Higher Perceived Stress Increases the Subjective Reporting of ADHD: A Sample of Medical Students

This study aimed to evaluate the subjective Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms with self-reported ratings and objective neurocognitive tests among medical students. Also, we examined to identify the psychological factors that predict ADHD reporting among medical students. Medical students (N=57) completed self-report questionnaires, and neurocognitive tests were conducted for attention measures. Participants had a mean age of 20.3 years, and 69.0% were female. High levels of perceived stress, state-trait anxiety, and current and childhood ADHD symptoms were possible risk factors; however, only higher perceived stress was a risk factor for the possibility of reporting themselves as ADHD in medical school students [odds ratio [OR] =1.184, 95% confidence interval [CI] = [1.015; 1.381]]. Higher perceived stress levels, the more reported ADHD subjectively in medical students. Objective attention measures had no impact on reporting ADHD subjectively. Screening for perceived stress is necessary for medical students, especially those with subjective ADHD symptoms

Factors affecting mortality in Pediatric Severe Head Injury

Aim: It is aimed to determine the factors affecting mortality in pediatric patients followed up with severe traumatic brain injury in the pediatric intensive care unit. Material and method: All patients followed up in the Pediatric Intensive Care Unit between April 2019 and April 2021 due to severe traumatic brain injury were included. Demographic characteristics, pre-intensive care interventions and imaging findings, treatments applied in intensive care and intervention information of all patients were collected. Results were evaluated as survival rate, presence of tracheostomy requirement, brain death, and Pediatric Cerebral Performance Scale at discharge. The patients divided into two groups as survivors and non-survivors. All obtained data were compared between the two groups. Results: During the study period, 47 patients with a diagnosis of severe traumatic brain injury were followed up. It was observed that the requirement of cardiopulmonary resuscitation, the need for inotrope-vasopressor and the need for erythrocyte transfusion were statistically significantly higher in the non-survivor group. (p value, respectively: 0.001, 0.001, 0.001) The survival rate in all patients in the study group was 70.2%. In non-survivor group most common pupil response at admission was fixed-dilated (71.4%). In non-survivor group 60% of the patients were lost in the first 24 hours of intensive care. Conclusion: Mortality increases in patients who need resuscitation, erythrocyte transfusion and inotrope before intensive care. Patients who died showed pathologic pupillary response and low GCS. Severe TBH patients died mostly in first 24 hours of admission

An improved computer based diagnosis system for early detection of abnormal lesions in the brain tissues with using magnetic resonance and computerized tomography images

Detection of masses can be a challenging task for radiologists and physicians. Manual tumor diagnosis in the brain is sometimes a time consuming process and can be insufficient for fast and accurate detection and interpretation. This study introduces an improved interface-supported early diagnosis system to increase the speed and accuracy for supporting the traditional methods. The first stage in the system involves collecting information from the brain tissue, and assessing whether it is normal or abnormal through the processing of Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) images. The next stage involves gathering results from the image(s) after the single/multiple and volumetric and multiscale image analysis. The other stage involves Feature Extraction for some cases and making an interpretation about the abnormal Region of Interest (ROI) area via Deep Learning and conventional Artificial Intelligence methods is the last stage. The output of the system is mainly the name of the mass type which was introduced to the network. The results were obtained for totally 300 images for High-Grade Glioma (HGG), Low-Grade Glioma (LGG), Glioblastoma (GBM), Meningioma as well as Ischemic and Hemorrhagic stroke. For the cases, the DICE score was obtained as 0.927 and the normal/abnormal differentiation of the brain tissues was also achieved successfully. Finally, this system can give a chance to the doctors for supporting the results, speeding up the diagnosis process and also decreasing the rate of possible misdiagnosis

