Chapters authored
Peripheral Nerve Injury and Current Treatment Strategies
Neuronal cells are the main fundamental anatomic unit of the system. Nerve injuries are generally divided into three categories as neuropraxia, axonotmesis and neurotmesis. Neurotmesis is the most severe form. Schwann cells are activated within 24 hours of the injury and the healing cascade continued with the cells, which are stimulated by Schwann cells. And neurotrophic factors like nerve growth factor (NGF) have a crucial role in regeneration and degeneration processes. Additionally, Schwann cells upregulate the expression of some proteins, such as fibronectin, which are crucial for axonal regeneration. All this information about nerve healing sheds light on treatment studies. Iatrogenic nerve injury has an important place in peripheral nerve injury. Causes may be direct surgical damage, wrong intraoperative patient positioning, anaesthesia-related reasons or limb tourniquets. Typical symptoms are motor or sensory deficits such as paraesthesia, weakness, paralysis and pain. Many of the traumatic nerve injuries require surgical repair. Direct nerve repair and autologous nerve grafts are still gold-standard treatment options. Additionally, nerve conduits are very successful to provide an ideal peripheral support for neuronal recovery but are still insufficient. In recent years, research efforts have focused on the neurotrophic factors and cell-based therapies to perform better microenvironment for neuronal healing.
Part of the book: Peripheral Nerve Regeneration