Changes in retinal nerve fiber layer thickness may be the cause of post-COVID-19 headaches.

OBJECTIVE: The prevalence of post-COVID headaches is not low. The eye can be affected by this infection, but it is not clear yet what the relationship is between persistent headaches and the thickness of the retinal nerve fiber layer (RNFL) after COVID-19 infection this study aims to investigate the relationship between these subjects. METHODS: In this retrospective study, in patients who have had a persistent headache, SD-OCT analysis of RNFL was obtained, and RNLF thickness values before and after COVID-19 infection were analyzed. RESULTS: A total of 26 eyes from 13 patients (nine (69.2%) females, four (30.8%) males) with persistent headaches after COVID-19 infection were studied. The average age was 47,35 years for females and 63 years for males. The mean RNFL thickness of both eyes between before and after COVID-19 infection decreased, which was statistically significant. CONCLUSION: In this study, a correlation between headache and changes in RNLF after COVID-19 infection was found. It may have wider ramifications to look into the COVID-19-associated headache phenotype of people with a history of migraines, contributing to a more comprehensive understanding of migraine pathogenesis. This relationship can provide further insight into this infection.

First report of validation of the prognostic nutritional index in patients with subarachnoid hemorrhage undergoing endovascular occlusion or surgical clipping.

PURPOSE: The study aims to investigate the effect of prognostic nutritional index (PNI) on the outcome of patients with SAH undergone endovascular occlusion or surgical clipping. METHODS: Clinical data of consecutive patients with SAH patients who were managed in the neurosurgical department of Kanuni Research and Training Hospital in Trabzon from January 2020 to June 2022 was analyzed. The primary endpoint was early mortality in one month. The prognostic role of PNI was investigated. RESULTS: Of the 46 patients, 17 were male and 29 were female. The median age was 57.3 (33-89). the last status according to the PNI values of the patients was statistically significant (p = 0.023 < 0.=5). When the patients were divided into two groups according to Glasgow Coma Score as group 1 (the patient's GCS was lower than 12) and Group 2 (GCS score whose GCS score was between 12-15, the non-parametric Mann-Whitney U test showed a statistical significant between this two group. CONCLUSION: This study indicates that PNI was correlated with the outcome in patients with SAH. Preoperative impaired nutritional status based on PNI can be accepted as a predictor of affecting the outcome in aneurysmal SAH patients undergoing endovascular occlusion or surgical clipping.

First report of the histopathological effect of electrocautery using on the urethral taste rosea during glans penis injury by incision in rabbits.

Objective: Currently, electrocautery devices have frequently been used in penile surgical procedures. We hypothesized that electrocautery using during penile surgical procedures may harm the taste rosea and the dorsal nerve of the penis or clitoris. Methods: Eighteen young age male New Zealand rabbits were studied: five in the control (Group I, n=5), five in the penile surgery without using electrocautery (sham group, Group II, n=5), eight in the monopolar cautery (study group, Group III, n=8) groups under general anesthesia. The animals were followed for 3 weeks and sacrificed. Penile tissue-pudendal nerve root complexes and dorsal root ganglion of sacral 3 level were examined using stereological methods. The results were compared statistically. Results: The live and degenerated taste bud-like structures and degenerated neuron densities of pudendal ganglia (mean±standard deviation, n/mm3) were estimated as 198±24/mm3, 4±1/mm3, and 5±1/mm3 in Group I; 8±3/mm3, 174±21/mm3, and 24±7/mm3 in Group II; and 21±5/mm3, 137±14/mm3, and 95±12/mm3 in Group III, respectively. Neurodegeneration of taste buds and pudendal ganglia was significantly different between groups. Conclusion: Intact spinal cord and normal parasympathetic and thoracolumbar sympathetic networks are crucial for human sexual function. The present study indicates that the glans penis injury by using electrocautery may lead to pudendal ganglia degeneration. Iatrogenic damage to taste rosea and retrograde degeneration of the pudendal nerve may be the cause of sexual dysfunction responsible mechanism.

Overlooked evidence for transmission deficit of pupillary light reflex can be secondary to trigeminal nerve ganglion degeneration following subarachnoid hemorrhage; preliminary experimental study.

