18 research outputs found

    Posterior reversible encephalopathy syndrome in IgA vasculitis: Neuroimaging of a 14-year-old child

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    IgA vasculitis (IgAV) is a leukocytoclastic vasculitis and characterized by involvement of small vessels in skin, gastrointestinal system, joints, kidneys, and less frequently other organs. It is the commonest vasculitis in childhood and etiology is not completely known. Neurological manifestations of IgAV are very rare and usually seen in patients with severe hypertension or as an uncommon feature such as peripheral neuropathy. Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiologic entity characterized with temporary vasogenic edema developing typically in posterior circulation of the brain and has been reported as a rare manifestation of IgAV. In this paper, a PRES case of 14-year-old male with IgAV is reported and etiopathogenesis was discussed with literature. Diagnosis was made by magnetic resonance imaging because of the existence of neurological symptoms (headache and visual loss) during the course of disease. His radiological findings have resolved with therapy. Although neurological involvement is a rare manifestation in IgAV, we recommend magnetic resonance imaging in such patients for diagnosis and evaluation of complications

    Morphometric Comparison of Interbody Fusion with Cage and Autograft at L4-L5 Levels versus Autograft Alone for Fusion

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    Objective:Lumbar interbody fusion (LIF) entails the placement of a bone graft within the intervertebral space, with or without the use of a cage, subsequent to discectomy. While numerous studies have explored caged LIF methods within the literature, limited attention has been given to direct comparisons between caged and cageless LIF techniques. This study aims to scrutinize the delayed outcomes of interbody fusion involving peek-caged and cageless laminar autografts. The investigation was specifically carried out at the L4-5 level.Method:This retrospective comparative study was conducted on patients who underwent surgical procedures at our institution’s neurosurgery clinic between 2011 and 2018, with the sanction of the ethics committee from the same institution. The study group (Group 1, n=27) comprised patients who underwent L4-5 single-level lumbar instrumentation and transforaminal LIF using a banana cage alongside autograft for the purpose of fusion. The control group (Group 2, n=31) consisted solely of cases that underwent posterior LIF operations with the utilization of autografts. Corticocancellous bone fragments sourced from posterior structures during decompression were utilized as autografts. The study parameters encompassed fusion rates, segmental and lumbar lordosis angles, disc height, ipsilateral and contralateral foramen heights, as well as slip distance.Results:Within our study, the late-stage fusion rates were determined to be 96.3% in the caged group and 96.7% in the cageless autograft group. No alterations were identified in segmental and lumbar lordosis angles across both groups. Notably, the caged group exhibited a propensity for late-stage cage embedding, while graft migration was the most prevalent complication within the autograft group.Conclusion:Both caged and cageless LIF methodologies are associated with elevated fusion rates. The autograft group demonstrates certain limited advantages in terms of fusion, whereas the caged group exhibits some benefits primarily related to alignment. The implementation of cageless autograft LIF, marked by its straightforwardness, simplicity, and cost-effectiveness, appears to be an underappreciated surgical technique within the current context

    A Neglected Giant Cervical Intradural Extramedullary Tumor

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    Primary spinal tumors are rarely seen, and representing 4-8% of all central nervous system tumors. Extradural tumors constitute approximately 40% of intraspinal tumors whereas intradural-extramedullary tumors make up the remaining approximately 60%. These tumors are classified as extradural, intradural, extramedullary, and intramedullary depending on their origin and anatomic location. Intradural extramedullary spinal tumors form schwannomas and meningiomas. Spinal meningiomas are usually intradural extramedullary tumors. Meningiomas can be seen in epidural localization, extradural extension only, with nerve rostral invasion as, vertebral meningioma, or as multiple spinal meningioma. Spinal meningiomas are the most common intradural-extramedullary tumors and are generally slowgrowing. Spinal meningiomas may have different clinical manifestations depending on their location and size. Surgical treatment should be planned according to the size of the tumor in the clinical situation after diagnosis. This study reports the case of a 57-year-old female patient presenting with a one-month history of increasing weakness in the lower extremities and numbness in the upper extremities. In addition, the report includes a literature review

    Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

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    A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS). The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI) showed an image of a mass compressing the medulla

