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Traditional shooting with guns often occurs and leads to unwanted gunshot injuries in areas where celebrations are held. Such injuries have been classified as celebratory gun shooting injury in the international disease classification... more
Traditional shooting with guns often occurs and leads to unwanted gunshot injuries in areas where celebrations are held. Such injuries have been classified as celebratory gun shooting injury in the international disease classification system. Case: An 8-year-old female patient presented with respiratory arrest. The heartbeats normalized upon cardiopulmonary resuscitation. On physical examination, the only pathological finding was a skin defect measuring 1 x 1 cm on the midline and located 2 cm in front of the coronal suture. Cranial CT revealed a bone defect of 0.5 cm in the area 2 cm in front of the coronal suture on the midline, tetraventricular and extensive subarachnoid hemorrhage and parenchymal hematoma in the frontal area. It was initially thought to be a gunshot injury; however, on cranial CT, no bullet fragments or bullet exit hole was observed. A cervicothoracal direct graph was obtained and an image that might have been compatible with a bullet core was detected at Th 2-3 vertebra level. Conclusion: Although gunshot injuries are generally well- known, this may not be a very familiar topic for neurosurgeons. The primary aim of this report is to emphasize that a bullet round randomly fired into the air ascends in reverse direction to gravity and after reaching a zero point, it returns to the ground at a high velocity that facilitates its penetration into the skull according to a principal physics law.
Research Interests: Medicine, Brain Death, Humans, Child, Female, and 7 morePubmed, Holidays, Skull, Gunshot wounds, Rifle, Heart arrest, and Fatal outcome
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Research Interests: Magnetic Resonance Imaging, Treatment Outcome, Medicine, Case Report, Humans, and 15 moreChild, Neuroradiology, Thorax, Male, Clinical Sciences, Ilium, Teratoma, X ray Computed Tomography, Sella Turcica, Brain Neoplasm, Neurosciences, Brain Neoplasms, Neoplasm metastasis, Third ventricle, and Fatal outcome
... Ağahan ÜNLÜ 1 , Celal BAĞDATOĞLU 2 , Gökalp SİLAV 1 , Varol AYDIN 3 , Önder GÜNEY 4 , Mehmet SELÇUKİ 5. ... Bazı deneylerde toksik olduğu sanılan maddeler kullanılarak defektlerin nedenlerinin mekanizmaları üzerindeki düşüncelere... more
... Ağahan ÜNLÜ 1 , Celal BAĞDATOĞLU 2 , Gökalp SİLAV 1 , Varol AYDIN 3 , Önder GÜNEY 4 , Mehmet SELÇUKİ 5. ... Bazı deneylerde toksik olduğu sanılan maddeler kullanılarak defektlerin nedenlerinin mekanizmaları üzerindeki düşüncelere katkıda bulunulmuştur. ...
... Corresponding Author Information Reprint requests: Basak Erguvan Dogan, MD, Department of Diagnostic Radiology, Unit 1350, University of Texas MD Anderson Cancer Center, 1550 Holcombe Blvd, Houston, TX 77230.... more
... Corresponding Author Information Reprint requests: Basak Erguvan Dogan, MD, Department of Diagnostic Radiology, Unit 1350, University of Texas MD Anderson Cancer Center, 1550 Holcombe Blvd, Houston, TX 77230. PII:áS0363-0188(05)00023-X. ...
