Lipoblastoma of scalp in a 4-month-old patient: an extremely rare case report and review of the literature.

Lipoblastoma is a rare benign tumor originating from adipose tissue, usually seen in infancy and early childhood. Here, we present a case of scalp lipoblastoma in a 4-month-old that we treated surgically and review the literature. Although lipoblastomas may be seen in various locations during infancy and early childhood, rarely, they can also develop in the scalp.

A comparison of the type IX collagen levels of the intervertebral disc materials in diabetic and non-diabetic patients who treated with lumbar microdiscectomy.

PURPOSE: The purpose of this study was to compare type IX collagen levels in the intervertebral disc (IVD) materials of diabetic and non-diabetic patients with lumbar disc herniation and to determine whether there is a relationship between diabetes mellitus (DM) and type IX collagen levels in degenerated discs. METHODS: Overall, 30 non-diabetic patients and 30 type II diabetic patients who underwent lumbar microdiscectomy were included in this study. All patients underwent lumbar microdiscectomy, and IVD samples were obtained during the surgery. Deparaffinization, macroscopic digestion, and staining procedures were performed immunohistochemically. Fractional area stained, staining intensity, and total staining score were graded semi-quantitatively. The results were evaluated within a 95% confidence interval, and significance was evaluated as bidirectional at 0.05 and 0.01 significance levels. RESULTS: The type IX collagen staining intensities and fractional area stained were lower in the diabetic group than those in the non-diabetic group (p = 0.001). The total immunoreactivity staining scores of type IX collagen in the diabetic group were statistically lower at higher significance levels than the total immunoreactivity staining scores of type IX collagen in the non-diabetic group (p = 0.001). The duration of DM of the patients with DM was increased, the total immunoreactivity staining score of type IX collagen was decreased (p = 0.001). CONCLUSIONS: Diabetes reduces the type IX collagen level in the intervertebral disc and the duration of diabetes is the most important factor for this reduction. Diabetes may play a role in the development of disc herniation by reducing type IX collagen levels in the intervertebral disc. However, the causes of increased herniation in diabetic patients still have to be determined.

Ventriculoperitoneal shunt malfunction caused by fractures and disconnections over 10 years of follow-up.

PURPOSE: We have discussed the diagnosis and treatment approaches in patients with discontinued (disconnected or fractured) ventriculoperitoneal (VP) shunts that caused mechanical dysfunction. METHODS: Between 2006 and 2016, VP shunt surgery was performed on 1357 pediatric patients in our clinic. In follow-up examinations, we retrospectively reviewed patients who underwent revision surgery. Except for diagnosis of discontinued VP shunt, by excluding revision-surgery patients, only those patients who underwent surgical treatment owing to discontinued (fracture or disconnection) catheter were included in the study. Age at first surgery, sex, reason for shunt discontinuity, anatomical region of pathology, time to discontinuity diagnosis after first surgery, and presence or absence of symptoms were evaluated. RESULTS: One thousand three hundred fifty-seven VP shunt surgeries were performed in total, with 305 (22.4%) patients requiring revision surgery. Of these 305 patients, after accounting for other complications like obstruction, infection, overdrainage, and so on, 25 (8.1%) patients (14 male, 11 female) required re-surgery due to discontinuity. The mean age of these patients was 5.4 ± 2.1 months during the first VP shunt surgery, and the mean age during revision surgery was 71.7 months. The mean duration until discontinuity was diagnosed was 66.3 ± 24.1 months (76.1 months for catheter fractures and 45.6 months for disconnections (p 0.021)). CONCLUSION: Disconnection and fracture are two significant mechanical VP shunt dysfunctions and must be adequately researched and understood even during routine follow-ups. A disconnected or fractured shunt may be working and it is not safe to state that the shunt is no longer needed.

Does Ventriculoperitoneal Shunting Improve Thyroid Hormone Levels in Hydrocephalic Newborns?

OBJECTIVE/AIM: The aim of this report was to investigate the effect of ventriculoperitoneal shunt insertion for the treatment of hydrocephalus on thyroid hormones in the first 3 months of life. METHODS: Thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) levels were compared at 7 days (preoperatively) and at 30 and 90 days (postoperatively) after birth between 25 ventriculoperitoneal shunt-inserted hydrocephalic newborns and 20 healthy newborns. RESULTS: The TSH level at 7 days was higher in the hydrocephalic patient group (6.33 µIU) compared to the control group (3.76 µIU). This value was significantly decreased at 90 days in the ventriculoperitoneal shunt-inserted newborns (2.35 µIU) compared to the control group (3.33 µIU; p < 0.05). There were no significant differences between time points for fT4 and fT3 values in the patient group or for TSH, fT4, and fT3 values in the control group. CONCLUSION: We propose that a ventriculoperitoneal shunt inserted in the early period of life may have beneficial effects on thyroid hormones.

