Footdrop: An Unexpected Complication After Anterior Cervical Discectomy and Fusion Operation

Among the various postoperative complications of anterior cervical discectomy and fusion (ACDF) operation, common peroneal nerve (CPN) palsy is a rare one. In this report we present a 47 years old, female patient who suffered from foot drop postoperatively after an ACDF operation performed in supine position and discuss the medicolegal implications of intraoperative nerve injuries in the light of the foregoing literature. CPN palsy due to intraoperative positioning in neurosurgical practice is very seldomly reported. CPN palsy occurrence should be anticipated and prevented espacially in the presence of the risk factors. There is still a serious need for a more comprehensive understanding of these risk factors. On the other hand intraoperative nerve injuries are becoming a subject of litigation more frequently. The interdisciplinary responsibilities concerning the positioning must be clearly defined and it is essential that the documentation of positioning is carried out as accurately as possible. [Cukurova Med J 2015; 40(1.000): 147-150

Endoscopic endonasal repair of spontaneous sphenoid sinus lateral wall meningocele presenting with cerebrospinal fluid leak

Spontaneous sphenoid sinus lateral wall meningoceles are rare lesions with an unknown etiology. Endoscopic endonasal technique is a considerable route in the treatment of this condition. The aim of this paper is to report the etiology, surgical technique, and outcome in a patient repaired via endoscopic endonasal approach. A 51-year-old male patient applied with rhinorrhea started three months ago after an upper respiratory infection. There were no history of trauma or sinus operation. Biochemical analysis of the fluid was positive for beta-2-transferrin. This asypthomatic patient had undergone for repairment of lateral sphenoid sinus meningocele with endoscopic endonasal transsphenoidal approach. After endoscopic endonasal meningocele closure procedure no complications occured and a quick recovery was observed. Endoscopic endonasal approach is an effective and safe treatment modality of spontaneous lateral sphenoid sinus meningoceles and efficient in anterior skull base reconstruction

TRANSPEDİKÜLER YAKLAŞIMLA TEDAVİ EDİLEN KALSİFİYE TORASİK DİSK HERNİLERİNiN KLİNİK SONUÇLARI

Giriş: Semptomatik torakal disk hernileri oldukça nadir görülmesi, farklı klinik durumlarla ortaya çıkması, ortak kabul edilebilir bir cerrahi endikasyonu olmaması ve farklı cerrahi girişimlerin olması nedeniyle tedavisi zor bir patolojidir. Biz bu çalışmada kalsifiye torakal disk hernili olgu serimizi ve sonuçlarını sunduk.Hasta ve Yöntemler: Bu geriye dönük çalışmada 2008-2013 yılları arasında torakal disk hernisi nedeniyle ameliyat edilmiş olgular incelendi. Bilgiler, temel demografik veriler, klinik bulgular, sonuçlar, ameliyat notları ve komplikasyon bilgilerini içeren hasta dosyalarından elde edildi.Sonuçlar: 10 olgunun 6'sı bayan, 4'ü erkekti (yaşları ortalaması 35,6 yıl olup 22-58 arasındaydı). Ortalama takip süresi 28,1 aydır . Bütün olgular transpediküler yaklaşımla ameliyat edildi ve 7 olguya posterior transpediküler fiksasyon uygulandı. Preoperatif dönemde 3 olguda Nurick skoru 1 iken, iki olguda 2, üç olguda 3 ve 2 olguda 4 olarak tespit edildi. Cerrahi tedavi tüm olgularda yeterli iyileşme ve Nurick skorlarında düzelme sağladı (%100). Beş olguda Nurick skoru 0 olurken 5 olguda 1 olarak tespit edildi. Ortalama Nurick skoru 2,5 dan 0,5 e iyileşti. Sonuç: Kalsifiye torakal disk hernilerinin cerrahisinde çelişkiler mevcuttur. Cerrahideki amaç seçilecek yöntemle spinal kortta herhangi bir manipülasyona neden olmadan nöral elemanları dekompresyonudur. Uygun şekilde tanı konup tedavi edildiğinde başarılı sonuçlar alınabilirIntroduction: Symptomatic thoracic disc herniations are relatively rare and challenging due to wide variety of clinical presentations, lack of consensus on surgical indications and variety of surgical approaches. Our objective was to describe our series of calcified thoracic disc herniations and outcomes.Materials and Methods: A retrospective cohort study of 10 patients with calcified TDH operated between 2008 and 2013. Data were collected from review of patients’ notes and radiological studies and included basic demographic data and clinical presentation and outcome, operative procedure and complications. 10 patients, including 6 males and 4 females (mean age 35.6 years, range 22-58 years). The mean follow-up was 28.1 months . All patients were operated by transpedicular approach and in 7 patients posterior transpedicular stabilization was performed.Results: In the preoperative period three patients were Nurick grade 1, two patients were grade 2, three patients were grade 3 and two patients were grade 4. Surgical treatment obtained satisfactory results and the Nurick grade improved in all of the patients (100 %). Five patients’ symptoms turned out to be Nurick grade 0 and five patients turned out to be grade 1. The mean Nurick grade improved from 2.4 to 0.5. Conclusion: Calcified TDHs remains a surgical challenge. The goal of the surgery is to decompress the neural elements without any manipulation of the spinal cord apart from the choice of surgical technique. When adequately diagnosed and treated, satisfactory results can be achieve

