scholarly journals Acute spontaneous spinal cord infarction: Utilisation of hyperbaric oxygen treatment, cerebrospinal fluid drainage and pentoxifylline

2020 ◽  
Vol 50 (4) ◽  
pp. 325-331
Author(s):  
Catherine Ashton ◽  
◽  
Neil Banham ◽  
Merrilee Needham ◽  
◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Triple Therapy ◽  
Hyperbaric Oxygen ◽  
Spinal Cord Infarction ◽  
Cerebrospinal Fluid Drainage ◽  
Hyperbaric Oxygen Treatment ◽  
Muscle Testing ◽  
Oxygen Treatment ◽  
Csf Drainage

(Ashton C, Banham N, Needham M. Acute spontaneous spinal cord infarction: Utilisation of hyperbaric oxygen treatment, cerebrospinal fluid drainage and pentoxifylline. Diving and Hyperbaric Medicine. 2020 December 20;50(4):325–331. doi: 10.28920/dhm50.4.325-331. PMID: 33325011.) Introduction: Spinal cord infarction (SCI) is a potentially devastating disorder presenting with an acute anterior spinal artery syndrome, accounting for an estimated 1% of stroke presentations. Aetiologies include aortic surgical complications, systemic hypotension, fibrocartilaginous embolism and vascular malformations. Diagnosis is clinical combined with restriction on diffusion-weighted magnetic resonance imaging (MRI). There are no treatment guidelines for non-perioperative cases although there is limited literature regarding potential therapies, including hyperbaric oxygen treatment (HBOT) and cerebrospinal fluid (CSF) drainage. We describe 13 cases of acute SCI, five receiving HBOT, and three also receiving pentoxifylline and drainage of lumbar CSF. Methods: Data for all patients with MRI-proven SCI at Fiona Stanley Hospital from 2014–2019 were reviewed. Results: Thirteen patients, median age 57 years (31–74), 54% female, were identified. Aetiologies: two fibrocartilaginous emboli; seven likely atherosclerotic; two thromboembolic; two cryptogenic. All presented with flaccid paraplegia except one with Brown-Sequard syndrome. Levels ranged from C4 to T11. Five patients received HBOT within a median time of 40 hours from symptom onset, with an average 15 treatments (10−20). Three of these received triple therapy (HBOT, pentoxifylline, CSF drainage) and had median Medical Research Council manual muscle testing power of 5, median modified Rankin Score (mRS) of 1 and American Spinal Injury Association (ASIA) score of D on discharge, compared with 2 power, mRS 3.5 and ASIA B in those who did not. Conclusions: SCI can be severely disabling. Triple therapy with pentoxifylline, CSF drainage and HBOT may reduce disability and further prospective trials are required.

scholarly journals Hyperbaric oxygen treatment of spinal cord injury in rat model

BMC Neurology ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Yongming Sun ◽  
Dong Liu ◽  
Qingpeng Wang ◽  
Peng Su ◽  
Qifeng Tang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hyperbaric Oxygen ◽  
Rat Model ◽  
Hyperbaric Oxygen Treatment ◽  
Oxygen Treatment ◽  
Cord Injury

The effects of intrathecal hypotension on tissue perfusion and pathophysiological outcome after acute spinal cord injury

2008 ◽  
Vol 25 (5) ◽  
pp. E12 ◽  
Author(s):  
Eric M. Horn ◽  
Nicholas Theodore ◽  
Rachid Assina ◽  
Robert F. Spetzler ◽  
Volker K. H. Sonntag ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Animal Model ◽  
Cerebrospinal Fluid ◽  
Tissue Damage ◽  
Tissue Perfusion ◽  
Venous Stasis ◽  
Cerebrospinal Fluid Drainage ◽  
Csf Drainage ◽  
Cord Injury

