Of the many potential source of free radial generation, the enzyme xanthine oxidase has been shown to be important in ischemia in non-cerebral tissues. Oxygen-derived free radicals have been implicated in various pathological conditions including ischemia. Xanthine oxidase serve as a source of oxidizing agents such as superoxide radical and hydrogen peroxide. It is investigated that the effect of a specific xanthine oxidase inhibitor, allopurinol, on infarct size in a model of continuous partial cerebral ischemia in rats. Infarct volume was measured by triphenyl tetrazolium chloride staining of brains removed 24 hours after middle cerebral arterial occlusion. Cortical tissue was more effectively protected than basal tissue, especially in allopurinol pretreated group. On histological examinations, hemispheric swelling, PMN cell infiltration and endothelial damage were noted irrespective of allopurinol treatment. It was speculated that free radicals are important in infarction secondary to partial continuous cerebral ischemia and that xanthine oxidase may by the primary source of these radicals.
Allopurinol* ; Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Free Radicals ; Hydrogen Peroxide ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Oxidants ; Rats ; Superoxides ; Xanthine Oxidase

No abstract available.
Child* ; Humans ; Hydrocephalus*

No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*

Osteochondromas make up about 30% to 40% of benign bone tumors. Most are solitary lesions but some are multiple, usually with autosomal dominant inheritance. From 1% to 4% of osteochondromas occur in the spine, where they can cause a variety of signs and symptoms, including those of spinal cord compression. Isolated osteochondromas are usually of little significance. However, if they are located near neural structures, they may cause irritation due to mechanical compression. In patients with hereditary multiple exostoses who present with neck or back pain, and particularly in those who have neurologic symptoms in the upper or lower extremities, a diagnosis of intracanalicular osteochondroma should be presumed until proven otherwise. Computerized tomography(CT) and MRI are the imaging procedures of choice. Prompt surgical excision affords the best prognosis for these patients who have spinal cord compression secondary to intracanalicular osteochondroma.
Back Pain ; Diagnosis ; Exostoses* ; Exostoses, Multiple Hereditary ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Osteochondroma* ; Prognosis ; Spinal Cord Compression ; Spine ; Wills

Results from lumbar disc operation in general are favorable in 70% to 90% of patients. The rate of necessary reintervention of the primary discectomy, however, may be as high as one fifth of cases even though diagnostic and technical standards have been improved. The purpose of this study was to analyse the reasons for failure of primary discectomy and which factors might have influenced the outcome of revisions in 53 patients with failed back surgery syndrome from the years 1989 to 1993. Mean follow up duration was 11.4 months with range of 1 to 69 months. Before revisions, all patients had one or more lumbar disc operations in whom disabling pain, neurologic deficits, and/or lumbar instabilities have been persisted or newly developed. The most common intraoperative findings of patients with revision were recurrent or persistent disc material(35.9%) followed by incomplete decompression from previous operations(24.5%), and disc lesions at new level(11.3%). In overall, 77.3% of total patients showed satisfactor y results(fair, good, and excellent) but this figure drops to 39.6% when those with at least good or excellent outcomes are only considered as definitively improved. Moreover only 22.9% good results were obtained among 35 patients with those less than 6 months of symptom duration. As for the total number of operations undertaken, it can not be conclusively stated due to small numbers in each categories, but less favorable results have been observed in those with more than one revisions. The factors predicting good outcome from revisions in our series were:1) greater than 6 months of pain relief after primary operation, 2) sciatica more prominent than lower back pain, 3) fewer operations.
Decompression ; Diskectomy ; Failed Back Surgery Syndrome ; Follow-Up Studies ; Humans ; Low Back Pain ; Neurologic Manifestations ; Sciatica