Split Cord Malformations

WOS: 000360663100001Split cord malformations are rare form of occult spinal dysraphism in children. Split cord malformations are characterized by septum that cleaves the spinal canal in sagittal plane within the single or duplicated thecal sac. Although their precise incidence is unknown, split cord malformations are exceedingly rare and represent %3.8-5 of all congenital spinal anomalies. Characteristic neurological, urological, orthopedic clinical manifestations are variable and asymptomatic course is possible. Earlier diagnosis and surgical intervention for split cord malformations is associated with better long-term fuctional outcome. For this reason, diagnostic imaging is indicated for children with associated cutaneous and orthopedic signs. Additional congenital anomalies usually to accompany the split cord malformations. Earlier diagnosis, meticuolus surgical therapy and interdisciplinary careful evaluation and follow-up should be made for good prognosis

The Effect of Deferoxamine on Superoxide Dismutase and Histopathological Changes Following Experimental Spinal Cord Injury

WOS: 000361529400009Aim: Primary traumatic spinal cord injury is defined as the injury occurring at the time of the trauma. The metabolic and biochemical processes lead to the secondary trauma in the following hours after the primary trauma. Free radicals and ischemic reperfusion injury are two factors which play role in secondary injury. An iron chelating agent deferoxamine has treatment effect on secondary injury mechanisms by binding free iron ion. This study is based on these effects of deferoxamine. Material and Methods: The experimental spinal cord injury model was applied on 26 rats. In control group I, 10 rats were sacrificed to provide normal spinal cord histopathology and biochemical baseline values. In group II, 6 rats underwent six segment laminectomy and spinal cord injury was produced by extradural compression of the exposed cord by aneurysm clip. Same procedures were performed in 10 rats in group III, but they also received 100mg/kg/day intraperitoneal injection of deferoxamine. Group II and III were sacrificed at 48 hours after the trauma. The effect of deferoxamine on superoxide dismutase and histopathological findings were studied. Results: Superoxide dismutase values of the treatment group were found to decrease significantly when compared to the trauma group. The histopathological evaluation revealed the preservation of spinal cord structure in the treatment group. Conclusion: Results showed that deferoxamine, might reduce secondary injury in damaged rat spinal cord tissue, by a possible mechanism of decreasing the production of free radicals

Dural Metastasis From Breast Carcinoma Mimicking Subdural Hematoma: Case Report

WOS: 000347122100022While intracerebral metastases are common, insulated dural metastases are seen very rarely. The clinical and radiological features of this uncommon condition are often unsuspected and could mimic various benign conditions such as meningioma and subdural hematoma (SDH) as reported in the literature. In this report, we presented a case of 62-year-old female patient with dural metastasis from breast carcinoma mimicking subdural hematoma. We describe the presentation, evaluation and differential diagnosis of this rare case. Our experience in this case has led us to consider metastasis as a differential diagnosis even when a subdural hematoma with uncommon radiological image is diagnosed. Contrast enhanced scan techniques should be recommended for patients in whom dural metastasis is suspected

