RESUMEN
The efficacy of sodium nitroprusside in resolving cerebral vasospasm was evaluated with multicisternal injections. Twelve animals received fresh, unheparinized arterial blood via three injections (15 ml total) into the cisterna magna. Selective vertebral arteriography was performed on Day 0, and blood injections were performed on the second and third days after the first injection. On the seventh day selective arteriography was performed to evaluate the diameter of the basilar artery. In the sodium nitroprusside group, intrathecal injections of the drug were started on Day 4 and continued for two days (25 micrograms/kg/day). The diameter of the basilar artery was reduced 72.98 +/- 11.07% in control experiments. For the animals treated with intrathecal sodium nitroprusside, the mean diameter of the basilar artery was reduced 29.25 +/- 4.54%. The effect of intrathecal sodium nitroprusside on intracranial pressure (ICP), blood pressure (BP) and electrocardiogram (ECG) was also evaluated in 14 animals. There were no prominent changes in ICP, BP, or ECG when sodium nitroprusside was given intrathecally, but BP decreased and ICP and heart rate increased with intravenous doses of sodium nitroprusside. These results support the hypothesis that sodium nitroprusside administered intrathecally is an effective treatment for cerebral vasospasm.
Asunto(s)
Ataque Isquémico Transitorio/tratamiento farmacológico , Nitroprusiato/uso terapéutico , Animales , Arteria Basilar/efectos de los fármacos , Arteria Basilar/patología , Presión Sanguínea/efectos de los fármacos , Angiografía Cerebral , Enfermedad Crónica , Perros , Método Doble Ciego , Evaluación Preclínica de Medicamentos , Electrocardiografía/efectos de los fármacos , Femenino , Inyecciones Intravenosas , Inyecciones Espinales , Presión Intracraneal/efectos de los fármacos , Ataque Isquémico Transitorio/diagnóstico por imagen , Ataque Isquémico Transitorio/etiología , Masculino , Nitroprusiato/administración & dosificación , Nitroprusiato/toxicidad , Distribución Aleatoria , Hemorragia Subaracnoidea/complicaciones , Vasodilatación/efectos de los fármacosRESUMEN
In this article a 32-case series of intraspinal lipoma localized to the lumbosacral region is presented. All of the patients underwent surgery. Recent reports in the literature indicate that although these lesions show advanced and progressive neurological deficits, very good results can be achieved with surgical treatment. The advantages of computed tomography in diagnosis and the importance of early surgical intervention and postoperative rehabilitation are emphasized.
Asunto(s)
Lipoma , Neoplasias de la Columna Vertebral , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Lipoma/diagnóstico , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/cirugía , Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
An experimental technique for producing delayed cerebral vasospasm in a rabbit model is described. The basilar artery is punctured via the transclival route and angiographic verification is illustrated.
Asunto(s)
Modelos Animales de Enfermedad , Ataque Isquémico Transitorio/fisiopatología , Hemorragia Subaracnoidea/fisiopatología , Insuficiencia Vertebrobasilar/fisiopatología , Animales , Arteria Basilar/fisiopatología , Angiografía Cerebral , Femenino , Masculino , ConejosRESUMEN
Surgery of pituitary tumors has been improved by microneurosurgical methods. However, despite improvements in surgical results, pituitary tumors still continue to represent a problem and, therefore, prompt a search for new surgical techniques. Since Nd:YAG laser energy penetrates the target tissue more deeply than other instruments, its use in the para- and suprasellar region should be considered. It is well known that Visual Evoked Potential (VEP) is a sensitive and objective method for the valuation of compressive or destructive lesions in or around the optic nerve. Visual function correlates with the latency and amplitude of P100 wave in VEP. We used the Nd:YAG laser in 50 transsphenoidal operations of pituitary adenomas. Postoperative effects of the laser on visual function was evaluated by conventional neurophthalmological tests as well as VEP and was compared with preoperative values. Following surgery using Nd:YAG laser, both conventional neurophthalmological tests and VEP values improved due to decompression of optic nerves by tumor removal. In this study, we also examined anterior lobe functions and found that Nd:YAG laser does not affect these functions. Our study shows that Nd:YAG laser has no harmful effects and seems to be very helpful especially for surgery for invading hormone-active adenomas.
Asunto(s)
Adenoma/cirugía , Potenciales Evocados Visuales/fisiología , Terapia por Láser , Neoplasias Hipofisarias/cirugía , Complicaciones Posoperatorias/fisiopatología , Adenoma/fisiopatología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nervio Óptico/fisiopatología , Neoplasias Hipofisarias/fisiopatología , Tiempo de Reacción/fisiología , Vías Visuales/fisiopatologíaRESUMEN
1. Experimental chronic cerebral vasospasm induced by subarachnoid haemorrhage (SAH) in rabbits was studied in order to evaluate the efficacy of repeated i.v. infusion of Iloprost (ILO). 2. The mean diameter of the basilar artery of intact animals was calculated as 737.5 +/- 52.8 microns while this value was reduced to 237.5 +/- 22.96 microns after SAH. 3. In the ILO treated group the mean diameter of the basilar artery was significantly increased and found to be 593.75 +/- 64.0 microns. 4. No change was observed in intracranial pressure (ICP) except a slight decrease in mean arterial pressure when relatively higher doses of ILO were used. 5. These results were taken as evidence of the high therapeutic value and low side effects of ILO in the treatment of persisting cerebral vasospasm due to SAH.