Coskun Yolas1, Ayhan Kanat2, Mehmet Dumlu Aydin3, Cengiz Ozturk4, Esref Kabalar5, Nezih Akca6, Huseyin Eren6, Cemal Gundogdu7, Dilcan Kotan8, Nazan Aydin9. 1. Department of Neurosurgery, Family Physician, Erzurum, Turkey. 2. Department of Neurosurgery, Medical Faculty, RecepTayyip Erdogan University, Rize, Turkey. Electronic address: ayhankanat@yahoo.com. 3. Department of Neurosurgery, Medical Faculty, Ataturk University, Erzurum, Turkey. 4. Osman Gazi Health Care Centre, Family Physician, Erzurum, Turkey. 5. Department of Pathology, Family Physician, Erzurum, Turkey. 6. Department of Urology, Medical Faculty, RecepTayyip Erdogan University, Rize, Turkey. 7. Department of Pathology, Medical Faculty, Ataturk University, Erzurum, Turkey. 8. Department of Neurology, Medical Faculty, Sakarya University, Adapazari, Turkey. 9. Department of Psychiatry, Bakırköy Mental and Neurologic Disease, Education and Research Hospital, İstanbul, Turkey.
Abstract
OBJECTIVE: The Adamkiewicz artery (AKA) supplies pudendal nerve roots and conus medullaris. The aim of this study was to elucidate if there is any relationship between neurodegenerative changes of the Onuf nucleus (ON)-pudendal nerve ganglia complex secondary to vasospasm of the AKA after spinal subarachnoid hemorrhage (SAH). METHODS: This study was conducted on 22 rabbits, which were randomly divided into 3 groups: control (n = 5), sham (n = 5), and spinal SAH (n = 12). Experimental spinal SAH was induced at the L2 level. After 2 weeks, the ON-pudendal nerve ganglia complex and AKA were examined histopathologically. Bladder volume values were estimated, and results were analyzed statistically. RESULTS: Two animals died within the first week of experiment. Histopathologically, severe vasospasm of the AKA and neuronal degeneration and neuronal apoptosis were observed in the ON-pudendal nerve ganglia complex in 5 animals of the SAH group. The mean volume of the imaginary AKA, mean bladder volumes, and degenerated neuron densities of ON and pudendal nerve ganglia were estimated. We found that vasospasm of the AKA led to numerous neuron degenerations in ON and pudendal ganglia and consequently urinary retention (P < 0.005). CONCLUSIONS: ON-pudendal nerve ganglia complex degeneration secondary to vasospasm of the AKA may be a cause of urinary retention after spinal SAH.
OBJECTIVE: The Adamkiewicz artery (AKA) supplies pudendal nerve roots and conus medullaris. The aim of this study was to elucidate if there is any relationship between neurodegenerative changes of the Onuf nucleus (ON)-pudendal nerve ganglia complex secondary to vasospasm of the AKA after spinal subarachnoid hemorrhage (SAH). METHODS: This study was conducted on 22 rabbits, which were randomly divided into 3 groups: control (n = 5), sham (n = 5), and spinal SAH (n = 12). Experimental spinal SAH was induced at the L2 level. After 2 weeks, the ON-pudendal nerve ganglia complex and AKA were examined histopathologically. Bladder volume values were estimated, and results were analyzed statistically. RESULTS: Two animals died within the first week of experiment. Histopathologically, severe vasospasm of the AKA and neuronal degeneration and neuronal apoptosis were observed in the ON-pudendal nerve ganglia complex in 5 animals of the SAH group. The mean volume of the imaginary AKA, mean bladder volumes, and degenerated neuron densities of ON and pudendal nerve ganglia were estimated. We found that vasospasm of the AKA led to numerous neuron degenerations in ON and pudendal ganglia and consequently urinary retention (P < 0.005). CONCLUSIONS: ON-pudendal nerve ganglia complex degeneration secondary to vasospasm of the AKA may be a cause of urinary retention after spinal SAH.
Authors: Hizir Kazdal; Ayhan Kanat; Mehmet Dumlu Aydin; Ugur Yazar; Ali Riza Guvercin; Muhammet Calik; Betul Gundogdu Journal: J Craniovertebr Junction Spine Date: 2017 Jan-Mar