    Port Catheterization: Our Clinical Experience with 156 Diseases

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    Objective:Port catheterization, which can be practically applied by various clinical and surgical branches in our country, is an extremely comfortable procedure in patient groups requiring long-term parenteral treatment, especially malignancy patients.Method:In this study, 156 patients who underwent port catheterization by an anesthesiologist after the approval of the local ethics committee were evaluated retrospectively.Results:The procedure was performed in 98.1% of the patients due to malignancy (originated esophagus: 37.3%, stomach: 24.8%). The most common application part was the right internal jugular vein (65.4%). Sixty-two patients required two or more punctures. Port was removed due to port pocket infection in 1.9% of the patients.Conclusion:In this study, we presented our port catheterization experience and aimed to contribute to the national literature

    Comparing The Rate of Radiological and Clinical Adjacent Segment Degeneration After Simple Anterior Cervical Discectomy Versus Discectomy Plus Fusion

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    Objective: To evaluate and compare the radiological changes on adjacent mobile segments and clinical findings in patients having undergone single-segment simple anterior cervical discectomy versus discectomy plus intervertebral fusion.Material and Methods: Twenty-five patients were treated with discectomy plus fusion and 20 patients with simple discectomy. Clinical pictures of the patients were evaluated with ODOM criteria before and 1 year after operation, and their improvement rates were calculated. The disc heights of superior and inferior adjacent segments, superior and inferior foramen heights, superior and inferior end plate heights of superior and inferior adjacent segments, new osteophyte development, segmental angulation and loss of cervical lordosis were evaluated on cervical radiographies before and 1 year after operation.Results: Although there were new degenerative findings in adjacent mobile segments in all patients when preoperative and postoperative measurements were compared, these radiological findings did not translate into clinical findings. In the fusion group, radiological degeneration findings were seen more frequently statistically; however, clinical results were not different between the two groups. On the other hand, loss of lordosis was significantly more frequent in the simple discectomy group.Conclusion: Although adding fusion to single-segment anterior cervical discectomy caused more frequent radiological degenerative changes in adjacent segments after 1 year compared to simple discectomy, clinical results were similar. It was thought that longer follow-up was necessary to observe clinical adjacent segment disease that was expected to become more frequent because of excessive mobility due to fusion

    NEUROSURGICAL INJURIES CAUSED BY THE 2011 VAN EARTHQUAKE: THE EXPERIENCE AT THE VAN REGIONAL TRAINING AND RESEARCH HOSPITAL

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    Background: On October 23, 2011, a devastating earthquake, magnitude 7.2 on the Richter Scale, jolted the province of Van in the east of Turkey and led to hundreds of casualties. Objectives: In this study, we aimed to present our clinical experience in the management of patients with cranial and spinal injuries who were admitted to the Van Regional Training and Research Hospital. Methods: The retrospective study included 44 (77.2%) patients who were referred to the neurosurgery department after being diagnosed with spinal and cranial injuries due to earthquake at the emergency department between October 23 and 27, 2011. Results: The patients comprised 32 male (72.7%) and 12 (27.3%) female patients with a mean age of 23.5 years. The injuries included scalp injury (n=16), burst fracture (n=7), compression fracture (n=3), epidural hematoma (n=9), subdural hematoma (n=3), contusion (n=1), traumatic subarachnoid hemorrhage (n=2), depressed skull fracture (n=3), linear fracture (n=9), cervical fracture (n=2), and pneumocephalus (n=1). Most of the patients (90.9%) had isolated injuries and the others (9.1%) presented with combined cranial and spinal injuries. At discharge, the 3 patients with spinal fractures were paraplegic, and of the 2 patients who were operatively treated due to subdural hematoma, 1 was hemiparesic and the other was hemiplegic. No mortality occurred in our patients. Conclusions: The results of this study demonstrated that, in the aftermath of a natural disaster, conducting correct triage procedures and performing a prompt intervention with appropriate and qualified equipment play key roles in reducing morbidity and mortality. (C) 2015 Elsevier Inc

    Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

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    A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS). The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI) showed an image of a mass compressing the medulla

    Rapidly Progressive Spontaneous Spinal Epidural Abscess

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    Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation

    The levels of trace elements and heavy metals in patients with acute migraine headache

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    Objective: To compare the levels of trace elements and heavy metal in patients with acute migraine and healthy controls
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