RESUMEN
Brain balance changes have been recognised in migraine, but cerebellar function between or during attacks has been assessed only in a few studies. Previous studies have indicated that migraine affects cerebellar function. In the present study we aimed to evaluate the hemicerebellar volume changes of patients with migraine without aura (MWoA). Volumetric changes of cerebellar hemispheres were evaluated in terms of asymmetry using stereological methods on magnetic resonance images (MRI) retrospectively. Nineteen patients with MWoA and 18 age- and gender-matched control subjects were included in the study. MRIs were analysed by using the point-counting approach of stereological methods by Cavalier's principle. There was no statistically significant cerebellar atrophy or hemicerebellar asymmetry between the MWoA and control subjects. There was no cerebellar atrophy or asymmetry between the MWoA and age-matched control group. The stereological evaluation of cerebellar asymmetry and atrophy in humans is important for both clinicians and anatomists. The technique is simple, inexpensive, and reliable.
Asunto(s)
Cerebelo/patología , Migraña sin Aura/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tamaño de los ÓrganosRESUMEN
Systematic sampling using the Cavalier's principle provides accurate, efficient, cheap, and simple quantitative estimates of objects within neuroanatomical structures like the cerebellum. We identified and isolated the Purkinje cell layer and used this information to extrapolate the stereological technique to estimate the total number of Purkinje cells and volume on light microscope in rabbits' cerebella. Volumes of the cell populations in the cerebellum have not been estimated previously. Using this method, we counted the Purkinje cells in the two right and three left hemicerebella of five male healthy rabbits and found the total number of Purkinje cells to have a mean of 671,597. The mean volume of the Purkinje cell was estimated at 2207 µm(3) for the entire cerebella. The contribution of the stereological method to cell quantification and volumetry was emphasised by the neuroanatomical experimental animal study. The method proved to be an excellent tool for evaluating the Purkinje cell numbers and volumes in the rabbits. The data may also support the significance of considering anatomical data when evaluating pathological changes in cerebella.
Asunto(s)
Células de Purkinje/patología , Técnicas Estereotáxicas , Animales , Masculino , Tamaño de los Órganos , ConejosRESUMEN
Comparison of entropy (state entropy [SE] and response entropy [RE]) with the bispectral index (BIS) during propofol sedation in monitored anaesthesia care (MAC) was carried out in patients undergoing hand surgery. Thirty candidates for elective hand surgery were pre-medicated with midazolam 0.06 mg/kg and atropine 0.01 mg/kg. Sedation was induced with intravenous propofol and fentanyl was also administered. The Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) was used to determine sedation level and pain was maintained at < 4 on a 0 - 10 verbal rating scale. The BIS, entropy, MOAA/S and pain values were recorded before initiation of sedation (control), during initiation of sedation, during surgery, and for 30 min after the end of surgery and anaesthesia. On initiation of sedation, entropy decreased more rapidly than BIS. At 10 min after initiation of sedation, the mean +/- SD values for MOAA/S, BIS, RE and SE were 3.00 +/- 0.36, 85.45 +/- 0.15, 74.00 +/- 0.60 and 72.02 +/- 0.12, respectively. During recovery, BIS and RE and SE increased in parallel with MOAA/S. It is concluded that entropy monitoring is as reliable as BIS monitoring in MAC.
Asunto(s)
Anestesia , Sedación Consciente , Entropía , Fentanilo/farmacología , Mano/cirugía , Propofol/farmacología , Adulto , Humanos , Monitoreo IntraoperatorioRESUMEN
This prospective study investigated the levels of procalcitonin (PCT) and C-reactive protein (CRP) in patients with various types and severity of multiple trauma, and their relationship to trauma-related complications. Adult multiple-trauma patients (n = 113) admitted to the intensive care unit (ICU) in the first 24 h after trauma were included. The Injury Severity Scores (ISS), and PCT and CRP levels were measured in the first 24 h (day 1), on day 7 and on the final day of their ICU stay. Survival at 30 days was recorded. Mean PCT and CRP levels were both significantly higher on day 7 compared with day 1 and the final assessment day in patients with an ISS > 20. Levels of PCT were significantly higher in cases with sepsis, severe sepsis or septic shock compared with cases who developed systemic inflammatory response syndrome (SIRS), however levels of CRP were significantly higher only in cases with severe sepsis or septic shock, but not in cases with sepsis alone. These data support the view that PCT levels may be a better indicator than CRP levels in the early diagnosis of septic complications in patients with multiple trauma.
Asunto(s)
Calcitonina/sangre , Unidades de Cuidados Intensivos , Traumatismo Múltiple/sangre , Traumatismo Múltiple/diagnóstico , Precursores de Proteínas/sangre , Adulto , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Péptido Relacionado con Gen de Calcitonina , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Traumatismo Múltiple/complicaciones , Traumatismo Múltiple/microbiología , Pronóstico , Sepsis/sangre , Sepsis/complicaciones , Análisis de SupervivenciaRESUMEN
STUDY DESIGN: A case report. OBJECTIVES: To report two cases of intra-radicular disc herniation. SETTING: Kocatepe University Faculty of Medicine, Department of Neurosurgery, Afyon, Turkey, Vakif Gureba Training Hospital, Department of Neurosurgery, Istanbul, Turkey and Yeditepe University Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey. METHODS: Two cases with intra-radicular disc herniation at L2-3 level in one, and at L5-S1 level in the other were presented. Both patients were admitted with complaints of severe leg pain and motor weakness. In both cases, intra-radicular disc herniation was diagnosed during surgery. RESULTS: The patients had uneventful recovery. They had no complaints or neurological deficits 6 and 3 months after surgery, respectively. CONCLUSIONS: The possibility of an intradural disc herniation should be kept in mind for the success of the management of lumbar disc herniation. In some patients who did not benefit from surgery, intra-radicular or intradural disc herniations may be the cause of failure.