Object Venous stasis and intrathecal hypertension are believed to play a significant role in the hypoperfusion present in the spinal cord following injury. Lowering the intrathecal pressure via cerebrospinal fluid (CSF) drainage has been effective in treating spinal cord ischemia during aorta surgery. The purpose of the present study was to determine whether CSF drainage increases spinal cord perfusion and improves outcome after spinal injury in an animal model. Methods Anesthetized adult rabbits were subjected to a severe contusion spinal cord injury (SCI). Cerebrospinal fluid was then drained via a catheter to lower the intrathecal pressure by 10 mm Hg. Tissue perfusion was assessed at the site of injury, and values obtained before and after CSF drainage were compared. Two other cohorts of animals were subjected to SCI: 1 group subsequently underwent CSF drainage and the other did not. Results of histological analysis, motor evoked potential and motor function testing were compared between the 2 cohorts at 4 weeks postinjury. Results Cerebrospinal fluid drainage led to no significant improvement in spinal cord tissue perfusion. Four weeks after injury, the animals that underwent CSF drainage demonstrated significantly smaller areas of tissue damage at the injury site. There were no differences in motor evoked potentials or motor score outcomes at 4 weeks postinjury. Conclusions Cerebrospinal fluid drainage effectively lowers intrathecal pressure and decreases the amount of tissue damage in an animal model of spinal cord injury. Further studies are needed to determine whether different draining regimens can improve motor or electrophysiological outcomes.

scholarly journals Protective Effect of Hyperbaric Oxygen Treatment on Axon Degeneration after Acute Motor Axonal Neuropathy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ni Komang Sri Dewi Untari ◽  
Kurnia Kusumastuti ◽  
Guritno Suryokusumo ◽  
I Ketut Sudiana
Keyword(s):  
Spinal Cord ◽  
Sciatic Nerve ◽  
Protective Effect ◽  
Hyperbaric Oxygen ◽  
Axonal Neuropathy ◽  
Axon Degeneration ◽  
Hyperbaric Oxygen Treatment ◽  
Acute Motor Axonal Neuropathy ◽  
Oxygen Treatment ◽  
Neuronal Swelling

Objectives. Acute motor axonal neuropathy (AMAN) is a disease that leads to acute flaccid paralysis and may result from the binding of antibody and antigen to the spinal cord. The objective of this study is to evaluate the protective effect of hyperbaric oxygen treatment (HBOT) on axon degeneration of the spinal cord and sciatic nerve of the AMAN model rabbit. Axonal degeneration was assessed by evaluating glutathione (GSH) activity, interleukin-1β (IL-1β) expression, and clinical and histopathological features. Methods. Twenty-one New Zealand rabbits were divided into three groups. The treatment group was exposed to 100% oxygen at 2.4 ATA 90 minutes for 10 days at a decompression rate of 2.9 pounds per square inch/minute. GSH level was evaluated using an enzyme-linked immune-sorbent assay. An expression of IL-1β in the spinal cord was determined by immunohistochemistry. Clinical appearances were done by motor scale and body weight. Histological features observed neuronal swelling and inflammatory infiltration in the sagittal lumbar region and the undulation of the longitudinal sciatic nerve. Results. Rabbits exposed to HBO had high GSH activity levels ( p < 0.05 ) but unexpectedly had high IL1β expression ( p > 0.05 ). In addition, the HBO-exposed rabbits had a better degree of undulation, the size of neuronal swelling was smaller, the number of macrophages was higher, and motor function was better than the AMAN model rabbits ( p < 0.05 ). Conclusions. These findings indicate that HBO therapy can decrease axon degeneration by triggering GSH activity, increasing IL-1β level, and restoring tissues and motor status. In conclusion, HBO has a protective effect on axon degeneration of the spinal cord and sciatic nerve of the AMAN model rabbit.

Prophylactic hyperbaric oxygen treatment and rat spinal cord re-irradiation

2003 ◽  
Vol 191 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Peter Sminia ◽  
Adrian J. van der Kleij ◽  
Ulrich M. Carl ◽  
John J. Feldmeier ◽  
K.Axel Hartmann
Keyword(s):  
Spinal Cord ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Treatment ◽  
Rat Spinal Cord ◽  
Oxygen Treatment

Hyperbaric oxygen treatment in the experimental spinal cord injury model

2014 ◽  
Vol 14 (9) ◽  
pp. 2184-2194 ◽  
Author(s):  
Onur Yaman ◽  
Banu Yaman ◽  
Figen Aydın ◽  
Ahmet Var ◽  
Cüneyt Temiz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Treatment ◽  
Experimental Spinal Cord Injury ◽  
Oxygen Treatment ◽  
Spinal Cord Injury Model ◽  
Injury Model ◽  
Cord Injury
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