Department of Neurosurgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Department of Pediatric Neurology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey.
J Clin Neurosci. 2019 Aug;66:235-238. doi: 10.1016/j.jocn.2019.05.039. Epub 2019 May 29.
Muscle abnormalities after spinal cord ischemia caused by subarachnoid hemorrhage (SAH) have not been explored for degenerative variations in the soma of second motor neurons of the spinal cord gray matter. This study aimed to investigate histopathological alterations in the gray matter and the role of peripheral nerves in SAH.
Twenty-two rabbits were allocated in the control (Group I, n = 5), SHAM (Group II, n = 5), and research (Group III, n = 12) groups. Muscle weakness of the upper extremities innervated by radial nerves was evaluated at the initial day, and outcomes were recorded as control data. Re-measurements were done after injecting 0.5 ml of SF for SHAM and autolog artery blood inside craniocervical subarachnoid space for the study group. After 3 weeks, radial nerve roots, their ganglia, and segments of the spinal cord around C5-6 root entry zones were extracted bilaterally. Degenerated second motor neuron somas and the degenerated radial nerve motor axons at the intervertebral foramen were assessed.
The average degenerated soma intensity/mm at the C5-6 levels in the spinal cord was 2 ± 1/mm, 13 ± 4/mm, and 56 ± 10/mm for Groups I, II, and Group III. The average degenerated axon intensity of radial nerves was 3 ± 1/mm, 34 ± 9/mm, and 234 ± 78/mm for Groups I, II, and III.
Gray matter ischemia in the spinal cord may lead to axonal deterioration on equal levels at the peripheral nerves with advanced SAH. Detected or undetected spinal SAH should be considered an important factor on the etiology of second motor neuron diseases.
尚未探讨蛛网膜下腔出血(SAH)引起的脊髓缺血后脊髓灰质中第二运动神经元体的退行性变化引起的肌肉异常。本研究旨在探讨灰质的组织病理学改变以及周围神经在 SAH 中的作用。
将 22 只兔子分配到对照组(I 组,n=5)、假手术组(II 组,n=5)和研究组(III 组,n=12)。在最初的一天评估由桡神经支配的上肢肌肉无力,并将结果记录为对照数据。在注射 0.5ml SF 后对 SHAM 进行重新测量,对研究组在颅颈蛛网膜下腔内部注入自体动脉血。3 周后,双侧提取桡神经根、神经节和 C5-6 神经根入口区周围的脊髓段。评估退变的第二运动神经元体和椎间孔处退变的桡神经运动轴突。
脊髓 C5-6 水平的平均退变体强度/mm 为 I 组 2±1/mm、II 组 13±4/mm 和 III 组 56±10/mm。各组桡神经退变轴突强度的平均强度分别为 I 组 3±1/mm、II 组 34±9/mm 和 III 组 234±78/mm。
脊髓灰质缺血可能导致周围神经在严重 SAH 时出现同等水平的轴突退变。应考虑检测或未检测到的脊髓 SAH 是第二运动神经元疾病病因的重要因素。