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BACKGROUND Epidermoid tumors of the cerebellopontine angle and posterior fossa account for approximately 1% of all intracranial tumors. Classifications that may guide surgical planning in the current neurosurgical practice are lacking.... more
BACKGROUND Epidermoid tumors of the cerebellopontine angle and posterior fossa account for approximately 1% of all intracranial tumors. Classifications that may guide surgical planning in the current neurosurgical practice are lacking. This study aimed to focus on the surgical outcome and suggest a classification system that may aid neurosurgeons in determining the goal of resection to minimize morbidity and mortality rates. METHODS The study population comprised patients who underwent surgery and follow-up for tissue-proven epidermoid tumors between 2015 and 2020. Patients' data, including demographic features, clinical symptomatology, the extent of surgical resection, and postoperative outcomes, were retrospectively evaluated. A new classification system was designed based on the anatomical-radiological findings and was evaluated in terms of clinical symptomatology, radiological features, surgical approach, and postoperative outcomes. RESULTS The patient population comprised 22 women (57.9%) and 16 men (42.1%), with a mean age of 34.9 years. A practical classification system based on the radiological-anatomical vertical (1, 2, and 3) and horizontal (a, b, and c) tumor extensions was designed. No significant differences were found in the patients in terms of sex/age. The most commonly observed symptom was gait disturbance (34.2%). The preoperative tumor diameter was significantly larger in the subtotal resection (STR) group than in the gross total resection (GTR) and near-total resection (NTR) groups. Significantly more cistern involvement was observed in the STR group than in the GTR group. The GTR, NTR, and STR rates were higher in grade 1, 3, and 2 cases, respectively. The subgroup 'a' was correlated with higher resection rates (GTR and NTR), whereas the subgroup 'b' was correlated with STR. CONCLUSIONS Our suggested classification system represents a simple and practical model that may guide neurosurgeons in predicting the goal of resection during surgical planning and in minimizing potential morbidity.
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Research Interests: Biology, Medicine, Embryo, Animals, Chickens, and 4 moreNeural Tube Defects, Piracetam, Levetiracetam, and Chick embryo
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BACKGROUND Ulnar nerve entrapment neuropathy at the elbow is the most common upper-extremity entrapment neuropathy after carpal tunnel syndrome. Surgical treatment can be complicated by perineural scarring and fibrosis, which may lead to... more
BACKGROUND Ulnar nerve entrapment neuropathy at the elbow is the most common upper-extremity entrapment neuropathy after carpal tunnel syndrome. Surgical treatment can be complicated by perineural scarring and fibrosis, which may lead to recurrent symptoms. Expanded polytetrafluoroethylene (ePTFE) is a synthetic polymer with antiadhesive properties. OBJECTIVE To introduce the operative technique and outcomes of anterior subcutaneous transposition with ePTFE (ASTEP) in primary and recurrent cubital tunnel neuropathy. METHODS We studied 14 adult patients (11 men, 3 women; mean age, 45 yr) with cubital tunnel neuropathy (10 primary, 4 revision) who underwent surgery with the ASTEP technique between January 2008 and May 2018. Pain, numbness in the fourth/fifth fingers, and weakness of the intrinsic hand muscles were the most common presenting symptoms. Surgical outcomes were assessed using the modified McGowan and Wilson-Krout criteria. RESULTS The average (± standard deviation) preoperative symptom duration was 12.1 ± 5.2 mo (McGowan Grade 1, n = 5; Grade 2, n = 6; Grade 3, n = 3). No intraoperative or postoperative complications were observed with the ASTEP technique. Postoperative follow-up ranged from 9 mo to 7 yr (mean, 4.3 yr). All 14 patients experienced improvement in or complete resolution of their symptoms after this unique intervention. CONCLUSION Our novel technique of anterior transposition of the ulnar nerve with ePTFE was safe and highly effective in treating primary and recurrent ulnar nerve entrapment neuropathy at the elbow and represents an alternative to the current techniques.
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Horseshoe kidney is a relatively common congenital anomaly. In 95% of the cases, lower poles are connected to each other. In a small subset, an isthmus connects both upper poles (reverse horseshoe kidney). Almost always, the fusion of... more
Horseshoe kidney is a relatively common congenital anomaly. In 95% of the cases, lower poles are connected to each other. In a small subset, an isthmus connects both upper poles (reverse horseshoe kidney). Almost always, the fusion of kidney poles occurs anterior to the aorta and vena cava. The fusion of renal poles posterior to both aorta and vena cava is extremely rare. Herein, we present a case with multiple rare congenital anomalies-retroaortic variant of reverse horseshoe kidney, retroaortic left renal vein, and butterfly vertebrae.
