Protective effects of cisternal irrigation on leptomeningeal and cortical structures in meningitis: an experimental study.

BACKGROUND: Meningitis, termed as foreign material collection in the subarachnoid space, leads to various meningeal, cerebral and spinal cord pathologies. Meningitis still remains a problematic disease with severe complications in spite of advanced medical technology. AIMS: In this study, we aimed to investigate the role of cisternal irrigation in the prevention of meningitis complications. SETTING AND STUDY DESIGN: Experimental study was done in the Social Security Hospital of Erzurum. Histopathological specimens were evaluated in the Pathology Department in the Ataturk University Research Hospital, Erzurum, Turkey. MATERIALS AND METHODS: This study was conducted on twelve lambs. Experimental meningitis was achieved with streptococcus pneumonia. Two animals were not treated. Ten animals were given Cefotaxime (4 x 1g/day) for 20 days, and additionally half of these animals underwent cisternal irrigation. Then, all animals were sacrificed and brains were observed histopathologically. RESULTS: Massive purulent CSF formation, hemorrhagic cortical lesions, vascular congestion, leptomeningeal and cortical adhesions and brain edema were observed in the non-irrigated group, but these findings were observed slightly or absent in the irrigated group. CONCLUSION: Meningitis can affect all central neural tissues, consequently serious central nervous system lesions may develop. The irrigation procedure may decrease the percentage and severity of meningitis complications by way of the excretion of inflamed purulent collection from the subarachnoid spaces.

Immune response to dehydrated human dura mater: evaluation in a rabbit model.

Ninety white hybrid rabbits, each weighing 2.5 to 3.5 kg, were used for this experimental model. Thirty rabbits were used for control, and sixty other rabbits were investigated for the response of host to the dural graft. In all animals, a dural defect, 1 x 1 cm in size, was created on the left parietal area following craniotomy. In the control group the excised free dural piece was then sutured again to the area from which it had been excised before. The dural defect was closed with dehydrated human dura mater (DHD) in the half of the rabbits in the group of study, and with autogenous fascia lata (AFL) in the other half. After operation, animals in each group were then subjected to one of five different groups comprising of 3,14,30,60 and 90 days follow-up periods. At the end of follow-up periods, histological, parameters such as cellular inflammatory response, development of fibrous tissue, capsulation, and calcification were examined in specimens obtained from the animals. There was no significant difference between AFL and DHD grafts. In conclusion, it seems that DHD is suitable as an ideal dural graft, because the immune response of host to DHD was almost similar to AFL.