Objective: Traumatic brachial plexus lesions (TBPL) in adults are usually secondary to traffic ac... more Objective: Traumatic brachial plexus lesions (TBPL) in adults are usually secondary to traffic accidents and gunshot wounds. Surgical treatment is indicated when the patients did not improve after conservative treatment. Outcome of surgery is determined by the clinical examination of the patient and[for full text, please go to the a.m. URL]
Lumbar spinal extradural arachnoid cysts are rare, expanding lesions and they commonly occur in t... more Lumbar spinal extradural arachnoid cysts are rare, expanding lesions and they commonly occur in the thoracic spine and lie posterolaterally. Their pathogenesis is still unclear and it is claimed that arachnoid cysts are the result of a widening of the septum posticum. The mechanism of cyst enlargement may be active CSF secretion from residual arachnoid matter or ball-valve effect. Congenital, hereditary, idiopathic, and inflammatory etiologies have been proposed. We report an extradural lumbar arachnoid cyst associated with a lumbar disc herniation. We only performed L1-2 discectomy and left L1-L2 foraminotomy to evaluate the role of disc herniation and spinal canal stenosis on the development of ball-valve effect which made the cyst enlarge.
With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal a... more With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions. Four different approaches were used including transtuberculum-transplanum, transethmoidal-transcribriform, transclival, and transmaxillary-transpterygoidal. The overall gross total resection (GTR) rate for these diverse pathologies was 75.0% in 88 patients (excluding the operations performed for non-neoplastic pathologies). GTR was achieved in 100%, 77.8%, 75%, 75%, 72.2%, 62.5%, 60% of fibro-osseou...
Objective: Infection is an important complication of cranioplasty and usually treated with system... more Objective: Infection is an important complication of cranioplasty and usually treated with systemic antibiotics and removal of cranioplasty material. The aim of this study was to analyze the antimicrobial activities of three cranioplasty materials and to compare their efficacies on microorganism cultures. Material and Methods: Methyl methacrylate, bioactive ceramic and bioactive glass were used in this study. In the first step, small pieces of the materials were cut and incubated. Then, they were washed and placed in agar medium. Finally, the number of colonies was counted. In the second step, the pieces were placed on agar plates containing Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans. The plates were incubated, and then, the inhibition zone for each material was measured. Results: No inhibition zone was observed in three plates for any microorganism. The number of colonies was lowest in the plate with methyl methacrylate and highest in the plate with bioactive glass for pseudomonas aeroginosa. The number of colonies was lowest in the plate with bioactive ceramic and highest in the plate with methyl methacrylate for Staphylococcus aureus. The number of colonies was lowest in the plate with methyl methacrylate and highest in the plate with bioactive glass for Staphylococcus epidermidis. The number of colonies was lowest in the plate with bioactive ceramic and highest in the plate with bioactive glass for candida albicans. Conclusion: None of these materials have significant antimicrobial effect. However, colonization was more prominent in bioactive glass. Methyl methacrylate and bioactive ceramic allowed less colonization in agar.
Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum ... more Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum of symptoms and high rates of mortality and morbidity. This study presents an evaluation of TBI caused by gunshot wounds presenting at a single institution and discusses possible predictive factors for the outcome of surgical intervention. The study sample consisted of 442 patients who underwent surgery for TBI over a 16-year period. All injuries were caused by gunshot wounds, such as bullets and shrapnel. All patients underwent surgical intervention. Almost all patients (99.3%) were male, and the mean patient age was 22.3 years. Wounds were caused by shrapnel in 68 percent of patients. The Glasgow Coma Scale (GCS) score at admission was below 8 in 116 patients (26.2%) and above 8 in 326 patients (73.8%). In total, 47 patients (10.6%) died despite surgical management, with diffuse brain injury the most common cause of death. Low GCS scores, ventricular injuries and bihemispheric injuries...
