Effects of clotrimazole on experimental spinal cord injury.

BACKGROUND: We examined a possible neuroprotective effect of clotrimazole on spinal cord clip compression injury. METHODS: Rivlin and Tator's acute extradural clip compression injury (CCI) model was used for producing SCI on 24 albino Wistar rats weighing 180-250 g. All rats were anesthetized with 30 mg/kg ketamine HCl intraperitoneally and were breathing spontaneously without tracheal intubation. Total laminectomy of T8-T12 was performed on all rats under operation microscope, and CCI was performed on all rats (expect those in group 1) with a 50-g closing force aneurysm clip for 1 min. Three hours later, all of the rats were killed with sodium pentobarbital. Spinal cords were excised for a length of 2 cm; 1 cm rostrally and caudally to the injury site and deep frozen at -76 degrees C for biochemical studies. RESULTS: Treatment with clotrimazole decreased MDA levels in rats with SCI with a statistically significant difference. CONCLUSIONS: To our knowledge, this the first study that shows the effects of clotrimazole on spinal cord clip compression injury. Clotrimazole was found to be effective on spinal cord clip compression injury, but further investigations are mandatory.

Ruptured chronic encapsulated intracerebral hematoma in infancy: review of the literature with a case report.

OBJECTIVES: We report a case of a 2-month-old boy with chronic encapsulated intracerebral hematoma (EICH) and discuss clinical, radiological and pathological features of the case. CONCLUSIONS: Chronic EICH in infants is extremely rare in the literature. Only two cases have been previously reported. One of the cases reported in the literature was supratentorial and the other was infratentorial.

Effects of citicoline on experimental spinal cord injury.

OBJECTIVE: To investigate the effects of citicoline on experimental spinal cord injury (SCI). BACKGROUND: Citicoline has been successfully used in clinical studies of head injury and cerebral infarction, but there is limited literature regarding its use in experimental SCI. STUDY DESIGN: Twenty adult Wistar rats were divided into four groups: sham, trauma, vehicle, and citicoline-treated. SCI was produced using a weight drop technique. Citicoline 300 mg/kg was given intraperitoneally, 5 minutes after the induction of trauma. The animals were sacrificed and 1 cm long samples of injured spinal cord were obtained at 48 hours post-SCI. Lipid peroxidation was estimated by the thiobarbituric acid test. Neurological examinations were performed using a previously described grading scale. RESULTS: Measures of lipid peroxidation and motor scores of the citicoline-treated group were significantly lower than those in the other injury groups. CONCLUSIONS: Citicoline attenuated lipid peroxidation after SCI and improved the motor scores. Further investigations will be required to determine the long-term effects of this drug on spinal cord injury.

Giant cranial extradural primary fibroxanthoma: a case report.

Primary fibroxanthoma of the cranium is an extremely rare condition. Xanthomatous tumors of the central nervous system are occasionally associated with diseases such as Hand-Schuler-Christian disease, malignant fibrous histiocytoma, hyperlipidemia, and a complication of metabolic or storage disorders. However, until 2003, only a few cases of primary fibroxanthoma have been reported. We report a giant fibroxanthoma destroying the lateral skull base unaccompanied by a systemic or metabolic disease.

Clinical course of spontaneous spinal epidural haematoma mimicking Guillain-Barré syndrome in a child: a case report and literature review.

We describe a 9-year-old female with thoracic epidural haematoma. The clinical course simulated Guillain-Barré syndrome (GBS) so intravenous immunoglobulin therapy was started at the paediatric clinic. Magnetic resonance imaging (MRI) 3 days after admission showed thoracic epidural haematoma between T2 and T8. An emergency laminectomy was performed and the patient's neurological symptoms began to improve immediately after surgery and she made a full recovery during the 2 weeks of follow-up. Time is a very important factor in achieving reversibility of symptoms of compressive cord lesions, such as spinal epidural haematoma, and MRI is mandatory for patients with progressive paraplegia, even though the signs and symptoms might suggest GBS.

Spontaneous thrombosis of vein of Galen aneurysmal malformation after ventriculoperitoneal shunting.

