ABSTRACT
Cerebrolysin is a neuropeptide-derived synthetic preparation produced by enzymatic breakdown of lipid-free animal neuroproteins. It regulates the neuronal energy metabolism and is supposed to afford brain protection by its neurotrophic stimulation. The present study aimed at assessing the possible neuroprotective effects of Cerebrolysin on an experimentally induced spinal cord injury in dogs depending on clinical and histological bases. The experiment was conducted on 20 adult male dogs, which were divided among five groups: A sham operated control group [subjected only to laminectomy of the midthoracic vertebrae], a positive control group [subjected to laminectomy with subsequent daily Cerebrolysin administration for 15 days], an acute spinal cord injury group [injury was induced by compression using an inflated balloon of the Folleyis catheter over the mid-thoracic spinal cord segments] and the animals were killed 24 hours after the surgery, a spinal cord injury group with subsequent daily administration of isotonic saline for 15 days and a spinal cord injury group with subsequent daily Cerebrolysin administration for 15 days. Clinical follow up of the experimental animals was daily recorded for 30 days, after which serial sections were prepared from the injured spinal cord segments of the different sacrificed groups. They were examined histologically by routine haematoxylin and eosin and by toluidine blue stains. The end results proved that Cerebrolysin achieved satisfactory protection to the nervous tissue. It prevented the setting in of degenerative changes in the majority of the anterior horn neurons of the injured spinal cord segments and subsequently its propagation in the axonal nerve fibers in the white matter. Therefore, Cerebrolysin administration was recommended as a successful treatment during the management of acute spinal cord injuries. It was also suggested that studies should be extended to investigate a possible similar effect in the case of human spinal cord injury as well as in chronic lesions
Subject(s)
Male , Animals , Neuropeptides , Neuroprotective Agents/administration & dosage , Dogs , Spinal Cord/pathology , Histology , Treatment Outcome , Acute Disease , Amino AcidsABSTRACT
The aim of this study was to highlight the anesthetist role in dealing with the severely head injured patients, the assessment of the arteriojugular venous oxygen difference as an important parameter in the management of head injured patient and evaluation the role of the tirilazad mesylate in improving the outcome. This study was carried out on 80 adult patients with severe head injury. They were divided into 2 equal groups according to arterio-jugular venous difference in oxygen content [AVDO2]. Then each group was further subdivided into 2 subgroups A and B, subgroups I A and IIA receiving tirilazad mesylate while subgroups IB and IIB received placebo. The incidence of unfavorable outcomes in patients with wide AVDO2 [group I] was significantly higher than in those with normal or narrow AVDO2 [group II]. Unfavorable outcome occurred in 92.6% of the patients who had one or more episodes of hypertension compared with only 41.5% in those who did not. The outcome in patients who suffered a single or multiple episode of raised [ICP] above 20 mmHg was grave compared with those without intracranial hypertension. The present study showed no significant difference between the 4 subgroups as regard cerebral perfusion pressure [CPP]. The study showed that the patients who had hyperglycaemia above 150-mg/ dl had unfavorable outcome compared with those with normoglycaemia. In the present study tirilazed mesylate failed to demonstarte any neuroprotective efficacy in those who received this drug. Retrograde jugular cannulation is a simple technique that should be mastered and implemented by anesthesiologists for jugular oxygenation monitoring to detect the presence or absence of ischemia and hyperemia and consequently can modify his anesthetic plan according to the prevailing condition