Objective: Since many years, spinal tumors became the focus of interest of neurosurgery because o... more Objective: Since many years, spinal tumors became the focus of interest of neurosurgery because of low morbidity rate and successfull outcome is obtained when the early diagnosis and appropriate surgical methods are applied. In this study, we aimed to document our experience and clinical outcomes on spinal tumors over a 10-year period. Materials and Methods: Ninety-four patients with spinal tumors who underwent surgical treatment between 1999 and 2008 are investigated retrospectively according to age and sex, presentation symptoms, neurological findings at admission, localizations, surgical techniques, resection types, pathological diagnosis, early surgical results, adjuvant therapies such as chemotherapy and radiotherapy, follow-up outcomes and surgical complications. Results: 77.65% of all cases were primary spinal tumors and 46.8% of the cases were located extradurally. Metastatic tumors were low than the primary tumors. Epandymomas were the most common tumors primary spinal tumo...
Myelomeningoceles are the common form of open neural tube defects that are usually associated wit... more Myelomeningoceles are the common form of open neural tube defects that are usually associated with neurological deficits. Many techniques of repair and methods of prevention have been proposed with respect to the size of defect and the neurological condition of patient. The aim of this study was to report our experience on the management of lumbosacral myelomeningoceles in children. We retrospectively analysed the data of 36 paediatric cases of surgically lumbosacral myelomeningocele treated in our department between 1998 and 2013. Twenty (56%) patients were female and sixteen were male, with a mean age of 4 months (ranged between 0 and 24 months). All patients had neurological deficits in the preoperative period. Computed tomography was performed in 33 (92%) patients and magnetic resonance imaging in 15 (42%) patients in the preoperative period. Repair of the myelomeningocele and closure of the skin defect were performed in all patients. The mean follow-up period was 36 months. Thirty (83%) patients were operated for hydrocephalus and 10 (28%) patients were re-operated for tethered cord syndrome during the follow-up period. Neurological worsening was not observed in any patient while cerebrospinal fluid fistula was detected in 2 patients. Surgical treatment using appropriate microsurgical techniques is crucial for lumbosacral myelomeningoceles in children. Early surgical intervention with close follow-up will improve the neurological condition of the patients.
The procedure of reconstruction after the removal of cranial fibrous dysplasia (FD) must be preci... more The procedure of reconstruction after the removal of cranial fibrous dysplasia (FD) must be precise to achieve good functional and aesthetic results. Intraoperative modeling of implants is difficult and may cause cosmetic disturbances. To present our experience with the treatment of cranial FD using preoperative computer-based surgical planning of tumor removal with reconstruction of the cranium with custom-made titanium implants. Four patients underwent surgical treatment for cranial FD over a 2-year period. All patients were male with a mean age of 25.25 years and had monostotic-type FD. Computed tomography (CT) with 0.5-mm slices was obtained preoperatively. Computer-based planning of the tumor removal was performed, and a template was created by the computer to determine the margins of tumor removal. After this procedure, the preoperative computer-based construction of the titanium implant was performed. The patients underwent surgical treatment, and the tumor was removed with the use of this template. Then, the titanium implant was inserted onto the bone defect and fixed with mini-screws. Patients were followed up by periodic CT scans. The histological diagnosis of all patients was FD. No intraoperative or postoperative complications have occurred. Postoperative CT scans showed complete tumor removal and confirmed appropriate cosmetic reconstruction. The mean follow-up period was 15.25 months. Computer-based surgical planning associated with the production of custom-made titanium implants is a highly promising method for the treatment of cranial FD. Better radiological and cosmetic outcomes could be obtained by this technique with interdisciplinary work with medical designers. DICOM, digital imaging and communications in medicineFD, fibrous dysplasia.
We aimed to show the effects of neuronavigation and intraoperative imaging systems on the surgica... more We aimed to show the effects of neuronavigation and intraoperative imaging systems on the surgical outcomes of orbital tumors. Seventeen patients who underwent surgical treatment for orbital tumors by transcranial and transnasal approaches between 2008 and 2013 were analyzed retrospectively. Twelve of them were male and 5 were female. The mean age was 41.6 years. Neuronavigation systems were used in all cases. Four patients were operated using intraoperative imaging systems. The transcranial approach was used in 9 (53%) patients, endoscopic medial orbital approach in 4 (23.5%), endoscopic inferolateral approach in 1 (6%), cranioorbitozygomatic approach in 1, lateral approach in 1, and the combined (medial endoscopic and lateral) approach in 1 patients. Total resection was achieved in 5 patients, gross total excision in 2, subtotal in 9 and partial in 1 patients. Modern technology has made a significant contribution to the treatment of orbital tumors. Although technological equipments facilitate the excision of tumors, the level of resection is mainly determined by the nature of tumor and adhesion to the adjacent neurovascular structures. It should not be forgotten that advanced technology never replaces a good anatomical knowledge and surgical experience, but has a complementary role.
