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J Spinal Cord Med ; 40(3): 338-345, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27814138


BACKGROUND: Diffusion tensor imaging (DTI) shows great advantage in the diagnosis of brain diseases, including cervical spinal cord (CSC) disease. This study aims to obtain the normal values of the DTI parameters for a healthy population and to establish a baseline for CSC disease diagnosis using DTI. METHODS: A total of 36 healthy adults were subjected to magnetic resonance imaging (MRI) for the entire CSC using the Siemens 3.0 T MR System. Sagittal DTI acquisition was carried out with a single-shot spin-echo echo-planar imaging (EPI) sequence along 12 non-collinear directions. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were determined at different cervical levels using a region of interest (ROI) method, following which they were correlated with parameters, like age and sex. Further, diffusion tensor tracking (DTT) was carried out to reconstruct the white matter fiber bundles of the CSC. RESULTS: The full and complete fiber bundle structure of a normal CSC was confirmed in both the T2-weighted and DTI images. The FA and ADC values were significantly negatively correlated with each other and showed strongly negative and positive correlations with age, respectively, but not with sex. Additionally, there was no significant difference between the FA and the ADC values at different cervical levels. CONCLUSION: The DTI technique can act as an important supplement to the conventional MRI technique for CSC observation. Moreover, the FA and ADC values can be used as sensitive parameters in the DTI study on the CSC by taking the effects of age into consideration.

Medula Cervical/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Adolescente , Adulto , Fatores Etários , Idoso , Medula Cervical/crescimento & desenvolvimento , Imagem de Tensor de Difusão/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
Turk Neurosurg ; 26(3): 384-288, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27161465


AIM: To investigate the variation and significance of malondialdehyde (MDA) and superoxide dismutase (SOD) in brain tissue after secondary brain injury (SBI) with seawater immersion in rats. MATERIAL AND METHODS: We randomly divided 163 male Sprague Dawley rats into 4 groups, as normal (Group A), SBI (Group B), SBI with physiological saline immersion (Group C) and SBI with seawater immersion (Group D) groups. The animal model of ischemic SBI with seawater immersion was established based on the Marmarou's model of diffuse brain injury. The water content, and the MDA and SOD contents of brain tissue were detected at 1, 3, 6, 12, 24 and 48 hours after the injury. RESULTS: Compared to group A, there were significant changes of various indicators in group D after injury at 1 hour after injury (P < 0.05). The water content and MDA contents in brain tissue were persistently elevated and significantly higher than that in groups B and C at each time phase (P < 0.05). The SOD content showed a persistent decline and was significantly lower than that in groups B and C at each time phase (P < 0.05). The SOD content was negatively correlated with the MDA content with a correlation coefficient of -0.992 (P < 0.01). CONCLUSION: The SBI with seawater immersion is faster and more serious than the simple SBI.

Química Encefálica , Lesões Encefálicas/metabolismo , Lesões Encefálicas/fisiopatologia , Imersão/fisiopatologia , Malondialdeído/metabolismo , Água do Mar , Superóxido Dismutase/metabolismo , Animais , Antioxidantes/metabolismo , Lesões Encefálicas/enzimologia , Masculino , Ratos , Ratos Sprague-Dawley , Água/metabolismo
Turk Neurosurg ; 23(4): 491-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24101269


AIM: The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. MATERIAL AND METHODS: Data from 56 patients with craniocerebral firearm injury were analyzed retrospectively for projectile types, traumatic conditions, and treatment approaches. RESULTS: 43 patients exhibited intracranial foreign body residence. Of them, 40 were subjected to complete foreign body removal and 2 to partial removal, leaving 1 without receiving removal treatment. 54 patients (96.4%) survived and 2 (3.6%) died. Of the survivors, 36 (64.3%) recovered well, 15 (26.8%) were moderately disabled, 2 (3.6%) were severely disabled, and 1 (1.8%) lapsed into vegetative state. Patients receiving debridement within 8 h after injury had a significantly higher recovery rate than those receiving such treatment after 8 h (82.1% vs. 26.7%; P < 0.001). CONCLUSION: Craniocerebral firearm injury is characterized by rapid traumatic condition development as well as serious trauma and contamination. Accurately judging the traumatic condition and the ballistic tract, performing complete debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury.

Traumatismos Craniocerebrais/cirurgia , Procedimentos Neurocirúrgicos/métodos , Ferimentos por Arma de Fogo/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/mortalidade , Desbridamento , Descompressão Cirúrgica , Feminino , Corpos Estranhos/cirurgia , Escala de Coma de Glasgow , Escala de Resultado de Glasgow , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuronavegação , Procedimentos Neurocirúrgicos/instrumentação , Admissão do Paciente , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ferimentos por Arma de Fogo/diagnóstico , Ferimentos por Arma de Fogo/mortalidade , Adulto Jovem
Exp Ther Med ; 5(4): 1057-1062, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23596471


The sphenoid sinus occupies a central location in transsphenoidal surgery (TSS). It is important to identify relevant anatomical landmarks to enter the sphenoid sinus and sellar region properly. The aim of this study was to identify anatomical landmarks and their value in single-nostril endonasal TSS. A retrospective study was performed to review 148 cases of single-nostril endonasal TSS for pituitary lesions. The structure of the nasal cavities and sphenoid sinus, the position of apertures of the sphenoid sinus and relevant arteries and the morphological characteristics of the anterior wall of the sphenoid sinus and sellar floor were observed and recorded. The important anatomical landmarks included the mucosal aperture of the sphenoid sinus, a blunt longitudinal prominence on the posterior nasal septum, the osseocartilaginous junction of the nasal septum, the 'bow sign' of the anterior wall of the sphenoid sinus, the osseous aperture and its relationship with the nutrient arteries, the bulge of the sellar floor and the carotid protuberance. These landmarks outlined a clear route to the sella turcica with an optimal view and lesser tissue damage. Although morphological variation may exist, the position of these landmarks was generally consistent. Locating the sphenoid sinus aperture is the gold standard to direct the surgical route of TSS. The 'bow sign' and the sellar bulge are critical landmarks for accurate entry into the sphenoid sinus and sella fossa, respectively.