Articles: peripheral-nerve-injuries-physiopathology.
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Neuroscience bulletin · Feb 2016
Upregulation of Chemokine CXCL12 in the Dorsal Root Ganglia and Spinal Cord Contributes to the Development and Maintenance of Neuropathic Pain Following Spared Nerve Injury in Rats.
Emerging evidence indicates that CXCL12/CXCR4 signaling is involved in chronic pain. However, few studies have systemically assessed its role in direct nerve injury-induced neuropathic pain and the underlying mechanism. Here, we determined that spared nerve injury (SNI) increased the expression of CXCL12 and its cognate receptor CXCR4 in lumbar 5 dorsal root ganglia (DRG) neurons and satellite glial cells. ⋯ The mechanical hypersensitivity induced in naïve rats by i.t. CXCL12 was alleviated by pretreatment with the MEK inhibitor PD98059. Collectively, our results revealed that TNF-α might mediate the upregulation of CXCL12 in the DRG and spinal cord following SNI, and that CXCL12/CXCR4 signaling via ERK activation contributes to the development and maintenance of neuropathic pain.
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Journal of neurosurgery · Jan 2016
Results of nerve grafting in radial nerve injuries occurring proximal to the humerus, including those within the posterior cord.
OBJECTIVE Results of radial nerve grafting are largely unknown for lesions of the radial nerve that occur proximal to the humerus, including those within the posterior cord. METHODS The authors describe 13 patients with proximal radial nerve injuries who were surgically treated and then followed for at least 24 months. The patients' average age was 26 years and the average time between accident and surgery was 6 months. ⋯ CONCLUSIONS The authors consider levels of strength of M4 for elbow and wrist extension and M3 for thumb and finger extension to be good results. Based on these criteria, overall good results were obtained in only 5 of the 13 patients. In proximal radial nerve lesions, the authors now advocate combining nerve grafts with nerve or tendon transfers to reconstruct wrist, thumb, and finger extension.
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Aquaporin-4 (AQP4), a water channel protein, is expressed mainly in the perivascular end-feet of astrocytes in the brain and spinal cord. Dysregulation of AQP4 is critically associated with abnormal water transport in the astrocytes. We aimed to examine whether peripheral nerve injury (PNI) could induce the changes of AQP4 expression and astrocytic morphology in the spinal cord. ⋯ Extravasation of systemically administered tracers Evans Blue and sodium fluorescein was not seen in both models. Taken together, PNI was associated with a long-lasting AQP4 up-regulation and enlargement of astrocytic processes in the spinal cord in rats, both of which were not related to the disruption of blood-spinal cord barrier. The findings could provide novel insights on the understanding of pathophysiology of spinal cords after PNI.
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J Clin Monit Comput · Oct 2015
Case ReportsTrans-cranial motor evoked potential detection of femoral nerve injury in trans-psoas lateral lumbar interbody fusion.
Trans-psoas lateral lumbar interbody fusion (LLIF) is frequently associated with neurological complications, limiting its value as a less invasive procedure. The routine use of EMG neuromonitoring has been inadequate to detect iatrogenic injuries; significant postoperative deficits have gone undetected by EMG. An effective way to monitor for these intraoperative neurological events is not yet well established. ⋯ These cases contribute to the developing perception that stand-alone EMG nerve monitoring is not adequate for trans-psoas surgery. The addition of MEP may improve the sensitivity of IONM during trans-psoas surgery. Multimodality IONM may offer the opportunity to intervene on evolving iatrogenic nerve injuries, and may reduce the incidence of adverse postoperative findings.