Surgical removal of sphenoorbital meningiomas is challenging for neurosurgeons. The aim of study ... more Surgical removal of sphenoorbital meningiomas is challenging for neurosurgeons. The aim of study is to share our experience on sphenoorbital meningiomas and to provide a picture of the current state of the art in surgical treatment of these tumors. The data of 13 cases of sphenoorbital meningioma who were operated between 2006 and 2013 was reviewed retrospectively. Intraorbital extension was present in 10 cases while sphenoid bone invasion was detected in 9 cases. All patients underwent surgical treatment after the radiological evaluation with magnetic resonance imaging and computed tomography. The degree of resection and the clinical outcome of all patients were analyzed. Extended pterional approach with a large frontotemporal craniotomy was performed in all cases. Simpson's grade I and II excision was achieved in 4 (31%) cases while subtotal excision (Simpson's grade III or higher) was performed in 9 cases. The main reason for subtotal excision was the cavernous sinus invasion. Optic canal decompression was performed in patients with intraorbital invasion. Although total removal is the main objective of surgery, the sphenoorbital meningiomas are difficult to resect especially with cavernous sinus invasion. But in the meantime, it is not recommended to take any excessive risks to achieve a greater degree of resection for a benign tumor. Endoscopic approach is an option for inferomedial orbital parts of these tumors.
Perception, definition and tolerance of pain vary individually because of its subjective characte... more Perception, definition and tolerance of pain vary individually because of its subjective character. This study aimed to determine the perception differences between patients with mechanical low back pain (MLBP) and their physicians regarding the assessments of the patients' pain severity. 181 patients with MLBP and 2 physicians took part in the study. Before the initial examination, the patients filled out a questionnaire consisting of demographic data, pain characteristics, Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS). The patients' forms were concealed from the physicians. Then physicians examined their patients and rated their pain severity using a different VAS form. The mean age of the patients was 36.2±12.3 years. 64.6% (n:117) were female, 71.9% (n:13) were highly educated and 57.1% (n:103) were obese. Physicians always rated the patients' pain severity significantly lower than the patients rated their own pain regardless of all demographic data (p < 0.001). Correlation between the VAS scores of patients and physicians were detected as 0.41 (p < 0.001) and the power of the study was calculated as 91.5%. The mean MODQ score of the patients was calculated as 54.4±21.1. Reliability of the questions in MODQ was calculated as alpha:0.87. A moderate correlation between VAS ratings and MODQ was observed (r:0.52, p < 0.001). As a main factor directly affecting many outcomes, good communication between patient and physician, is essential to assess the patients' pain more accurately.
the aim of this study was to assess and to compare the ability of intrathecal flunarizine and nim... more the aim of this study was to assess and to compare the ability of intrathecal flunarizine and nimodipine to prevent vasospasm in a rabbit model of subarachnoid hemorrhage (SAH). forty male New Zealand white rabbits were allocated into 5 groups randomly. The treatment groups were as follows: (1) control (no SAH [n = 8]), (2) SAH only (n = 8), (3) SAH plus vehicle (n = 8), (4) SAH plus nimodipine (n = 8), and (5) SAH plus flunarizine (n = 8). Before sacrifice, all animals underwent femoral artery catheterization procedure by open surgery under anesthesia and angiography performed for each animal. there was a statistically significant difference between the mean basilar artery cross-sectional areas and the mean arterial wall thickness measurements of the control and SAH-only groups (p < 0.05). Basilar artery vessel diameter and luminal section areas in group 4 were significantly higher than in group 2 (p < 0.05). Basilar artery vessel diameter and basilar artery luminal section areas in group 5 were significantly higher than in group 2 (p < 0.05).Basilar artery vessel diameter and basilar artery luminal section areas in group 5 were significantly higher than in group 4 (p < 0.05). these findings demonstrate that flunarizine has marked vasodilatatory effect in an experimental model of SAH in rabbits.
