Hemangioblastoma of the Filum Terminale Associated with Von Hippel-Lindau Disease: A Case Report

Bel ağrısı, alt ekstremitelerde parestezisi, idrar yapamama ve konstipasyon şikayeti olan 41 yaşında erkek hasta takdim ediyoruz. Hastada yapılan manyetik r&ouml;zanans tetkiki ikinci lomber vertebra seviyesinde vask&uuml;ler intradural-extramed&uuml;ller lezyon g&ouml;sterdi. Hastanın medikal hikayesinden 5 sene &ouml;nce serebellar hemanjioblastom nedeniyle opere edildiği &ouml;ğrenildi. Hasta spinal b&ouml;lgesinden opere edildi ve filum terminaleden vask&uuml;ler t&uuml;m&ouml;r &ccedil;ıkarıldı. T&uuml;m&ouml;r&uuml;n patoloji sonucu hemanjioblastom olarak bildirildi. Hemanjioblastomlar sporadik olarak g&ouml;r&uuml;lebilir veya Von Hippel-Lindau hastalığına eşlik eder. Von Hippel-Lindau hastalığına eşlik ettiği zaman &ccedil;oğunlukla multipl olurlar ve serebellar ve beyin sapı lezyonları ile beraber g&ouml;z&uuml;k&uuml;rler. Hemanjioblastomlar konus medullaris ve konus medullarise komşu ekstramedullar alanda nadir olarakg&ouml;z&uuml;k&uuml;rler, kauda ekuinada daha nadirlerdir, filum terminalede ise &ccedil;ok ender g&ouml;z&uuml;k&uuml;rler. Biz filum terminalesinde hemanjioblastom olan ve Von Hippel-Lindau hastalığı olan bir hasta takdim ediyoruz ve hemanjioblastomun teşhisini, patojenezini ve tedavisini tartışıyoruz. We report a 41-year-old man who presented with low back pain, lower extremity paresthesia, urinary retention and constipation. Magnetic resonance imaging showed a vascular intradural-extramedullary lesion at the second lumbar vertebral level. His medical history revealed that he had undergone surgery for a cerebellar hemangioblastoma 5 years ago. The patient underwent a spinal operation and a vascular tumor was removed from filum terminale. Pathologic examination of the tumor revealed a hemangioblastoma. Hemangioblastomas may occur sporadically or in association with von Hippel-Lindau disease. In the second case, they are often multiple and accompanied by cerebellar and brainstem lesions. The hemangioblastomas reported in the conus medullaris or in the extramedullary compartment adjacent to the conus medullaris are rare, tumors of the cauda equina are uncommon, and lesions of the filum terminale are extremely rare. We report a patient with von Hippel-Lindau disease having filum terminale hemangioblastoma and discuss the diagnosis, pathogenesis and treatment of hemangioblastoma. &nbsp;</p

Neuroprotective Effects of Agmatine in Experimental Peripheral Nerve Injury in Rats: A Prospective Randomized and Placebo-Controlled Trial

AIM: The purpose of this study was to demonstrate the activity of agmatine, an inducible nitric oxide synthase (iNOS) inhibitor and selective N-methyl-D-aspartate receptor (NMDAR) antagonist, on reducing tissue damage in distal part of traumatic nerve in an experimental rat peripheral nerve injury model. MATERIAL and METHODS: Sciatic nerves of 30 Sprague Dawley male rats were used. Rats were divided into 5 groups; group 1 (n=6), control group; group 2 (n=6), axonotmesis + placebo group; group 3 (n=6), axonotmesis + 50 mg/kg agmatine treatment group; group 4 (n=6), neurotmesis + placebo group; group 5 (n=6), neurotmesis + 50 mg/kg agmatine treatment group. Axonolysis, axon degeneration, edema, hemorrhage, and inflammation were evaluated in histopathologic examinations of all the groups. RESULTS: When group 2 was compared with group 3 in histopathologic sections, axonolysis was less in group 3 (p=0.007), as was axon degeneration (p=0.022) and edema (p=0.018). When group 4 was compared with group 5, axonolysis was less in group 5 (p=0.009), as was axon degeneration (p=0.006) and edema (p=0.021). CONCLUSION: This study demonstrated agmatine to have antioxidant and antineurotoxic effects in an experimental rat peripheral nerve injury model

The Effect of Copper on Vasospastic Femoral Artery in Rats

AIM: The aim of this study was to investigate the effect of copper, which is the cofactor and regulator of the superoxide dysmutase enzyme, on preventing experimental peripheral vasospasm in rats through antioxidative mechanisms

Light Microscopic Evaluation of Acute and Chronic Hypophyseal Endocrinopathy in a Kaolin-Induced Hydrocephalus Model