Effects of Mucuna pruriens on Free Fatty Acid Levels and Histopathological Changes in the Brains of Rats Fed a High Fructose Diet.

OBJECTIVE: To investigate free fatty acid levels and histopathological changes in the brain of rats fed a high fructose diet (HFrD) and to evaluate the effects of Mucuna pruriens, known to have antidiabetic activity, on these changes. MATERIALS AND METHODS: The study comprised 28 mature female Wistar rats. The rats were divided into 4 groups, each included 7 rats. Group 1: control; group 2: fed an HFrD; group 3: fed normal rat chow and M. pruriens; group 4: fed an HFrD and M. pruriens for 6 weeks. At the end of 6 weeks, the rats were decapitated, blood and brain tissues were obtained. Serum glucose and triglyceride levels were measured. Free fatty acid levels were measured in 1 cerebral hemisphere of each rat and histopathological changes in the other. The Mann-Whitney U test was used to compare quantitative continuous data between 2 independent groups, and the Kruskal-Wallis test was used to compare quantitative continuous data between more than 2 independent groups. RESULTS: Arachidonic acid and docosahexaenoic acid levels were significantly higher in group 2 than in group 1 (p < 0.05). Free arachidonic acid and docosahexaenoic acid levels in group 4 were significantly less than in group 2 (p < 0.05). Histopathological examination of group 2 revealed extensive gliosis, neuronal hydropic degeneration, and edema. In group 4, gliosis was much lighter than in group 2, and edema was not observed. Neuronal structures in group 4 were similar to those in group 1. CONCLUSIONS: The HFrD increased the levels of free arachidonic acid and docosahexaenoic acid probably due to membrane degradation resulting from possible oxidative stress and inflammation in the brain. The HFrD also caused extensive gliosis, neuronal hydropic degeneration, and edema. Hence, M. pruriens could have therapeutic effects on free fatty acid metabolism and local inflammatory responses in the brains of rats fed an HFrD.

The effectiveness and clinical outcomes of the Minerva cervical thoracic jacket in patients with type II odontoid fractures

Background/aim: The objective of this study was to carry out a detailed analysis and assess the outcomes for the Minerva cervical thoracic jacket (CTJ) in patients with type II odontoid fractures who could not be surgically treated. Materials and methods: Twenty-six patients for whom the Minerva CTJ was used rather than surgery for different reasons were included in the study. All patients were fitted with the Minerva CTJ within the first 24 h following diagnosis. The patients were followed 4 weeks after hospital discharge and then at 2-week intervals. Results were considered significant at P < 0.05 and a 95% confidence interval was calculated. Results: Of the 26 patients, 17 were male and 9 were female. The mean age was 49.03 years old (range: 16?86 years old). Fusion occurred in 25 of the 26 patients (P = 0.004), and the mean time to fusion was 6.8 weeks (P = 0.002). The mean length of hospital stay was 4 days and the mean follow-up period was 7.3 weeks. None of the patients had any complications due to the Minerva CTJ and the mortality rate was 0%. Conclusions: The Minerva CTJ application was a safe and cheap technique in the management of type II odontoid fractures. It had a high fusion rate and no complications.

Evaluation of Hearing Function by Auditory Brainstem Response in Newborn Patients with Hydrocephalus before and after Ventriculoperitoneal Shunt Surgery.