OBJECTIVE: Although the effect of oculomotor and cervical sympathetic networks on pupil diameter is well known; the effect of the trigeminal nerve on pupil diameter has not been investigated yet. This subject was investigated. MATERIALS AND METHODS: Five of 23 rabbits were used as a control group (GI; n = 5); 0.5 ccs saline solution into cisterna magna injected animals used as SHAM (GII; n = 5); autologous blood injected to produce SAH used as the study group (GIII; n = 13) and followed up three weeks. Light-stimulated pupil diameters were measured with an ocular tomography device before, middle, and at the end of the experiment. Considering the sclera area/pupil area ratio index (PRI) as the pupillary reaction area, we used this equation for the pupil's rush to light. Degenerated neuron densities of trigeminal ganglia and pupil diameters compared with the Mann-Whitney U test. RESULTS: The PRI, degenerated neuron density of trigeminal ganglia (n/mm3) were: (2.034 ± 0.301)/(13 ± 3) in GI; (1.678 ± 0.211)/(46 ± 9) in GII; and (0.941 ± 0.136)/(112 ± 21) in GIII. P-values between groups as: p < 0.005 in GI/GII; p < 0.0001 in GII/GIII and p < 0.00001 in GI/GIII. CONCLUSION: Light stimulates the cornea which is innervated by the trigeminal nerves. This experimental study indicates that the pupil remains mydriatic as the cornea is damaged by trigeminal ischemia following SAH and blocks the light flow.

New Evidence for Regulatory Role of Trigeminal Ganglion on the Intraocular Pressure Following Subarachnoid Hemorrhage.

BACKGROUND: Increased intraocular pressure (IOP) likely secondary to an activated oculo-trigeminal reflex network is an important issue following subarachnoid hemorrhage (SAH). The relationship between the IOP and trigeminal ganglion (TGG) following experimental SAH was investigated in this study. METHODS: Twenty-three rabbits were used in this study. Five rabbits (n = 5) were used as the control group, another 5 as the sham group (n = 5), and the remaining 13 (n = 13) as the study group. The study group was further divided into two groups of animals with mild (n = 6) and severe (n = 7) TGG degeneration. The IOP values were recorded. After 2 weeks, the animals were decapitated. The mean degenerated neuron density of TGGs was estimated by stereological methods and analyzed statistically. RESULTS: The average IOP values were 11.85, 14.12, and 21.45 mm Hg in the control (n = 5), sham (n = 5), and study (n = 13) groups, respectively. The mean degenerated neuron density was 34, 237, and 3,165 mm3 in the control, sham, and study groups, respectively. CONCLUSION: According to the findings of this study, the experimental SAH leads to changes in IOP by affecting the TGG. By predicting and preventing IOP elevation in the setting of SAH, our findings will shed light on secondary sequelae such as glaucoma and irreversible blindness.

Olfactory bulbectomy leads to prolonged induction phase of sevoflurane anesthesia in rats.

The effect of olfactory bulb lesions on the induction time of sevoflurane has never been studied. We aimed to investigate this issue. In this study, we found that the volume of olfactory bulbs and the pore of the fila olfactoria were significantly lower with the fibrosis of olfactory bulbs in animals subjected to olfactory bulbectomy. Volatile anesthetics induction times were measured in all groups. Prolonged induction was observed in olfactory bulbectomy group. It was concluded that increased induction times of sevoflurane may be due to the olfactory bulb lesion.

Interaction between Neurogenic Pulmonary Edema and Thoracic 3 DRG Degeneration Following Spinal Subarachnoid Hemorrhage: First Experimental Study.

BACKGROUND: Neurogenic pulmonary edema (NPE) following subarachnoid hemorrhage (SAH) is still one of the most catastrophic complications with high morbidity and mortality rates. Systemic sympathetic hyperactivity has been considered in the pathogenesis, but it has not been clarified. In this study, we investigate the relationship between the degeneration of the T3 dorsal root ganglion (DRG) and the development of NPE following spinal SAH. METHODS: The study was conducted on 23 rabbits. Five rabbits were used as the control group, 5 as the sham group (n = 5), and 13 as the study group. The correlation between the degenerated neuronal densities of the T3 nerve axons and neurons in the DRG and NPE scores was analyzed statistically. RESULTS: A correlation between the neuronal degeneration of the T3 nerve, its DRG, and high NPE scores was found in the study group and the sham group. Massive NPE was detected in the study group along with neural degeneration of T3 axons and ganglia. CONCLUSION: The present study indicates that NPE and pulmonary artery vasospasm can be prevented by reducing T3 DRG degeneration.

New histopathological evidence for the relationship between hydromyelia and hydrocephalus following subarachnoid hemorrhage: An experimental study.