Objective: Traumatic brachial plexus lesions (TBPL) in adults are usually secondary to traffic ac... more Objective: Traumatic brachial plexus lesions (TBPL) in adults are usually secondary to traffic accidents and gunshot wounds. Surgical treatment is indicated when the patients did not improve after conservative treatment. Outcome of surgery is determined by the clinical examination of the patient and[for full text, please go to the a.m. URL]
Lumbar spinal extradural arachnoid cysts are rare, expanding lesions and they commonly occur in t... more Lumbar spinal extradural arachnoid cysts are rare, expanding lesions and they commonly occur in the thoracic spine and lie posterolaterally. Their pathogenesis is still unclear and it is claimed that arachnoid cysts are the result of a widening of the septum posticum. The mechanism of cyst enlargement may be active CSF secretion from residual arachnoid matter or ball-valve effect. Congenital, hereditary, idiopathic, and inflammatory etiologies have been proposed. We report an extradural lumbar arachnoid cyst associated with a lumbar disc herniation. We only performed L1-2 discectomy and left L1-L2 foraminotomy to evaluate the role of disc herniation and spinal canal stenosis on the development of ball-valve effect which made the cyst enlarge.
With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal a... more With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions. Four different approaches were used including transtuberculum-transplanum, transethmoidal-transcribriform, transclival, and transmaxillary-transpterygoidal. The overall gross total resection (GTR) rate for these diverse pathologies was 75.0% in 88 patients (excluding the operations performed for non-neoplastic pathologies). GTR was achieved in 100%, 77.8%, 75%, 75%, 72.2%, 62.5%, 60% of fibro-osseou...
Objective: Infection is an important complication of cranioplasty and usually treated with system... more Objective: Infection is an important complication of cranioplasty and usually treated with systemic antibiotics and removal of cranioplasty material. The aim of this study was to analyze the antimicrobial activities of three cranioplasty materials and to compare their efficacies on microorganism cultures. Material and Methods: Methyl methacrylate, bioactive ceramic and bioactive glass were used in this study. In the first step, small pieces of the materials were cut and incubated. Then, they were washed and placed in agar medium. Finally, the number of colonies was counted. In the second step, the pieces were placed on agar plates containing Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans. The plates were incubated, and then, the inhibition zone for each material was measured. Results: No inhibition zone was observed in three plates for any microorganism. The number of colonies was lowest in the plate with methyl methacrylate and highest in the plate with bioactive glass for pseudomonas aeroginosa. The number of colonies was lowest in the plate with bioactive ceramic and highest in the plate with methyl methacrylate for Staphylococcus aureus. The number of colonies was lowest in the plate with methyl methacrylate and highest in the plate with bioactive glass for Staphylococcus epidermidis. The number of colonies was lowest in the plate with bioactive ceramic and highest in the plate with bioactive glass for candida albicans. Conclusion: None of these materials have significant antimicrobial effect. However, colonization was more prominent in bioactive glass. Methyl methacrylate and bioactive ceramic allowed less colonization in agar.
Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum ... more Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum of symptoms and high rates of mortality and morbidity. This study presents an evaluation of TBI caused by gunshot wounds presenting at a single institution and discusses possible predictive factors for the outcome of surgical intervention. The study sample consisted of 442 patients who underwent surgery for TBI over a 16-year period. All injuries were caused by gunshot wounds, such as bullets and shrapnel. All patients underwent surgical intervention. Almost all patients (99.3%) were male, and the mean patient age was 22.3 years. Wounds were caused by shrapnel in 68 percent of patients. The Glasgow Coma Scale (GCS) score at admission was below 8 in 116 patients (26.2%) and above 8 in 326 patients (73.8%). In total, 47 patients (10.6%) died despite surgical management, with diffuse brain injury the most common cause of death. Low GCS scores, ventricular injuries and bihemispheric injuries...
