Fossa posterior fossa yerleşimli glioblastoma

A 63-year-old woman operated eight months ago for glioblastoma (GB) located in posterior fossa was admitted to emergency room for stuporous, nausea, vo-miting and headache. CT and MR showed recurrence of posterior fossa cystic-necrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF) fistula from the incision was occurred and contaminated by multidrug resistant Acinetobacter ba-umannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and child-ren; and it appears as two different subsets: de novo (primary type) and secondary glioblastomas. Although our patient's immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour was de novo because of no other brain involvement, staining with GFAP, vimentin, and nearly absent p53 mutation

A multi-technique approach to determine temporal and spatial variability of groundwater-stream water exchange

Characterizing the spatio-temporal distribution of groundwater-surface water exchange fluxes is of paramount importance in understanding catchment behavior. A wide range of field-based techniques are available for such characterization. The objective of this study is to quantify the spatio-temporal distribution of the exchange fluxes along the Çakıt stream (Nigde, Turkey) through coupling a set of geophysical techniques and in-stream measurements in a hierarchical manner. First, geological and water quality information were combined at the catchment scale to determine key areas for reach-scale focus. Second, electromagnetic induction (EMI) surveys were conducted along the reach to pinpoint potential groundwater upwelling locations. EMI anomalies guided our focus to a 665 meter-long reach of the stream. Along this selected reach, a fiber-optic distributed temperature sensing (FO-DTS) system was utilized to investigate streambed-temperature profiles at fine spatial and temporal scales. Furthermore, vertical hydraulic gradients and exchange fluxes were investigated using nested piezometers and vertical temperature profiles, respectively, at two potential upwelling locations and a potential downwelling location identified by previous surveys. The results of the study reveal heterogeneity of vertical water-flow components with seasonal variability. The EMI survey was successful in identifying a localized groundwater upwelling location. FO-DTS measurements revealed a warm temperature anomaly during cold air temperature and low streamflow conditions at the same upwelling site. Our point-based methods, namely vertical temperature profiles and vertical hydraulic gradient estimates, however, did not always provide consistent results with each other and with EMI and DTS measurements. This study, therefore, highlights the opportunities and challenges in incorporating multi-scale observations in a hierarchical manner in characterization of the groundwater-surface water exchange processes that are known to be highly heterogeneous in time and space. Overall, a combination of different methods helps to overcome the limitations of each single method and increases confidence in the obtained results

Supratentorial hemangioblastoma without von Hippel-Lindau syndrome in an adult: A rare case report

Hemangioblastomas (HBLs) are highly vascular and cystic benign neoplasms. They form very small part of intracranial tumours and are often localized in the posterior fossa. Although most of them are sporadic, a significant group is accompanied with von Hippel-Lindau (VHL) syndrome. This case report presents a 57-year-old woman treated with total resection using micro-surgical technique and was diagnosed as HBL based on histopathologic findings. Contrast-enhanced cranial MRI of the patient with the complaints of spasms in the right side of body showed a right paracentral mass that caused midline shift. In literature, the previously reported cases of supratentorial HBL unaccompanied with VHL syndrome were searched in PUBMED, compiled and presented. It should be borne in mind that rare HBLs manifesting with various neurological symptoms may occur in the supratentorial region, and may not accompany with VHL syndrome

Efficacy of Gabapentin for Radiculopathy Caused by Lumbar Spinal Stenosis and Lumbar Disk Hernia

WOS: 000285797500004PubMed: 21206180The efficacy of gabapentin monotherapy was investigated against both acute or chronic radicular pain caused by lumbar disk hernia (LDH) or lumbar spinal stenosis (LSS). Seventy-eight patients with radicular pain, 10 males and 68 females aged 23 to 76 years (mean 49.4 years), caused by LSS in 45 patients or LDH in 33 patients were treated with oral administration of gabapentin and were followed up for 3 months. The evaluation included neurological examination, Odom's criteria, visual analog pain scale (VAS), and walking distance. Gabapentin treatment resulted in decreased VAS scores in both groups. Odom's criteria scores had improved to excellent or good in 36 patients with LSS and 28 patients with LDH. Furthermore, walking distance was significantly longer at the 3rd month of the treatment protocol. Eight patients discontinued gabapentin therapy because of the side effects. Gabapentin could be an option in the conservative management of acute or chronic radicular pain

Spontaneous regression of lumbar disc hernia: Original image

The most important issue is to perform suitable surgery to the correct patient at the correct time. We should not consider immediate surgery for disc hernia patients except for emergency indications. Cauda equina syndrome, progressive motor deficit and the pain uncured with narcotics are the main emergency surgery indications. Spontaneous regression is common particularly for the lumbar region. However, the spontaneous regression mechanism is unclear. Dehydration, enzymatic degradation and phagocytosis, and the retraction of hernia disc in annulus fibrosus are the suggested mechanisms. Magnetic resonance (MR) images support the dehydration. Conservative treatment was effective in three lumbar disc henna cases that did not have emergency surgery indication. Three lumbar disc hernia cases who had spontaneous regression and their MR findings are here presented

SHORT-TERM OUTCOMES OF THREE DIFFERENT SURGICAL PRACTICES IN LUMBAR DISC HERNIATION

Objective: Many surgical protocols are used for surgical treatment of lumbar disc herniation. Here, we discussed the postoperative short-term outcomes of patients with lumbar disc herniation who underwent three different surgical protocols. Material and Method: This study included patients who underwent simple discectomy, microdiscectomy, and discectomy+implantapproaches to treat lumbar disc herniation. We then compared patient demographics, lumbar segment, and the duration of postoperative hospital stay between the three procedures. Results: There were no statistically significant differences between the simple discectomy and implant groups in terms of the visual analogue pain scale (VAS) and Oswestry disability index (ODI) results (p > 0.05). Themicrodiscectomy group also had the best Oswestry disability index results for the third month compared with other groups (p < 0.05). Conclusion: The microdiscectomy group was the most advantageous in terms of VAS score, Oswestry scale and duration of hospital stay. As microdiscectomy is a minimally invasive procedure, it is the preferred method for the surgical management of lumbar disc herniation

Lumbar Disc Hernia and Erectile Dysfunction

WOS: 000289644500005Lumbosacral disc disease and sexual dysfunction are two non-lethal health entities that are common and decrease quality of life of patients. With interruption of communication between the brain and the penis, erectile dysfunction should be expected. However, there are very limited data on the interaction of lumbosacral disc disease and sexual functioning. The aim of this review is to highlight the association between lumbosacral disc disease and sexual dysfunction and to overview the diagnosis and treatment options for this subset of patients. (Archives of Neuropsychiatry 2011; 48 Supplement 1:31-4