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.

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.

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.

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.

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.

The Influence of Music on Neurosurgical Cases: A Neglected Knowledge.

BACKGROUND: The human brain can respond to and participate in music. Learning to play a musical instrument requires complex multimodal skills involving the simultaneous perception of several sensory modalities. In case of brain damage, the musician and nonmusician brains may have different capacities for reorganization and neural remapping. We aimed to investigate the effect of music on patients who had a brain tumor and/or underwent a neurosurgical procedure, comparing the recovery of those who had a musical background with those who did not. METHODS: A literature review was performed to search for any evidence on this issue. We divided the cases into two groups: as group I consisted of the nonmusician patients, while group II consisted of musicians with a neurosurgical disease. Studies were rated from 0 (no effect) to 4 (high effect). RESULTS: We found seven published studies as well as case reports. It was observed that the outcomes and quality of life of the musician group were better than those of the control groups or nonmusician patients in all of the investigated studies, but no statistical difference between musicians and nonmusicians was found. CONCLUSION: Music-related structural changes in the brain may occur in musicians. However with limited number of cases, it cannot be assorted the improved recovery in musicians after neurosurgical disease or procedures by his or her enhanced plasticity. There are limited number of cases, for that reason, it cannot be assorted the improved recovery in musicians after neurosurgical disease or procedures by his or her enhanced plasticity. Professional musicians, who are making a living through their musical abilities, may also have a strong motivation to undergo stressful and enduring rehabilitation. An early restart of the musical activity in musicians with neurosurgical disease may lead to better outcomes, better quality of life, and better psychological parameters, in a shorter time than in nonmusicians.

Recrudescence of the syringomyelia after surgery of Chiari malformation type 1 with duraplasty.

Background: Few case reports describe an increase in the size of syringomyelia and the worsening of neurologic symptoms after surgery for foramen magnum decompression. We report three such cases.Material and method: Retrospective review of patients with Chiari malformation (CM) and syringomyelia operated at the Erzurum Regional Hospital, Department of Neurosurgery between 1 January 2008 and 18 June 2018.Results: A total of 118 patients were operated during the study period. Of the 118 patients, 81 were females, 37 were males. Ages range between 4 and 82 years, mean 38 years. Cervical or thoracic syringomyelia was found in 81 patients. Decompressive surgery with duraplasty was performed in all patients, and the patients were followed at least 2 years. The syrinx was the same or smaller in volume in 74 patients postoperatively, however, in three patients (3.7% of all patients with syringomyelia), the syrinx increased in volume.Conclusions: In this study, it was observed that an improvement or resolution of syringomyelia in 74 patients (91.3%) after decompression. There were no changes in the cavity in 4 and increased size in 3.

Interesting different survival status of musicians with malignant cerebral tumors.

Introduction: The education of a musician may have an effect on the neuronal functions and organization of the brain, promote brain plasticity, resulting in functional and structural changes. A variety of malign cerebral tumors have affected the musician, instrumentalist or singer, at some time during their lives. No comprehensive investigation for musicians with malignant tumors has been performed yet. The aims of the study are to investigate if there is a relationship between the performed music style (classic or pop/rock) and the malignancy of the tumor.Patients and methods: The key words were 'neurosurgery and music' and the names of composers. We used digital catalogs like 'Pubmed' as well as the libraries of universities. We investigated a list of people with brain tumors from the English Wikipedia. (https://en.wikipedia.org/wiki/List_of_people_with_brain_tumors).We divided musicians into two groups according to their performing of classic or rock-pop music, and their gender.Results: We found 27 classic and rock/pop musicians who suffered from malign cerebral tumors. The median survival time estimations were 18 (mean 22.33, 95% CI ranged from 7.49 to 37.17) months for pop-rock musicians and 8 (mean 8.67, 95% CI ranged from 4.13 to 12.19) months for classical music performers. However, in Cox regression analysis, performed classical music type was associated with an increased risk of early death, lesser survival time age associated with an adjusted hazard ratio (aHR) of 1.06 [95% confidence interval (CI) 1.020 to 1.111; p = .004),Conclusion: In musicians with malign cerebral tumors, music type performed by musician may affect the survival status, classical musicians have a worse outcome than rock-pop musicians.

New Histopathologic Evidence for the Parasympathetic Innervation of the Kidney and the Mechanism of Hypertension Following Subarachnoid Hemorrhage.

