Neuroprotection effect of female sex steroids after traumatic brain injury in rats: the role of inflammatory cytokines

Previous studies have demonstrated estrogen and progesterone decrease brain edema induced by TBI. The aim of the present study was to determine the effect of female sex steroids on cytokines, and proinflammatory evaluation of the effects of cerebral edema of these hormones whether ovarian hormones decrease brain edema by change in concentrations of proinflammatory cytokines. In this experimental study, 98 ovariectomized female rats [except groups 1 and 2] were divided into groups of control, sham, vehicle, low does of estrogen [El], high dose of estrogen [E2], low dose of progesterone [PI] and high dose of progesterone [P2]. Vehicle and sexual steroid hormones were injected intraperitoneally at 0.5 h after Moderate and diffuse TBI induced by Marmarou method. Brain level of cytokines and ovarian hormones were measured 6 h after TBI by ELISA method. Both E2 and PI caused significant increase of 52.8% and 79.2% in brain level of IL-lp. P2 significantly decreased the levels of IL-6 and TNF-alpha by 45.9% and 72% respectively. TGF-beta level seem to be increased by El up to 3.37 times significantly. Level of beta-Estradiol increased 4.58 times in E2 group and progesterone increased 1.56 times in P2 group significantly. This results suggested that ovarian hormones increased brain IL-lp and TGF-P and decreased IL-6 and TNF-alpha, this may be one mechanism by which hormones reduce cerebral edema

[Effect of combined administration of estrogen and progesterone on brain edema and neurological outcome after traumatic brain injury in female rats]

Many studies have shown uncontrolled brain edema to be the cause of disabilities and deaths following head trauma. Current data also suggests that a single administration of estrogen or progesterone can have neuroprotective effects on brain injury. In this study we investigated the combined effect of estrogen and progesterone on brain edema and neurological outcomes following traumatic brain injury [TBI] in female rats This interventional-experimental study was performed on 8 groups of female rats as follows: 1- control, 2-Sham, 3-Ovarectomized trauma [TBI+OVX] 4-Vehicle 5-Physiologic dose of estrogen + physiologic dose of progesterone [E1+P1], 6- physiologic dose of estrogen+pharmacologic dose of progesterone [E1+P2] 7-Pharmacologic dose of estrogen+physiologic dose of progesterone [E2+P1] and 8-Pharmacologic dose of estrogen+pharmacologic dose of progesterone [E2+P2]. Hormones were injected i.p, half an hour after diffuse traumatic brain injury through marmarou model to 2 week old ovarectomized rats. Brain edema [via brain water content], blood-brain barrier permeability [via extra vascular evans blue dye] and neurological outcome [via veterinary coma scale] were measured in this animals The results showed significance decreases of 2.68% and 2.88% in water content in group 8 compared to the vehicle group and group 6 respectively and a significant decrease of 2.29% in water content in group 5 compared to group 6. Evans blue level showed significant decreases of 14.7% and 21.1% in groups 6 and 7 compared to the vehicle group. Neurological scores showed a significant increase of 2.5 and 2 in group 5 compared to the vehicle group and group 3, 1 hour after TBI respectively a significant increase was seen in all groups compared to group 3 at 4 and 24 hours after TBI. Scores showed a significant increase of 1.2 in groups 7 and 8 compared to the vehicle group at 24 hours following the TBI. Based on these results, it can be concluded that combined administration of estrogen and progesterone have beneficial effects on both the reduction of brain edema and the neurological outcomes, the improvement depending on what dose of estrogen is administered with progesterone

[Foot drop electrodiagnostic evaluation in soldiers referred to 501 army hospital in years 1378-1386]

Background: Foot drop is one of the most common cause of soldiers referral to electrodiagnostic clinics. With respect to importance of disability due to Foot drop specially in young adults, this study was performed

Materials and Methods: This cross- sectional and retrospective study was done on 75 soldiers referred to electrodiagnostic clinic of 501 army hospital in years 1378-1386. Demographic information, History, physical examination and electrodiagnostic tests were obtained of patients files and were written in the questionnier. The results were then analyzed by statistical soft ware of SPSS 13

Results: causes of foot drop with respect to electrodiasgnostic results included: 62 cases [82/7%] damage at common peroneal never, 3 cases [4%] at level of roots, 7 cases [9.3%] peripheral neuropathy, and Deep peroneal nerve, sacral plexus and sciatic nerve damage, each of, 1 case [1.3%]. There was meaningful correlation between onset of symptum and severity of lesion

Conclusion: Common peroneal nerve lesion at head of fibula is the most common cause of foot drop in studying group and nearly all patients were involved in military education period. Reassessment of military education is recommended