarachnoid hemorrhage (SAH). The effect of intraperitoneal administration of selenium, which is an antioxidant on cerebral vasospasm was investigated in an experimental model. By means of intracisternal blood injection model, SAH was induced in 24 rabbits, which were randomly divided into 3 groups (group 1= control group, group 2=SAH alone group, and group 3=SAH plus selenium group). Basilar artery angiography was performed on day 0 and day 3 as described. Intraperitoneal selenium (0.05 mg/kg) treatment was started after the induction of SAH and administered once a day. Three days later, the animals were killed and the basilar artery was examined histologically for the luminal diameter and thickness of the arterial muscular wall. The mean values for the measurements of angiographic luminal diameter, pathologic luminal area, muscular wall thickness derived from the blind observer were analyzed statistically. There was no statistically significant difference in basal angiographic luminal diameter evaluation between groups 1-2-3 (P>0.005). But in third day angiography; comparison of group 2 and group 1-3 showed statistically significant differences (P<0.001). In pathologic investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between groups 1, 2, and 3 (P<0.005). Intraperitoneal selenium treatment was found effective by increasing the angiographic diameter; pathologic luminal area and reducing muscular wall thickness measurements. This is the first study to show that intraperitoneal administration of selenium is effective in preventing vasospasm after SAH in rabbits.
Journal of neurosurgical anesthesiology 09/2009; 22(1):53-8. · 2.41 Impact Factor
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ABSTRACT: Although subarachnoid hemorrhage (SAH) serves as a good model to study heart-brain interactions, neither the changes on the single ventricular action potential (SVAP) and contraction nor the effects of possible cardioprotective agents have been investigated.
A total of 18 male rabbits were used for the three experimental groups. SAH was induced by replacing the cerebrospinal fluid (CSF) with fresh autologous blood at the ratio of 1 mL to the 1-kg body mass (N = 6). In the control (CON; N = 6) group, the CSF was replaced with serum physiologic at the same ratio. The treated SAH group (SAH+NAC) received daily intraperitoneal N-acetylcysteine (NAC; 150 mg/kg for 3 days) starting from just before SAH was induced by CSF replacement. On the fourth day, animals were examined for the single action potential and contraction recordings from the left ventricular papillary muscle.
At the end of 3 days, the overshoot decreased together with increased time to reach the peak potential. Additionally, the resting membrane potential was depressed and repolarization was slowed during SVAPs. On the other hand, peak tension depressed and time to peak increased. NAC treatment, which protects infarction in the brain, prevented these pathological changes in the cardiac muscle.
SAH-induced cardiac changes can be attributed to adenosine triphosphate depletion through mitochondrial dysfunction. Pretreatment of NAC to SAH on the other hand had a positive effect on these cardiac changes. But the exact mechanism by which NAC treatment protects the cardiac muscle needs further investigation.
Journal of Interventional Cardiac Electrophysiology 05/2009; 26(2):95-100. · 1.17 Impact Factor
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ABSTRACT: We evaluated the use of a bypass between the middle meningeal artery (MMA) and P2 segment of the posterior cerebral artery (PCA) as an alternative to an external carotid artery (ECA-to-PCA) anastomosis. Five adult cadaveric heads (10 sides) were used. After a temporal craniotomy and zygomatic arch osteotomy were performed, the dura of the floor of the middle cranial fossa was separated and elevated. The MMA was dissected away from the dura until the foramen spinosum was reached. Intradurally, the carotid and sylvian cisterns were opened. After the temporal lobe was retracted, the interpeduncular and ambient cisterns were opened and the P2 segment of the PCA was exposed. The MMA trunk was transsected just before the bifurcation of its anterior and posterior branches where it passes inside the dura and over the foramen spinosum. It was anastomosed end to side with the P2 segment of the PCA. The mean caliber of the MMA trunk before its bifurcation was 2.1 +/- 0.25 mm, and the mean caliber of the P2 was 2.2 +/- 0.2 mm. The mean length of the MMA used to perform the bypass was 32 +/- 4.1 mm, and the mean length of the MMA trunk was 39.5 +/- 4.4 mm. This bypass procedure is simpler to perform than an ECA-to-P2 revascularization using long grafts. The caliber and length of the MMA trunk are suitable to provide sufficient blood flow. Furthermore, the course of the bypass is straight.
Skull Base Surgery 03/2006; 16(1):39-44. · 0.66 Impact Factor
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ABSTRACT: The authors report the case of a 53-year-old woman with monostotic fibrous dysplasia of the thoracic spine. The patient presented with a 1-month history of pain in the thoracic spinal region. En bloc resection of the lesion was successfully performed via a transthoracic approach, and a histopathological examination confirmed the diagnosis of fibrous dysplasia. At 24-month follow-up examination, pain and vertebral instability were absent. The findings in this case illustrate that, although very rare, monostotic fibrous dysplasia of the thoracic spine should be considered in the differential diagnosis of spinal tumors. Although a consensus for management of this disease has not been achieved, the authors recommend radical removal of all involved bone as well as internal fixation or bone graft-assisted fusion to achieve long-term stabilization.
Journal of Neurosurgery 05/2004; 100(4 Suppl Spine):378-81. · 2.96 Impact Factor
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ABSTRACT: An unusual case of hydatid disease is reported. Review of the pertinent literature did not reveal any hydatid disease located simultaneously in both the intracranial and submandibular glands. This is the first case with hydatid disease occurring in both locations at the same time.
The case of an 18-year-old is presented; the symptoms, findings, methods of diagnosis, and our approach for treatment are discussed; and the literature is reviewed.
The intracranial lesion was completely excised by left-sided frontoparietal craniotomy, and the mass in the right side of the submandibular gland was removed through a submandibular approach at the same session. The intact cyst was completely excised. Histological examination of both lesions confirmed the diagnosis of hydatid cyst by. Postoperative recovery was uneventful, and the patient was discharged on the seventh day.
Hydatid cyst should be suspected during the evaluation of cervical masses, particularly in endemic regions. Hydatid disease infestations are best treated with complete excision of the intact cyst.
The Laryngoscope 11/2002; 112(10):1857-60. · 1.75 Impact Factor
