RESUMEN
There are many causes of chronic abdominal pain and abdominal protrusion. But, they are likely to be confused with diabetic thoracic polyradiculopathy. Differentiation between this self-limiting complication and abdominal herniation is important to avoid unnecessary procedure. We describe the case of 77-years-old man with 10 years history of non-insulin dependent diabetes mellitus, who was suffering from postherpetic neuralgia for 10 months and presented with a abdominal segmental paresis and protrusion. The paraspinal electromyography showed bilateral lower thoracic radiculopathy.
Asunto(s)
Humanos , Dolor Abdominal , Diabetes Mellitus , Electromiografía , Neuralgia Posherpética , Paresia , Polirradiculopatía , Radiculopatía , Estrés Psicológico , Procedimientos InnecesariosRESUMEN
BACKGROUND: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglion (SCG). The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats subjected to permanent focal cerebral ischemia. METHODS: Thirty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of three groups (control, lidocaine and ropivacaine). A brain injury was induced in all rats by middle cerebral artery occlusion with a nylon thread. The animals of the local anesthetic group received 30 microl of 2% lidocaine or 0.75% ropivacaine in the SCG. Neurologic scores were assessed 24 hours after brain injury. Brain samples were then collected. The infarct and edema ratios were measured by 2.3.5-triphenyltetrazolium chloride staining. RESULTS: There were no differences in the death rates, neurologic scores, or infarction and edema ratios between the three groups. CONCLUSIONS: These findings suggest that superior cervical sympathetic ganglion block may not influence the brain damage induced by permanent focal cerebral ischemia in rats.
Asunto(s)
Animales , Humanos , Masculino , Ratas , Amidas , Vasos Sanguíneos , Encéfalo , Lesiones Encefálicas , Isquemia Encefálica , Edema , Ganglios Simpáticos , Infarto , Infarto de la Arteria Cerebral Media , Lidocaína , Fármacos Neuroprotectores , Nylons , Ratas Sprague-Dawley , Ganglio Cervical SuperiorRESUMEN
BACKGROUND: Cerebral blood vessels are innervated by sympathetic nerves that originate in the superior cervical ganglia (SCG). This study was conducted to determine the effect of an SCG block on brain injury caused by focal cerebral ischemia/reperfusion in a rat model. METHODS: Male Sprague-Dawley rats (270-320 g) were randomly assigned to one of three groups (lidocaine, ropivacaine, and control). After brain injury induced by middle cerebral artery (MCA) occlusion/reperfusion, the animals were administered an SCG bloc that consisted of 30 microliter of 2% lidocaine or 0.75% ropivacaine, with the exception of animals in the control group, which received no treatment. Twenty four hours after brain injury was induced, neurologic scores were assessed and brain samples were collected. The infarct and edema ratios were measured, and DNA fragmented cells were counted in the frontoparietal cortex and the caudoputamen. RESULTS: No significant differences in neurologic scores or edema ratios were observed among the three groups. However, the infarct ratio was significantly lower in the ropivacaine group than in the control group (P<0.05), and the number of necrotic cells in the caudoputamen of the ropivacaine group was significantly lower than in the control group (P<0.01). Additionally, the number of necrotic and apoptotic cells in theropivacaine group were significantly lower than inthe control group in both the caudoputamen and the frontoparietal cortex (P<0.05). CONCLUSIONS: Brain injury induced by focal cerebral ischemia/reperfusion was reduced by an SCG block using local anesthetics. This finding suggests that a cervical sympathetic block could be considered as another treatment option for the treatment of cerebral vascular diseases.