Thesis (Ph.D.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed on Feb. 2, 2010). Includes bibliographical references.

The majority of the population in South Africa use traditional health care to treat various mental conditions. This thesis has two main objectives; to bring together a comprehensive and detailed record of psychotropic plants used in southern Africa by indigenous peoples for medicinal or cultural purposes. Secondly, this research attempts to investigate the validity and rationale of the use of these plants by screening them in various biological assays for psychotropic activity. Plants were selected, based on their traditional use and availability, and were screened in four assays, which detect biological activity of a useful nature. A number of in vitro enzymatic and neuronal signal transduction assays were employed in this thesis, the inhibition of the serotonin reuptake transporter protein (SERT); inhibition of catabolic enzymes (e.g. acetylcholinesterase, monoamine oxidase); GABAA- benzodiazepine receptor binding. The influence of legislation, past and present, on the state of traditional medicine is highlighted. Aspects of the philosophies and practises of the various practitioners of South African traditional medicine will be discussed. An annotated list compiled from available ethnobotanical literature of plants traditionally used for central nervous system-related purposes is provided. It contains more than 330 species, from 94 families, which are currently used or have been used for cultural, medicinal and recreational purposes related to the central nervous system (CNS). Where available, information pertaining to plant part used, preparation method, dosage, route of administration, known and potentially active constituents are included. Seventy five extracts from 34 indigenous plant species used in South African traditional medicine or taxonomically related to these were investigated for their affinity to the serotonin reuptake transport protein, making use of an in vitro [3H]-citalopram serotonin reuptake transport protein binding assay. Aqueous and 70% ethanolic extracts of various plant parts were screened and 45 extracts derived from 15 plant species showed affinity. The affinity of 12 extracts from four plants was characterized as high (more than 50% inhibition at 5, 1, and 0.5 mg/ml). Plant species with high affinity to the serotonin reuptake transport protein included Agapanthus campanulatus, Boophone disticha, Datura ferox and Xysmalobium undulatum. Agapanthus campanulatus yielded high activity in aqueous extracts from leaves and flowers. B. disticha showed high activity both in aqueous and ethanolic extracts of leaves and bulbs. D. ferox showed high activity in aqueous extracts from the seeds and X. undulatum showed high activity in the ethanolic extract of the whole plant. Two compounds, buphanadrine and buphanamine, were isolated by bioassay-guided fractionation on vacuum-liquid-chromatography (VLC) and preparative thin-layer-chromatography (TLC) from B. disticha. The structures of the compounds were determined by 1H and 13C NMR. Fractions were tested for affinity to the serotonin transporter in a binding assay using [3H]-citalopram as a ligand. The IC50 values of buphanidrine and buphanamine were 274 ìM (Ki = 132 ìM) and 1799 ìM (Ki = 868 ìM), respectively. The two alkaloids were also tested for affinity to the 5HT1A receptor, but only showed slight affinity. Aqueous and ethanol extracts of 43 plants that are traditionally used to treat against epilepsy and convulsions were initially tested in the GABAA-benzodiazepine receptor binding assay, where the binding of 3H-Ro 15-1788 (flumazenil) to the benzodiazepine site is measured. The GABAA-benzodiazepine receptor complex is involved in epilepsy and convulsions. Out of the 118 extracts tested, one aqueous and 18 ethanol extracts showed activity. The most active extracts were the ethanolic leaf extracts of Searsia tridentata, Searsia rehmanniana and Hoslundia opposita and the ethanolic corm extract of Hypoxis colchicifolia, which all showed good dose-dependent activity. A further forty-six ethanol extracts from another 35 species, both indigenous and exotic that are traditionally used predominantly as sedatives or to treat various CNS-related ailments were tested in the GABAA-benzodiazepine receptor-binding assay. Out of the 46 extracts tested, seven showed good activity and 10 showed moderate activity. The most active extracts were the ethanolic leaf extracts of Arctopus echinatus, Artemisa afra, four Helichrysum species and Mentha aquatica which all showed good dose-dependent activity. Two biflavonoids with activity in the 3H-Ro 15-1788 (flumazenil) binding assay were isolated by high pressure liquid chromatography (HPLC) fractionation of the ethanol extract of the leaves from Searsia pyroides. The structures of the two biflavonoids were elucidated by nuclear magnetic resonance spectroscopy (NMR) to be agathisflavone and