No abstract available.
Intracranial Aneurysm*

PURPOSE: This study was aimed to elucidate the effect of hyperthermia on neuronal nitric oxide synthase(nNOS) expression in both cerebral hemispheres after left common carotid artery occlusion in gerbils. METHODS: Using Mongolian gerbils, cerebral ischemia was produced by occluding carotid artery for 1-4 hours. Rectal temperature was maintained at 36degrees C for normothermia and 40degrees C for hyperthermia by heating pad. Western blot and RT-PCR was used to examine the nNOS and the mRNA expression. Neuronal damages were observed by histological study. RESULTS: After cerebral ischemia, mRNA of nNOS was expressed more abundantly in ischemic hemisphere than control in both normothermia and hyperthermia. Hyperthermia reduced nNOS protein expression markedly. In pathological study, neurons of hippocampal region were degenerated by ischemia. Hyperthermia by itself induced neuronal degeneration in both control and ischemic region. In immunohistochemistry of brain, there was no significant difference of nNOS expression between normothermia and hyperthermia. CONCLUSION: These findings suggest that increase in body temperature might enhance nNOS mRNA expression but reduce nNOS protein, and that hyperthermia aggravates neuronal damage by ischemia, independent of nNOS gene expression.
Blotting, Western ; Body Temperature ; Brain ; Brain Ischemia* ; Carotid Arteries ; Carotid Artery, Common ; Cerebrum ; Fever* ; Gene Expression ; Gerbillinae* ; Heating ; Hot Temperature ; Immunohistochemistry ; Ischemia ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase Type I* ; RNA, Messenger

Recently the cause of hemifacial spasm and trigeminel neuralgia is known to be vascular compression-distortion in the root exit and entry zone of each nerve. The microvascular decompression of the 5th and 7th cranial nerves is a method of refined and non-traumatic surgical treatment of these disabling diseases. 33 patients with intractable hemifacial spasm and 7 patients with trigeminal neuralgia were treated by microvascular decompression and the follow-up results were evaluated. The surgical results in 33 cases of hemifacial spasm were as follow: Excellent-18, Good-7, Fair-6, Poor-2. Disturbance of hearing as a complication appeared in 6 cases, but improved gradually except one case. The surgical finding and results in 7 cases of trigeminal neuralgia were as follow: In 6 cases the causative vessel was SCA and in one case SCV indented the nerve root. All 7 patients with trigeminal neuralgia were relieved from facial pain after surgery.
Cranial Nerves ; Facial Nerve* ; Facial Pain ; Follow-Up Studies ; Hearing ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery* ; Neuralgia ; Trigeminal Neuralgia

No abstract available.

No abstract available.
Aneurysm*

OBJECTIVE: This study was undertaken to demonstrate the usefulness of endovascular technique in treatment of vertebral artery dissecting aneurysms. METHODS: The clinical characteristics of vertebral artery dissecting aneurysms were reviewed in 11 patients with particular focus on clinical presentation, angiographic feature and outcome. RESULTS: All patients underwent the GDC embolization. One of them was managed with surgical trapping after failure of GDC embolization and the other with GDC embolization after failure of stent insertion. Nine patients were recovered with intact neurological feature, one patient died as result of sepsis and ARDS, and one patient was suffered from cerebellar infarction. CONCLUSION: Although the timing of the procedure and site of occlusion remain controversial, proximal GDC occlusion of vertebral artery appears to be a safe and effective therapy for patients with vertebral artery dissecting aneurysm. This procedure provides an important, less invasive alternative for this condition.
Aneurysm, Dissecting* ; Endovascular Procedures ; Humans ; Infarction ; Sepsis ; Stents ; Vertebral Artery*

OBJECTIVE: The authors present an investigation of the effect of transglutaminase(TG) on the recovery of somatosensory evoked potentials in the rat model of spinal cord injury. METHODS: Female Sprague-Dawley rats(280-310g) were used for this study. Rats were divided into two groups: TG treated and control. The lesion was made by transecting the right dorsal column of the thoracic spinal cord without damage to the vasculature using specially devised micro-glass pipette after laminectomy. For TG treated group, normal saline with TG were injected into the lesion site using micro-pipette through the opening of the dura. Saltatory repetitive somatosensory evoked potentials(SSEPs) recording were carried out on post-injury 6th and 12th week. RESULTS: The amplitudes of N19 were 1.28+/-1.60 microV on 6th week, 3.45+/-3.63 microV on 12th week in control group(n=10) and 1.46+/-1.75 microV on 6th week and 5.01+/-2.65 microV on 12th week in TG-treated group(n=11). Statis-tically significant recovery of SSEPs were seen in TG-treated group(p=0.003, Wilcoxon Signed Ranks Test). In TG-treated group, vacuolated degeneration around the lesion site was rarely observed on histological evaluation. CONCLUSION: This study demonstrates the possibility of long-term survival and saltatory recording of SSEPs in small animals like rats, after selective spinal cord injury. In addition, this study shows that TG is a factor facilitating the recovery of injured axon of central nervous system.
Animals ; Axons ; Central Nervous System ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Laminectomy ; Models, Animal* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord Injuries* ; Spinal Cord*

The treatment of stroke is undergoing a revolution, which is reflected in the wide spread use of the term "Brain Attack". Our understanding of the pathophysiology of cerebral ischemia, and our ability to effectively intervene in the clinical setting have changed the way patients at risk of or suffering from a stroke are managed.
Brain Ischemia ; Brain* ; Humans ; Stroke

OBJECTIVE: Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. METHODS: We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease (mean+/-SD age, 37.96+/-11.27 years; range, 18-62 years) who underwent direct bypass surgery over 6 years. RESULTS: Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; p=0.001), PCA involvement (p=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first (p<0.0001) and second (p=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. CONCLUSION: In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.
Adult ; Arterial Pressure ; Blood Pressure ; Cerebral Revascularization ; Humans ; Hypotension ; Incidence ; Medical Records ; Moyamoya Disease ; Neuroimaging ; Passive Cutaneous Anaphylaxis ; Perioperative Period ; Posterior Cerebral Artery ; Retrospective Studies ; Risk Factors ; Stroke

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*