ABSTRACT
Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.
Subject(s)
Blood-Brain Barrier , Brain , Cause of Death , Endothelial Cells , Incidence , Metals, Heavy , Prevalence , Stroke , Tight Junctions , XenobioticsABSTRACT
OBJECTIVE: Study was designed preliminarily to observe the accordance of caregivers strain and depression with other factors such as sex of the patient, caregiver, lesion side, Mini Mental Status Examination (MMSE) score and Beck's Depression Index (BDI). METHOD: We composed a questionnaire with BDI, and the Sense of Competence Questionnaire (SCQ) in order to evaluate the amount of stress and depression of caregivers. Evaluation of the patient was done by interviewing them along with reviewing their medical records and obtaining scores such as the MMSE, Functional Inependence Index (FIM) and the Geriatric Depression Scale (GDS). RESULTS: BDI of the caregivers showed a negative correlation with the patients' age. Lesion side nor age, nor the prevalence of hemiplegia of patients did not show statistical relevance with the strain that the caregiver felt. The first subscale of SCQ showed a positive correlation with the caregiving time that the caregiver gave. In accordance to the sex of the caregiver, females showed to spend more time with the patient, showed to be more unsatisfied with the patient but showed a tendency of lesser SCQ score. CONCLUSION: Depression, strain and burden that the caregivers went through showed to have slight correlation with the patient and caregiver factors.
Subject(s)
Female , Humans , Caregivers , Depression , Hemiplegia , Medical Records , Mental Competency , Prevalence , Surveys and QuestionnairesABSTRACT
The ideal approach in microvascular decompression(MVD) for hemifacial spasm(HFS) should provide the shortest and perpendicular route to the facial nerve root exit zone(FNREZ) with minimal cerebellar retraction and early cerebrospinal fluid drainage to avoid surgical morbidity. Small basal craniectomy anterior, posterior and superior to the condylar foramen would be the ideal approach for HFS, because it is maximal basal route to FNREZ. We performed this approach in 15 patients with HFS. Slightly curved skin incision 5cm in length was placed from inferior nuchal line 2cm posterior to the mastoid notch toward the angle of the mandible and the neck muscles were splitted. Posterior condylar emissary vein was elevated from condylar fossa. Small basal craniectomy extending from the inferior nuchal line to the condylar foramen was made. Jugular process was drilled out along the superior margin of the occipital condyle to expose distal sigmoid sinus and the junction of sigmoid sinus and jugular bulb. Lateral margin of foramen magnum posteroinferior to the condylar foramen was removed for early drainage of CSF from lateral medullary cistern. Dura was opened in T-shaped manner. With minimal elevation of cerebellum, arachnoid around lower cranial nerves can be dissected and FNREZ can be identified easily and safely. In conclusion, para-condylar foraminal approach can be considered to be minimally invasive and maximally safe in MVD for HFS.