Objective: Since many years, spinal tumors became the focus of interest of neurosurgery because o... more Objective: Since many years, spinal tumors became the focus of interest of neurosurgery because of low morbidity rate and successfull outcome is obtained when the early diagnosis and appropriate surgical methods are applied. In this study, we aimed to document our experience and clinical outcomes on spinal tumors over a 10-year period. Materials and Methods: Ninety-four patients with spinal tumors who underwent surgical treatment between 1999 and 2008 are investigated retrospectively according to age and sex, presentation symptoms, neurological findings at admission, localizations, surgical techniques, resection types, pathological diagnosis, early surgical results, adjuvant therapies such as chemotherapy and radiotherapy, follow-up outcomes and surgical complications. Results: 77.65% of all cases were primary spinal tumors and 46.8% of the cases were located extradurally. Metastatic tumors were low than the primary tumors. Epandymomas were the most common tumors primary spinal tumo...
Myelomeningoceles are the common form of open neural tube defects that are usually associated wit... more Myelomeningoceles are the common form of open neural tube defects that are usually associated with neurological deficits. Many techniques of repair and methods of prevention have been proposed with respect to the size of defect and the neurological condition of patient. The aim of this study was to report our experience on the management of lumbosacral myelomeningoceles in children. We retrospectively analysed the data of 36 paediatric cases of surgically lumbosacral myelomeningocele treated in our department between 1998 and 2013. Twenty (56%) patients were female and sixteen were male, with a mean age of 4 months (ranged between 0 and 24 months). All patients had neurological deficits in the preoperative period. Computed tomography was performed in 33 (92%) patients and magnetic resonance imaging in 15 (42%) patients in the preoperative period. Repair of the myelomeningocele and closure of the skin defect were performed in all patients. The mean follow-up period was 36 months. Thirty (83%) patients were operated for hydrocephalus and 10 (28%) patients were re-operated for tethered cord syndrome during the follow-up period. Neurological worsening was not observed in any patient while cerebrospinal fluid fistula was detected in 2 patients. Surgical treatment using appropriate microsurgical techniques is crucial for lumbosacral myelomeningoceles in children. Early surgical intervention with close follow-up will improve the neurological condition of the patients.
The procedure of reconstruction after the removal of cranial fibrous dysplasia (FD) must be preci... more The procedure of reconstruction after the removal of cranial fibrous dysplasia (FD) must be precise to achieve good functional and aesthetic results. Intraoperative modeling of implants is difficult and may cause cosmetic disturbances. To present our experience with the treatment of cranial FD using preoperative computer-based surgical planning of tumor removal with reconstruction of the cranium with custom-made titanium implants. Four patients underwent surgical treatment for cranial FD over a 2-year period. All patients were male with a mean age of 25.25 years and had monostotic-type FD. Computed tomography (CT) with 0.5-mm slices was obtained preoperatively. Computer-based planning of the tumor removal was performed, and a template was created by the computer to determine the margins of tumor removal. After this procedure, the preoperative computer-based construction of the titanium implant was performed. The patients underwent surgical treatment, and the tumor was removed with the use of this template. Then, the titanium implant was inserted onto the bone defect and fixed with mini-screws. Patients were followed up by periodic CT scans. The histological diagnosis of all patients was FD. No intraoperative or postoperative complications have occurred. Postoperative CT scans showed complete tumor removal and confirmed appropriate cosmetic reconstruction. The mean follow-up period was 15.25 months. Computer-based surgical planning associated with the production of custom-made titanium implants is a highly promising method for the treatment of cranial FD. Better radiological and cosmetic outcomes could be obtained by this technique with interdisciplinary work with medical designers. DICOM, digital imaging and communications in medicineFD, fibrous dysplasia.
We aimed to show the effects of neuronavigation and intraoperative imaging systems on the surgica... more We aimed to show the effects of neuronavigation and intraoperative imaging systems on the surgical outcomes of orbital tumors. Seventeen patients who underwent surgical treatment for orbital tumors by transcranial and transnasal approaches between 2008 and 2013 were analyzed retrospectively. Twelve of them were male and 5 were female. The mean age was 41.6 years. Neuronavigation systems were used in all cases. Four patients were operated using intraoperative imaging systems. The transcranial approach was used in 9 (53%) patients, endoscopic medial orbital approach in 4 (23.5%), endoscopic inferolateral approach in 1 (6%), cranioorbitozygomatic approach in 1, lateral approach in 1, and the combined (medial endoscopic and lateral) approach in 1 patients. Total resection was achieved in 5 patients, gross total excision in 2, subtotal in 9 and partial in 1 patients. Modern technology has made a significant contribution to the treatment of orbital tumors. Although technological equipments facilitate the excision of tumors, the level of resection is mainly determined by the nature of tumor and adhesion to the adjacent neurovascular structures. It should not be forgotten that advanced technology never replaces a good anatomical knowledge and surgical experience, but has a complementary role.