Anesthesia and Early Postoperative Follow-up in Craniosynostosis Surgery

The treatment of craniosynostosis is mainly surgical and may require extensive interventions. The major anesthetic problems continue to be the management of massive blood transfusion and prolonged anesthesia in small children that can be further complicated by syndrome-specific issues. Communication between the surgical and anesthetic teams is vital and plays a key role in the prompt management of hemorrhage. Both in the intraoperative and postoperative periods, there is inevitable leakage-type bleeding from the bones undergoing osteotomy and the wide subgaleal area dissected. Multiple technologies and medications have been introduced to reduce the volume of blood transfused. The aim of this review was to provide an overview of anesthetic considerations, and postoperative management for these children.Kraniosinostoz çoğunlukla cerrahi olarak tedavi edilmekte ve kapsamlı cerrahi girişimler gerekebilmektedir. Küçük çocuklarda ağır kan transfüzyonu ve uzun süren anestezi, hâlâ daha en önemli anestezi problemleridir ve sendromik olgulara özel durumlarla daha da komplike hale gelebilmektedir. Anestezi ve cerrahi ekipler arasında sağlam bir işbirliği ve iletişim özellikle ağır kanamalara hızlı müdahale edilebilmesinde anahtar rol oynamaktadır. Hem intraoperatif hem de postoperatif dönemde, osteotomi yapılan kemikler ve diseke edilen geniş ciltaltı alandan sızıntı şeklinde kanama olmaktadır. Birçok yeni teknoloji ve ilaçlar, transfüzyon yapılan kan miktarını azaltmak için kullanılmaktadır. Derleme kraniosinostoz olgularındaki anestezi uygulamalarını ve postoperatif bakım konularını genel olarak gözden geçirmeyi amaçlamaktadır

Spinal Surgery Complicated With Some Congenital And Childhood Neural Diseases

Clinical and radiological data analysis, and the review of literature. The aim of this study was to determine the factors affecting spinal deformity treatment in patients with diseases of the central nervous system following neurosurgical management. Material and Methods: Three sample cases presented and the relevant literature were interpreted by the lights of these analyses. Patients are consisted of 20 and 44 years old females and 9 years old boy with childhood neural diseases. These accompanying diseases were detected during evaluation for spinal surgery by neurologic examination and imaging modalities. Results: All patients have been doing neurologically well with almost no deficits and manageable pain problems. A 44-year-old women who had CSF diversion operation previously, was resolved her arachnoiditis by extending the cervical stenosis operation. Neurofibromas that complicated kyphosis operation of a 9-year-old boy were removed. And tethered cord of a 20-year-old girl was untethered during scoliosis operation. All patient’s neurological status is well after operations and follow-ups. Conclusions: Surgical treatment of patients with spinal diseases may become a quite challenging case when they have congenital anomalies or CNS related problems. Staging surgical approach should be kept in mind for these kinds of patients. Besides, growing of spine and spinal cord at different rates shouldn’t be forgotten for children. The whole spinal axis must be kept under lifetime control by some regular intervals for spine patients with additional congenital or CNS anomalies

Spınal Surgery Complıcated Wıth Some Congenıtal And Chıldhood Neural Dıseases

Objective: This study was a retrospective clinical research based on challenging cases with clinical and radiological data analysis, and the review of literature. The aim of this study was to determine the factors affecting spinal deformity treatment in patients with diseases of the central nervous system following neurosurgical management. Material and Methods: Three sample cases presented and the relevant literature were interpreted by the lights of these analyses. Patients are consisted of 20 and 44 years old females and 9 years old boy with childhood neural diseases. These accompanying diseases were detected during evaluation for spinal surgery by neurologic examination and imaging modalities.Results: All patients have been doing neurologically well with almost no deficits and manageable pain problems. A 44-year-old woman who had CSF diversion operation previously, was resolved her arachnoiditis by extending the cervical stenosis operation. Neurofibromas that complicated kyphosis operation of a 9-year-old boy were removed. And tethered cord of a 20-year-old girl was untethered during scoliosis operation. All patient's neurological status is well after operations and follow-ups.Conclusions: Surgical treatment of patients with spinal diseases may become a quite challenging case when they have congenital anomalies or CNS related problems. Staging surgical approach should be kept in mind for these kinds of patients. Besides, growing of spine and spinal cord at different rates shouldn't be forgotten for children. The whole spinal axis must be kept under lifetime control by some regular intervals for spine patients with additional congenital or CNS anomalies