BACKGROUND/AIM: There is currently no objective evaluation of hearing in patients with hydrocephalus (HCP), and we could not find any study in the literature comprising a sufficient number of patients with a high level of scientific evidence. In the current study, we used the auditory brainstem response (ABR) test to assess whether hearing function in patients with HCP is altered after ventriculoperitoneal shunt surgery. METHODS: In total, 20 newborn patients with HCP (13 female, 7 male) were enrolled in this study. For each patient, ABR testing was performed at three time points: 1 day prior to the operation and on days 7 and 90 after the operation. ABRs using click stimuli of 90, 70, 50 and 30 dB nHL (normal hearing level) were achieved for V-wave latency, and I-III and I-IV interpeak latencies for both ears were recorded. Variance analysis for parametric data and Tukey's post hoc honest significant difference test were used to demonstrate the relationship between the results obtained from the different recording periods. Results were considered significant at p < 0.05, and 95% confidence intervals were calculated. RESULTS: The mean values of the ABR tests were compared between the pre- and postoperative results, which showed an increase (faster transmission) of nerve conduction velocity of 0.2 ms. The results were not statistically significant for 50 and 90 dB (p > 0.05) but were significant for 30 and 70 dB (p < 0.05). CONCLUSION: Diagnosis in hydrocephalic patients is important not only for the treatment but also for the prevention of HCP-associated complications. Early treatment appears to be promising in terms of auditory benefit. Prompt diagnosis and treatment are therefore essential as soon as possible.

Sacrococcygeal sinus angle: as a new anatomic landmark for the posterior approach of presacral lesions.

PURPOSE: We have discussed the importance of sacrococcygeal sinus angle (SSA), which is a new anatomical landmark in the surgery of presacral lesions. Because of its anatomical structure, the sacrum limits the surgical exposure like a compact barrier for the posterior surgical approach. The main aim of this paper is to explain the anatomical description and clinical importance of SSA in the surgery of presacral lesions. METHODS: Three groups were designated, consisting of ten patients in each group, as early childhood (group 1), late childhood (group 2) and adulthood (group 3). Patients were selected randomly. The degree of SSA measurement was performed between the line tangent to the anterior margin of the first sacral vertebra and the line from the promontorium to the tip of the coccyx. The measurement of SSA was performed on patients' lumbosacral magnetic resonance images. When the SSA forms a triangle via a parallel line starting from the inferior tip of the sacrum and running parallel to the ground, the area of the triangle also covers the field of view of the presacral region. In addition, the sacral region needed to be resected for maximum exposure is also within this area. RESULTS: The mean SSA was measured to be 53.9 ± 11.4° in group 1, 77.8 ± 11.2° in group 2 and 74.5 ± 12.5° in group 3. Intergroup comparisons revealed a significant difference between group 1 and the other two groups statistically. It was found that the SSA was 20° less in group 1 as compared to the other age groups (p = 0.0005). The area of a triangle is calculated using the sine area formula, and according to this formula the area of a triangle increases when the degree of the angle increases, thus comprising larger part of the sacrum. This condition requires more and wide sacral resection to obtain maximum exposure in the presacral zone. CONCLUSIONS: We have observed that the SSA is significantly smaller during early childhood compared with the other age groups. This feature provides an anatomical superiority in this age group for the posterior approach in the surgical treatment of presacral masses.

Can Behenic Acid (C22:0) Levels be a Prognostic Factor in Glial Tumors?

BACKGROUND: Inhibition of fatty acid synthase leads to apoptosis in cancers, which leads to high levels of fatty acid synthesis. This indicates that cancer cells depend on fatty acid in order to survive. In this study, we investigated whether or not there was a relationship between the glial tumor grade and free fatty acid level of tumor tissue. METHODS: Twenty patients who had high grade glial tumors and 20 patients who had low grade glial tumors, were included in the study. Tumors samples were obtained intraoperatively in order to measure the fatty acid levels. The fatty acids were studied in three groups: saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. They were analyzed with gas chromatography. RESULTS: The oleic acid, linoleic acid, eicosadienoic acid, arachidonic acid, and docosadienoic acid levels were high in the tumor tissue of low grade tumors. The myristic acid, palmitic acid, stearic acid, alpha linoleic acid, eicosenoic acid, dihomo-gamma-linolenic acid, docosahexaenoic acid, and ceramide levels were high in the tumor tissue of high grade glial tumors. However, none of these high values were statistically significant. The high values of behenic acid, a saturated fatty acid, in low grade glial tumors were statistically significant. CONCLUSION: High levels of behenic acid in patients with low grade glial tumor is important as it indicates persistence of the tissue integrity and tissue resistance. behenic acid levels can be a prognostic factor in glial tumors.Le taux d'acide béhénique (C22:0) peut-il constituer un facteur de pronostic dans les tumeurs gliales?

How innocent is corpus callosum dysgenesis?