Surgical removal of sphenoorbital meningiomas is challenging for neurosurgeons. The aim of study ... more Surgical removal of sphenoorbital meningiomas is challenging for neurosurgeons. The aim of study is to share our experience on sphenoorbital meningiomas and to provide a picture of the current state of the art in surgical treatment of these tumors. The data of 13 cases of sphenoorbital meningioma who were operated between 2006 and 2013 was reviewed retrospectively. Intraorbital extension was present in 10 cases while sphenoid bone invasion was detected in 9 cases. All patients underwent surgical treatment after the radiological evaluation with magnetic resonance imaging and computed tomography. The degree of resection and the clinical outcome of all patients were analyzed. Extended pterional approach with a large frontotemporal craniotomy was performed in all cases. Simpson's grade I and II excision was achieved in 4 (31%) cases while subtotal excision (Simpson's grade III or higher) was performed in 9 cases. The main reason for subtotal excision was the cavernous sinus invasion. Optic canal decompression was performed in patients with intraorbital invasion. Although total removal is the main objective of surgery, the sphenoorbital meningiomas are difficult to resect especially with cavernous sinus invasion. But in the meantime, it is not recommended to take any excessive risks to achieve a greater degree of resection for a benign tumor. Endoscopic approach is an option for inferomedial orbital parts of these tumors.
Perception, definition and tolerance of pain vary individually because of its subjective characte... more Perception, definition and tolerance of pain vary individually because of its subjective character. This study aimed to determine the perception differences between patients with mechanical low back pain (MLBP) and their physicians regarding the assessments of the patients' pain severity. 181 patients with MLBP and 2 physicians took part in the study. Before the initial examination, the patients filled out a questionnaire consisting of demographic data, pain characteristics, Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS). The patients' forms were concealed from the physicians. Then physicians examined their patients and rated their pain severity using a different VAS form. The mean age of the patients was 36.2±12.3 years. 64.6% (n:117) were female, 71.9% (n:13) were highly educated and 57.1% (n:103) were obese. Physicians always rated the patients' pain severity significantly lower than the patients rated their own pain regardless of all demographic data (p < 0.001). Correlation between the VAS scores of patients and physicians were detected as 0.41 (p < 0.001) and the power of the study was calculated as 91.5%. The mean MODQ score of the patients was calculated as 54.4±21.1. Reliability of the questions in MODQ was calculated as alpha:0.87. A moderate correlation between VAS ratings and MODQ was observed (r:0.52, p < 0.001). As a main factor directly affecting many outcomes, good communication between patient and physician, is essential to assess the patients' pain more accurately.
the aim of this study was to assess and to compare the ability of intrathecal flunarizine and nim... more the aim of this study was to assess and to compare the ability of intrathecal flunarizine and nimodipine to prevent vasospasm in a rabbit model of subarachnoid hemorrhage (SAH). forty male New Zealand white rabbits were allocated into 5 groups randomly. The treatment groups were as follows: (1) control (no SAH [n = 8]), (2) SAH only (n = 8), (3) SAH plus vehicle (n = 8), (4) SAH plus nimodipine (n = 8), and (5) SAH plus flunarizine (n = 8). Before sacrifice, all animals underwent femoral artery catheterization procedure by open surgery under anesthesia and angiography performed for each animal. there was a statistically significant difference between the mean basilar artery cross-sectional areas and the mean arterial wall thickness measurements of the control and SAH-only groups (p < 0.05). Basilar artery vessel diameter and luminal section areas in group 4 were significantly higher than in group 2 (p < 0.05). Basilar artery vessel diameter and basilar artery luminal section areas in group 5 were significantly higher than in group 2 (p < 0.05).Basilar artery vessel diameter and basilar artery luminal section areas in group 5 were significantly higher than in group 4 (p < 0.05). these findings demonstrate that flunarizine has marked vasodilatatory effect in an experimental model of SAH in rabbits.
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