amentoflavone. Agathisflavone and amentoflavone competitively inhibited the binding of 3H-Ro 15-1788 with a Ki of 28 and 37 nM, respectively. Extracts of Searsia dentata and Searsia pentheri were not as active as the extract from Searsia pyroides; both were found to contain apigenin and agathisflavone. The monomer apigenin, agathisflavone and amentoflavone were fitted into a pharmacophore model for ligands binding to the GABAA receptor benzodiazepine site. This reflected the affinities of the compounds in the [3H]-flumazenil binding assay. Mentha aquatica, a mint that is found in Europe and Africa, is used in Zulu traditional medicine for spiritual purposes. The ethanolic leaf extract showed a strong affinity to the GABA-benzodiazepine receptor. Viridiflorol from the essential oil and (S)-naringenin from an ethanolic extract was isolated by bioassay-guided fractionation using binding to the GABA-benzodiazepine site. Viridiflorol had an IC50 of 0.19 M and (S)-naringenin of 0.0026 M. Twenty plants used in Zulu traditional medicine for several CNS-related ailments were screened for MAO inhibition and specific MAO-B inhibition activity. MAO-B inhibitors are currently employed in the treatment of neurodegenerative related illnesses such as Parkinson's and Alzheimer's diseases. A photometric peroxidase linked assay was used to determine the inhibition of the oxidative deamination of tyramine by MAO isolated from rat liver. Ruta graveolens exhibited the best MAO inhibitory activity (ethyl acetate leaf extract = IC50 5 ± 1 ìg/ml, petroleum ether extract = 3 ± 1 ìg/ml) and specific MAO-B inhibition (ethyl acetate leaf extract = IC50 7 ± 6 ìg/ml petroleum ether extract = 3 ± 1 ìg/ml). Schotia brachypetala, Mentha aquatica and Gasteria croucheri also exhibited good MAO-B inhibition activity. Six extracts of varying polarity of Mentha aquatica were tested in a photometric peroxidase linked MAO bioassay. The 70% ethanol extract had highest inhibitory activity. (S)-Naringenin was isolated from the extract by bioassay guided fractionation on VLC and preparative TLC. The structure of the compound was determined by 1H, 13C and 13C-DEPT NMR and optical rotation. The IC50 values for MAO inhibition by naringenin were 342 ± 33 ìM for the rat liver mitochondrial fraction, 955 ± 129 ìM for MAO-A and 288 ± 18 ìM for MAO-B respectively. South African traditional medicine clearly utilizes many botanical species with CNS-related activity. Only a small number of the more than 330 southern African plant species reported to treat or alter the CNS have been scientifically evaluated. To date very few of the active compounds have been isolated and identified. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

Multiple Sclerosis (MS) is a neurological autoimmune disease characterized by demyelination of central nervous system tissue and one way this is presented is in the demyelination of the retinal nerve, causing vision disturbance and loss (Munger et al., 2006). The thinning of the retinal nerve fiber layer (RNFL) can be measured and visualized using a noninvasive technique called Optical Coherence Tomography (OCT), which is also used to measure relative MS severity (Petzold et al., 2010). One environmental factor that has been found to have a relationship with MS is vitamin D; research findings suggest that sufficient levels of vitamin D may reduce the risk of developing MS, decrease MS severity, and may slow its progression (Ascherio et al., 2010; Munger et al., 2006; Muris et al., 2013). The mechanism by which vitamin D affects certain symptoms requires deeper investigation. This research examines the relationship between serum concentrations of 25-hydroxyvitamin D and retinal nerve fiber layer thicknesses in patients with MS. It was hypothesized that patients with sufficient vitamin D levels would have less demyelination of the retinal nerve caused by MS, and therefore would have a thicker RNFL in both eyes based on the proposed immunomodulatory role of vitamin D found in other studies. Blood samples were assayed to measure the concentration of 25-hydroxyvitamin D and OCT was used to measure RNFL thicknesses in patients with MS at the Harbor-UCLA Medical Center Neurology Clinic. Patients with sufficient levels of 25-hydroxyvitamin D had a greater mean global RNFL thickness in both eyes than in patients with insufficient levels of 25-hydroxyvitamin D; however the differences were not significant. Further research is necessary in order to determine whether or not there is a correlation between vitamin D and RNFL thickness and what role vitamin D plays in MS presentation.

Thesis (Ph. D.)--University of Lund, 1994. / Published dissertation. Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2010. / Title from document title page. Document formatted into pages; contains x, 102 p. : ill. (some col.). Includes abstract. Includes bibliographical references.

Thesis (Ph. D.)--University of Lund, 1994. / Published dissertation. Includes bibliographical references.

