Non-invasive diagnosis of traumatic occlusion of extracranial internal carotid artery by magnetic resonance angiography

PubMedID: 9007895A case of traumatic occlusion of the left extracranial internal carotid artery that was diagnosed by magnetic resonance angiography is reported. The non-invasiveness and safety of drug therapy is superior to intraarterial digital angiography

Prognosis and prognostic factors in nonaneurysmal perimesencephalic hemorrhage: A follow-up study in 29 patients

PubMedID: 12009538BACKGROUND: Perimesencephalic nonaneurysmal hemorrhage is a benign form of subarachnoid hemorrhage with a low risk of rebleeding. The authors conducted a retrospective study to investigate the prognosis, possible prognostic factors, and long-term natural history in perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH). METHODS: This report contains a retrospective analysis of 29 patients with PNSH who were followed from 1 month to 8 years with an average follow-up period of 5.4 years. We evaluated computed tomography (CT) scan features; clinical grade; loss of consciousness during hemorrhage; ventricular ratio; angiographic spasm; complications such as ischemic complications, early rebleeding, late rebleeding, epilepsy, hydrocephalus, and fixed ischemic deficit; and outcome. RESULTS: There were 7 men and 22 women, and the ages ranged from 22 to 69 years (mean 49.5 years). In the group with PNSH 93% of the patients were in grade I-II, as compared to 70.8% of patients with non-PNSH according to the Hunt and Hess system. Loss of consciousness during hemorrhage was detected in 9 patients (31%). We observed acute hydrocephalus in 4 patients (13.7%). The first cerebral four-vessel angiograms disclosed vasospasm in 3 patients (10.3%). Patients with PNSH have the best outcome according to the activities of daily living (ADL) grading system when compared with other groups of patients with negative angiogram (aneurysmal pattern and invisible blood). CONCLUSION: This study provides evidence that patients with PNSH have an uncomplicated course and a particularly favorable outcome. © 2002 by Elsevier Science Inc

Cervical intradural extramedullary hydatid cyst

A case of intradural extramedullary hydatid cyst with spinal cord compression located in the cervical region is presented. The diagnosis was made preoperatively on the basis of MRI findings. Many cases of cranial or spinal extradural hydatid cyst have been reported in the literature, but intradural extramedullar location of the cyst in the cervical region is extremely rare

An unusual complication of the ventriculo-peritoneal shunt: Migration of the distal end into the scrotum through the inguinal canal

[No abstract available

The evaluation of killer cell immunoglobulin-like receptor gene polymorphism in glioblastoma patients

PubMedID: 30984996AIM: To assess the distribution of genetic polymorphisms of killer cell immunoglobulin-like receptors (KIRs) to predict the clinical course of glioblastoma, report on the genetic mechanisms, and provide guidance on potential therapeutic methods. MATERIAL and METHODS: Our study included 31 adult patients who were admitted to the Department of Neurosurgery at our institution and diagnosed with glioblastoma between October 2013 and January 2014 together with 50 control subjects. RESULTS: The mean age of the patients was 53.5 vs. 53.9 years, respectively, and the gender distribution (male/female: 64.5/35.5% vs. 64/36%, respectively) was comparable among patients and controls (p>0.05). Sixteen different KIR genes including inhibitory, activating, and pseudogenes were investigated for each sample, and the framework genes including KIR2DL4, 3DL2, 3DL3, and 3DP1 were present in all patients and controls. In addition, the inhibitory KIR genes and the 2DL3 gene were significantly more common in patients compared to controls (p<0.05). CONCLUSION: This study demonstrated that the inhibitory KIR gene 2DL3 has a predisposition for glioblastoma. Identifying the potential link between glioblastoma cells and immune system genetics is critical in predicting familial predisposition and early diagnosis. In addition, this clue may be a key factor in developing post-surgery individual immunotherapy models in the future. © 2019 Turkish Neurosurgical Society.Preparation for publication of this article is partly supported by Turkish Neurosurgical Society

