Melatonin Ameliorates Hemorrhagic Transformation via Suppression of ROS-Induced NLRP3 Activation after Cerebral Ischemia in Hyperglycemic Rats.

Melatonin is a strong antioxidant which beneficially protects against middle cerebral artery occlusion (MCAO) followed by hemorrhagic transformation in rats; protection includes the reduction of neurological deficits, infarction, and hematoma volume. The molecular mechanisms underlying these neuroprotective effects in the MCAO model have not been clearly identified. This study examined the influence and involved mechanism of melatonin on inflammation in hemorrhagic transformation following hyperglycemia MCAO rat model. Compared with the MCAO group, MCAO+dextrose (DX) group showed worse neurological function and higher infarction and hematoma volume. Interestingly, the protein expression of Nod-like receptor protein 3 (NLRP3) inflammasome increased in the MCAO+DX group compared with the MCAO group, which indicated that NLRP3 inflammasome may be involved in the DX-induced hemorrhagic transformation following MCAO. Then, three dosages of melatonin were intraperitoneally injected 2 h after MCAO induction. Melatonin treatment attenuated inflammatory response by inhibiting the reactive oxygen species (ROS) and NLRP3 inflammasome, alleviating neuronal injury, and reducing infarction and hematoma volume, finally improving neurological score. Melatonin also repressed cortical levels of proinflammatory cytokine IL-1ß, which were increased 24 h after hyperglycemia MCAO. In order to identify the potential mechanisms, we further revealed that nigericin administration reversed the neuroprotective effect of melatonin by promoting NLRP3 inflammasome activation. In general, this present study reveals that melatonin prevents the occurrence of hyperglycemia-enhanced hemorrhagic transformation, and this effect might be beneficial to attenuate neurological dysfunction via suppressing the inflammatory response after MCAO which possibly associated with the inhibition of the ROS/NLRP3 inflammasome pathway.

[The state of thyroid system in patients with non-traumatic supratentorial hematomas].

Concentrations of thyroid hormones (thyrotrophic - TTG, T3, T4) were measured with radioimmunological assay in the blood serum of 69 operated patients with supratentorial stroke interbrain hematomas. Hematomas were removed using a puncture/ aspiration method with local fibrinolysis. The lethality was 19%. It has been shown that medial hematomas lead to the decrease in TTG secretion while lateral and lobar ones inhibit T4 and T3 synthesis. Replacement therapy with thyroid hormones is needed to improve results of operative treatment of non-traumatic interbrain hematomas.

Effect of minimally invasive surgery for cerebral hematoma evacuation in different stages on motor evoked potential and thrombin in dog model of intracranial hemorrhage.

OBJECTIVE: To observe the effect of minimally invasive surgery for cerebral hematoma evacuation in different stages on motor evoked potential (MEP) and thrombin in dog model of intracranial hemorrhage. METHODS: Twenty dogs were selected to prepare the intracranial hemorrhage model, which were randomly divided into 6, 12, 18 and 24 hour groups, respectively. The animals in each group underwent a minimally invasive surgery to evacuate the cerebral hematoma after the models were prepared. Before and after procedures, Purdy score, MEP and thrombin in hematoma region were determined and compared. RESULTS: Significant decreases in Purdy score, latency of MEP and thrombin expression were observed in 6 and 12 hour groups as compared with the 18 and 24 hour groups (p<0.01). DISCUSSION: In the present experiment, we established a dog model of intracranial hemorrhage, which was minimally invasive, easy to operate, highly repeated, simulating the pathological and physiological changes of clinical hypertensive intracranial hemorrhage. Both the latency of MEP and the expression of thrombin decreased after evacuation of intracranial hematoma in early stages by minimally invasive procedures, indicating that minimally invasive procedures for cerebral hematoma in ultra-early and early stages might be more effective to limit brain injury and decrease the latency of MEP and thrombin expression.

Lesión intracraneal transorbitaria por florete. Caso clínico / Cranial wounds of the skull by fencing - foil

Introducción. Las heridas penetrantes intracraneales por arma blanca son poco frecuentes en países occidentales y su diagnóstico y tratamiento pueden presentar dificultades que las hacen diferentes al resto de los traumatismos de cráneo. Caso clínico. Se presenta el caso de un profesor de esgrima que practicando sin la debida protección, recibió una lesión por florete, transorbitaria derecha con penetración intracraneana. La misma le produjo un hematoma intraparenquimatoso temporoparietal derecho, con efecto de masa. Dicha lesión se hizo evidente en la evolución, ya que de inicio, el paciente no presentó ningún síntoma oftalmológico o neurológico. El hematoma se evacuó sin incidentes con buena evolución clí- nica del paciente. No hubo lesiones en el globo ocular. Discusión y conclusiones. La lesión de estructuras intracraneales por objetos penetrantes transorbitarios es poco frecuente. Su diagnóstico exige un alto índice de sospecha, teniendo en cuenta el objeto agresor, mas allá del estado clínico inicial del paciente (AU)

Penetrating stab cranial wounds of the skull by fencing - foil are rare in western countries. Case report. This 46 year old man suffered a penetrating stab wound of the skull throughout the right orbital region. As a consecuence he developed on intracranial hematoma requiring surgical evacuation. Discussion and conclusions. Damage of intracranial cuntents due to transorbital penetrating objects other than missiles is a rare event (AU)