Magnetic resonance imaging study; does the olfactory bulb volume change in major depression?

Goal: The olfactory region function disorders and olfactory bulb volume changes in neurodegenerative and neuropsychiatric disorders are defined. In this study, the olfactory bulb values of patients diagnosed with major depression in accordance with DMS-IV criteria, are measured with MRI, and these values are compared with the values of healthy volunteers to see if there are any statistically significant changes.Method: The study was carried out with 20 healthy volunteers and 20 patients who had been diagnosed with acute major depression in accordance with ‘diagnostic and statistical manual of mental disorders’ (DMS) IV criteria and have been getting treatment for more than 2 years in Istanbul Education and Research Hospital. 1,5 Tesla MRI were used in 40 cases, and the olfactory bulb volume on two hemispheres were measured separately.Results: Contrary to the former studies, we found no statistically significant difference between the olfactory bulb volume measurements of the control group and the group diagnosed with major depression

A rare case of cervical epidural extramedullary plasmacytoma presenting with monoparesis

Multiple myeloma and other plasma cell disorders are characterized by production of a large number of plasma cells in the bone marrow. On the other hand, plasmacytoma results from proliferation of abnormal plasma cells in the soft tissue or skeletal system. Neurological complications are frequently observed in these diseases. The most commonly known complications among those complications are spine fractures, spinal cord compressions, and peripheral neuropathies. Although neurological involvements are common in plasmacytomas, extramedullary spinal epidural localizations have been reported very rarely. In this case report, we aimed to present a plasmacytoma case that presented with acute onset of upper extremity monoparesis. A 40-year-old woman was admitted to our clinic with complaints of sudden weakness and numbness in her left arm following neck and left arm pain. Emergency cervical magnetic resonance imaging (MRI) revealed an epidural mass and the patient underwent emergency surgery. The patient showed improvement post-operatively and the pathology was reported as plasmacytoma. Following hematology consultation, systemic chemotherapy was initiated and radiotherapy was planned after wound healing

Incidence, hospital costs and in-hospital mortality rates of surgically treated patients with traumatic cranial epidural hematoma

Background: In this study, the patients who were operated in two clinics due to traumatic cranial epidural hematoma (EDH) were assessed retrospectively and the factors that increase the costs were tried to be revealed through conducting cost analyses.Methods: The patients who were operated between 2010 and 2016 with the diagnosis of EDH were assessed in terms of age, sex, trauma etiology, Glasgow coma scale (GCS) at admission, the period from trauma to hospital arrival, trauma-related injury in other organs, the localization of hematoma, the size of hematoma, length of stay in the intensive care unit (ICU), length of antibiotherapy administration, number of consultations conducted, total cost of in-hospital treatments of the patients and prognosis.Results: Distribution of GCS were, between 13-15 in 18 (36%) patients, 9-13 in 23 (46%) patients and 3-8 in 9 (18%) patients. The reasons for emergency department admissions were fall from high in 29 (58%) patients, assault in 11 (22%) patients and motor vehicle accident in 10 (20%) patients. The average cost per ICU stay was 2838 $(range=343-20571$). The average cost per surgical treatment was 314 $. ICU care was approximately 9 times more expensive than surgical treatment costs. The mortality rate of the study cohort was 14% (7 patients).Conclusion: The prolonged period of stay in the ICU, antibiotherapy and repeat head CTs increase the costs for patients who are surgically treated for EDH

Incidence, hospital costs and in-hospital mortality rates of surgically treated patients with traumatic cranial epidural hematoma

Background: In this study, the patients who were operated in two clinics due to traumatic cranial epidural hematoma (EDH) were assessed retrospectively and the factors that increase the costs were tried to be revealed through conducting cost analyses. Methods: The patients who were operated between 2010 and 2016 with the diagnosis of EDH were assessed in terms of age, sex, trauma etiology, Glasgow coma scale (GCS) at admission, the period from trauma to hospital arrival, trauma-related injury in other organs, the localization of hematoma, the size of hematoma, length of stay in the intensive care unit (ICU), length of antibiotherapy administration, number of consultations conducted, total cost of in-hospital treatments of the patients and prognosis. Results: Distribution of GCS were, between 13-15 in 18 (36%) patients, 9-13 in 23 (46%) patients and 3-8 in 9 (18%) patients. The reasons for emergency department admissions were fall from high in 29 (58%) patients, assault in 11 (22%) patients and motor vehicle accident in 10 (20%) patients. The average cost per ICU stay was 2838 $(range=343-20571$). The average cost per surgical treatment was 314 $. ICU care was approximately 9 times more expensive than surgical treatment costs. The mortality rate of the study cohort was 14% (7 patients). Conclusion: The prolonged period of stay in the ICU, antibiotherapy and repeat head CTs increase the costs for patients who are surgically treated for EDH

Nontraumatic Intradiploic Epidermoid Cyst and Older Age: Association or Causality?

