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    Intraventricular albumin: An optional agent in experimental post-traumatic brain edema
    (2005) İş, Merih; Uzan, Mustafa; Ünal, Faruk; Kırış, Talat; Tanrıverdi, Taner
    Hypothesis: Human albumin may be effective in the treatment of posttraumatic brain edema due to its hyperoncotic features. Therefore, the aim of the experimental study presented in this paper has two points: the first is to evaluate the efficacy of intraventricular hyperoncotic human albumin on post-traumatic brain edema and the second is to try to show the appropriate post-traumatic time window for albumin administration. Method: Traumatic brain injury and subsequent edema was formed by a model of impact acceleration injury in rats. Human albumin was administered via intraventricular route by using a stereotactic head holder. All animals in each group were decapitated 24 hours after the procedure and the effect of albumin was evaluated by measurement of tissue specific gravity. Results: Tissue specific gravity decreased in edematous tissue (trauma indicator), increased after albumin administration at the 12th (p<0.001), and both at the 1st and 12th hour of the trauma (edema treatment; p<0.001). On the other hand, albumin administered at the 12th, and at both the 1st and 12th hours in the rats without trauma has caused the formation of the brain edema. Conclusion: We conclude that human albumin is effective in cytotoxic, but not in vasogenic edema and exerts its best anti-edematous effect at the 12th hour of severe head trauma and this study may help future studies that will try to show the effects of albumin with different time modalities after severe head injury.
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    Lack of association between the IL1A gene (-889) polymorphism and outcome after head injury
    (2006) Tanrıverdi, Taner; Uzan, Mustafa; Sanus, Galip Zihni; Baykara, Onur; iş, Merih
    Background: Interleukin (IL) 1 is a proinflammatory cytokine that has been identified as an important mediator of neurodegeneration induced by ischemia or traumatic brain injury. Accumulating evidence to date has suggested that the major cytokine contributing to neurodegeneration after head injury is IL-1? rather than IL-1?; however, there is no sufficient data regarding IL-1? in literature, and there may be an association between IL1A gene polymorphism and outcome after head injury. Methods: We performed a prospective clinical study and included a recruited series of 71 patients who had head injury and were admitted to our neurosurgical unit. Severity of initial injury was assessed by the Glasgow Coma Scale. Outcome at 6 months after injury was assessed by means of the Glasgow Outcome Score. Interleukin 1? genotypes were determined from blood samples by standard methods. Results: Of 40 patients with IL1A*2, 18 (45%) had an unfavorable outcome (dead, vegetative state, or severe disability) compared with 7 (22.5%) of 31 without IL1A*2 (P = .08). Conclusion: Our findings show that there is no genetic association between IL1A gene polymorphism and outcome after head injury. Further clinical studies should be designed to confirm and further evaluate these findings. © 2006 Elsevier Inc. All rights reserved.
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    Prolonged elevation of magnesium in the cerebrospinal fluid of patients with severe head injury
    (Taylor & Francis Ltd, 2007) Kafadar, Ali Metin; Sanus, Galip Zihni; İş, Merih; Coşkun, Abdurrahman; Tanrıverdi, Taner; Hanımoğlu, Hakan; Uzan, Mustafa
    Objectives: Several works have investigated the role of serum magnesium (Mg) concentrations in traumatic brain injury. However, there is restricted information about cerebrospinal fluid (CSF) levels of Mg in patients with severe head injury (SHI). We assessed the changes of Mg concentrations in CSF and serum in patients with SHI during the first 10 days after the trauma. Methods: Eleven patients with SHI were studied prospectively on days 1-3, 5 and 10 with analysis of CSF and serum levels of Mg and Ca. The control group consisted of nine patients with hydrocephalus. Results: CSF levels of Mg were significantly higher in patients than controls in the corresponding time points except on days 5 and 10 of trauma. The CSF Mg levels tended to decrease and the highest level was found on day 1 after trauma (2.81 +/- 0.65 mg/dl). In the control group, the CSF level of Mg was 1.95 +/- 0.66 mg/dl. No significant difference can be detected between controls and patients regarding serum Mg and Ca levels. In addition, significantly higher values of Ca in the CSF were observed in all time points after trauma in patients with SHI than in the controls. There was no correlation between the CSF and serum levels of Mg and Ca levels. Discussion: Our study demonstrates that in patients with SHI, CSF levels of Mg and Ca are elevated during the whole observation period. Further works should be designed in order to show the role and importance of CSF levels of ionized Mg in outcome of patients with SHI.