The effect of choroidal artery vasospasm on choroid plexus injury in subarachnoid hemorrhage: Experimental study

Aim: We examined whether vasospasm of choroidal arteries (ChAs) may be resulted in ischemic injury in choroid plexus (CP) after subarachnoid hemorrhage (SAH). MaterIal and Methods: This study has been conducted on 30 rabbits. Eight, fourteen and eight of them were used as control, SAH and SHAM groups, respectively. The volumes of choroidal arteries were examined and measured by using the micrometric microscope barr. Ischemic morphological changes of the choroid plexus cells and villus were examined as follows: cellular shrinkage (1 point), cytoplasmic condensation (2 points), angulation (3 points) and villus desquamation (4 points) were considered as 1st, 2nd, 3rd, 4th degree downward choroid plexus degeneration criteria. Degeneration scores of 1 to 4 criteria were calculated by summing the exacerbated ones with the existing one. Results: Choroidal artery diameter&volume, and CP degeneration scores in three groups were evaluated: The mean volumes were 1.080±0.650mm3, 0.907±0.330 mm3, 0.480±0.175 mm3 and the degeneration scores of choroidal plexuses were scored as 0 and 1-1, and 4-3 and 10 in the control, SHAM and SAH groups respectively. A significant correlation between the degree of vasospasm and CP degeneration was found. ConclusIon: Vasospasm of choroidal arteries may be at a serious degree in cases with SAH incurs damages on choroid plexuses, and affects structures which play important roles in immune, endocrine, detoxifying, thermoregulatory, and secretory functions of the brain resulting in worsened prognosis

Seizures in supratentorial meningioma: a systematic review and meta-analysis

OBJECT: Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. METHODS: The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre- and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. RESULTS: The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2% of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95% CI 1.30–2.34); an absence of headache (OR 1.77, 95% CI 1.04–3.25); peritumoral edema (OR 7.48, 95% CI 6.13–9.47); and non–skull base location (OR 1.77, 95% CI 1.04–3.25). After surgery, seizure freedom was achieved in 69.3% of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3% of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. CONCLUSIONS: Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but evidence does not support routine use of prophylactic anticonvulsants in patients without seizures. Limitations associated with systematic review and meta-analysis should be considered when interpreting these results

The effect of degenerated neuron density of petrosal ganglion on the development of blood pressure variabilities after subarachnoid hemorrhage in a rabbit model: an experimental study

AMAÇ: Bu çalışmanın amacı, subaraknoid kanama (SAK) sonrası, glossofaringeal sinir petrozal ganglion iskemik nörodejenerasyonu ve KB dalgalanmaları arasındaki ilişkiyi belirlemektir. YÖNTEM ve GEREÇLER: Yirmi dört tavşanın kan basıncı ve kalp ritmi 20 gün boyunca günlük olarak takip edildi. Daha sonra, tüm hayvanların petrozal ganglionu histopatolojik olarak incelenmiştir. Petrozal gangliondaki normal ve apoptotik nöron yoğunluğu ile kan basıncı değerleri istatistiksel olarak karşılaştırıldı. BULGULAR: Petrozal ganglionun ortalama toplam hacmi 0,9 ± 0,34 / mm3 olarak hesaplandı. Kontrol grubunda KB düzeyi 96,1 ± 2,1 mmHg idi. Hafif hipertansiyon (HT) grubunun 116,5 ± 4mmHg ve ağır HT grubunda 128,1 ± 3,6 mmHg idi, gruplar birbirleriyle karşılaştırıldığında gruplar arasında anlamlı fark bulundu. Kontrol grubunda normal-apoptotik nöron düzeyi 11.240 ± 802/mm3-40 ± 6,3 / mm3 idi hafif HT grubunda 9730 ± 148,7/mm3 - 1560 ± 256,2/mm3 ve ağır HT grubunda 6870 ± 378,8/mm3-4240 ± 628,2/mm3. Gruplar birbirleriyle karşılaştırıldığında anlamlı fark vardı. SONUÇ: Bu çalışmada, kan basıncı değişkenliklerinin SAK’ ın petrozal ganglionda iskemik nörodejenerasyona neden olması ile açıklanabileceği görülmüştür. Bu çalışmanın sonuçları, petrozal ganglion iskemisinin hipertansiyon gelişimine potansiyel etkileri olduğunu göstermiştir. Bu bulgular yeni tedavi stratejilerinin SAK tedavisi için düşünülmesi gerektiğini göstermektedir