Introduction: The increase of cardiovascular disease risk has been demonstrated in subjects with HIV infection. The dysfunction in the regulation of the autonomic system has been identified as a mechanism underlying to cardiac death in this group of patients. This study aimed to analyze the association between cardiovascular risk and cardiac autonomic control in patients with HIV. Methods: The sample consisted of 25 patients with HIV, of both genders, in use of antiretroviral therapy and with undetectable viral load, treated on the of Infectious Diseases Ambulatory, from the University Hospital of Santa Maria (HUSM), between August and December of 2014. Patients with cardiovascular disease, metabolic, respiratory, neurological or kidney were excluded. The cardiovascular risk was assessed by Framingham score, used to estimate the probability of cardiovascular events in ten years. The cardiac autonomic control was assessed by measuring the heart rate variability, analyzing the following variables: 1) in the time domain were measured SDNN, triangular index (overall variability) and rMSSD (parasympathetic activity); 2) in the frequency domain understood the low frequency components (LF; sympathetic activity) and high frequency (HF; parasympathetic activity), both normalized, and the LF/HF ratio (sympatho-vagal balance). Results: The sample (12 women and 13 men) had a mean age of 48.7±10.9 years, body mass index of 25.7±5.1 kg/m2, heart rate of 72.1±13.4 bpm, respiratory rate of 16.3±3.8 bpm, systolic blood pressure of 125.2±18.7 mmHg and diastolic 83.3±12.2 mmHg. The average time since diagnosis of the disease was 10.2±5.0 years, the medication time of 7.2±4.2 years and the CD4 count of 628.6±223.8 mm3 of blood. The score obtained in the Framingham score was 9.5±5.1 and the risk of cardiovascular events was 9.5±7.9%, with 7 patients classified as low risk, 14 as intermediate risk and 4 as high cardiovascular risk. The Framingham score presented a correlation with the medication time (r=0.53), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.44), but it was inversely correlated with SDNN (r=-0.43), rMSSD (r=-0.47) and with the triangular index (r=-0.49). The risk of cardiovascular events was positively correlated with the medication time (r=0.54), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.45), but had negative correlation with SDNN (r=-0.40), rMSSD (r=-0.43) and the triangular index (r=-0.48). Conclusion: Patients with HIV classified into different bands of Framingham score, presented association between cardiovascular risk and increased sympathetic activity, decreased parasympathetic activity and sympatho-vagal balance. This demonstrates that even in patients with undetectable viral load, cardiovascular autonomic dysfunctions may be associated with cardiovascular risk in ten years. These findings point to the importance of routine assessments of cardiovascular autonomic nervous system in this population. / Introdução: o aumento do risco de doença cardiovascular tem sido demonstrado em sujeitos com infecção por HIV. A disfunção na regulação do sistema autônomo tem sido apontada como mecanismo subjacente a morte cardíaca nesse grupo de pacientes. Este estudo objetivou analisar a associação entre risco cardiovascular e controle autonômico cardíaco em portadores de HIV. Métodos: a amostra foi composta por 25 pacientes com HIV, de ambos os sexos, em uso de antirretrovirais e com carga viral não detectável, oriundos do Ambulatório de Doenças Infecciosas do Hospital Universitário de Santa Maria (HUSM), entre agosto e dezembro de 2014. Pacientes com doença cardiovascular, metabólica, respiratória, neurológica ou renal foram excluídos. O risco cardiovascular foi avaliado pelo Escore de Framingham, utilizado para estimar a probabilidade de eventos cardiovasculares em dez anos. O controle autonômico cardíaco foi avaliado pela medida da variabilidade da frequência cardíaca, analisando-se as seguintes variáveis: 1) no domínio do tempo foram mensurados o SDNN, índice triangular (variabilidade global) e rMSSD (atividade parassimpática); 2) o domínio da frequência compreendeu os componentes de baixa frequência (LF; atividade simpática) e de alta frequência (HF; atividade parassimpática), ambos normalizados, e a relação LF/HF (balanço simpato-vagal). Resultados: a amostra (12 mulheres e 13 homens) apresentavam idade média de 48,7±10,9 anos, índice de massa corporal de 25,7±5,1 kg/m2, frequência cardíaca de 72,1±13,4 bpm, frequência respiratória de 16,3±3,8 rpm, pressão arterial sistólica de 125,2±18,7 mmHg e diastólica de 83,3±12,2 mmHg. O tempo médio de diagnóstico da doença foi de 