Objectives: Subarachnoid hemorrhage (SAH) is a serious pathology with a high death and morbidity rate. There can be a relationship between hydromyelia and hydrocephalus following SAH; however, this subject has not been well investigated. Materials and Methods: Twenty-four rabbits (3 ± 0.4 years old; 4.4 ± 0.5 kg) were used in this study. Five of them were used as the control, and five of them as the SHAM group. The remaining animals (n = 14) had been used as the study group. The central canal volume values at the C1-C2 levels, ependymal cells, numbers of central canal surfaces, and Evans index values of the lateral ventricles were assessed and compared. Results: Choroid plexus edema and increased water vesicles were observed in animals with central canal dilatation. The Evans index of the brain ventricles was 0.33 ± 0.05, the mean volume of the central canal was 1.431 ± 0.043 mm3, and ependymal cells density was 5.420 ± 879/mm2 in the control group animals (n = 5); 0.35 ± 0.17, 1.190 ± 0.114 mm3, and 4.135 ± 612/mm2 in the SHAM group animals (n = 5); and 0.44 ± 0.68, 1.814 ± 0.139 mm3, and 2.512 ± 11/mm2 in the study group (n = 14). The relationship between the Evans index values, the central canal volumes, and degenerated ependymal cell densities was statistically significant (P < 0.05). Conclusions: This study showed that hydromyelia occurs following SAH-induced experimental hydrocephalus. Desquamation of ependymal cells and increased cerebrospinal fluid secretion may be responsible factors in the development of hydromyelia.

Could the Cerebral Involvement of COVID-19 Disease be Related to Microstructural Changes that are not Reflected in Conventional MRI Images?

In patients with COVID-19, neurodegeneration may develop before clinical symptoms appear. Diffusion-weighted (DW) MRI is an important technique for analyzing microstructural changes such as gliosis. In this study, a quantitative evaluation of microstructural changes in the brain with apparent diffusion coefficient (ADC) values in patients presenting with a headache after the COVID-19 disease was analyzed and compared. DW MR images of patients of 20 COVID-19 patients (13 females, 7 males) who required imaging due to headache; 20 controls (16 females, 4 males) were retrospectively reevaluated. ADC measurements were taken from 16 regions of the brain, including right and left symmetrical in patients with COVID-19 infections and control groups. All regions of interest (ROIs) were taken from the hypothalamus, parahippocampus, thalamus, corpus striatum, cingulate gyrus, occipital gyrus, dentate nucleus, and medulla oblongata posterior. ADC values in the dentate nucleus right (784.6 ± 75.7 vs. 717.25 ± 50.75), dentate nucleus left (768.05 ± 69.76 vs. 711.40 ± 52.99), right thalamus (731.15 ± 38.14 vs. 701.60 ± 43.65), left thalamus (744.05 ± 39.00 vs. 702.85 ± 28.88), right parahippocampus (789.10 ± 56.35 vs. 754.75 ± 33.78), right corpus striatum (710.00 ± 39.81 vs. 681.55 ± 39.84) were significantly higher than those in the control group. No significant changes were observed in other areas. A significant increase in ADC values at many levels in the brain in patients with COVID-19 disease and headache was observed. Thus, this study indicates that cerebral involvement in COVID-19 disease may be related to microstructural changes that are not reflected in conventional MRI images.

Posterior longitudinal ligament suturation after lumbar discectomy provides postoperative a large intradural area: First report.

Background: Stability and flexibility of the spine are provided by the posterior longitudinal ligament (PLL). It plays a key role in the pathogenesis of lumbar disc herniation (LDH) by preventing disc protrusion. The effect of the suturing of the PLL on the intradural area was investigated. Patients and Methods: The patients were included in whom lumbar microdiscectomy was performed between January 2021 and July 1, 2022. The patients were randomly divided into two groups as PLLs were sutured and unsutured. Results: Forty-six (23 males and 23 females) patients were included. The PLLs were sutured in 22 patients (Group 1) and not sutured in 24 patients (Group 2). The levels, sides of LDHs, and ages and gender of patients were also analyzed in both groups, which were not statistically significant. Preoperative mean spinal intradural areas were 77.29 mm2 for the PLL unsutured group and 85.40 mm2 for the PLL sutured group (Groups 1 and 2). For patients in Groups 1 and 2, the postoperative mean spinal intradural areas grew to 134.73 mm2 and 96.12 mm2, respectively. The difference in preoperative mean spinal intradural regions between the two groups was not statistically significant; however, Group 1 showed a substantial difference (sutured PLL patients). Conclusions: This study first time indicates that suturing PLL has a protective and supportive role in patients who were operated on for LDH.