The role of oxidative stress and inflammatory response in high-fat diet induced peripheral neuropathy

Objective: Earlier studies suggest that high-calorie diet is an important risk factor for neuronal damage resulting from oxidative stress of lipid metabolism. In our experimental study of rats under high-fat diet, oxidative stress markers and axonal degeneration parameters were used to observe the sciatic nerve neuropathy. The aim of this study is to evaluate the pathophysiology of neuropathy induced by high-fat diet

Diffuse Idiopathic Skeletal Hyperostosis: Neurosurgical Cause of Dysphagia

Diffuse idiopathic skeletal hyperostosis (DISH) is a chronic entesopathy which causes excessive formation of osteophytes along the ventral spine in the absence of degenerative, traumatic and inflammatory pathologies of spinal ligaments or paravertebral muscles. Dysphagia is the most common symptom of this disease which may need surgical management. In this article, we report three cases with diffuse idiopathic skeletal hyperostosis treated in our department. The clinical and diagnostic imaging characteristics along with treatments performed and outcomes of these three patients were described. Diffuse idiopathic skeletal hyperostosis is an idiopathic rheumatological disorder which may need surgical treatments in severe forms of the disease. [Cukurova Med J 2015; 40(Suppl 1): 51-57

Treatment of chronic subdural hematoma: 5-year clinical experience

WOS: 000439240200002Introduction: Chronic subdural hematoma is one of the most common types of intracranial hemorrhage, especially in the elderly. Multiple standart surgical techniques exist for the evacuation of chronic subdural hematoma. We compared the results of treatment with burr-hole craniostomy and craniotomy techniques. Materials and Methods: A retrospective study was performed on 93 patients who underwent surgical treatment with chronic subdural hematoma. Two surgical procedures were performed; burr-hole craniostomy with membranectomy (Group A) and craniotomy with extensive membranectomy (Group B). Results: The general outcome of the patients was good. Overall, the rate of reoperation was 11%. Individual reoperation rates of the groups were 14% and 5%, respectively. Coagulopathy was the most common cause of rebleeding in the reoperated patients' group (80%) and the remaining patients had cerebral atrophy which was preventing re-expansion of the brain. In 76 patients, neurologic status improved significantly in the postoperative period and the operative mortality rate was found 4%. Conclusion: Both surgical techniques seem to be effective for the treatment of chronic subdural hemtaoma. Coagulopathy and brain atrophy are defined as two major risk factors for recurrence

Biochemical and Histopathological Effects of Catechin on Experimental Peripheral Nerve Injuries

AIM: Catechin is a type of polyphenol, along with epicatechin, epigallocatechin, and epigallocatechin-gallate (EGCG). This study aims to investigate the effect of EGCG, a major metabolite of catechin, which is the principle bioactive compound in green tea, on rats with peripheral nerve injury. MATERIAL and METHODS: A total of 74 rats were divided into six groups, namely the control, the trauma, the normal saline, a 25mg/kg EGCG, a 50mg/kg EGCG and a daily consumption group (10mg/kg EGCG was given intraperitoneally for 14 days before the trauma). Except the first group, the other groups underwent a 1-minute sciatic nerve compression by clip with 50gr/cm(2) pressure. Nerve samples were obtained at 28 day after trauma for the biochemical and histopathological analysis. RESULTS: Our study showed that the Daily consumption, 25mg/kg EGCG and 50mg/kg EGCG groups demonstrated statistically significant decreased lipid peroxidation levels and particularly daily consumption, and the 25mg/kg EGCG group showed a favourable reduction of degeneration and edema histologically. CONCLUSION:This study shows that Catechin and its derivatives have a protective effect on peripheral nerve injury