BACKGROUND: The Cushing response was first described in 1901. One of its components is elevated systemic blood pressure secondary to raised intracranial pressure. However, controversy still exists in its pathophysiologic mechanism. Hypertension is attributed to sympathetic overactivity and vagotomy increased renal-based hypertension. However, the role of the parasympathetic system in hypertension has not been investigated. This subject was investigated following subarachnoid hemorrhage (SAH). METHODS: A total of 24 rabbits were used: control group (n = 5), SHAM group (n = 5), and an SAH group (n = 14; bolus injection of blood into the cisterna magna). Blood pressures were examined before, during, and after the experiment. After 3 weeks, animals were decapitated under general anesthesia. Vagal nodose ganglion, axonal degeneration, and renal artery vasospasm (RAV) indexes of all animals were determined histopathologically. RESULTS: Significant degenerative changes were detected in the vagal axons and nodose ganglia following SAH in animals with severe hypertension. The mean degenerated neuron density of nodose ganglions, vasospasm index (VSI) values of renal arteries of control, SHAM, and study groups were estimated as 9.0 ±â€Š2.0 mm, 1.87 ±â€Š0.19; 65.0 ±â€Š12.0 mm, 1.91 ±â€Š0.34; and 986.0 ±â€Š112.0 mm, 2.32 ±â€Š0.89, consecutively. Blood pressure was measured as 94.0 ±â€Š10.0 mmHg in control group, 102.0 ±â€Š12.0 mmHg in SHAM; 112.0 ±â€Š14.0 mmHg in middle (n = 9); and >122.0 ±â€Š10.0 mmHg in severe RAV-developed animals (n = 5). Differences VSI values and blood pressure between groups were statistically significant (P < 0.05). CONCLUSION: The degeneration of vagal nodose ganglion has an important role in RAV and the development of RAV and hypertension following SAH.

What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?

PURPOSE/AIM OF THE STUDY: Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship. MATERIAL AND METHODS: Spectral-domain OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed. RESULTS: The mean RNFL thicknesses at the left side (91.8 µm) were significantly smaller than the right side (94.5 µm) (P = 0.040). However, the mean left sinus volume (44.5 cm) is larger than the right side, (34.5 mm) (P < 0.005). Left and right differences of both parameters are statistically significant (P < 0.05). CONCLUSION: There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes.

Water-Filled Vesicles of Choroid Plexus Tumors.

OBJECTIVE: Choroid plexus cysts are the most common neuro-epithelial cysts. METHODS: The authors describe 2 cases. The first case is a 1-year-old child presenting with hydrocephalus and cyst of the choroid plexus. The child was treated with endoscopic fenestration of the cysts. RESULTS: The histological examination of the cyst wall was consistent with choroid epithelium and water-filled vesicles. The second case is a 63 year old male with a highly vascularized tumor extending to choroid plexus. A quaductus Silvius was obstructed by the tumor. The histopathologic examination of choroid plexus showed a low number, water-vesicles. CONCLUSIONS: According to our knowledge, there are no previous reports of water-filled vesicles with choroid plexus cyst causing hydrocephalus. The first case is a good example of over secretion of cerebrospinal fluid (CSF) with the water-filled vesicle. The second case with low number of water filled vesicle shows that the cause of hydrocephalus is not over production of CSF, it is blockage of the CSF pathway in Aquaductus Silvius by the tumor itself. These 2 cases are illustrative and more importantly highlight the need to study for water-filled vesicles in these kind of cases.

Describing a New Mechanism of Retinal Detachment Secondary to Ophthalmic Artery Vasospasm Following Subarachnoid Hemorrhage: An Experimental Study.

BACKGROUND: The pterygopalatine ganglion (PPG) and ophthalmic arteries (OpAs) have important roles in ocular autoregulation and retinal and visual functions. The relationship between PPG neuron density, OpA vasospasm, and retinal detachment in subarachnoid hemorrhage (SAH) has never been studied. METHODS: This study was conducted on 25 rabbits. Five animals were in the control group (GI; n = 5), five in the sham group (GII; n = 5), and 15 in the study group (GIII; n = 15). After injection of 1 cc serum saline into the cisterna magna in the sham group, and autologous blood in the SAH group, the animals were followed for 3 weeks. All animals underwent a retinal examination five times a week for 3 weeks before and after the experiment. After the experiment, the neuron density of PPGs of the facial nerves, vasospasm index (VSI) of OpAs, and total basal surface values of the detached retinal parts (DRPs) were calculated. RESULTS: In the funduscopic examination, intravitreous hemorrhage ( Terson's syndrome) was detected in four animals in the SAH group. In the control groups, neuron density was 12,000 ± 1,240/mm3, VSI = 0.345 ± 0.076, and DRP = 0 to 1.5 mm2. Mean neuron density was 9,450 ± 940/mm3, VSI = 1.645 ± 0.940, and DRP = 6.23 ± 1.61 mm2 in the sham group (p < 0.05). Neuron density was 6,890 ± 932/mm3, VSI = 2.92 ± 0.97, and DRP = 9.43 ± 2.54 mm2 in SAH group. CONCLUSION: Mean neuron density, VSI of OpAs, and DRP values differed statistically significant between the SAH group and other groups (p < 0.005). There is an inverse relationship between PPG neurons and DRP. However, a direct relationship was observed between the mean VSI and DRP values.

