title: The Effect of l-Arginine on Dural Healing After Experimentally Induced Dural Defect in a Rat Model.
abstract: BACKGROUND
  Incomplete repair of the dura mater may result in numerous complications such as cerebrospinal fluid leakage and meningitis. For this reason, accurate repair of the dura mater is essential. In this study, the effect of systemic and local supplementation of l-arginine on dural healing was evaluated.
  
  
  METHODS
  Thirty male Wistar rats were used and divided into control, local, and systemic l-arginine groups, with 10 rats in each. In each group, a 5-mm experimental incision was made at the lumbar segment of the dura mater and cerebrospinal fluid leakage was induced. Each group was divided into 2 subgroups and at the end of the first and sixth weeks, the rats were killed and the damaged segments of the dura were separated, histologically evaluated and the dural healing indicators including cell types, granulation tissue formation, collagen deposit, and vascularization were compared between groups.
  
  
  RESULTS
  The systematic supplementation of l-arginine showed a significant effect in dural healing compared with the control group. After the first week, granulation formation increased considerably (P < 0.031), and after 6 weeks, collagen deposition and neovascularization were significantly different compared with the control group (P < 0.030; P < 0.009). In comparison between different groups at the end of the first and sixth weeks, maximum changes in healing indicators were observed in the systemic group and the least variations were related to the control group.
  
  
  CONCLUSIONS
  The systemic supplementation of l-arginine may accelerate dural healing by increasing the level of granulation tissue formation, collagen deposition, and vascularization.
authors.affiliation: Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Sayed Ali
authors.initials: SA
authors.lastname: Ahmadi
authors.affiliation: Student Research Committee, Arak University of Medical Sciences, Arak, Iran. Electronic address: Mostafa.medicine87@gmail.com.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Jafari
authors.affiliation: Department of Anatomy, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Darabi
authors.affiliation: Thyroid Research Center, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Chehrei
authors.affiliation: Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Rezaei
authors.affiliation: Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Mirsalehi
mesh_terms: D000818:Animals; D001120:Arginine / Q000627:therapeutic use*; D065634:Cerebrospinal Fluid Leak / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003094:Collagen / Q000378:metabolism; D004195:Disease Models, Animal; D004388:Dura Mater / Q000187:drug effects; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D003094:Collagen; D001120:Arginine
keywords: Arginine; CSF leakage; Dura mater; Dural healing