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M Karasoy

Publications and source records attributed to M Karasoy.

3 recordsLinked to original sources

The effect of mild hypothermia, mannitol and insulin-induced hypoglycaemia on ischaemic infarct volume in the early period after permanent middle cerebral artery occlusion in the rat.

We investigated the effect of mild hypothermia (32-34 degrees C), mannitol and insulin - induced hypoglycaemia on the ischaemic infarct volume on permanent middle cerebral artery occlusion with bilateral carotid artery ligation in rats. Temporalis muscle temperature as an indicator of brain temperature was monitored throughout the experiment in all rats, which were randomly divided into seven groups. During ischaemia, control rats received intravenous saline in a normothermic condition; treated rats had hypothermia and intravenous saline, hypothermia and mannitol, normothermia and mannitol, normothermia and insulin, normothermia, insulin and glucose, and hypothermia and insulin applied. After the experiment, the animals were killed, and brain sections were stained with haematoxylin and eosin. Images of infarct areas were determined using a camera attached to the microscope, and analysed by image analysis software. The total volume of infarcted tissue, right hemispheric volume, and the percentage of infarction were determined at the end of the image analysis investigation. The infarct volume on the control group was found to be 128.16+/-6.67 mm(3). Infarct volumes in hypothermic groups were significantly smaller than those of the control group (p<0.05). There were no significant differences between infarct volumes in the hypothermic groups. However, we found that hypothermia plus mannitol have the greatest neuro-protective effect. In normothermic rats, the infarct volume decreased proportionally but not statistically (p>0.05) whether mannitol or insulin was given. Our results also demonstrate that pre-, and post-ischaemic serum glucose concentrations influence the volume of infarction. Rats that had had pre-ischaemic high serum glucose concentrations had a higher volume of infarct than the hypothermic rats (p<0.05), while rats with post-ischaemic low serum glucose concentrations had a lower volume of infarct than the control rats.

Animals↗

Post-traumatic bilateral diffuse cerebral swelling.

This study confirms that bilateral diffuse cerebral swelling with or without parenchymal haemorrhages (< 15 cc) is a more common occurrence in the paediatric patients with severe head injury as compared with adults, since the analysed sample represented 42.55% and 20.43% of all paediatric and adult patients with severe head injury recorded in our clinic at the time of the study, respectively. The incidence of patients with diffuse cerebral swelling without parenchymal haemorrhages was found to be 27.65% of paediatric patients and 5.37% of adult patients with severe head injury. Secondary neurological deterioration occurred only in 5 (12.5%) paediatric patients and in 4 (10.5%) adult patients with diffuse cerebral swelling and was not to be found associated with parenchymal haemorrhages. A better outcome was seen in paediatric patients. Mortality rates were 12.5% in paediatric patients and 34.21% in adult patients. Our data also suggest that the mortality rate between paediatric and adult patients with diffuse cerebral swelling without parenchymal haemorrhages was similar (15.38% and 20% in paediatric and adult group, respectively), while the adult patients with diffuse cerebral swelling associated with small intraparenchymal haemorrhages have a worse prognosis than paediatric patients.

Adolescent↗

Conservative management of extradural haematomas: effects of skull fractures on resorption rate.

In conservative management of extradural haematomas (EDH), several mechanisms were described to explain the resorption of the haematoma. One of these was the transfer of the clot into the epicranial space through the skull fracture. In this study, the effects of skull fracture and associated intracranial lesions in the conservative management of EDH were investigated. Skull fracture and associated intracranial lesions were found in 71.11% and 51.1% of the patients, respectively. Resorption rate was calculated using an original formula and it was 0.548 +/- 0.227 in patients with skull fracture and 0.507 +/- 0.170 in patients with both skull fractures and additional intracranial lesions. These rates were found to be significantly higher than in the patients without fracture. In conclusion, in the patients with EDH planned to be managed conservatively, skull fracture and additional intracranial lesions must not be thought as risk factors, on the contrary, resorption of the clot might be earlier than in the others.

Absorption↗