ABSTRACT
Objective To investigate the efficiency and complications of stereotactic surgery combined with intra-operative electrocorticography (ECoG) and intra-operative neurophysiologic monitoring (IOM) in treating epilepsy secondary to subcortex small tumors in the functional areas.Methods Fifteen patients with epilepsy secondary to subcortex small tumors in the functional areas,admitted to our hospital from June 2006 to June 2011, were chosen in our study. Resection was performed to these tumors. Guiding with stereotaxic apparatus, epileptogenic foci and boundary localizing by intra-operative ECoG monitoring,functional areas and neuronal structures in the epileptic region judging by IOM,the epileptogenic foci were resected or performed multiple subpial wansaction (MST) and/or cortices lower output powers thermocoagulation.The treatment efficacy was concluded.Results Total resection was achieved in 13 patients and subtotal resection in 2.Epileptogenic foei were ablated in 4 patients,and peri-lesioned cortex of epileptogenic foci in other 11 patients were performed lower output powers thermocoagulation or/and MST. ECoG monitoring found epileptiform discharge disappearance in 6 patients,residual of a few spikes in 6,residual of a lot of spikes as well as having mild to moderate abnormal basilic rhythms in EEG in 3.No permanent and severe complications were noted.All patients were followed up for 1 to 3 y; tumor recurrence was noted in 2; according to Engel's classification standards,Engel I was noted in 10,Engel Ⅱin 3 and Engel Ⅲ in 2,and the effective rate was 100％. Conclusion Stereotactic surgery combined with intra-operative ECoG and IOM is a safe,effective and microinvasive management for epilepsy secondary to subcortex small tumor in the functional areas; it can accuratly locate and totally resect the tumors,treating the epileptogenic foci and avoiding functional defects.
ABSTRACT
Objective To investigate the protective effect of gypenoside (GP) on oxidative damage of the white matter in rats after chronic cerebral hypoperfusion and on its alterations of cognitive function.Methods A total of 57 male SD rats were randomly assigned to 4 groups:sham-operated group (n=12),vehicle group (n=15),200 mg/kg GP treatment group (n=15) and 400 mg/kg GP treatment group (n=15); chronic cerebral hypo-peffused models in the later 3 groups were established by permanent bilateral common carotid artery occlusion (2-VO).The dosage volume of all groups was 10 mL/kg; 3 h after the surgery,all rats orally received the initial administration of 400 mg/kg or 200 mg/kg GP dissolved in saline solution or matched volume of normal saline daily for a consecutive 33 d according to the above-mentioned experimental plan.Spatial learning and memory were assessed using Morris water maze test.Following behavioral tests,the activities of superoxide dismutase (SOD) and changes of malondialdehyde (MDA) level in the corpus callosum and optic tracts were measured by ELISA.The oxidative central nerve cell damages were assessed by immunohistochemical staining for 8-hydroxy-2'-deoxyguanosine (8-OHdG).Results Rats of the 400 mg/kg GP treatment group spent significantly fewer time in finding the platform,but significantly longer time spending in the platform region as compared with those of the vehicle group (P＜0.05).As compared with those in rats of the sham-operated group,the SOD activity was markedly reduced and MDA content was significantly increased in rats of the vehicle group (P＜0.05).Rats of the 400 mg/kg GP treatment group had decreased MDA content,increased SOD activity and decreased 8-OHdG level as compared with rats of the vehicle group (P＜0.05); however,200 mg/kg GP treatment group had no such significant effects as compared with those of the vehicle group (P＞0.05).Conclusion GP can ameliorate the oxidative damage in the corpus callosum and optic tract of rats after chronic cerebral hypoperfusion,indicating that GP may have therapeutic potential for treating dementia induced by chronic cerebral hypoperfusion; however,the related mechanisms for its alteration of cognitive function needs further research.