Adult cervicothoracic subpial fibrolipoma without dysraphism: An extremely rare case report.

INTRODUCTION: Spinal tumors constitute 15 % of all tumors in the central nervous system. Pain is often the initial symptom, which can be localized, nocturnal, or radiated to the arms and/or limbs. We report a rare case with a subpial lipoma in the cervicothoracic spine and review the current literature. CASE PRESENTATION: A 22-year-old female presented with the chief complaint of tetraparesis for three months before admission. Magnetic resonance imaging revealed an intradural tumor on the fifth cervical to fourth thoracic vertebrae. She underwent a laminectomy to remove the tumor completely. Histopathological examination revealed a proliferation of mature fat cells amongst fibrous connective tissue. Surrounding nerve fibers and erythrocyte-filled blood vessels were also found, suggesting a subpial fibrolipoma. Postoperatively, there was an improvement in muscle strength six weeks after surgery. Motoric strength was grade 5 for the upper extremities and grade 4 for the lower extremities. DISCUSSION: In this patient, cervicothoracic laminectomy and tumor removal were performed without instrumentation. Total tumor resection is the primary goal when removing a pathological lesion. However, this depends on the lesion's adhesion to the surrounding tissue. Therefore, partial tumor resection may be possible, given the neurological complications that can occur. CONCLUSION: Because subpial lipomas are rare, their treatment is highly specialized. An assessment of the patient's physical condition and imaging assessments can provide information about potential treatment strategies and outcomes.

The role of diphenhydramine HCl on tumor necrosis factor-α levels in wistar rats with traumatic brain injury: An in vivo study.

Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide that imposes a significant burden on both individuals and their families. Many of the symptoms experienced by patients with TBI are thought to be mediated by the neuroinflammatory process that occurs after the primary injury. Therefore, the present study aimed to determine the effect of diphenhydramine HCl (DPM) on serum levels of the inflammatory cytokine tumor necrosis factor-α (TNF-α) after TBI. Materials and methods: This was an experimental study with a pre- and post-test control group design. A total of 10 adult Wistar rats were divided into 2 groups, the DPM group and the placebo group. The effect of DPM on serum levels of TNF-α was evaluated at 30 min, 2 h, and 24 h after the induction of experimental TBI in the rats using Marmarou's weight-drop model. Results: TNF-α levels in the DPM group significantly decreased from 0 min to 24 h after TBI (p = 0.004). In the placebo group, TNF-α levels significantly increased from 0 min to 24 h after TBI (p < 0.001). Post hoc analysis found that TNF-α levels in the DPM group decreased significantly from 30 min to 2 h and from 2 h to 24 h after TBI (p = 0.019 and p = 0.005, respectively). Conclusion: The results of this study suggest that administration of DPM causes a reduction in serum levels of TNF-α, indicating that DPM has a significant anti-inflammatory effect in experimental rats after TBI.

The role of MLC901 in reducing VEGF as a vascular permeability marker in rats with spinal cord injury.

Background: Damaged neural tissue caused by SCI could induce vascular endothelial growth factor (VEGF) that can worsen the condition in the late phase by increasing vascular permeability, thus inducing tissue oedema, which can worsen the infarction. MLC 901 has been widely used in Asia for stroke patients because its mechanism is known to down-regulate VEGF levels in ischemic tissue. Methods: Ten Sprague-Dawley rats were used in this experiment. To create a severe spinal cord injury in animal models. The animals were then randomly divided into two groups. MLC 901 was given to the first group, which was the intervention group, and placebo to the second group, which was the control group. Results: This study showed a decrease in the mean VEGF mRNA expression in the group given MLC 901 compared to the control group, which had a very high mean VEGF mRNA expression starting after 1 h of administration of MLC 901 until day 14 after spinal cord injury. In addition, there was a decrease in VEGF levels in the MLC 901 group compared to the control group from 3 h after spinal cord injury (1 h after MLC 901 administration) to 14 days after spinal cord injury. Conclusion: It can be concluded that administration of MLC 901 can reduce vascular permeability, one of the mechanisms that is thought to occur is to reduce VEGF levels. MLC 901 also maintains the neuroprotective effect provided by VEGF by maintaining this level above the basal level until day 14.

Effect of erythropoietin administration on expression of mRNA brain-derived Neutrophic factor, levels of stromal cell-derived Factor-1, and neuron specific enolase in brain injury model Sprague Dawley.