10,2±5,0 anos, o tempo de medicação de 7,2±4,2 anos e a contagem de CD4 de 628,6±223,8 mm3 de sangue. A pontuação obtida no Escore de Framingham foi de 9,5±5,1 e o risco de eventos cardiovasculares foi de 9,5±7,9%, sendo 7 pacientes classificados como baixo risco, 14 como risco intermediário e 4 como alto risco cardiovascular. A pontuação do Escore de Framingham apresentou correlação com o tempo de medicação (r= 0,53), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,44), mas correlacionou-se inversamente com o SDNN (r=-0,43), rMSSD (r=-0,47) e com o índice triangular (r=-0,49). O risco de eventos cardiovasculares esteve correlacionado positivamente com o tempo de medicação (r=0,54), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,45), porém, apresentou correlação negativa com o SDNN (r=-0,40), rMSSD (r=-0,43) e com o índice triangular (r=-0,48). Conclusão: Pacientes portadores de HIV, classificados em diferentes faixas do Escore de Framingham, apresentam associação entre o risco cardiovascular e o aumento da atividade simpática, redução da atividade parassimpática e do balanço simpato-vagal. Isso demonstra que, mesmo em pacientes com carga viral não detectável, as disfunções autonômicas cardiovasculares podem estar associadas ao risco cardiovascular em dez anos. Estes achados apontam para a importância de avaliações rotineiras do sistema nervoso autonômico cardiovascular nesta população.

Orientador: Leonilda Maria Barbosa dos Santos / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-07T03:41:32Z (GMT). No. of bitstreams: 1 Castro_FabianoRobertode_M.pdf: 943470 bytes, checksum: 271c21deb3b25015f9737d33adf49814 (MD5) Previous issue date: 2006 / Resumo: A Síndrome de Guillain-Barré (SGB) é uma doença desmielinizante do sistema nervoso periférico (SNP). Baseado principalmente nas similaridades clínicas e histopatológicas a Neurite Experimental Auto-imune (EAN) tem sido extensivamente usada como modelo de estudo da SGB. A EAN é uma doença auto-imune, que pode ser experimentalmente induzida em ratos geneticamente suscetíveis através da imunização com os componentes da mielina de nervos periféricos tais como os peptídeos P0 e P2 , ou ainda por transferência adotiva de lifócitos T CD4+ do tipo Th1. Diferentes tentativas de tratamentos para a SGB têm sido estudadas, dentre elas pode-se citar a plasmaferese, o uso de anticorpos monoclonais, administração de corticóides e a imunossupressão global através da administração de intérferon ß. A utilização de venenos totais de serpentes, ou frações deles, já demonstrou bons resultados na tentativa de tratamento de alguns modelos de doenças auto-imunes como a diabetes auto-imune insulino dependente, lúpus e encefalomielite experimental auto-imune (EAE). No presente trabalho foi estudado o efeito de uma fração do veneno da cascavel sul americana Crotalus durissus terrificus (Cdt), a crotapotina, no modelo de EAN. São apresentadas evidências de que tanto a administração intraperitoneal (IP) como a oral de crotapotina reduz significativamente a gravidade da EAN induzida em ratos Lewis, associada a um significativo declínio na resposta proliferativa das células T neuritogênicas, assim como diminuição de infiltrados de células mononucleares no nervo ciático dos os animais / Abstract: Biomedical research in which venom components are being investigated for their potential as novel therapeutic agents has emerged as an interesting option. Crotapotin which is a fraction of the venom of the rattlesnake Crotalus durissus terrificus, has been described as an antinflammatory that acts on the innate arm of the immune response. Here we have demonstrated that intraperitoneal (IP), as well as oral administration of crotapotin significantly reduces the severity of experimental autoimmune neuritis (EAN), an experimental model for Guillain-Barré Syndrome. The reduction of the severity of the disease is associated with a reduction in the mononuclear cells infiltrating in the sciatic nerve and a significant decrease in the lymphocyte proliferative response to neuritogenic peptide / Mestrado / Ciencias Basicas / Mestre em Clinica Medica