Aneurysmal dilatation of the vein of Galen (AVG) is a common finding in vascular malformations that involve the Galenic system and spontaneous thrombosis is very rare. Although the presentation of the cases may differ with the age, the mortality and morbidity is high in all age groups. Here, we present a case of AVG in a six-month-old boy. The patient underwent insertion of a ventriculoperitoneal shunt. Surveillance of the lesion with subsequent MRI revealed spontaneous thrombosis of the AVG with excellent clinical outcome. Proposed mechanisms of spontaneous thrombosis include slow flow shunts, obstruction of the venous outflow or obstruction of the feeding artery. The case is discussed with the relevant literature.

Shunt dysfunction due to calcification of a ventriculo-peritoneal shunt: a case report.

Calcification and related dysfunction of ventriculo-peritoneal shunts are rare events in neurosurgical practice. Shunt calcification causes shunt dysfunction in two ways, namely disconnection and obstruction. We present a 16-year-old girl with shunt malfunction due to disconnection secondary to calcification. The shunt tubing fractured during attempted removal and some of the remaining components, including the ventricular catheter, had to be left in situ. The shunt was revised and the patients symptoms resolved. Replacement of the calcified and perished shunt components with a new shunt is essential. Aggressive surgical manipulation for removal of the remaining shunt components is not advisable as this may increase morbidity and mortality.

The effects of tyrphostine Ag 556 on experimental spinal cord ischemia reperfusion injury.

BACKGROUND: To investigate the effects of Tyrphostin Ag 556 on spinal cord ischemia reperfusion injury. METHODS: The inhibition of tyrosine kinase may represent a novel approach in the treatment of spinal cord ischemia reperfusion injury. Recently, a family of tyrosine kinase inhibitors, the tyrphostins, has been successfully used in models of endotoxemia, peritonitis, and hypovolemic shock. MATERIALS AND METHODS: Twenty-four Wistar rats were used in the study. Rats were divided into 4 groups of 6 animals. The groups were named as sham operated group, injury group, vehicle group, and treatment group. Clamping of the abdominal aorta was performed for 45 minutes with all of the groups except sham-operated group. All of the rats were sacrificed 24 hours after the operation for biochemical and ultrastructural studies. RESULTS: Tyrphostin Ag 556 treatment was found effective on experimental spinal cord ischemia reperfusion injury. The Malondialdehyde (MDA) values of the treatment group were statistically significant lower then the other reperfusion injury groups. The histologic examination showed better cellular structure in the treatment group than the other reperfusion injury groups. The neurologic scores of the treatment group also improved after treatment. CONCLUSIONS: Tyrphostin Ag 556 alters spinal cord ischemia reperfusion injury by inhibiting protein kinases. Further investigations will be required to determine the long-term effects of this drug.

Ligamentum flavum cyst.

INTRODUCTION: Although magnetic resonance imaging (MRI) of ligamentum flavum and other spinal cysts have been well described, the role of contrast enhancement in this diagnosis has been neglected. We describe such a case and correlate the MRI findings with the histopathology. CASE REPORT: A 71-years-old woman was admitted with of neurogenic lumbar claudication. X-rays of the lumbar spine showed degenerative changes with scoliosis. Lumbar magnetic resonance imaging demonstrated a L3/4 extradural cystic mass. An L3 laminectomy was performed and the mass excised. The histopathological diagnosis was consistent with a ligamentum flavum cyst. Postoperatively, the patient's symptoms resolved completely. CONCLUSION: The possibility of a ligamentum flavum cyst should be considered whenever a hyperintense extradural mass with a peripheral hypointense rim on T2 weighted and slightly contrast enhanced peripheral rim on T1 weighted MRI is identified in a patient with degenerative changes of the lumbar spine.

Posterior epidural migration of lumbar disc fragments: report of three cases.

STUDY DESIGN: Report of three cases. OBJECTIVES: To describe a rare location of intervertebral disc migration. SUMMARY OF BACKGROUND DATA: Migration of sequestered disc fragments to the posterior extradural space is rare, and posterior migration of the free fragments causing cauda equina syndrome is exceptionally rare. METHODS: Three patients with posteriorly migrated epidural disc fragments were evaluated with radiograph, computed tomography, and magnetic resonance imaging and underwent surgery. RESULTS: All of the patients responded well to operative therapy with complete relief of symptoms. CONCLUSIONS: Early surgery should be the first choice of therapy in patients with large posteriorly migrated sequestered disc fragments, to prevent severe neurologic deficits such as cauda equina and conus medullaris syndromes.