The volume of experimental design cerebellum: stereological microanatomic study.

Cerebellum is responsible to higher cognitive functions and delicate motor activity. Because of its significance, cerebellum may play a major role in cognitive, behavioral, and psychiatric diseases. Therefore, the investigations on cerebellum may be contributed to the future researches so as to solve reasons of the diseases. The rabbit brain relatively larger than the rat and mouse brain and the individual evaluation of its subdivisions are rather easy. There are no data on cerebellar volume of rabbits in literature. Thus, the study presents microscopic volume calculation of rabbits' cerebellum using the stereological method. The mean (SD) calculated volume of the cerebellum in the rabbit brain was found to be 0.69 (0.03) cm3. The individual microscopic volume estimation of an animal subject can be achieved by Cavalier method. Researchers believed that the findings and the applied method in this study may be useful for the scientists.

Ocular and periocular injuries associated with an isolated orbital fracture depending on a blunt cranial trauma: anatomical and surgical aspects.

The anatomical location of fractures following blunt cranio-orbital trauma is important for neurosurgeons and maxillofacial surgeons. In this study, 588 cranio-orbital fractures following blunt trauma were evaluated retrospectively with regard to the anatomical site and surgical treatment. Orbital cranial nerve injuries and the outcomes of the medical and/or surgical treatment are described. Distribution of the zygomatic complex and orbital fractures were as follows: zygomatic complex fractures (n:304), isolated orbital fractures (n:58), complex comminuted fractures (n:226). In 58 cases, 69 orbit fractures were found (11 bilateral and 47 unilateral fractures). The lateral wall was the most frequent fracture (n:63). The least frequent fracture was the roof of the orbit (n:11). The accompanying lesions were as follows: 89.65% of cases were associated with periorbital haematoma (n:52), 13.79% of cases with retrobulbar haemorrhage (n:8), 96.55% cases with periorbital soft tissue oedema (n:56), 53.45% cases with pneumocephalus (n:31), 8.62% cases with intra-parenchymal contusion (n:5), 6.89% cases with enophthalmia (n:4), 5.17% of cases with rhinorrhoea (n: 3), 5.17% cases with optic bulb injury and adnexial trauma (n:3), 32.76% cases with intra-orbital emphysema (n:19), and 20.69% with vision dysfunctions (n:12), of whom 2 had no optic nerve injury.

Residue bone wax simulating spinal tumour: a case report.

Bone wax is primarily used in case of bleeding of the diploic vessels of the bones in surgical procedures. It is useful in neurosurgical procedures because of its inert, nonreactive characteristics. Bone wax is safe material and its use rarely leads to complications but there may be complications of over use. It can cause direct pressure of neural tissue as a mass, simulating tumour with the symptoms and on MRI. In the present case the authors evaluated the signs and symptoms, diagnosis, surgical treatment, and outcome in a patient with an unusual sequestered mass simulating a spinal tumour or another space-occupying lesion on preoperative MR imaging. A 64-year-old was woman admitted to the Neurosurgery Clinic with a 10 year history of low back pain, 1-year history of gait disorder, leg weakness, paraparesis, and 1-month history of urinary incontinence and weight loss. T1- weighted sagittal MRI showed the L3 hemilaminectomy, discectomy defect, heterogeneous hyperintense extradural mass and spinal stenosis extending from L2. A hypointense mass relative to the spinal structures was detected in T2- weighted axial MR images.The provisional diagnosis of a cauda equina syndrome and intra- or extradural spinal tumour was made. The patient underwent an L2 total laminectomy. In our case the fragment was seen in the epidural space, under the lamina of L2. The histopathology showed granulation tissue, inflammatory cells, macrophages and multinuclear giant cells. Postoperatively the patient's neurological findings recovered quickly and she began to walk more comfortably.

Evaluation of cerebellar asymmetry with vertigo cases: a stereological study.

AIM: We aimed to evaluate the relevant methods of stereology to estimate cerebellar asymmetry according to gender in both adult right-handed vertigo cases and healthy cases. MATERIAL AND METHODS: The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined on MRI using the point-counting approach of stereological methods. RESULTS: The mean (+/-SD) of the right cerebellar hemispheres in the patients with vertigo were 52.49+/-5.42 cm3 in males, 50.11+/-4.02 cm3 in females. The mean (+/-SD) of the left cerebellar hemispheres in the patients with vertigo were 53.11+/-3.70 cm3 in males and 49.73+/-4.69 cm3 in females. There was no significant quantitative evidence detected in terms of cerebellar asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p > 0.05). There were no statistically significant differences by genders between vertigo and control subjects (p > 0.05). There was statistical significance only between right and left hemispheres in male control subjects (p=0.039) CONCLUSION: There was no cerebellar asymmetry between control and vertigo cases by gender. The stereological evaluation of cerebellar asymmetry or atrophy in humans in correlation with gender is of importance both for clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased.

Neurosurgical gossypiboma radiologically mimicking a lumbar abscess.

Lumbar discectomy is the most common operative technique at neurosurgery clinics around the world. The complications of lumbar disc operation include infections, dural tear, bleeding, vascular, and intestinal injuries. Infectious complications of lumbar disc surgery are superficial and profound tissue infections, meningitides, and epidural abscess. Although retained surgical sponges (gossypiboma) are well known intraoperative complications in other surgical branches, they have not been widely reported in neurosurgery. In this report, we present a case of retained surgical sponge at the operation site and discuss with the literature.

Spontaneous regression of lumbar disc herniation.

We present 3 cases of spontaneous regression of lumbar herniated disc. The disc regression correlated with clinical improvement documented by MRI studies. Although the phenomenon of spontaneous disappearance of decrease in size of herniated disc fragments is well known, the exact mechanism underlying this process remains unclear. We discuss 3 possible explanations for disc regression: retraction into the vertebral space, dehydration/shrinkage, and resorption due to inflammatory reaction.

Primary spinal anaplastic ganglioglioma.

Gangliogliomas of the spinal cord are very unusual and the anaplastic variant of these tumors is extremely rare. In spinal anaplastic gangliogliomas, malignant changes (hypercellularity, vascular proliferation, necrosis, high numbers of mitotic figures) are typically evident in the glial element of the tumor. Gangliogliomas can arise in any part of the central nervous system and the features of adult and pediatric cases differ significantly. We describe the case of a pediatric patient who had a spinal anaplastic ganglioglioma extending from the T9 to the L3 level. The signs at presentation were bilateral knee flexion (quadriceps weakness) while walking and intermittent urinary incontinence. The tumor was partially resected with an ultrasonic aspirator, but the patient's neurological status deteriorated as a result and adjuvant radiotherapy did not resolve the deficit.

Elevated intracranial pressure management.

The treatment strategy for increased intracranial pressure (ICP) management includes decisions on head and body position, hypothermia, ventilation, anesthetics, osmotic drugs and surgical procedures. We can treat sudden increases in ICP using osmotic agents, some anesthetics and short episodes of mild hyperventilation. Propofol seems to be suitable for sedation of the increased ICP patients. Surgical decompression of the cranium seems to improve the outcome of the younger patients (below 50 years old), especially children.