Cerebral ischaemia/reperfusion injury could be managed by using tramadol.

OBJECTIVES: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury. METHODS: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1ß, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-α, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically. RESULTS: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result. DISCUSSION: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques.

Episodic Migraine and White Matter Hyperintensities: Association of Pain Lateralization.

Background: Migraine pathophysiology involves a neuronal mechanism that is closely associated with the neuronal activation of peripheral trigeminal nociceptive pathways. It also involves a vascular mechanism that is supported by studies concerning the presence of migraine with aura in various vascular diseases. Migraine is associated with silent infarct-like lesions and white matter hyperintensities (WMHs) that can be encountered during magnetic resonance imaging. In this study, we aimed to demonstrate the migraine-WMH link based on pain lateralization. Methods: We recruited 628 episodic migraine patients and examined their cranial magnetic resonance images regarding the presence of deep, subcortical, and periventricular WMHs. We sought to identify an association between lesion occurrence and pain side. Results: We found that the patients had more deep/subcortical hyperintensities in the cerebral hemisphere that was ipsilateral to the pain side (ƙ = 0.421). Periventricular hyperintensities were not associated with the pain side (P = 0.768). Conclusions: Based on our study results, we concluded that pain in episodic migraine is associated with the occurrence of WMHs in the cerebral hemispheres.

Comparison of early postoperative period electrophysiological and clinical findings following carpal tunnel syndrome: is EMG necessary?

BACKGROUND: In this study, we aimed to compare the clinical findings and ENMG results of the patients who underwent surgery due to CTS, in the preoperative and early postoperative period. METHODS: 33 wrists of 29 patients who underwent open carpal tunnel surgery in our clinic due to CTS, between 2009 and 2011, were evaluated. Electrophysiological progress was evaluated with ENMG and clinical state with Boston scale. RESULTS: A significant decrease was observed in the postoperative BS symptomatic (SSS) and functional (FSS) scores of patients as compared to preoperative period (P=0.00), In the electrophysiological findings, statistically significant improvement was observed in all groups but very severe CTS group (P<0.05). When preoperative and postoperative EMG findings were compared, changes in DSL and DSA values were statistically significant (P<0.05). However, no statistically significant difference was seen between DML (P=0.085) and DMA (P=246) values on the 3rd month. When an examination was conducted on the patients whose DML and DSL values could not be obtained in the preoperative EMG, DML values were obtained in the early postoperative period in 6 of 7 cases (85.71% P<0.001), and DSL values were obtained in 17 of 24 cases (70.8% P<0.000). CONCLUSIONS: Sensory nerve findings were more significant, showed faster recovery compared to motor nerve findings, and accompanied the clinical recovery. Performance of an EMG test, especially on sensory nerves, will be more effective in patients selected in the early period, with the exception of patients with very severe CTS.