Objective : Dexpanthenol (DXP), which has known neuroprotective effects, has been shown to be beneficial in various experimental models and ischaemic diseases. The aim of this study was to investigate the possible neuroprotective effects of DXP in a traumatic brain injury (TBI) model.Methods : Thirty-six Wistar-Albino female rats, approximately 6 months old, weighing 220–285 g were used. All rats were subjected to closed head trauma by dropping a weight of 350 g on the parietal region from a height of 50 cm at an angle of 180 degrees in the prepared head trauma model setup. The rats were divided into four groups as control (group 1), trauma (group 2), trauma + DXP (group 3), and DXP (group 4). In group 3, DXP was administered intraperitoneally at a dose of 500 mg/kg for six times at 30 minutes, 6, 12, 24, 36, and 48 hours. In group 4, DXP was administered intraperitoneally simultaneously with group 3 without causing head trauma. Blood samples were taken from all rats 72 hours later for biochemical examination. After blood samples were taken, rats were decapitated under general anaesthesia. Cerebral tissue samples were taken from decapitated rats for immunohistochemical and histopathological examination.Results : Cytokine markers were found to be increased in posttraumatic brain tissue. Malondialdehyde and glutathione reductase levels were lower in group 3 compared to group 2. In addition, superoxide dismutase, glutathione peroxidase and catalase levels were significantly higher in group 3 compared to group 2. In histological evaluation, congestion in the piamater layer, cell infiltration, vascular congestion, hemorrhage and neuronal degeneration were significantly decreased in group 3 compared to group 2. DXP seems to be beneficial in neurological recovery in terms of histological and oxidative changes after head trauma in rats.Conclusion : DXP should be further evaluated for its possible therapeutic effect in TBI.

Impact of BrainLab VectorVision Infrared-Based Neuronavigation on Surgical Outcomes in Intracranial Meningioma Patients: A Retrospective Study - Article abstract #944724

Kronik Subdural Hematom: Tanı ve Tedavi Yasin TAŞKIN Travmatik İntraserebral Hematom Tolga EROL Akut Subdural Hematom İsmail İÇLEK Travmatik Hemorajik Kontuzyon Hasan ŞENER Recai ENGİN Epidural Hematom Veysel KIYAK Travmatik Subaraknoid Kanama Durmuş Emre KARATOPRAK

Background and Objectives: The optimal surgical technique for Chiari type I malformation (CM-I) remains debated, particularly in patients without syringomyelia. While duraplasty (DP+) may enhance radiological outcomes, it can carry higher complication risks. We compared clinical, radiological, and morphometric outcomes after suboccipital decompression with DP+ and without duraplasty (DP−), with prespecified subgroup analyses by syringomyelia status. Materials and Methods: Ninety-three consecutive adult CM-I underwent DP− (n = 54) or DP+ (n = 39) between 2014 and 2022. Pre- and post-operative MRI and neurological evaluations were obtained at 1 year. Functional recovery was assessed using the Chicago Chiari Outcome Scale (CCOS). Clinical and radiological outcomes, complication rates, and subgroup results (with vs. without syringomyelia) were compared. Results: Overall clinical improvement was observed in 92.5% of patients (DP−: 94.4%; DP+: 89.7%; p > 0.05). Among patients without syringomyelia, clinical improvement remained high with DP−. Radiological benefit—including syrinx regression and mega cisterna magna formation—was greater with DP+ (64.1% vs. 24.1%; p < 0.001), but this did not translate into improved functional outcomes (p > 0.05). Cerebellar slump occurred more often after DP+ (30.8% vs. 9.3%; p < 0.05). Complication rates, particularly CSF-related events, were significantly higher with DP+ (17.9% vs. 3.7%, p = 0.032). Morphometric expansion of the foramen magnum did not correlate with functional outcomes. Conclusions: At 1-year follow-up, suboccipital decompression without duraplasty appears to provide comparable clinical improvement to DP+, with fewer complications, in selected CM-I patients without syringomyelia. Duraplasty offers radiological advantages, especially for syringomyelia, but at the cost of increased risk. Longer follow-up is necessary to determine the durability of these findings.

Bilinç, farkındalık ve uyanıklık bileşenlerinden oluşan, Asendan Retiküle Edici Sistem (ARAS) ve serebral korteksin eşgüdümüyle sağlanan bir durumdur. Bilinç kaybı, çevresel uyarılara yanıt verilemeyen ve hızlı müdahale gerektiren kritik bir nörolojik acildir. Nedenleri arasında %85 oranında metabolik ve sistemik bozukluklar, %15 oranında ise merkezi sinir sistemi (SSS) patolojileri yer alır. Değerlendirme sürecinde Glasgow Koma Skalası (GKS), FOUR Skoru ve AVPU gibi ölçekler kullanılarak bilinç düzeyi (konfüzyon, stupor, deliryum, koma) sınıflandırılır. Özellikle FOUR skoru, entübe hastalarda beyin sapı reflekslerini de değerlendirdiği için GKS'ye göre daha kapsamlı bilgiler sunar. Ayırıcı tanıda Locked-in sendromu, vejetatif durum ve beyin ölümü gibi durumlar dikkatle incelenmelidir. Yaklaşımın temel amacı, ABC (havayolu, solunum, dolaşım) prensibiyle hastayı stabilize etmek ve kalıcı hasarı önlemektir. GKS skoru 8’in altında olan veya aspirasyon riski taşıyan hastalar entübe edilmelidir. Tanı için laboratuvar testleri, kontrastlı/kontrastsız kranial BT ve MR görüntüleme yöntemlerinden yararlanılırken; tedavi perfüzyonu optimize etmeyi ve altta yatan nedeni düzeltmeyi hedefler. Consciousness consists of awareness and wakefulness components, maintained by the coordination of the Ascending Reticular Activating System (ARAS) and the cerebral cortex. Loss of consciousness is a critical neurological emergency where a person is unresponsive to environmental stimuli, requiring rapid intervention. Its etiology includes metabolic and systemic dysfunctions (85%) and central nervous system (CNS) pathologies (15%). During the evaluation process, the level of consciousness (confusion, stupor, delirium, coma) is classified using scales such as the Glasgow Coma Scale (GCS), FOUR Score, and AVPU. Specifically, the FOUR score provides more comprehensive information than the GCS as it evaluates brainstem reflexes in intubated patients. Conditions such as Locked-in syndrome, vegetative state, and brain death must be carefully examined in the differential diagnosis. The primary objective of the approach is to stabilize the patient following the ABC (airway, breathing, circulation) principles and prevent permanent damage. Patients with a GCS score below 8 or those at risk of aspiration should be intubated. For diagnosis, laboratory tests, cranial CT (with or without contrast), and MRI imaging methods are utilized, while treatment aims to optimize perfusion and correct the underlying cause.