BACKGROUND/AIMS: We aimed to investigate the relationship between corpus callosum dysgenesis (CCD) and associated asymptomatic closed spinal dysraphisms (CSDs). METHODS: 2,840 pediatric patients who were referred to our outpatient clinic between the years 2005 and 2013 with the diagnosis of microcephaly, macrocephaly, congenital hydrocephaly, epilepsy, mental-motor retardation and suspicion of intracranial mass were evaluated. Eighty-five patients were identified with a CCD by cranial magnetic resonance imaging (MRI). The 85 patients with CCD were evaluated by whole spinal vertebral MRI for possible CSD and the results were evaluated. RESULTS: 31/85 (36.4%) patients (20 males, 11 females) were detected to have radiological findings of CSD. The most common radiological finding was a low-lying conus medullaris, either alone, or as part of a multiple pathology in 26 of the 31 patients, followed by diastematomyelia in 16 of 31 cases and spinal lipoma in 4 of the 31 cases. CONCLUSION: When the neuroaxis emerges as a whole, the structures of embryological ectodermal origin and cranial and spinal structures are not independent regions from each other and thus, asymptomatic CSDs have been demonstrated to accompany CCD. In diseases of neural origin in which early diagnosis is of the utmost importance, each case with dysgenesis, diagnosed incidentally or during differential diagnosis, should be evaluated for possible CSD and should be treated with a multidisciplinary approach before any neurological deficit appears.

Safety and effectiveness of a posterior approach alone for surgical treatment of sacral-presacral tumors.

Aim: We aimed to examine the safety and effectiveness of a posterior approach alone in the surgical treatment of sacral-presacral tumors. In addition, we investigate factors that determine the selection of a posterior approach alone. Materials and Methods: Patients with sacral-presacral tumors who underwent surgery in our institution between 2007 and 2019 were examined in this study. Data regarding patient age, gender, tumor size (>6 cm and <6 cm), tumor localization (below or above S1), tumor pathology (benign or malignant), surgical approach (anterior alone, posterior alone, or combined), and extent of resection were recorded. The Spearman's correlation analyses were conducted between surgical approach and tumor size, localization, and pathology. Factors influencing the extent of resection were also examined. Results: Complete tumor resection was achieved in 18 of 20 patients. A posterior approach alone was used in 16. No strong or significant relation was detected between surgical approach and tumor size (r = 0.218; P = 0.355). There was no strong or significant relationship between surgical approach and tumor localization (r = 0.145; P = 0.541) or tumor pathology (r = 0.250; P = 0.288). Tumor size, localization, and pathology were not independent factors that determined surgical approach. The only significant independent determining factor for incomplete resection was tumor pathology (r = 0.688; P = 0.001). Conclusion: A posterior approach is safe and effective in the surgical treatment of sacral-presacral tumors independent of tumor localization, size, or pathology and is a feasible first-line treatment option.

Evaluation of BMP-2, VEGF, and Vitamin D Receptor Levels in the Ligamentum Flavum of Patients with Lumbar Spinal Stenosis and Disc Herniation.

AIM: To histopathologically evaluate and compare bone morphogenetic protein (BMP)-2, vascular endothelial growth factor (VEGF), and vitamin D receptor (VDR) levels in the ligamentum flavum (LF) of patients with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH). MATERIAL AND METHODS: Surgical specimens of the LF in 25 patients who underwent surgery for LDH and 25 patients who underwent surgery for LSS were examined histopathologically. The prevalence and severity of BMP-2, VEGF, and VDR immunoreactivity were evaluated to create histoscores (prevalence × severity), which were compared between groups. RESULTS: The mean BMP-2 histoscore was similar in both groups. In the LSS group, the mean VEGF histoscore was significantly higher and the mean VDR histoscore was significantly lower. CONCLUSION: Elevated VEGF and decreased VDR levels in the LF in LSS are associated with more intense inflammation and chronic process of the disease. The prominent expression of BMP-2 in the LF in both diseases suggests that BMP-2 might be affected by inflammation regardless of chronic pressure and degeneration.

Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus and Ventriculocystostomy for Intraventricular Arachnoid Cysts.

OBJECTIVE: To evaluate and discuss the outcomes of a combination of ventriculocystostomy (VC) and endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus (HCP) due to ventricular/cisternal arachnoid cysts, and only ETV for obstructive HCP due to different etiologies. METHODS: We retrospectively reviewed all 40 symptomatic patients (aged 4 months - 61 years) of obstructive HCP treated by ETV or VC+ETV during October 2014 - April 2019. VC+ETV was performed in 7 patients with intraventricular/cisternal arachnoid cyst and obstructive HCP. Only ETV was performed in 33 patients with obstructive HCP due to other etiologies. RESULTS: Successful ETV or VC+ETV surgery was performed in 35 patients. The procedure failed in 5 patients aged 90 percentile at the time of surgery. Another 5 patients aged 90 percentile).