The Effect of Neuroscientists on the Studies of Autonomic Nervous System Dysfunction Following Experimental Subarachnoid Hemorrhage.

OBJECTIVE: The autonomic nervous system dysfunctions following subarachnoid hemorrhage (SAH) are common in neurosurgical clinical practice. The aim of the study is to investigate the effect of Asian neuroscientists on the studies of autonomic nervous system dysfunction following experimental subarachnoid hemorrhage. METHODS: A systematic search was conducted using the MEDLINE and Web of Science databases for studies pertaining to SAH and autonomic nervous system dysfunction. The searched terms contained "experimental subarachnoid hemorrhage," "autonomic nervous system," and "Ganglion." RESULTS: There are many animal studies because the live human brain vessels cannot be used in investigations. The considerable efforts have been made to investigate the effect of SAH on the autonomic nervous system in laboratory animals. Seventy-four studies were published by various authors. Most of the articles came from Asian Countries 49 studies (66.2% of the total studies). The most preferred animals were rabbits (in 43 studies, 58.1% of the total studies). CONCLUSION: Asian neuroscientists published enormous contributions in SAH-related autonomic nervous system dysfunction. It was shown that there is a great interest of Asian neuroscientists for autonomic nervous system changes secondary to SAH.

Paradoxic Relations between Basilar Artery Reconfiguration and Superior Cervical Ganglia Ischemia After Bilateral Common Carotid Artery Ligation.

BACKGROUND: The relationship between superior cervical ganglia (SCG) ischemia due to bilateral common carotid artery ligation (BCCAL) and basilar artery (BA) reconfiguration was investigated. METHODS: Twenty-three rabbits were randomly divided into 3 groups: group III rabbits underwent BCCAL (n = 13), group II rabbits were sham-operated controls (n = 5), and group I rabbits did not undergo surgery (n = 5). Degenerated neuron densities (DND) within the SCG were correlated with the BA vasodilatation index (VDI). RESULTS: Mean live and DND in SCG of group I rabbits were 11.235 ± 982/µm3 and 11 ± 3/µm3, respectively, with a mean heart rate of 294 ± 21 beats/min. Mean SCG DND and heart rates were 213 ± 42/µm3 and 242 ± 17 beats/min for the sham group (group II) rabbits and 1743 ± 285/µm3 and 199 ± 19 beats/min for the study group (group III) rabbits, respectively. The BA VDI values in the sham group (group II) (1.32 ± 0.10) and the study group (group III) (0.976 ± 0.112) significantly differed from those in the control group (group I) (1.65 ± 0.12; P < 0.005) versus the sham group (group II) (P < 0.0001) versus the BCCAL applied group (group III) and between group II and group III (P < 0.005). CONCLUSIONS: A meaningful and paradoxic correlation was detected between the BA VDI values and degenerated neuron density of SCG after BCCAL. Although a low degenerated neuron density within SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation with steno-occlusive carotid artery diseases, a high degenerated neuron density may cause dangerous vasodilatation of BA.

Analyzing of dark past and bright present of neurosurgical history with a picture of musicians.

AIM: Currently, neurosurgery has gone through moments of great renewal, however, in the first half of the 20th century, unwanted outcome after surgical approach had occurred. The aim of this historical overview of a picture of the musicians is to show the development of Neurosurgery in 20 century. METHODS: History of neurosurgery in the first half of the 20th century and the current was investigated through PubMed. A brief tour of some of the major landmarks of contemporary neurosurgery was also made. RESULTS: A musician picture was found which taken in 1928. Two of the musicians suffered neurosurgical disorder, and operated in 1937, both immediately died without gaining conscious at early postoperative period. CONCLUSION: We described the role of neurosurgery in the lives of two famous musicians, George Gershwin and Maurice Ravel. A picture taken 1928, shows the developing of Neurosurgery from first half of 20th century to current.