Denaturation of the nucleus pulposus with the Nd:YAG laser in animal model

Successful results in well selected patients have been reported following percutaneous laser discolysis in the treatment of herniated intervertebral disc disease. Two groups with four pigs in each were formed. First four pigs were used as the control group and the second four was used as the treatment group. Intervertebral disc spaces of the treatment group was hydrated with 0, 1 cc saline. Intervertebral disc spaces of each pig in both groups have been irradiated with Nd:YAG laser of 1318 nm wavelength and designated energy level. Macroscopic and microscopic findings of the lesions formed have been evaluated. As a result we can say that percutaneous discolysis can be more successful especially in the young patients due to our observation obvious evaporation in the hydrated group

Effect of thyrotropin releasing hormone on the cerebral artery after CO2 laser induced lesion

[No abstract available

Anterior or posterior instrumentation in the treatment of unstable thoracolumbar fractures: A retrospective analysis of 30 cases

Surgical procedures designed to decompress and stabilize unstable trauma-related thoracolumbar fractures are primarily anterior or posterior operative approaches combined with anterior or posterior instrumentation. Our goal is to identify patients that are likely to benefit from either fixation system. Two treatment groups were studied. The first group of 20 patients underwent posterior instrumentation and fusion. Also, eighteen patients with evidence of neural compression were treated with posterior decompressive surgery. The second group, consisting of 10 patients with neurological deficits, was managed with single-stage anterior decompression, interbody strut grafting, and anterior instrumentation. There were no statistically significant differences between the groups with regard to postoperative neurological outcome (Mann-Whitney U, P>0.05), pain assessment and ability to return to work (Chi-square, P>0.05), rate of instrument failure (Chi-square, P>0,05), rate of solid fusion (Chi-square, P>0,05) and loss of reduction (Mann-Whitney U, P>0.05). When surgery is indicated, the operative approach (anterior or posterior) and type of instrumentation used (anterior or posterior) are determined by the location and characteristics of the fracture (e.g., neural compression and instability) and the surgeon's familiarity with the various techniques. Based on the results of this study, we conclude that posterior spinal instrumentation is as effective as anterior instrumentation in the treatment of unstable thoracolumbar fractures

Interleukin-2 and tumour necrosis factor values in intracranial tumours

Tumour Necrosis Factor (TNF) and Interleukin-2 (IL-2) values were determined in 44 intracranial tumour patients pre- and postoperatively and compared with the values in 20 healthy persons and 14 with Behcet's disease, who were used as the control group. There was no significant difference in IL-2 values of the control group and preoperative values of the tumour group except for meningioma and acustic neurinoma. We think that macrophages and glycoaminogaycans which encapsulate the tumour prevent stimulation of T helpers by the tumour antigens, so IL-2 is not secreted from the T helpers. Probably for the same reason we could not find significant TNF values between the control group and the preoperative tumour group. Postoperative decrease in IL-2 is considered to be the result of corticosteroids used for 7 days. Increased TNF values in the postoperative tumour group can be due to the breakdown of the glycoaminoglycan barrier and stimulation of macrophages by the tumour antigens

The effect of thyrotropin releasing hormone (TRH) on the experimental carbon dioxide laser brain lesion: Ultrastructural and biochemical study

Although the main advantage of the CO2 laser lies in the possibility of a less traumatic effect on the surrounding tissue, its use in neurosurgery still necessitates a thorough and detailed evaluation of the effect on surrounding normal central nervous system (CNS) tissue, Therefore this study was undertaken to investigate the ultrastructural and biochemical effects of the CO2 laser on the application area and the surrounding normal central nervous system tissue. Sodium-potassium activated and magnesium-dependent adenosine-5'-triphosphatase (Na+-K+/Mg2+ ATPase E.C.3.6.3.1), magnesium dependent adenosine-5'-triphosphatase (Mg2+ ATPase E.C.3.6.1.3) and calcium activated magnesium dependent adenosine-5'-triphosphatase (Ca2+/Mg2+ ATPase E.C.3.6.1.3) enzymes, superoxide dismutase, light microscopic and ultrastructural findings were determined in dog brain following laser application with and without thyrotropin releasing hormone (TRH) treatment. Laser lesions were created by a CO2 laser in the cerebrum. Fifteen days later, after thyrotropin releasing hormone injection, ultrastructural and biochemical investigations were undertaken to evaluate the effect of thyrotropin releasing hormone on the laser induced lesion and particularly surrounding cerebral tissue. Ultrastructural findings, showed that thyrotropin releasing hormone reduced degeneration on the CO2 laser-applied lesion