Low back pain and sciatica related with the premenstrual period in patients with lumbar disc herniation.

AIM: We examined the clinical progress of low back pain and radicular pain during the premenstrual period in patients with lumbar disc protrusion and discussed the probable effective physiopathological mechanisms and laboratory results reported in the literature. MATERIAL AND METHODS: Fifty female patients with complaints of low back and leg pain, and with lumbar disc protrusion in their MRI investigations were included in the study. The pain was assessed using the modified "Low Back Outcome Scale of Greenough and Fraser" in the premenstrual and the normal postmenstrual periods. RESULTS: There was an increase in the use of analgesic drugs and the need for rest during the premenstrual period (p < 0.05). The severity of pain was significantly different between the two periods and it was more severe at the premenstrual period (p < 0.05). CONCLUSION: All the criteria that we chose from the modified "Low Back Outcome Scale of Greenough and Fraser" to assess the pain showed a significant difference between the premenstrual period and the normal period in our patients. This difference should be considered in the treatment strategies in the clinical setting. Patients should be re-evaluated for surgical decisions after the premenstrual period if possible.

Efects of melatonin and octreotide on peridural fibrosis in an animal model of laminectomy.

AIM: To investigate the effects of melatonin and octreotide in the prevention of peridural fibrosis in an experimental rat model. MATERIAL AND METHODS: A total of 36 rats were divided into three groups: Group I was laminectomized and not given any treatment. Group II received an intraperitoneal 30 microg/kg/day dose of octreotide for six weeks after the laminectomy. Group III rats were injected with melatonin 7.5 mg/kg/day for six weeks after the laminectomy. At the end of six weeks, plasma transforming growth factor beta-1 levels and peridural fibrous tissue hydroxyproline concentrations were determined and histopathological examinations was performed. RESULTS: Serum TGF-Beta1 levels of the octreotide and melatonin groups were found to be lower than the control group. The lower levels of TGF-Beta1 was statistically significant in both of the groups. Hydroxyproline levels of the octreotide and melatonin groups were found to be lower than that of the control group. The decrease was statistically significant only in the melatonin group. Peridural fibrosis scores of the octreotide and melatonin groups were lower than the control group. This histopathological improvement was statistically significant only in the melatonin group. CONCLUSION: Melatonin and octreotide prevented TGF-Beta1 increase in peridural fibrosis, but only melatonin significantly improved hyroxyproline levels and fibrosis scores as demonstrated.

Investigating a correlation between the results of transcranial Doppler and the level of nerve growth factor in cerebrospinal fluid of hydrocephalic infants: clinical study.

OBJECTIVE: In this study, the correlation between the level of nerve growth factor (NGF) in cerebrospinal fluid (CSF) and transcranial Doppler (TCD) results has been investigated during preoperative and postoperative periods of hydrocephalic infants. METHODS: In the study, 27 patients (11 males and 16 females, aged 0-6 months) with congenital hydrocephalus were studied. CSF levels were obtained from the patients preoperatively and on postoperative days 3 and 30, and TCD was applied. The level of NGF was investigated in CSF by the ELISA method. The pulsatility index (PI) and resistive index (RI) were examined in the right middle cerebral artery by TCD. RESULTS: The mean NGF level (0.27 +/- 0.48 ng/ml) on the 3rd (NGF3) postoperative day was observed to be higher than the preoperative mean NGF level (NGF0; 0.15 +/- 0.16 ng/ml; p < 0.05). The mean NGF level on postoperative day 30 (NGF30; 0.13 +/- 0.13 ng/ml) was lower than the mean NGF3 level (p < 0.05). While the mean PI value on postoperative day 30 (PI30; 1.06 +/- 0.068) was observed to decrease compared to the preoperative PI (PI0; 1.26 +/- 0.83) and the PI on postoperative day 3 (PI3; 1.09 +/- 0.063), the mean PI3 value exhibited a drop compared to the PI0 value (p < 0.05). Whereas the mean RI value on postoperative day 30 (RI30; 0.63 +/- 0.023) showed a decrease compared to both preoperative mean RI (RI0; 0.70 +/- 0.025) and RI on postoperative day 3 (RI3; 0.65 +/- 0.021), RI3 displayed a drop compared to RI0 (p < 0.05). CONCLUSION: In this study, no correlation was determined between preoperative and postoperative NGF levels and preoperative and postoperative RI and PI values obtained from TCD examination. However, a positive correlation was found between the following results: preoperative PI and preoperative RI (r = 0.848); PI on postoperative day 3 and RI on postoperative day 3 (r = 0.690), and PI on postoperative day 30 and RI on postoperative day 30 (r = 0.707).