Research Interests: Urology, Spine, Medicine, Anatomy, Humans, and 6 moreKidney, Female, Clinical Sciences, Aorta, Child preschool, and Renal veins
Research Interests: Algorithms, Medicine, Catheterization, Elasticity, Anesthesia, and 14 moreExperimental Study, Clinical Sciences, Mechanical Stress, Polyurethane, Polyurethanes, Tensile Strength, Equipment Failure Analysis, Neurosciences, Modulus of Elasticity, Catheter, Needles, Probability of Failure, Ultimate Tensile Strength, and Mechanical Property
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Involvement of spine in patients with hydatid disease (HD) is less than 1 % and primary intra-spinal extradural HD is extremely rare. Although this disease is introduced as benign pathology according to its clinical presentation and... more
Involvement of spine in patients with hydatid disease (HD) is less than 1 % and primary intra-spinal extradural HD is extremely rare. Although this disease is introduced as benign pathology according to its clinical presentation and biological behavior, intraoperative rupture of the cyst may aggravate the patients' outcome in the long-term especially in pediatric patient population. We report a 9-year-old girl who presented a progressive neurological deterioration due to an enlargement of a ventrally located extradural hydatid cyst within the thoracic spinal canal. Total removal of the cyst was achieved by preserving the capsule integrity for preventing potential seeding. Our preoperative initial diagnosis based on the radiological findings was confirmed as cyst hydatid histopathologically. Cyst hydatid should be considered in the differential diagnosis of the presence of homogenous cystic lesions with regular shape inside the spinal canal especially in patients from endemic region. To our knowledge, this pediatric patient is the first case of cyst hydatid located ventral side of the spinal cord extradurally located inside the spinal canal showing no extension.
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Research Interests: Chemistry, Calcium, Fluorescent Dyes and Reagents, Medicine, Animals, and 15 moreCalcium channels, Male, Calcium Channel, Central Nervous System, Denervation, Nerve Regeneration, Clinical Sciences, Neurological, Rats, Sciatic Nerve, Axons, Neurosciences, Agonist, Recovery of Function, and fluorescent dyes
A 17-year-old boy was admitted to hospital with a history of backache, weakness of the lower extremities and fever. While the diagnosis of brucellosis was made his clinical course worsened. Acute medulla spinalis mass effect and signs of... more
A 17-year-old boy was admitted to hospital with a history of backache, weakness of the lower extremities and fever. While the diagnosis of brucellosis was made his clinical course worsened. Acute medulla spinalis mass effect and signs of meningitis predominated. It was shown that he had a dermoid cyst infected with Brucella abortus biotype 3 which was the same strain growing in his blood cultures.
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The efficacy of sodium nitroprusside in resolving cerebral vasospasm was evaluated with multicisternal injections. Twelve animals received fresh, unheparinized arterial blood via three injections (15 ml total) into the cisterna magna.... more
The efficacy of sodium nitroprusside in resolving cerebral vasospasm was evaluated with multicisternal injections. Twelve animals received fresh, unheparinized arterial blood via three injections (15 ml total) into the cisterna magna. Selective vertebral arteriography was performed on Day 0, and blood injections were performed on the second and third days after the first injection. On the seventh day selective arteriography was performed to evaluate the diameter of the basilar artery. In the sodium nitroprusside group, intrathecal injections of the drug were started on Day 4 and continued for two days (25 micrograms/kg/day). The diameter of the basilar artery was reduced 72.98 +/- 11.07% in control experiments. For the animals treated with intrathecal sodium nitroprusside, the mean diameter of the basilar artery was reduced 29.25 +/- 4.54%. The effect of intrathecal sodium nitroprusside on intracranial pressure (ICP), blood pressure (BP) and electrocardiogram (ECG) was also evaluated in 14 animals. There were no prominent changes in ICP, BP, or ECG when sodium nitroprusside was given intrathecally, but BP decreased and ICP and heart rate increased with intravenous doses of sodium nitroprusside. These results support the hypothesis that sodium nitroprusside administered intrathecally is an effective treatment for cerebral vasospasm.