Dor neuropática e neuropatia causadas pelo quimioterápico oxaliplatina são comuns e causam restrições às atividades funcionais e qualidade de vida. Muitos estudos têm quantificado e qualificado esses sintomas, porém raramente utilizando amostra expressiva e instrumentos validados e específicos para este fim. Neste estudo é proposta uma análise ampla, por instrumentos que quantificam e qualificam a dor e neuropatia relacionadas à oxaliplatina e suas características associadas. Objetivos: Identificar a prevalência de dor neuropática e neuropatia periférica em doentes com câncer colorretal recebendo tratamento com oxaliplatina durante os seis meses de tratamento quimioterápico e após seguimento (de 3 a 6 meses); avaliar, comparar e descrever as características da dor e neuropatia nesta população e avaliar seu impacto nas atividades de vida diária e qualidade de vida. Métodos: Foram incluídos 110 doentes (média 55,6 anos) com câncer colorretal durante o tratamento quimioterápico com oxaliplatina e seguidos por 3 a 6 meses após quimioterapia. Os doentes responderam ao questionário sócio-demográfico e a questionários específicos para dor e neuropatia antes da quimioterapia e bimestralmente por até seis meses durante a quimioterapia e em avaliação de seguimento realizada de 3 a 6 meses após o término da quimioterapia. Os instrumentos utilizados foram: Questionário de Qualidade de Vida da Organização Européia para Pesquisa e Tratamento do Câncer - C30 (EORTC QLQ-C30); Questionário de Dor McGill reduzido (QDMR), Inventário de Sintomas de Dor Neuropática (ISDN), Inventário Breve de Dor (BPI-Brief Pain Inventory) Questionário de Dor Neuropática 4 (DN4), Escala Hospitalar de Ansiedade e Depressão (HADS), Escore Total de Neuropatia (TNS - Total Neuropathy Score). Resultados: Em geral, a dor e neuropatia aumentaram durante o período de quimioterapia e diminuíram após fim do tratamento, permanecendo em níveis significativamente mais elevados após o fim do tratamento quimioterápico. A média de intensidade de dor (dor mais intensa) segundo o IBD foi 2,54 na V3 (após 4 meses de tratamento com oxaliplatina). A dor foi do tipo neuropática em 21,67% dos doentes ao fim da quimioterapia e em 10,00% após fim do seguimento. As médias segundo o ISDN foram 0,67 no basal, 18,67 na V2, 17,77 na V3, 17,44 após quimioterapia e 11,03 após seguimento. A característica da dor mais frequente foi em choque elétrico, enjoada e incômoda segundo o QDMR e segundo o ISDN foram choque elétrico, frio doloroso e dormência. A qualidade de vida sofreu impacto negativo. Conclusões: Dor neuropática foi prevalente após a quimioterapia e após seguimento e se associou com interferência negativa sobre as atividades diárias. Estes dados poderão auxiliar o desenvolvimento de tratamentos individualizados da neuropatia relacionada à oxaliplatina / Neuropathic pain and neuropathy caused by oxaliplatin chemotherapy are common and cause restrictions in activities of daily living and quality of life. Many studies have quantified and qualified these symptoms but only rarely used a comprehensive sample of patients and employed validated and specific instruments for pain assessment. In this study we proposed a comprehensive analysis by instruments that quantify and qualify the pain and neuropathy and its characteristics. Aim of Investigation: To identify the prevalence of neuropathic pain and peripheral neuropathy in patients with colorectal cancer receiving treatment with oxaliplatin during the six months of chemotherapeutic treatment and after follow-up (3 to 6 months); to evaluate, compare and describe pain and peripheral neuropathy characteristics in this population and evaluate their impact on activities of daily living. Methods:110 patients (mean 55.6 years) with colorectal cancer were included during the six months of chemotherapy with oxaliplatin and follow-up (3 to 6 months) after chemotherapeutic treatment. Patients answered socio-demographic questionnaires and specific assessment tools for pain and neuropathy evaluation at the baseline visit and every 2 months during chemotherapy and after follow-up (3-6 months). The instruments used were: The European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30); Reduced McGill Pain Questionnaire (MPQ), Neuropathic Pain Symptom Inventory (NPSI), Brief Pain Inventory (BPI) Neuropathic Pain Diagnostic Questionnaire (DN4), Hospital Anxiety and Depression Scale (HADS), Total Neuropathy Score (TNS), Results: In general, pain and neuropathy intensity increased during chemotherapy and decreased after the end of treatment (follow-up). The most severe pain according to the BPI was 2.54 in V3 (after 4 months treatment with oxaliplatin). Pain was neuropathic in 21.67% right after chemotherapy and in 10.00% after follow-up according to the DN4. The average sum of neuropathic pain symptoms according to the NPSI were 0.67 in V1, 18.67 in V2, 17.77 in V3, 17.44 after chemotherapy and 11.03 after follow-up. The most common characteristics of the pain was electric shocks, nauseating and fearful, according to MPQ and according to NPSI were electric shock, evoked by cold stimuli and tingling. Conclusions: Patients treated with oxaliplatin had significant pain and neuropathy that negatively interfeared with daily activities. These data may help tailor individualized treatment of chemotherapy related neuropathic pain