New Entity of Skull Lesions due to Birth Trauma: Kanat (Wing) Fractures

AIM: To discuss a special type of skull lesion detected after delivery. We reviewed our experience on scalp swelling in term neonates to further investigate the relationship between cranial injuries and labor process. MATERIAL and METHODS: A total of 55 newborns with scalp swellings were assessed with medical records retrospectively between January 2007-July 2017. A radiologist and a pediatric neurosurgeon re-analyzed all skull X-ray images via picture archiving and communication system of the hospital. RESULTS: A special type of skull fracture, called Kanat (wing) fracture, was detected. The fractures appeared unique, were located in the midline parietal bone, and were difficult to detect by X-ray. Kanat fractures accounted for 12.7% of the 55 cases (n=7). Patients without (group-1) and patients with (group-2) Kanat fractures were compared based on the head circumference of the newborns (p=0.881), fetal birth weight (p=0.20), maternal age (p=0.04), duration of second stage of labor (p=0.217), maternal body mass index (p=0.278), total labor time (p=0.922) and parity (p=0.375). No statistically significant difference between the two groups was determined for the compared parameters. CONCLUSION: The present study is the first research describing and discussing the possible effects of maternal, fetal and delivery characteristics on Kanat fractures. Designing clinical and experimental researches to enhance awareness and acknowledgement of skull injuries and labor process could improve the clinical outcome of the newborns

Comparison of Craniometric and Stereotactic Calculation Results for Planning of Intracranial Surgery

Objective: Stereotactic interventions started to play a more important role in current neurosurgery interventions. Superficial craniometric calculations based on anatomical reference points are still valid for determining the location of craniotomy site. We compared these two methods to find the ideal craniotomy place for patients in the planning phase of intracranial surgery. Material and Method: We used 22 patients with brain tumor which were operated in Dışkapı Education and Research Hospital between 2010-2011. Stereotactic frame has been installed for each patient and ideal entry point was labeled with the frame. The manual calculations were done according to anatomical reference points based on radiological views and labeled. The variations and the distance between the two ideal entry points were calculated on the same patient before the surgery. Results: The same points were labeled in 11 of 22 patients. The difference between these two points ranged from 5 mm to 3 cm in the other 11 patients. The surgeon’s preference for craniotomy place according to surgery plan made this difference between these two different calculation methods. Conclusion: Use and education of anatomic markers and craniometric methods is of great importance especially for neurosurgeons in centers without stereotactic frame.Amaç: Günümüz nöroşirürji pratiğinde stereotaktik girişimler giderek daha fazla önemli hale gelmektedir. Kranial anatomik belirteçler ve radyolojik yöntemler kullanılarak yapılan yüzeysel manuel ölçümler kafa içindeki lezyon girişimlerinde kraniotomi fleplerinin yerleşimini belirlemede hala oldukça önemli bir yere sahiptir. Biz bu çalışmada her iki farklı yöntemi kullanarak ideal kraniotomi giriş noktaları asasıdaki farkları belirlemeye çalıştık. Gereç ve Yöntem: Dışkapı Eğitim ve Araştırma Hastanesinde 2010-2011 yılları arasında beyin tümörü nedeniyle ameliyat planlanan hastalarda, ideal giriş yerinin belirlenmesinde bilgisayar eşliğinde stereotaktik çerçeveyle yapılan ölçümler ile hastanın radyolojik görüntüleri baz alınarak yüzeysel anatomik noktalarından manuel olarak yapılan ölçümler karşılaştırılmıştır. Her hasta için stereotaktik çerçeve takıldıktan ve gerekli görüntülemeler yapıldıktan sonra, bilgisayarda hedefleme ve giriş koordinatları hesaplanıp uygun giriş noktası işaretlenmiş, aynı hastada kraniometrik yöntemlerle hesaplamalar yapılıp, uygun giriş noktası hastanın kafasına çizildikten sonra her iki farklı giriş noktası fotoğraflanarak aradaki mesafe hesaplanmıştır. Bulgular: Çalışmaya dahil edilen 22 hastanın 11’de giriş yeri seçimi açısından hiç fark yok iken diğer 11 hastada fark 5 mm ile 3 cm arasında değişmekle birlikte, oluşan bu fark cerrahın giriş yeri tercihinden kaynaklanmıştır. Sonuç: Anatomik belirteçlerin ve kraniometrik yöntemlerin kullanılması ve öğretilmesi, özellikle stereotaktik çerçeve bulunmayan merkezlerde çalışacak nöroşirürjiyenler açısından önem taşımaktadır