From Nose to Lumbar Spinal Cord - Reduced Sperm Numbers Occur by Olfactory Bulbectomy-Related Onuf's Nucleus Degeneration: New Experimental Evidence for Kallmann Syndrome.

INTRODUCTION: Olfaction and its relation to human health is an area of growing interest. Although olfaction disorders have been considered a part of Kallmann syndrome, the role of olfactory dysfunction on spermatogenesis has not been studied yet. We studied if olfactory bulbectomy (OBX) causes dysfunction in spermatogenesis as a result of Onuf's nucleus damage. METHODS: Twenty-eight male rats were divided into three groups: six as the control (G-1; n = 6), six as the only frontal burr hole applied animals SHAM (G-2; n = 6), and 16 as the study group (G-3; n = 16) in which OBX was performed. The animals were followed for 2 months. After the decapitation of the animals, olfactory bulb (OB) volumes (mm3), the neuron density of the Onuf's nucleus (n/mm3), and sperm density (n/mm3) were estimated stereologically and analyzed. RESULTS: OB volumes (mm3), degenerated neuron density of Onuf's nucleus (n/mm3), and sperm numbers of control, SHAM, and study groups were estimated as: 4 ± 0.5; 6 ± 2 and 103.245 ± 10.841 in G-1; 3.5 ± 0.7; 14 ± 4 and 96.891 ± 9.569 in G-2; and 1.3 ± 0.3; 91 ± 17 and 73.561 ± 6.324 in G-3. The statistical results of degenerated neuron density of Onuf's nucleus and sperm numbers between groups are p < 0.005 for G-1/G-2; p < 0.0005 for G-2/G-3; and p < 0.00001 for G-1/G-3. DISCUSSION: This study first time indicates that Onuf's nucleus degeneration secondary to OBX seems to be responsible for reduced sperm numbers.

The Enigma of Basilar Artery Dissections Secondary to Vasospasm following Subarachnoid Hemorrhage; Exploration of the Unknown Effect of Superior Cervical Ganglia: A Preliminary Experimental Study.

BACKGROUND: Life-threatening basilar artery dissection (BAD) can be seen following subarachnoid hemorrhage (SAH), but it is not clear whether subarachnoid hemorrhage causes dissection, or not. This study aims to investigate the relationship between, degenerative changes in the superior cervical ganglia and the dissection rate of the basilar artery. MATERIAL AND METHOD: In this article, after three weeks of experimental SAH, animals were decapitated. 18 rabbits were divided into three groups, according to their vasospasm indexes. The basilar arteries were examined by anatomical and histopathological methods. RESULTS: Basilar dissection with high vasospasm index value (VSI>3) was detected in six animals (G-I, n=6); severe basilar edema and moderate vasospasm index value (VSI>2.4) in seven rabbits (G-II, n=7) and slight vasospasm (VSI<1.5) index value in five subjects (G-III, n=5) was detected. The degenerated neuron densities (n/mm3) of the superior cervical ganglia were detected as 12±4 in G-I, 41±8 in G-II; and 276±78 in G-III. The dissected surface values/lumen values were calculated as (42±1)/(64±11) in G-I; (21±6)/(89±17) in G-II; and (3±1)/(102±24) in G-III. If we look at these ratios as a percentage: 62%in G-I, 23% in G-II, and 5% in G-III. CONCLUSION: Inverse relationship between the degenerated neuron densities (n/mm3) of the superior cervical ganglia and the dissected surface values basilar artery was observed. The common knowledge is that basilar artery dissection may lead to SAH, however, this study indicates that SAH is the cause of basilar artery dissection.

Age- and gender-related radiological changes of the cervical spine: A study with largest magnetic resonance imaging database of 5672 consecutive patients.

Background: The morphological features of the cervical spine are an essential issue. This retrospective study aimed to investigate the structural and radiological changes in the cervical spine. Materials and Methods: A total of 250 patients with neck pain but no apparent cervical pathology were selected from a database of 5672 consecutive patients undergoing magnetic resonance imaging (MRI). MRIs were directly examined for cervical disc degeneration. These include Pfirrmann grade (Pg/C), cervical lordosis angle (A/CL), Atlantodental distance (ADD), the thickness of transverse ligament (T/TL), and position of cerebellar tonsils (P/CT). The measurements were taken at the positions of T1- and T2-weighted sagittal and axial MRIs. To evaluate the results, patients were divided into seven age groups (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70, and over). Results: In terms of ADD (mm), T/TL (mm), and P/CT (mm), there was no significant difference among age groups (P > 0.05). However, in terms of A/CL (degree) values, a statistically significant difference was observed among age groups (P < 0.05). Conclusions: Intervertebral disc degeneration was more severe in males than in females as age increased. For both genders, cervical lordosis, decreased significantly as age increased. T/TL, ADD, and P/CT did not significantly differ with age. The present study indicates that structural and radiological changes are possible reasons for cervical pain at advanced ages.

