No abstract

GCS score on admission, and the extent of brain injury as visualized by CT scan, seem to be the 2 most significant predictors of outcome in cranio-cerebral gunshot wounds. Patients with a GCS score of more than 8, or brain lesions limited to a single lobe of the brain, may benefit from aggressive management.

Object The authors assessed the effectiveness of percutaneous pulsed radiofrequency treatment for providing pain relief in patients with chronic low-back pain with or without lower-limb pain. Methods Data were obtained in 127 patients who had chronic low-back pain with or without lower-limb pain due to a herniated intervertebral disc or previous failed back surgery and who underwent pulsed radiofrequency treatment. Their conditions were proven by clinical features, physical examination, and imaging studies. Low-back pain was treated with pulsed radiofrequency applied to the L-2 dorsal root ganglion (DRG) and lower-limb pain was treated with pulsed radiofrequency applied to the L3–S1 DRG. Patients underwent uni- or bilateral treatment depending on whether their low-back pain was unilateral or bilateral. A visual analog scale was used to assess pain. The patients were followed up for 3 years postoperatively. Results In patients without lower-limb pain (Group A), 27 (55.10%) of 49 patients had initial improvement ≥ 50% at 3-month follow-up. At 1-year follow-up, 20 (44.44%) of 45 patients in Group A had pain relief ≥ 50%. An analysis of patients with pain relief ≥ 50% for at least 1 month showed that the greatest effect was at 3 months after treatment. In patients with low-back pain and lower-limb pain (Group B), 37 (47.44%) of 78 patients had initial improvement ≥ 50% at 3-month follow-up. At 1-year follow-up, 34 (45.95%) of 74 patients had pain relief effect ≥ 50%. An analysis of patients in Group B with pain relief ≥ 50% for at least 1 month showed that the greatest effect was at 1 month after treatment. Conclusions The results of this prospective analysis showed that treatment with pulsed radiofrequency applied at the L-2 DRG is safe and effective for treating for chronic low-back pain. Satisfactory pain relief was obtained in the majority of patients in Group A with the effect persisting for at least 3 months. The results indicate that pulsed radiofrequency provided intermediate-term relief of low-back pain. Further studies with long-term follow-up are necessary.

Neural progenitors cells are capable of promoting neurogenesis after ischemic stroke in the adult mammalian brain; however the function of these cells and their fate is still not clear. Therefore the purpose of this study investigated the relationship between neural progenitors and reactive astrocytes after middle cerebral artery occlusion (MCAO). Brain infarction was induced by occlusion of a right cerebral artery in male Wistar rats. The fate of progenitor cells and the surrounding cells was investigated by immunochemical staining for nestin, vimentin and glial fibrillary acidic protein (GFAP) positive cells at several locations. Vimentin and nestin positive cells were observed in the ipsilateral subventricular zone (SVZ), striatum, and cortex at 3 and 7 days after MCAO, but those cells were not found at 28 days after ischemia. In contrast, reactive astrocyte positive cells increased following MCAO. These reactive astrocytes induced astrocytes differentiation of progenitor cells and formed dense astroglioses surrounding the ischemic lesion. Reactive astrocytes are thought to protect the penumbra during brain ischemia. We examined which brain cell expressed nestin and GFAP in the ipsilateral co-expression at 7 days after MCAO, especially at the core of injury. These results suggest that robust reactive astrocytes after MCAO were possibly differentiation from the induced nestin-positive cells after early ischemia.

We consider this hybrid surgery to be a feasible and good alternative surgical procedure for the treatment of CTO of the internal carotid artery.