Pediatric Posterior Fossa Epidural Hematomas

Aim: Posterior fossa epidural hematoma (PFEDH) in the pediatric age group is a very rare condition and the treatment method is still a matter of debate. The aim of this study is to evaluate the observation results in the management of pediatric patients with PFEDH in our tertiary care hospital and to investigate the importance of the relationship of the hematoma with the cerebral venous sinuses, which has not been investigated before in the literature, in the treatment decision. Materials and Methods: This is a retrospective study conducted at Selcuk University, Faculty of Medicine. All patients (≤ 17 years) diagnosed with PFEDH between January 2010 and May 2022 were included in this study. Demographic data, clinical signs, trauma type and symptoms at presentation, CT findings, type of treatment, and outcomes were collected. CT findings including hematoma thickness, hydrocephalus, presence of fourth ventricular compression, relation with cerebral venous sinuses and other associated brain injuries were evaluated. Results: The patient group consists of two girl and six boy. The most common cause of PFEDH was a fall from a height resulting in a blow to the back of the head in four patients. Vomiting was the most frequent presenting symptom. Four patients had a relation between cerebral venous sinuses and hematoma, and two of these patients underwent surgical treatment Conclusion: In addition to criteria such as hematoma thickness, GCS, hydrocephalus, and compression of the fourth ventricle, we determined that the relationship of hematoma with venous sinuses is a criterion to be evaluated

Atipik hipofiz adenomu olgularının insidansı, hormonal dağılımı ve postoperatif takibi

AMAÇ: Hipofiz adenomu tanısı ile operasyon uygulanan olgularımızdan patoloj ik tanısı atipik hipofiz adenomu olanların görülme sıklığı, hormonal aktivitesi ve postoperatif takipleri araştırılmıştır. YÖNTEM ve GEREÇlER: Kliniğimizde Ocak 2009 - Mayıs 2012 tarihleri arasında endoskopik endonasal transsfenoidal yolla opere edilen 146 hipofiz adenomu olgusundan WHO 2004 kriterlerine göre patoloj isi atipik hipofiz adenomu olarak saptanan 13 olgu çalışmaya dahil edildi. BUlGULAR: Histoloj ik olarak 133 hasta tipik hipofiz adenomu (%91,1), 13 hasta ise atipik hipofiz adenomu (%8,9) idi. Bu hastaların 10 tanesi erkek (%76,9), 3 tanesi kadındı (%23,1). Yaş dağılımı 27 ile 80 arasında idi (ortalama 52.7). Dokuz olgu nonsekretuar adenom (%69,3), 3 olgu prolaktinoma (%23,1), 1 olgu ise somatostatinoma (%7,6) idi. Dört olguda hipofizer apopleksi mevcuttu (%30,7). Tipik hipofiz adenomlu hastalardan 11 tanesinde nüks saptanırken (%8,2), atipik hipofiz adenomlu olgulardan ise 5 tanesinde nüks adenom (%38,4) nedeniyle tekrar operasyon yapıldı. SONUÇ: Atipik hipofiz adenomları iyi bir patoloj ik inceleme yapıldığında çok da nadir görülen adenom tipi değildir. Tümör rekürrensinde tek başına belirleyici olmamakla birlikte tipik adenomlara göre çok daha yüksek oranda rekürrense neden olduğu unutulmamalıdır. Bu yüzden bu hastalarda total tümör eksizyonu, eğer mümkün olmuyorsa postoperatif daha yakın takip ile ek tedavi uygulamalarının kullanılması gereklidir.AIM: To assess the incidence, hormonal activity and postoperative follow up of the cases that are histopathologically diagnosed as atypical pituitary adenoma (APA) in our series. MATERIAL and METHODS: In this study, 13 atypical pituitary adenoma cases, by the WHO 2004 criteria, among the 146 pituitary adenoma patients operated on in our clinic between January 2009 and May 2012 by endoscopic endonasal transsphenoidal approach were included. results: In histological studies, 133 cases were diagnosed as typical pituitary adenoma (91.1%) and 13 cases were APAs (8.9%) of which 10 were male (76.9%) and 3 were female (23.1%), ranged between 27 and 80 (mean 52.7) ages. Histopathological distribution of APAs was 9 non- secretory adenomas (69.3%), 3 prolactinomas (23.1%) and 1 somatostatinoma (7.6%). Asymptomatic pituitary apoplexy was diagnosed in 4 cases (30.7%). Eleven cases of typical pituitary adenomas (8.2%) and 5 cases of the atypical pituitary adenomas (38.4%) were re-operated due to tumor recurrences. CONCLUSION: Accurate histopathological examination shows that atypical pituitary adenoma is not a rare disease. Although it is not the only determinant, APAs are more prone to recurrence than typical adenomas. In our opinion, if total resection is not possible for the patients with APA, close postoperative follow up and additional curative therapy modalities are needed

Malnutrition Despite Adequate Nutrient Intake: A Clue For Diencephalic Syndrome

Diencephalic syndrome is characterized by excessive weight loss and subcutaneous fatty tissue loss, hyperactivity, euphoria, and hypervigilance observed in early childhood. It usually accompanies space-occupying neoplastic lesions of the hypothalamic–optochiasmatic region. There is an inverse relationship between mass size and weight gain. In this case report, a patient aged 1 year and 2 months with hypothalamic–optochiasmatic glioma was presented. We aimed to draw attention to diencephalic syndrome, which is a rare cause of weight gain and vomiting