BACKGROUND: Traumatic brain injury (TBI) is a complicated condition that is the primary cause of death and disability in children and young adults in developed countries. Various kinds of therapy have been carried out in the management of brain injury, one of which is the administration of erythropoietin (EPO). There are not many studies in Indonesia have proven that EPO administration is effective on parameters such as stromal cell-derived factor 1 (SDF-1), brain-derived neurotrophic factor (BDNF mRNA), and neuron-specific enolase (NSE) in brain injury patients. The purpose of this study was to see how EPO affected BDNF mRNA expression, SDF-1 serum levels, and NSE levels in experimental rats with TBI. METHODS: This study was conducted using a rat head injury model. Fifteen rats were randomly assigned to one of three groups: A, B, or C. EPO was administered subcutis with a dose of 30.000 U/kg. Blood samples were taken after brain injury (H0), 12 h (H12), and 24 h (H24) after brain injury. Serum level of SDF-1 and NSE were measured using mRNA BDNF gene expression was measured with Real-Time-PCR, and ELISA. RESULTS: This study found EPO increase BDNF mRNA expression in group C at H-12 (7,92 ± 0.51 vs 6.45 ± 0.33) compared to group B, and at H-24 (9.20 ± 0.56 vs 7.22 ± 0.19); increase SDF-1 levels in group C at H-12 (7,56 ± 0,54) vs 4,62 ± 0,58) compared to group B, and at H-24 (11,32 ± 4,55 vs 2,55 ± 0,70); decrease serum NSE levels in group C at H-12 (17,25 ± 2,02 vs 29,65 ± 2,33) compare to group B and at H-24 (12,14 ± 2,61 vs 37,31 ± 2,76); the values are significantly different with p < 0,05. CONCLUSION: EPO may have neuroprotective and anti-inflammatory properties in TBI by increasing mRNA BDNF expression and serum SDF-1 levels, and decrease serum NSE levels.

Effect of folinic acid on serum homocysteine, TNFα, IL-10, and HMGB1 gene expression in head injury model.

BACKGROUND: Head injury or traumatic brain injury is the leading cause of mortality and morbidity. Many modalities of neuroprotection had been developed in brain injury but there was no much information regarding folinic acid's effect on neuroinflammation associated with homocysteine, TNFα, IL-10, and HMGB1. OBJECTIVE: This study aimed to investigate whether folinic acid has improving effect on head injury model. METHOD: This study was done in the rat's head injury model using modified Marmarou weight drop model. Fifteen rats were randomized and grouped into 3 groups: Group A: Folinic acid (+), head injury (-); Group B: Folinic acid (-), head injury (+); Group C: Folinic acid (+), head injury (+). Folinic acid was administered intraperitoneally with a dose of 60 mg/m2. Blood samples were taken immediately after head injury (H0), 12 h (H12), and 24 h (H24) after head injury from the lateral vein of tail. Serum level of homocysteine, TNFα, and IL-10 were measured using ELISA, and HMGB1 gene expression was measured with Real-Time RT-PCR. RESULTS: This study found serum level of homocysteine, TNFα, IL-10 and HMGB1 gene expression were markedly increased at all time points after head injury. Significantly lower level of serum homocysteine, TNFα, IL-10 and HMGB1 gene expression were found after 24 h treatment with folinic acid in group C compared to those in group B. CONCLUSION: Folinic acid may have anti-inflammatory properties in traumatic brain injury by inhibition of serum level of homocysteine, TNFα, IL-10 and HMGB1 gene expression.

Traumatic Atlantoaxial Dislocation with Type II Odontoid Fractures: A Case Report.

BACKGROUND: Odontoid fracture frequently ensues after a cervical trauma, and most commonly at the junction between the dens and the body (type II odontoid fracture). CASE PRESENTATION: This report is focused on a 24-years-old male patient with right-sided hemiparesis, resulting from traumatic atlantoaxial dislocation with type II odontoid fracture. Cervical CT-scanning showed a spondylolisthesis of the C1-C2 complex with type II odontoid fracture, and the injury was treated using posterior reduction and internal stabilization. Therefore, hemiparesis was reduced, and during the follow-up period, our patients were disease-free. CONCLUSION: Early diagnosis and the appropriate management of atlantoaxial trauma is a possible approach towards preventing severe neurological deficits.