title: Neuroprotective Effect of Erythropoietin in Postoperation Cervical Spinal Cord Injury: Case Report and Review.
abstract: BACKGROUND
  New research shows shown that erythropoietin has neuro-protective effects. In preclinical trial and human clinical trials, it was demonstrated that erythropoietin is effective treatment for spinal cord injury. Early administration of medications after injury increases the hope of attenuating secondary damage and maximizing an improved outcome.
  
  
  METHODS
  A 42-year-old female patient presented with gait instability and progressive weakness in her right leg over a 6-year period. She was diagnosed as myelomalacia and was candidate for cervical discectomy. After surgery, she suffered from right hemiplegia due to spinal cord injury that did not respond well to routine treatment. Darbepoetin alpha (Aranesp) 100 mcg, subcutaneous daily for three days, was added to the patient's treatment seven days after trauma and resulted in rapid improvement. The patient recovered progressively and was discharged from the hospital ten days after erythropoietin therapy.
  
  
  CONCLUSIONS
  This case report supports the beneficial role of erythropoietin in function, maintenance, and recovery of neurons. Erythropoietin is a double-edge sword, as long-term erythropoietin therapy has some complications, like thromboembolism and stroke. Recent studies suggested that erythropoietin should be given as single high dose to exert a rapid neuro-protective effect with minimal hematopoietic side effects. We believe that the effects and other adverse consequences of erythropoietin and its non-erythropoietic derivatives should be evaluated in clinical trials.
authors.affiliation: Anesthesiology and Pain Management Department, Centre hospitalier de l'Universite de Montreal (CHUM), Montreal, Canada.
authors.forename: Alireza
authors.initials: A
authors.lastname: Nekoui
authors.affiliation: Anesthesiology Department, San Felipe Clinic, Lima, Peru.
authors.forename: Violeta
authors.initials: V
authors.lastname: Del Carmen Escalante Tresierra
authors.affiliation: Anesthesiology and Pain Management Department, Centre hospitalier de l'Universite de Montreal (CHUM), Montreal, Canada.
authors.forename: Sadegh
authors.initials: S
authors.lastname: Abdolmohammadi
authors.affiliation: Neurosurgery Department, Centre hospitalier de l'Universite de Montreal (CHUM), Montreal, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shedid
authors.affiliation: Anesthesiology and Pain Management Department, Centre hospitalier de l'Universite de Montreal (CHUM), Montreal, Canada.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Blaise
keywords: Erythropoietin; Neuro-Protective Agents; Neuropathic Pain; Spinal Cord Injury