Research Interests: Medicine, Electrocardiography, Dogs, Blood Pressure, Chronic Disease, and 15 moreFemale, Animals, Male, Anesthesia, Clinical Sciences, Neurological, Intrathecal, Basilar Artery, Neurosciences, Intracranial Pressure, Cerebral Angiography, Cerebral Vasospasm, Random Allocation, nitroprusside, and cisterna magna
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We present a case of umbilical perforation of the distal end of ventriculoperitoneal shunt as a rare complication of ventriculoperitoneal shunts including an umbilical abscess and an infection related with ventriculoperitoneal shunt. The... more
We present a case of umbilical perforation of the distal end of ventriculoperitoneal shunt as a rare complication of ventriculoperitoneal shunts including an umbilical abscess and an infection related with ventriculoperitoneal shunt. The ventriculoperitoneal catheter was removed, the umbilical abscess was drained and appropriate medication was employed for infection with successful outcome. Possible factors that might predispose to these complications of ventriculoperitoneal shunting are suggested.
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Research Interests: Surgery, Neurosurgery, Magnetic Resonance Imaging, Evolution, Treatment Outcome, and 15 moreMedicine, Humans, Child, Female, Spinal Cord, Male, Clinical Sciences, Retrospective Studies, Group, Tethered Cord, Nino, Severity of Illness Index, Conus medullaris, Spinal cord compression, and Filum Terminale
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Traditional shooting with guns often occurs and leads to unwanted gunshot injuries in areas where celebrations are held. Such injuries have been classified as celebratory gun shooting injury in the international disease classification... more
Traditional shooting with guns often occurs and leads to unwanted gunshot injuries in areas where celebrations are held. Such injuries have been classified as celebratory gun shooting injury in the international disease classification system. An 8-year-old female patient presented with respiratory arrest. The heartbeats normalized upon cardiopulmonary resuscitation. On physical examination, the only pathological finding was a skin defect measuring 1 x 1 cm on the midline and located 2 cm in front of the coronal suture. Cranial CT revealed a bone defect of 0.5 cm in the area 2 cm in front of the coronal suture on the midline, tetraventricular and extensive subarachnoid hemorrhage and parenchymal hematoma in the frontal area. It was initially thought to be a gunshot injury; however, on cranial CT, no bullet fragments or bullet exit hole was observed. A cervicothoracal direct graph was obtained and an image that might have been compatible with a bullet core was detected at Th 2-3 verte...
Research Interests: Medicine, Brain Death, Humans, Child, Female, and 6 moreHolidays, Skull, Gunshot wounds, Rifle, Heart arrest, and Fatal outcome
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The resolution of cerebral vasospasm and protection of endothelial damage by Iloprost was evaluated with multicisternal injections. Sixteen adult mongrel dogs (18-20 kg) were assigned to one of three experimental groups. All animals... more
The resolution of cerebral vasospasm and protection of endothelial damage by Iloprost was evaluated with multicisternal injections. Sixteen adult mongrel dogs (18-20 kg) were assigned to one of three experimental groups. All animals received a total amount of 15 ml fresh unheparinized arterial blood via three injections into the cisterna magna. Selective vertebral angiography was performed on day 0 and subsequently blood injections were performed on the 2nd and 3rd days after the first injection. On the 7th day angiography was reperformed to determine the chronic vasospasm. The first group (5 dogs) was the control group and received intrathecal saline which was equal to the amount of saline in which Iloprost was diluted. The second group (5 dogs) did not receive any treatment until the 7th day. The third group (6 dogs) received Iloprost intrathecally (total 10 micrograms kg-1). In the first two groups angiographic vasospasm was prominent. For the second group intraarterial Iloprost was given on the 7th day in order to evaluate its acute effect. However there was no evidence of resolution of vasospasm. In the third group, resolution of vasospasm was verified on angiograms. Electron microscope studies of basilar arteries of the first two groups revealed degenerative changes of the endothelial cells which were separated from each other and the elastic lamina was irregularly arranged. In the intrathecal Iloprost-treated group there was little thickening in the elastic lamina and the endothelial cells were almost normal in structure. These results can be considered as the evidence of the prophylactic effect of Iloprost given by the intrathecal route in the prevention of chronic cerebral vasospasm.