AIM: To demonstrate progression of acute and chronic endocrinopathies in a kaolin-induced hydrocephalus model using light microscopy. MATERIAL and METHODS: Adult male Sprague-Dawley rats (n = 48) were divided into six groups. Hydrocephalus was induced by intracisternal injection of kaolin solution in the acute and chronic kaolin groups, whereas an identical volume of sterile saline was injected into the sham groups. RESULTS: Somatotropic cell concentrations were lower in the kaolin groups compared with their controls, but there was no difference in somatotropic cell concentration between the acute and chronic kaolin groups. Corticotropic cell concentrations were higher in the acute kaolin and sham groups compared with acute controls. Thyrotropic cell numbers were higher in the acute sham and kaolin groups compared with their controls, and although thyrotropic cell concentations were higher in the acute kaolin group than the acute sham group. No differences were observed between the acute and chronic controls and sham and kaolin groups regarding mammotropicand gonadototropic cell concentations. CONCLUSION: Somatotropic cells are most affected by hydrocephalus that causes pituitary dysfunction, and this effect was more prominent under acute and chronic phases.Turkish Neurosurgical SocietyPreparation for publication of this article is partly supported by Turkish Neurosurgical Society

The Use of Neuronavigation and Intraoperative Imaging in Spinal Stabilization Surgery

AIM: Misplacement of pedicle screw is the serious complication of spinal surgeries. Intraoperative imaging techniques and navigation systems are currently in use for the prevention of this complication. The aim of this study was to document the results of our experience with the navigation and intraoperative imaging technique and to share our experience with our colleagues. MATERIAL and METHODS: Between 2011 and 2014, one hundred and two patients underwent instrumented spinal surgery while using intraoperative computed tomography (iCT) and a navigation system. All patients had a CT scan performed no more than three days postoperatively to confirm adequate placement of the screws. The accuracy of pedicle screw placement was assessed by postoperative CT scan. Pedicle violations were graded according to an established classification system. RESULTS: In the 36-month period, a total of 610 screws in 102 patients were evaluated. Stabilization surgery was performed in the lumbosacral region in 51 (50%) patients, lumbar region in 35 (34.31%) patients, cervical region in 5 (4.9%) patients, thoracolumbar region in 7 (6.86%) patients and thoracic region in 4 (3.92%) patients. Of the 610 screws, 396 (64.91%) were placed in lumbar, 66 (10.81%) in thoracic, 106 (17.37%) in sacral and 42 (6.8%) in cervical vertebrae. Of the 610 screws, 599 screws (98.18%) were placed without a breach. Grade 1 breaches occurred in 8 screws (1.31%), Grade 2 breaches occurred in 2 screws (0.32%), and Grade 3 breaches in 1 screw (0.16%). No dural defect or neurological deficit occurred after the surgeries. CONCLUSION: The use of an ICT scan associated with a navigation system increases the accuracy of pedicle screw placement. This system protects the surgical team from fluoroscopic radiation exposure and the patient from the complications of screw misplacement and repeated surgeries

Mutation in MEOX1 gene causes a recessive Klippel-Feil syndrome subtype

Background: Klippel-Feil syndrome (KFS) is characterized by the developmental failure of the cervical spine and has two dominantly inherited subtypes. Affected individuals who are the children of a consanguineous marriage are extremely rare in the medical literature, but the gene responsible for this recessive trait subtype of KFS has recently been reported

THE COVID-19 PANDEMIC AND ARTIFICIAL INTELLIGENCE (AI) APPLICATIONS IN HEALTH: HOW MUCH ARE WE INTERESTED IN?

Purpose: New viruses have emerged, causing global damage and mass deaths that can spread to international borders, the latest of which is the new coronavirus (COVID-19). After the Second International Congress on Artificial Intelligence in Health, themed "Artificial Intelligence in Health During COVID-19 Pandemic Process" organized online by Izmir Bakircay University and Izmir Provincial Health Directorate with the contributions of the International Association of Artificial Intelligence in Health, a questionnaire was conducted to evaluate the knowledge of the participants about artificial intelligence applications.Material and Methods: This study aimed to evaluate the interest of the congress participants in this field with the questions which form the questionnaire such as the duration of the interest of the participants in the field of artificial intelligence in health, their publication status, the development of studies on artificial intelligence with the COVID-19 pandemic, demographic structures such as age and gender, and educational level. 130 participants answered the questionnaire consisting of 23 questions. Questionnaire responses were analyzed in a statistical setting.Results: We found that 130 people filled out the questionnaire and the majority of the participants were female, with participation from many organizations, but university staff showed more interest. We have seen that the 30-39 age group is more interested in artificial intelligence than the other age groups, but the majority of the participants do not have academic studies in this field. We found that the technical terms related to artificial intelligence were not well known by the participants, and that the number of participants who tended to this field, especially in the recent year, was high. Another important point was that people working in this field stated that they would definitely follow up if scientific activities continued.Conclusion: We know how important congresses, symposiums, courses and other meetings are, especially for scientist candidates, which will be held to raise awareness about the usage areas of artificial intelligence-based health technologies, to develop new communication and work networks by bringing together different disciplines, to create an agenda and to lay the groundwork for new studies, and we think that there is a need for many repetitive activities in this field and that these activities should be continued