Important aspect of hypoglossal nerve injury following gunshot wound; Can the clivus has a role? A case report.

Cranial nerve palsies after gunshot injury are not uncommon. We report the mechanism of isolated hypoglossal nerve paralysis caused by a gunshot. We report a 74 years old patient in whom a bullet entered through the right nostril and then ended up right occipital condyle. The only neurologic deficit was tongue deviation which resolved in one week. The bullet was not removed. The effect of clival slope may have an importance in this type of injury.

Important Finding for COVID-19 Pandemic: Hydrocephalus-producing effect of Vaporized Alcohol Disinfectant.

BACKGROUND: Alcohol exposure may cause hydrocephalus, but the effect of vaporized nasal alcohol exposure on the choroid plexus, and ependymal cells, and the relationship between alcohol exposure and developing hydrocephalus are not well known. This subject was investigated. METHODS: Twenty-four male (∼380 g) Wistar rats were used in this study. The animals were divided into three groups, as the control, sham and study groups. The study group was further divided into two groups as the group exposed to low or high dose of alcohol. The choroid plexuses and intraventricular ependymal cells and ventricle volumes were assessed and compared statistically. RESULTS: Degenerated epithelial cell density of 22 ± 5, 56 ± 11, 175 ± 37, and 356 ± 85/mm3 was found in the control, sham, low alcohol exposure, and high alcohol exposure groups, respectively. The Evans index was <34% in the control group, >36% in the sham group, >40% in the group exposed to low alcohol dose (low-dose alcohol group), and >50% in the group exposed to high dose of alcohol (high-dose alcohol group). CONCLUSIONS: It was found that alcohol exposure caused choroid plexus and ependymal cell degeneration with ciliopathy and enlarged lateral ventricles or hydrocephalus. In the COVID-19 pandemic era, our findings are functionally important, because alcohol has often been used for hygiene and prevention of transmission of the Sars-Cov-2-virus.

Interesting negative correlation between transorbital optic nerve sheath diameter and Evans' index values; can it be predictive for failure of endoscopic third ventriculostomy?

Background: Currently, Endoscopic third ventriculostomy (ETV) is one of the commonly used surgical options for the treatment of non-communicating hydrocephalus but reported success rates from ETV vary considerably, and a reliable noninvasive means to detect the efficacy of ETV is still lacking. In this study, the changes in Evans's Index and the transorbital optic nerve sheath (ONSD) diameter measurement after endoscopic third ventriculostomy were compared. Methods: Preoperative and early postoperative ultrasonographic ONSD measurement and preoperative and postoperative 3 months Evans' index of patients with hydrocephalus on whom ETVs were performed between 1 February 2018 and 23 May 2022 and analyzed. Results: The chart of 8 male and 2 female patients was analyzed. Their median age at presentation was 5.3 years (range 1 - 14 years). Mean ONSD values were 5.66 mms in the preoperative period, which was decreased to a mean of 4.17 mms in the early postoperative period. The Evans' index was 0.5320 in the preoperative period; however, it decreased to 0.4460 in the postoperative 3rd months. The preoperative and early postoperative mean ONSD values and Evans' Index of patients were significantly different. Interestingly, a negative correlation was also observed between ONSD values and Evans' index. Conclusions: ONSD measurement and Evans' index have been commonly used after ETV procedures In pediatric patients with hydrocephalus. Still, there is an unexplained negative correlation between ONSD and Evans' index values. This study indicates that the two measures (Evans's index and ONSD) should be considered when performing follow-up examinations in patients after ETV.

Biomechanical analysis of odontoid and transverse atlantal ligament in humans with ponticulus posticus variation under different loading conditions: Finite element study.