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SUMMARY Neuronal recovery from stroke, trauma, or neurodegenerative disorders is very limited because the human CNS has a very restricted regeneration capacity. Lots of experiments have been done to improve the limited capacity of injured... more
SUMMARY Neuronal recovery from stroke, trauma, or neurodegenerative disorders is very limited because the human CNS has a very restricted regeneration capacity. Lots of experiments have been done to improve the limited capacity of injured CNS neurons. Those experiments have mainly focused on improving the intrinsic capacity of the CNS neurons, and overcoming the inhibitory CNS environment which has been shown blocking the axonal regeneration. Optic nerve, sympathic ganglions, dorsal root ganglions have been used for in vivo regeneration experiments. The main advantage of these experiments is that the celi body which is situated outside CNS have been easily manipulated and the results have been identified at nerve body level. In this article optic nerve and dorsal root ganglion model have been presented. Ali the techniques that have been used are previously defined techniques. The aim of this article is to collect these data and clarify with some simple modifications. OZET SANTRAL SINIR SISTEMI REJENERASYON CALIŞMALARINDA TEMEL CERRAHI TEKNIKLER Inme, travma veya norodejeneratif hastaliklardan sonra noronal yapilarin tamiri, Santral Sinir Sisteminin (SSS) sinirli rejeneratif kapasitesi nedeni ile sinirlidir. Hasarlanmis SSS noronlarinin sinirli rejeneratif kapasitelerinin artirilmasi icin bir cok calisma yapilmistir. Bu calismalar esas olarak SSS noronlarin intrinsik kapasitelerinin artirilmasina ve axonal rejenerasyonu engelledigi gosterilmis olan SSS nin inhibitor cevresinin etkilerinin engellenmesine yoneliktir. Optik, sinir, sempatik gangliyon, dorsal kok gangliyonlari invivi rejenerasyon calismalarinda kullanilmistir. Bu deneylerin esas avantaji SSS disinda yerlesmis olan hucre govdesinin kolayca etkilenebilir olmasi ve sonuclarinda bu govdede gosterilebilir olmasidir. Bu calismada optik sinir ve dorsal kok gangliyon modeli sunulmustur. Bu tekniklerin tumu daha once tanimlanmis tekniklerdir. Bu yazinin amaci bu bulgularin toparlanmasi ve bazi duzeltmeler ile anlasilir hale getirilmesidir.
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Nicotine is a well-known agent among 4000 chemicals in cigarettes. About 70 to 80% of nicotine is converted to cotinine, a major metabolite. The aim of the present study is to investigate the effect of cotinine on neural tube development... more
Nicotine is a well-known agent among 4000 chemicals in cigarettes. About 70 to 80% of nicotine is converted to cotinine, a major metabolite. The aim of the present study is to investigate the effect of cotinine on neural tube development in a chick embryo model. Sixty fertile, specific pathogen free eggs were divided into 6 groups for this study. In the first group, a fixed cotinine concentration for each egg was calculated just to simulate the concentration of a smoker's blood level. A second experimental group was designed at a higher cotinine concentration. Embryos that succeeded to reach Hamburger-Hamilton stage 12 from each group were then embedded into paraffin for permanent sections. These two groups were compared with eggs subjected to vehicle (standard alcohol and ten times more alcohol concentration) and control groups (saline and sham groups). Embryos of the cotinine (regular dose), vehicle and control groups were normal, but embryos subjected to higher cotinine conce...