INTRODUÇÃO: A formação do hematoma intraneural com comprometimento dos nervos periféricos pode ocorrer após traumas ou em associação com distúrbios de coagulação. A opção por conduta conservadora (expectante) ou descompressão cirúrgica ainda é controversa. Essas duas condutas foram analisadas comparativamente por meio de modelo experimental em ratos submetidos a hematoma intraneural associado à compressão extrínseca. MATERIAL E MÉTODOS: Cinqüenta ratos Wistar foram divididos em 5 grupos. Em 4 grupos (A, B, C e D) o nervo ciático direito foi envolvido por tubo de silicone de diâmetro interno maior que o do nervo, simulando o trajeto do nervo periférico através de regiões inextensíveis (exemplo: túnel do carpo). No grupo B, foi realizada injeção intraneural no segmento envolvido pelo tubo de 0,2 ml de sangue autógeno. No grupo C, após produção do hematoma, foi feita a imediata remoção do tubo de silicone simulando-se a descompressão túnel do carpo, e epineurotomia longitudinal complementar. No grupo D, após produção do hematoma, foi realizada apenas a remoção do tubo de silicone. No grupo E (CONTROLE) o nervo foi apenas exposto sem a presença de hematoma ou compressão extrínseca. A avaliação funcional foi feita periodicamente durante 61 dias através do Índice de Função Ciática (IFC) de Bain-Mackinnon-Hunter, e a análise histomorfométrica realizada ao término deste período. RESULTADOS: O grupo A (compressão extrínseca) apresentou IFC inicial de -26,29±2,89 com retorno aos valores pré-operatórios no 5º dia de pós-operatório. O grupo B (hematoma e compressão extrínseca) foi aquele com pior função ciática inicial (IFC -85,23±3,51) com recuperação da função no 23º dia. O grupo C apresentou IFC inicial de -32,78±7,45 com normalização no 5º dia. O grupo D apresentou IFC inicial de -45,13±6,84 com normalização da função ciática no 5º pós-operatório. A análise estatística do IFC identificou diferença significativa (p<0,0001) entre a conduta expectante (grupo B) e o tratamento cirúrgico descompressivo (grupos C e D) até o 19° dia. O número e a densidade de fibras mielínicas em degeneração foi significativamente maior no grupo B quando comparado aos outros grupos. CONCLUSÃO: Neste estudo experimental, descompressão cirúrgica e epineurotomia reduziram a perda de fibras mielínicas e determinaram recuperação funcional mais rápida. / INTRODUCTION: Intraneural hematoma can result in the median nerve in the carpal tunnel after trauma or coagulation disorders. The decision for expectant management or descompressive surgical techniques is still controversial. MATERIAL AND METHODS: Fifty male Wistar rats were divided into 5 groups. The sciatic nerve was wrapped around with a silastic device in 4 groups. Group A the sciatic nerve was just wrapped by the silastic tube. In group B an intraneural injection of autologous blood was added. In group C, after the hematoma creation the silastic device was removed and a longitudinal epineurotomy was performed. In group D, we removed the silastic device after the hematoma but the nerve was not opened. In the group E (sham-operated) sciatic nerve was exposed without hematoma or compression. Nerve function recovery was assessed periodically over 61 days using the Bain-Mackinnon-Hunter Sciatic Function Index (SFI). RESULTS: Group A (extrinsic compression) presented initial SFI of -26.29±2.89, with return to baseline values on the 5th postoperative day. Group B (hematoma and extrinsic compression) exhibited the poorest function (SFI - 85.23±3,51) after surgery and recovery in 23 days. Group C (liberation of silastic and hematoma drainage through epineurotomy) and Group D (only removal of the silastic tube) presented similar initial SFI values of - 32.78±7.45 and - 45.13±6.84, respectively. In both groups SFI values returned to baseline level on 5th postoperative day. The statistical analysis of SFI identified a significant difference (p<0.0001) between the expectant management (group B) and the descompressive surgery approach (groups C & D) by 1st to 19th postoperative day. The number of degenerative fibers and density of degenerative fibers were statistically significant bigger in the group B when compared to the other groups. There was no statistical difference between the other groups when these parameters were analysed. CONCLUSION: Thus, immediate descompressive procedures of the intraneural hematoma provide a faster functional recovery and reduce the damage to the axon fibers.