PURPOSE: Ponticulus posticus (PP) is a variation of the bone bridge that appears in the first cervical vertebra and through which the vertebral artery passes. Odontoid fractures are common spinal bone fractures in older people. This study aims to investigate the effect of neck movements on the odontoid and transverse atlantal ligament (TAL) of people with PP variation from a biomechanical view. METHOD: C1, C2, and C3 vertebrae of the occipital bone were analyzed using the finite element method (FEM). In this study, solid models were created with the help of normal (N), incomplete (IC), and asymmetric complete (AC) PP tomography images. The necessary elements for the models were assigned, and the material properties were defined for the elements. As boundary conditions, models were fixed from the C3 vertebra, and 74 N loading was applied from the occipital bone. Stress and deformation values in the odontoid and transverse atlantal ligament were obtained by applying 1.8 Nm moment in flexion, extension, bending, and axial rotation directions. RESULTS: The stress and deformation values of all three models in odontoid and TAL were obtained, and numerical results were evaluated. In all models, stress and deformation values were obtained in decreasing order in rotation, bending, extension, and flexion movements. The highest stress and strain values were obtained in AC and the lowest values were obtained in N. In all movements of the three models, the stress and deformation values obtained in the TAL were lower than in the odontoid. CONCLUSION: The greatest stresses and deformations obtained in spines (AC) with PP were found in the odontoid. This may help explain the pathogenesis of odontoid fractures in older people. First, this study explains the mechanism of the formation of neck trauma in people with PP and the need for a more careful evaluation of the direction of impact. Secondly, the study reveals that the rotational motion of the neck independent of PP has more negative effects on the odontoid.

Does the anesthesia technique of cesarean section cause persistent low back pain after delivery? A retrospective analysis.

OBJECTIVE: Cesarean sections (CS) under spinal anesthesia may lead to newly developed low back pain (LBP) after anesthesia. The cause of this pain is still unknown. This subject was investigated. METHODS: The persistent LBP after the section was retrospectively analyzed in patients who were operated on under spinal or general anesthesia between January 1, 2018, and January 1, 2020. RESULT: General anesthesia was used in 52 women, but 251 women were operated on under spinal anesthesia. Newly developed persistent LBP was detected in 57 (18,8%) of a total of 303 patients. Of those patients with LBP, general anesthesia was used in 14 of 52 (26,9%) patients, but 43 of 251 (17.1%) patients received spinal anesthesia. Baby weight after CS was the only variable associated with persistent LBP after 3 and 6 months (P < 0.05) in multiple logistic regression analysis. Patient age and anesthesia type were not associated with persistent LBP (P > 0.05). CONCLUSION: This study shows anesthesia type as spinal or general was not associated with increased persistent LBP. Performing more spinal than general anesthesia in the cesarean section may be false data about the increased rate of LBP after CS.

How does the side of lumbar disc herniation influence the psoas muscle size at the L4-5 level in patients operated for unilateral hip arthroplasty?

Study Design: Retrospective studyObjection: There can be a relationship between degenerative diseases in the spine and hipSummary of Background Data: Degenerative diseases in the spine and hip may occur concomitantly. This study was done to investigate the cross-sectional area of psoas muscle size and incidence of lumbar disc herniation after unilateral hip arthroplasty.Methods: The data files of patients who were operated on for unilateral hip arthroplasty between January 2014- and 15 May 2021 at the Recep Tayyip Erdogan University Hospital were retrospectively analyzed for the relationship between the psoas muscle volume and the incidence of lumbar disc herniation. The patients were divided according to their operated sides.Results: The data files of 48 patients were retrospectively analyzed. The patients were divided into two groups according to the operated side of their hip joints. Gender and age differences were not significant, and the mean ages were 68,68 years old in the right hip arthroplasty group, and 69,39 in the left hip arthroplasty group.Conclusions: A complex interaction between the development of lumbar disc herniations and increased contralateral cross-sectional area of the psoas muscle at the L4-5 level was observed in patients operated for unilateral hip arthroplasty. This interaction can be a compensatory mechanism to counteract the spinal imbalance.

The relationship between mean platelet volume and the mortality of patient severe head trauma; first study.

BACKGROUND: Prediction of mortality in a patient with head trauma is essential. In this study, the effect of mean platelet volume (MPV) on the mortality rate of patients with severe head trauma was studied. MATERIAL AND METHODS: The relationship between mortality and mean platelet volumes of patient with cranial trauma was retrospectively analyzed. RESULTS: 43 patients with head trauma were admitted to the intensive care unit during the study period. While 17 patients died (Group I), 26 patients survived (Group II). Cox regression analysis showed that late MPV (at exitus or discharged date), WBC at admission, and age increase the mortality rate 1,770, 1,202, 1,052 times, respectively. CONCLUSIONS: The present study shows that MPV may be a useful predictor of mortality in patients with severe head trauma.