Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2011
Cerebrospinal fluid tenascin-C in cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
Tenascin-C (TNC) has been reported to be a useful biomarker for the activity of inflammatory diseases. This study investigated the association between TNC levels in the cerebrospinal fluid (CSF) and symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH), and the prognostic value of TNC levels. ⋯ TNC in the CSF may be a useful biomarker for predicting subsequent development of cerebral vasospasm.
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J Neurosurg Anesthesiol · Oct 2011
Isoflurane preconditioning protects astrocytes from oxygen and glucose deprivation independent of innate cell sex.
Isoflurane exposure can protect the mammalian brain from subsequent insults such as ischemic stroke. However, this protective preconditioning effect is sexually dimorphic, with isoflurane preconditioning decreasing male while exacerbating female brain damage in a mouse model of cerebral ischemia. Emerging evidence suggests that innate cell sex is an important factor in cell death, with brain cells having sex-specific sensitivities to different insults. We used an in vitro model of isoflurane preconditioning and ischemia to test the hypothesis that isoflurane preconditioning protects male astrocytes while having no effect or even a deleterious effect in female astrocytes after subsequent oxygen and glucose deprivation (OGD). ⋯ More studies are needed to determine how cell type and cell sex may impact on anesthetic preconditioning and subsequent ischemic outcomes in the brain.
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J Neurosurg Anesthesiol · Oct 2011
Common variants of the ACE gene and aneurysmal subarachnoid hemorrhage in a Danish population: a case-control study.
The intron 16 insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene has been associated with rupture of intracranial aneurysms, but the effect of haplotypes within ACE has not been studied. This study investigated whether ACE haplotypes including the I/D polymorphism are associated with aneurysmal subarachnoid hemorrhage. ⋯ In this Danish population, ACE haplotypes and the I/D polymorphism did not contribute significantly to the overall risk of intracranial aneurysm rupture. Larger studies are needed to delineate the association between ACE polymorphism and ruptured middle cerebral artery aneurysms.
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J Neurosurg Anesthesiol · Oct 2011
Perioperative management of children with encephalocele: an institutional experience.
Encephaloceles are neural tube defects that are characterized by protrusion of the brain and meninges through a defect in the cranium. The inherent implications of pediatric anesthesia and difficult airway make surgical correction challenging for anesthesiologists ⋯ Difficult airway is not the only concern in children with encephalocele, but associated congenital malformations, hydrocephalus, large size of sac, and hemodynamic disturbances all require careful consideration.
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J Neurosurg Anesthesiol · Oct 2011
The effects of insulin, glucagon, glutamate, and glucose infusion on blood glutamate and plasma glucose levels in naive rats.
Elevated levels of glutamate in brain fluids, in the context of several neurodegenerative conditions, are associated with a worsened neurological outcome. Because there is a clear relationship between brain glutamate levels and glutamate levels in the blood, and an association of the latter with stress, the purpose of this study was to investigate the effects of glucose, insulin, and glucagon on rat blood glutamate levels. ⋯ The results of this study demonstrate that glucose, insulin, and glucagon significantly reduce blood glutamate levels. The effect of insulin is immediate and transient, whereas the effect of glucagon is delayed but longer lasting, suggesting that the sensitivity of pancreatic glucagon and insulin-secreting cells to glutamate is dependent on glucose concentration. The results of this study provide insight into blood glutamate homeostasis and may assist in the implementation of new therapies for brain neuroprotection from excess glutamate.