WOS: 000427989400018PubMed: 28953141Background:Intradiploic epidermoid cysts (IEC) are rare, benign lesions derived from ectodermal remnants during neural tube closure. Their origin is still debated or unknown.Objective:Analyzing of the patients with intradiploic epidermoid cysts operated in the authors' department.Methods:The patients with IEC who were operated in the authors' department between January 2014 and December 2015 were investigated from data file.Results:Six patients with IEC were found, reviewed the literature, and noted that these cysts usually occur in adults. There are only 3 young cases that occurred after head injury.Conclusion:It was shown that the nontraumatic IEC are more frequent in older ages. in youngs, it can generally be embryologic or rarely of mechanical origin following trauma. Cranial trauma may be important for developing of IEC. Trauma may lead to inclusion of epidermal cells into the diploe of the skull and may be a reason of intradiploic epidermoid cyst in older age. the effect of older age, and gender difference on occurrence should be investigated

Uncovering a New Cause of Obstructive Hydrocephalus Following Subarachnoid Hemorrhage: Choroidal Artery Vasospasm-Related Ependymal Cell Degeneration and Aqueductal Stenosis-First Experimental Study

AYDIN, Nazan/0000-0003-3232-7713; Gundogdu, Cemal/0000-0003-2857-923X; Kanat, Ayhan/0000-0002-8189-2877WOS: 000380360500060PubMed: 27020981BACKGROUND: Hydrocephalus is a serious complication of subarachnoid hemorrhage (SAH). Obstruction of the cerebral aqueduct may cause hydrocephalus after SAH. Although various etiologic theories have been put forward, choroidal artery vasospasm-related ependymal desquamation and subependymal basal membrane rupture as mechanisms of aqueductal stenosis have not been suggested in the literature. METHODS: This study was conducted on 26 hybrid rabbits. Five rabbits were placed in a control group, 5 were placed in a sham group, and the remaining rabbits (n = 16) were placed in the SAH group. in the first 2 weeks, 5 animals in the SAH group died. the other 21 animals were decapitated after the 4-week follow-up period. Choroidal artery changes resulting from vasospasm, aqueduct volume, ependymal cell density, and Evans index values of brain ventricles were obtained and compared statistically. RESULTS: Mean aqueduct volume was 1.137 mm(3) +/- 0.096, normal ependymal cell density was 4560/mm(2) +/- 745, and Evans index was 0.32 +/- 0.05 in control animals (n = 5); these values were 1.247 mm(3) +/- 0.112, 3568/mm(2) +/- 612, and 0.34 +/- 0.15 in sham animals (n = 5); 1.676 mm(3) +/- 0.123, 2923/mm(2) +/- 591, and 0.43 +/- 0.09 in animals without aqueductal stenosis (n = 5); and 0.650 mm(3) +/- 0.011, 1234/mm(2) +/- 498, and 0.60 +/- 0.18 in animals with severe aqueductal stenosis (n = 6). the choroidal vasospasm index values were 1.160 +/- 0.040 in the control group, 1.150 +/- 0.175 in the sham group, 1.760 +/- 0.125 in the nonstenotic group, and 2.262 +/- 0.160 in the stenotic group. Aqueduct volumes, ependymal cell densities, Evans index, and choroidal artery vasospasm index values were statistically significantly different between groups (P<0.05). CONCLUSIONS: Ependymal cell desquamation and subependymal basal membrane destruction related to choroidal artery vasospasm may lead to aqueductal stenosis and hydrocephalus after SAH

Spinal paragangliomas Surgical treatment and follow-up outcomes in eight cases

Paragangliomas are neuro-endocrine tumors originating from the adrenal gland. They are usually benign and nonfunctioning, rarely seen in central nervous system. More than 90% of central nervous system paragangliomas are manifested as carotid and glomus jugulare tumors. Spinal paragangliomas are quite rare

How Reliable Is Pupillary Evaluation Following Subarachnoid Hemorrhage? Effect of Oculomotor Nerve Degeneration Secondary to Posterior Communicating Artery Vasospasm: First Experimental Study

AYDIN, Nazan/0000-0003-3232-7713WOS: 000434669900006PubMed: 29241271Background and Study Aim Basic neurophysiologic principles of the light reflex are well known. However, the effects of degenerated axon densities of oculomotor nerves (OMNs) secondary to posterior communicating artery (PComA) vasospasm following subarachnoid hemorrhage (SAH) have not been investigated. Our aim was to study this subject. Methods This study was conducted on 19 rabbits. There was a control group of five animals, a sham group of five animals in which saline was injected into the cisterna magna and a study group of nine animals in which homologous blood was injected into the cisterna magna. Pupillary diameters were measured for 1week, then the animals were decapitated. the normal and degenerated axon densities of the OMNs were examined by stereological methods. Vasospasm indexes (VSIs) of posterior communicating arteries (PComAs) supplying OMNs were estimated and analyzed statistically. Results the pupillary diameter was 5.439368 mu m, and the mean axon density of the OMNs was 0.924 +/- 324/mm (3) in the control group. the pupillary diameter and degenerated axon density of the OMNs in animals of the sham group were 6.980 +/- 0.370 mu m and 36 +/- 8/mm (3) , respectively. the pupillary diameter was 9.942 +/- 653 mu m, and degenerated axon density of the OMNs was 265 +/- 57/mm (3) in animals with SAH. the mean VSI values of PComAs were 0.927 +/- 0.224 in the control group, 1.542 +/- 0.257 in the sham group, and 2.321 +/- 0.324 in the SAH group. Conclusion We found a linear relationship between the axon density of the OMNs and pupillary diameters. High degenerated neuron density in the OMNs may be responsible for an unresponsive pupillary that has not been mentioned in the literature

Lumbosacral Meningocele in Adulthood

Spinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect and characterized by cystic dilatation of the meninges containing cerebrospinal fluid (CSF), without the involvement of neural tissue. These lesions are often benign and typically diagnosed at birth. Neurosurgical intervention is necessary in the newborn period, since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported among spinal dysraphic lesions in adulthood. They are tethering lesions of the spinal cord, adhering to the dura and other soft tissues with fibrous elements. In addition, the caudal lesions tend to leak CSF, unlike cervical congenital midline meningoceles. Here, we present a 41 year-old female patient with a meningocele that has developed CSF leakage. The clinical course, surgical management, and follow-up period of this rarely seen adulthood meningocele are also discussed. [Cukurova Med J 2015; 40(Suppl 1): 131-135