Intracranial aneurysm in childhood and interrupted aortic arch.

BACKGROUND: Intracranial aneurysms are very rare in children. Headache and nausea/vomiting are the most prominent clinical findings. The only effective treatment is obliteration of aneurysm by surgical or endovascular techniques. Interrupted aortic arch is also a rare, congenital cardiovascular malformation characterized by the lack of continuity between the ascending and descending thoracic aorta. Aortic interruption is an uncommon cause of intracranial aneurysm. The course of disease is lethal unless effective collateral flow develops. Long-term survival may be possible with surgical repair. METHOD: We report on a 17-year-old boy affected with interrupted aortic arch disease and associated multiple intracranial aneurysms. Both aneurysms clipped successfully. After patient had recovered, he referred to cardiovascular surgery for further treatment. CONCLUSION: Surgical or endovascular obliteration remains the main therapy for intracranial aneurysms. Accompanying systemic diseases such as interrupted aortic arch challenge the management of both diseases.

Trigeminal neuralgia associated with cerebellopontine angle lipoma in childhood.

Cerebellopontine angle lipomas are rare and more rarely associated with trigeminal neuralgia especially in childhood. Medical treatment provides relief from the pain; however, the effect may not be permanent. Surgical treatment is associated with a high morbidity rate; therefore, surgery should be considered only in intractable cases. In this article we describe the clinical course and radiological features of a 6-year-old girl with a cerebellopontine angle lipoma who presented with a 4-year history of left-side trigeminal neuralgia, especially in the mandibular area. Magnetic resonance imaging revealed an extra-axial fatty mass at the level of the 'dorsal-entry zone' of the trigeminal nerve. The pain improved with carbamazepine therapy.

A comparison of the effectiveness of waxed paper and Gore-Tex on the minimally invasive epidural fibrosis model.

STUDY DESIGN: Experimental animal study. OBJECTIVE: The authors conducted a study to determine the effectiveness of waxed paper in preventing postlaminectomy epidural fibrosis in rats. SUMMARY OF BACKGROUND DATA: Extensive epidural fibrosis after lumbar surgery may be the underlying cause in most cases of failed back surgery syndrome. Various materials have been used to prevent epidural fibrosis, but only moderate success has been shown. METHODS: Laminectomies were performed at the fourth lumbar vertebra (L-4) in 30 rats. Waxed paper or Gore-Tex was applied in a blinded fashion to the operative sites. In the control group, only the L-4 laminectomy was performed. The rats were killed 28 days after surgery. RESULTS: The extent of epidural fibrosis was evaluated by histologic analysis. There was a meaningful statistical difference among the waxed paper group and the Gore-Tex group compared with the control group, but there was no difference when the effectiveness of waxed paper was compared with that of Gore-Tex. CONCLUSIONS: In this experimental model, the waxed paper applied locally effectively reduced epidural fibrosis, completely avoided dural adherence, and induced no side effects.

Can Quercetin be an Option for Treatment of Spinal Cord Injury? An Experimental Study.

AIM: To determine the neuroprotective functions of quercetin and compare them with methylprednisolone in an experimental spinal cord injury model in rats. MATERIAL AND METHODS: Thirty male, Wistar rats were assigned to five experimental groups: sham (n=6), trauma (n=6), methylprednisolone (n=6), single dose quercetin (n=6), and multiple doses of quercetin (n=6). An aneurysm clip compression method was used to produce spinal cord injury at level T7-9 after performing a laminectomy. In the sham group, only a laminectomy was performed. Clip compression was performed to the spinal cord after laminectomy in the trauma group. For Group 3, a single dose of intraperitoneal (ip) methylprednisolone (30mg/kg) was administered after laminectomy and trauma. A single dose of ip quercet in (100mg/kg) was administered after laminectomy and trauma in Group 4. For Group 5, multiple doses of ip quercetin (100 mg/kg) were administered on the first, second, and third days after laminectomy and trauma. Spinal cord and serum samples were obtained to measure the levels of malondialdehyde (MDA), nitric oxide (NO), total antioxidant levels (TAL) at the 72nd hour. Neurofunctional examinations of all the rats according to Drummond and Moore criteria and inclined-plane tests to evaluate functional healing were performed. All rats were sacrificed via intracardiac blood depletion after the procedure. RESULTS: Quercetin and methylprednisolone both increased plasma and tissue levels of NO and MDA, and decreased TAL, with a statistically significant difference (p < 0.05). NO and MDA levels in plasma and tissue were significantly higher in the trauma group (Group 2) when compared to the sham group (Group 1), and TAL levels were significantly lower (p < 0.05). There was a statistically significant increase in the treatment group's inclined-plane test (p < 0.05), while there was no difference in motor examination evaluations. CONCLUSION: The results of this experimental study suggest that quercetin can be thought as an option of treatment in spinal cord injury.

Establishment of a primary pleomorphic xanthoastrocytoma cell line: in vitro responsiveness to some chemotherapeutics.

BACKGROUND: Anaplastic pleomorphic xanthoastrocytoma is an aggressively growing, malignant, and eventually fatal tumor of the central nervous system. Testing chemotherapeutic drug sensitivity under in vitro conditions would be a useful strategy to determine sensitive or resistant drugs for fatal brain cancers. OBJECTIVE: To establish primary cell cultures of excised tumor tissue from pleomorphic xanthoastrocytoma-bearing patients and to test their sensitivity against various anticancer chemotherapy drugs. METHODS: Prepared suspensions of the excised tumor tissue from a patient who had a recurrent grade 3 pleomorphic xanthoastrocytoma was cultured in culture dishes until cells began to grow. Immunofluorescent and immunohistochemical visualizations were performed using confocal and light microscopy. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay in comparison with ³H-thymidine incorporation assay was used to test cellular toxicity of several anticancer drugs. RESULTS: We established vigorously growing primary cells of the tumor. Drug sensitivity testing was conducted successfully. CONCLUSION: Primary cell cultures of surgically removed tumor tissues may be useful in studies of cancer biology and chemotherapeutic drug sensitivity for recurrent malignant brain tumors, particularly for anaplastic pleomorphic xanthoastrocytoma.