Is the size of an epidural haematoma related to outcome?

Recently we treated 54 patients with acute epidural haematoma, diagnosed by early CT scan and operated on quickly, within 6 hours after trauma. In 18 cases the volume of the haematoma, calculated by three different methods, was more than 150 cc, and GCS score was equal to or less than 8. In all 18 patients, as well as in another 36, we obtained good results: all patients survived and 17 fully recovered (only one was left with moderate neurological disability). Our experience leads us to the conclusion that even volumes of over 150 cc can be compatible not only with survival but also with very low morbidity, if rapid surgical treatment is performed.

A single electroconvulsive treatment affects platelet serotonin uptake in bipolar I patients.

We evaluated serotonin (5HT) uptake parameters in platelets of a group of bipolar I patients in both a depressive phase and a mixed state, before (t0) and after (t1) the first electroconvulsive treatment (ECT). The results showed the presence of significant changes in the number of the carrier proteins for 5HT at t1, which in most cases preceded the clinical improvement. Although other mechanisms are certainly involved, these data suggest that ECT may influence the 5HT transport through platelet membranes.

[Changes in serotoninergic mechanisms in essential hypertension]. / Modificazioni di meccanismi serotoninergici nell'ipertensione essenziale.

Several data suggest the possible involvement of serotonin (5HT) and of the serotoninergic (5HTergic) system in the pathophysiology of essential hypertension. Our study aim was thus to measure a peripheral 5HTergic marker, such as platelet 5HT uptake, in 8 hypertensive patients, as compared with healthy controls. All subjects included underwent evaluation of the pain threshold, in view of the possible relationship between mechanisms involved in pain modulation and those regulating blood pressure. The results showed a decrease of the maximal velocity (Vmax) of platelet 5HT uptake in the patients, who also exhibited an increase in the pain threshold. These data, although preliminary, are suggestive with regard to an increased concentration of extraplatelet 5HT, which might play a role in both hypertension and the change in pain threshold.

Seasonal serotonin uptake changes in healthy subjects.

Platelet 5-hydroxytryptamine (5HT) uptake was measured in 12 healthy subjects in the spring, summer, and late autumn. The uptake was performed according to the method of Arora and Meltzer (1981). The maximal velocity of 5HT uptake was higher in the spring and in summer than in the autumn. In addition, a significant negative correlation between the Michaelis constant and the photoperiod was observed in spring. These findings seem to indicate the possible evidence of physiological season-related changes of platelet 5HT uptake that may be linked to the photoperiod.

Age-related differences in human platelet 5-HT uptake.

Platelet 5-hydroxytryptamine (5-HT) uptake was measured in a group of young healthy volunteers and a group of aged healthy volunteers. Our results show a significant increase in the maximal velocity of uptake (Vmax) in the platelets of aged subjects. This could result in a decreased concentration of extracellular 5-HT in old age. Such reduced levels of 5-HT, if they occurred at 5-HT synapses in the brain, could result in susceptibility to the development of neurological or psychiatric illness.