Subgaleal migration of the distal catheter of a ventriculoperitoneal shunt.

Proximal migration of the distal end of a ventriculoperitoneal shunt has been observed much more rarely than other numerous shunt-related complications. Subgaleal migration of the peritoneal end is one of the samples. In the preset report we have discussed a case of subgaleal migration of the peritoneal end detected as a result of the examinations performed for shunt dysfunction. There was ventricular dilatation on CT scan of the brain. X-ray examinations confirmed proper ventricular catheter and shunt valve placement but a complete migration of distal (peritoneal) catheter into the subgaleal space. Then the patient's shunt was revised. When our case and the literature were examined, we observed that this complication was frequently encountered during the first postoperative months, in the pediatric ages and in patients with advanced hydrocephalus. Besides, we have detected that the peritoneal catheters had tendency to migration into the subgaleal tissues similar to pre-insertion forms of the preoperatively original packages.

Cranially migrated lumbar intervertebral disc herniations: A multicenter analysis with long-term outcome.

OBJECTIVE: Risk factors of cranial migration were investigated in patients with lumbar disc herniation (LDH) that migrated in the cranial direction and the long-term outcomes are discussed in this study. MATERIALS AND METHODS: Patients who underwent surgery for LDH at four different centers between 2012 and 2017 were studied. Extraligamentous discs were located in the lateral part of the posterior longitudinal ligament (PLL) within the spinal canal of the axial plane, and subligamentous discs were located under the PLL. The extent of cranial migration was calculated as a percentage of the height of the migrated corpus. Based on the extent of cranial migration, partial hemilaminectomy or hemilaminectomy was performed at different rates in each patient and the amount of laminectomy performed was recorded. During surgery, all free fragments were attempted to be removed. The appropriate technique was decided intraoperatively, and the surgery was performed on an individual patient basis. RESULTS: Of 1289 patients who underwent surgery for LDH, 654 (50.73%) had caudal migration, 576 (44.68%) had migration at the level of the disc, and 59 (4.57%) had cranial migration. Analysis of 59 patients with cranial migration according to the localization of the disc fragment revealed that 31 had extraligamentous and 28 had subligamentous fragments (P = 0.024). CONCLUSIONS: Extraligamentous intervertebral disc fragments migrate more cranially than subligamentous intervertebral fragments. The anatomy of the PLL that varies along the corpus is the main reason for the weakness of the resistance of the disc material to the dorsolateral region, direction of discrete force vectors, and orientation of the disc fragment due to torsional vertebral movements.

Effects of Intrathecal Caffeic Acid Phenethyl Ester (CAPE) on IL-6 and TNF-α Levels and Local Inflammatory Responses in Spinal Cord Injuries.

AIM: To investigate the effects of intrathecal caffeic acid phenethyl ester (CAPE) on tissue and serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-?) levels following spinal cord injury (SCI) as well as its effects on edema and microhemorrhage. MATERIAL AND METHODS: Forty rats were divided into four groups. The sham group underwent single-level laminectomy and then received an intrathecal injection of isotonic saline. The control group received an intrathecal injection of isotonic saline following SCI induction. The methylprednisolone (MP) group received a single dose of MP intrathecally following SCI. The CAPE group received a single dose of CAPE intrathecally following SCI. IL-6 and TNF-? levels were determined using the enzyme-linked immunosorbent assay (ELISA) method. Spinal cord samples were evaluated histopathologically. RESULTS: The decrease in IL-6 levels in the CAPE group was significantly higher than that in the sham and control groups. However, this decrease was not as significant as that in the MP group. No significant decrease was identified in TNF-? levels. A significant decrease was observed in spinal cord edema and microhemorrhage in the CAPE group. A decrease in edema was observed in the MP group, but no effect was observed on microhemorrhage. CONCLUSION: Intrathecal CAPE administration following SCI decreases tissue and serum IL-6 levels as well as decreases spinal cord edema and microhemorrhage.