Pituitary adenomas are uncommon in childhood and adolescence. From a series of 94 patients with pituitary adenoma operated by microsurgical technique during the period of June. 1988 to March, 1994, the cases of nine young people whose symptoms had appeared between the ages of 8.3 and 17.3 years are selected and presented. Of these 9 patients, three(33.3%) had prolactin(PRL)-secreting tumors. 3(33.3%) had PRL and adrenocorticotropic hormone(ACTH)-secreting tumors, and among remaining three patients had a tumor secreting both growth hormone(GH) and PRL, one with clinically nonfunctioning tumor, and one with a craniopharyngioma. The average age of patients at the time of surgery was 14.8 years with the youngest patient being 8.5 years old. Presenting symptoms primarily reflected the increased intracranial pressure. All but one underwent operations by the transsphenoidal approach(TSA). There was no death in this patient group. Significant operative morbidity included one incidence of third nerve palsy in one case after transcranial approach and diabetes insipidus in another after TSA. Both incidences were transient and were resolved later. Plurihormonal tumors, broadly defined as tumors producing more than one hormone, were common in this study group. Follow-up study revealed good control of tumors in the majority of cases, however there were two cases of recurrences on 80% of initial remission rate. Based on the observed data, it is concluded that: 1) transsphenoidal surgery is feasible and safe in this age group: 2) plurihormonal tumors occur more frequently in the pediatric and adolescent age group than in adults: 3) Suprasellar extension is more frequent in this age group that in adults: 4) initial remission is high, but recurrence rate seems to be higher in this age group than in adults.
Adolescent* ; Adult ; Craniopharyngioma ; Diabetes Insipidus ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Pressure ; Oculomotor Nerve Diseases ; Pituitary Neoplasms* ; Prolactinoma ; Recurrence

No abstract available.
Brain* ; Krukenberg Tumor* ; Neoplasm Metastasis*

Spinal cord compression associated with plasma cell neoplasm is observed always in the patients suffering from the multiple myeloma or solitary plasmacytoma that occur in the marrow of the spine. Authors report a rare case of extramedullary plasmacytoma forming a mass in the epidural space of the thoracic spine. In 70 year old woman with paraplegia, MRI of the thoracic spine indicated a presence of epidural mass at the 2nd to 8th thoracic vertebrae. There was no abnormal bony changes in the spine on plain X-ray and MRI. Total removal of the epidural mass was performed by posterior approach. Histopathologic examination including immunohistochemical stain showed the plasma cell neoplasm producing IgM and kappa light chain. Cancer workup after operation including bone marrow study and whole body simple radiologic studies supported the diagnosis of extramedullary plasmacytoma.
Aged ; Bone Marrow ; Diagnosis ; Epidural Space* ; Female ; Humans ; Immunoglobulin M ; Magnetic Resonance Imaging ; Multiple Myeloma ; Neoplasms, Plasma Cell ; Paraplegia ; Plasmacytoma ; Spinal Cord Compression ; Spine ; Thoracic Vertebrae

We report a series of 19 consecutive patients with post-traumatic cerebral infarction. Post-traumatic cerebral infarction(PTCI) was diagnosed by CT within 24 hours of admission in 6 cases and up to 14 days after admission in 13 cases of 1092 patients who required cranial CT for trauma during the period. The frequency, vaascular territories, cause, and mortality rate of post traumatic cerebral infarction were discussed.
Cerebral Infarction* ; Humans ; Mortality

During the past decade, internal fixation techniques for stabilization of spinal fracture, correction of spinal deformity and immobilization in degenerative spinal diseases have increased in general, pedicle screw fixation of the spine provides the three dimensionally rigid grip on each vertebra and minimizes the levels of spinal segment that is needed for proper fixation. But with the increasing use of pedicle screw, there is an increase in incidences of complication. Major complications of pedicle instrumentation are screw malposition, pedicle fracture, iatrogenic foraminal encroachment, injury to the facet joints or vessels, and mechanical failure. These complications may be associated with irreversible damage of both vertebral and neural elements. Therefore, full understanding and knowledge of vertebral morphology is essential for proper instrument fixation and avoidance of complications. A total of 500 pedicle measurements were made from L1 to L5 vertebra. Five morphometric parameters were studied, transverse pedicle width, transverse pedicle angle, depth to anterior cortex, sagittal pedicle width, sagittal pedicle angle. Measurements were done using both spinal computed tomography and simple lumbar X-rays. As for the results, the means of transverse pedicle width is 7.9-16.6mm, transverse pedicle angle is 8.3-29.1 degrees And depth to anterior cortex is 43.8-47.9mm. The results were compared with previous data.
Congenital Abnormalities ; Hand Strength ; Immobilization ; Incidence ; Spinal Diseases ; Spinal Fractures ; Spine ; Zygapophyseal Joint