No abstract

Background: To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal®) on epidural fibrosis (EF) following laminectomy in rats.Materials and methods: A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal®, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF. Results:The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3. Conclusion:Intraoperative Coseal®, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.

Meningioma is one of the most common tumors in the spinal cord. Extradural and en-plaque variety of meningioma occur less frequently. A 47-year-old woman is presented with radiculopathy signs. Magnetic resonance imaging revealed a lesion from C6 through T3 vertebral levels compressing the cord both anteriorly and posteriorly. Subtotally excision was performed and histopathologic signs showed transitional type of meningioma (WHO Grade 1). Post operatively, she had good neurological recovery. Intraoperative findings point out that the en-plaque meningioma was pure extradural. Twelve cases of pure extradural en-plaque meningioma have been reported in the literature. Besides, to the best our knowledge coexistence of "en plaque" spinal epidural meningioma with meningiomas in cranial cavity has not been reported. Complete resection is mandatory to prevent recurrence. Moreover, it is considerably difficult to remove the parts of tumor over anterior of the dura without complication.

Aim: Many studies reported that the degree of tonsillar herniation does not correlate with the severity of symptoms in Chiari Malformation Type 1 patients. The aim of this study is to investigate the relationship between tonsillar herniation, Cerebrospinal Fluid (CSF) flow and Somatosensory Evoked Potentials (SEP) in Chiari Malformation Type 1 patients. Material and Method: We have retrospectively reviewed 27 patients which had Chiari Malformation at our clinic. There were 7 men (25.3%) and 20 female (74.1%) with a mean age of 38 (range 15-62) years. Results: Fourteen patients (51.9%) had tonsillar ectopia 0-5mm, 13 patients had tonsillar ectopia over 5mm (48.9%). CSF flow abnormality was found in 13 patients (48.1%) and SEP abnormality in 6 patients (22.2%). In all patients clivus, supraoccipital, cerebellum hemisphere, Mc Rae line, Twinning line lengths and tentorium Twinning angle, Welcher basal angle, Boogaard angle were measured. There was no significant difference between tonsillar ectopia degree and abnormal SEP. Six patients who had abnormal SEP also had CSF flow abnormality (p<0.05). There was a significant difference between SEP and platybasia (p<0,05). Of the 27 patients, 5 were operated. There was statistical difference between CSF flow, tonsillar ectopia, and surgery (p<0.05). Discussion: The presence of CSF flow disorder in Chiari symptomatic patients is a finding of a hypoplastic posterior fossa. CSF flow disorder was associated with tonsillar ectopia. Despite the high rate of platybasia in patients with SEP disorder, more studies should be done in the future.

Bu çalışmada, ratlarda deneysel omurilik yaralanmasında farklı dozlarda hesperidinin (HSP) oksidatif hasara karşı koruyucu etkisini histopatolojik ve biyokimyasal değerlendirmeler kullanarak araştırmayı amaçladık. Gereç ve yöntem: Çalışma 4 grup ve her grupta 10 adet Wistar albino cinsi rat olacak şekilde planlandı. Grup 1 (kontrol grubu): laminektomi yapıldı. Laminektomi sonrası üç gruba (G2, G3, G4) travma uygulandı. Grup 2 (patoloji grubu): laminektomi yapıldı ve ekstradural klip uygulandı. Grup 3 (düşük doz HSP): laminektomi yapılıp, ekstradural klip uygulandı ve tek doz düşük doz HSP intraperitoneal olarak verildi (50 mg/kg). Grup 4 (yüksek doz HSP): laminektomi yapılıp, ekstradural klip uygulandı ve tek doz yüksek doz HSP intraperitoneal olarak verildi (100 mg/kg). Nöroprotektif etkiyi değerlendirmek için alınan doku örnekleri biyokimyasal ve histopatolojik olarak incelendi. Bulgular: Travma gruplarındaki inflamatuar bulgular ve nöron sayısının morfometrik sonuçları, Grup 4'te diğer gruplara kıyasla istatiksel olarak anlamlı şekilde daha iyiydi. Klinik motor muayene ve eğik düzlem test sonuçları açısından gruplar arasında fark yoktu. Her iki tedavi grubunda (Grup3, Grup4), lipid peroksidasyonunun son ürünü olan malondialdehit anlamlı bir farklılık gözlemlenmezken (p>0,05); total antioksidan plazma seviyelerinde kontrol ve patoloji gruplarına kıyasla istatistiksel olarak anlamlı bir farklılık gözlemlendi (p:0,001). Sonuç: Sonuçlarımız, yüksek doz HSP' nin spinal kord hasarında nöronların sayısındaki azalmaya olumlu etkisi ve hafif dejenerasyon bulguları ile neuroprotektif etki sağlayabileceğini düşündürmektedir.