Lıpoma and ıncomplete agenesıs of the corpus callosum assocıated wıth arachnoıd cyst located ın the temporal pole: case report

This is a rare case of corpus callosum lipoma appearing with an intracranial arachnoid cyst located in the temporal pole. This case has been incidentally diagnosed by cranial computerized tomography and magnetic resonance imaging

Lıpoma and ıncomplete agenesıs of the corpus callosum assocıated wıth arachnoıd cyst located ın the temporal pole: Case report

This is a rare case of corpus callosum lipoma appearing with an intracranial arachnoid cyst located in the temporal pole. This case has been incidentally diagnosed by cranial computerized tomography and magnetic resonance imaging

Anevrizmal subaraknoid hemorajide yeni bir molekül: Dendroaspis natriüretik peptid

WOS: 000331663300009PubMed ID: 24535789AIM: Dendroaspis natriuretic peptide (DNP) is the most recently identified member of the natriuretic peptide family. Although DNP has similar structure and function to other members, it is genetically different. The other members are known to cause vasorelaxation but the effects of DNP on vascular structure still remains unclear. In this study, we aimed to find out the role of DNP in the development of vasospasm following aneurysmal SAH (subarachnoid hemorrhage). MATERIAL and METHODS: DNP levels of 17 patients diagnosed with aneurysmal SAH and 25 volunteers as control were measured. All SAH patients were treated with aneurysm clip. Five ml of venous blood sample was obtained on postoperative 1,3 and 7th days from each patient. Additionally, DNP levels were determined by obtaining cerebrospinal fluid (CSF) postoperative 1,3 and 7th days. RESULTS: Statistically significant difference was observed between cerebrospinal fluid DNP levels on day 1 and day 3 (P<0.05). CONCLUSION:This study suggests that DNP can be anticipated among molecules leading development of vasospasm. The findings of present study are believed to encourage further studies regarding receptors and receptor specific drugs.AMAÇ: Dendroaspis natriüretik peptid (DNP), natriüretik peptid ailesinin en yeni üyesidir. Yapısal olarak diğer üyelerine benzemesine rağmen genetik olarak farklıdır. Diğer üyelerin vazorelaksasyona neden olduğu bilinmesine rağmen DNP nin insanın vasküler yapısındaki etkisi bilinmemektedir. Bu çalışmada Anevrizmal SAH (subaraknoid hemoraji) sonrası vazospazm gelişiminde DNP nin rolunü araştırdık. YÖNTEM ve GEREÇLER: Anevrizmal SAH tanısı konan 17 hasta ve 25 gönüllü kontrol grubunda DNP düzeyleri araştırıldı. Tüm SAH hastaları anevrizma klibi ile tedavi edildi. Postoperatif dönemde 5ml venöz kan 1., 3., 7. günlerde alındı. 1., 3., 7. günlerde Beyin Omurilik Sıvısı (BOS) alınarak DNP düzeyleri incelendi. BULGULAR: Olguların 1.gün BOS’taki DNP düzeyleri 3.gündeki DNP düzeylerinden anlamlı derecede yüksektir (P<0,05). SONUÇ: Bu çalışma, DNP’nin vazospazm gelişmesinde etkenlerden biri olabileceğini düşündürmektedir. Çalışmamızın gelecekte reseptör düzeyinde yapılacak çalışmalar ve bu reseptörlere özgü yeni ilaç çalışmalarını cesaretlendireceğine inanmaktayız

Spinal arteriovenous malformation: Use of intraoperative color Doppler ultrasonography guidance for surgical resection. Case report

WOS: 000345159600019PubMed ID: 25463896Spinal arteriovenous malformations (AVMs) may be associated with sensory and motor deficits, bowel or bladder dysfunction, radicular pain or deficit, and back pain. Hemorrhage can occur in the parenchyma leading to the acute onset of symptoms. Neurosurgical resection is one of the way of treatment. Several techniques including intraoperative angiography, dye-injection and the micro Doppler method have proven to be useful during the surgical resection of spinal vascular lesions. Herein, we report our experience with intraoperative ultrasonography (IOUS) and color Doppler ultrasonography guidance for visualizing a spinal cord AVM during surgery. IOUS is a time-saving and noninvasive method for intraoperative imaging of spinal AVM

Konjenital kraniyal teratomlarin tanı ve tedavi yönetimi: Dört olgu sunumu ve review

Konjenital intrakraniyal teratomlar iyi bilinen ancak ancak nadir görülen bir patolojidir, ve genellikle normal intrakraniyal yapının tam kaybı ile karakterizedirler. Her üç germ yaprağından da dokular içerirler. Bu yazıda literatür ve deneyimlerimiz ışığında kranyal teratomlarda klinik bulgular, tanı yöntemleri ve tedavi yöntemleri sunulacaktır. Materyal ve metod: Patolojik olarak kanıtlanmış dört Konjenital Kraniyal teratom olgusu gözden geçirildi. Biri doğum öncesi, diğerleri postnatal olarak tespit edilmişti. BT ve MRG tüm hastalarda yapılmış iken, ultrasonografi sadece bir hastada yapıldı. Kraniyofasiyal kitle, macrocephalus, ve / veya hidrosefali en belirgin bulgulardı. Lokalize nörolojik defisit çok büyük tümörlerde bile görülmedi. Tüm hastalarda, kitle total olarak çıkarıldı ve ventriküloperitoneal şant hidrosefali olan iki hastada uygulandı. Histolojik incelemede her üç germ yaprağından dokular içeren çeşitli yapılar gözlendi. Teratomların her üç formuda vardı. Operatif mortalite ve morbidite görülmedi, ancak iki hasta ameliyat sonrası 2 ve 3 yaşında hayatını kaybetti. Sonuçlar: Teratomlar erken antenatal ultrason ile teşhis edilebilir. Postnatal makrosefali ve/veya hidrosefali varlığı ile saptanırlar. BT ve MRG ile multiloküle, heterojen solid-kistik, hemde lipid ve kalsifikasyon içeren kitle gösterilmektedir. Tümörlerin rezeksiyonunu takiben 3.5 yıl kadar uzun sağ kalımlı nadir olgular yayınlanmış olsa da, prognoz, doğumdan kısa süre sonra meydana gelen ölüm şeklinde genellikle kötüdür. Erken tanı önemlidir ve fetal dönemde tanı konan olguların ailelerinin mortalite ve morbidite yönünden bilgilendirilmeleri gereklidir.Congenital cranial teratomas are a well-recognized but infrequent entity and are usually characterized by complete loss of the normal intracranial architecture. They contain tissues from all three germ layers. This review presents the clinical features, diagnostic methods and management of cranial teratomas based on our experience and the literature. Material and methods: Four pathologically proven cases of congenital cranial teratomas were reviewed. One case was diagnosed prenatally, and the others were diagnosed postnatally. While CT and MRI had been performed in all patients, ultrasonography was only performed in one patient. Craniofacial mass, macrocephalus and/or hydrocephalus were the prominent findings. Localized neurological deficits were not observed even with very large tumors. In all patients, the mass was totally removed, and a ventriculoperitoneal shunt was performed in two patients who had hydrocephalus. Histological examination demonstrated a variety of tissues from all three germ layers. All three forms of teratomas were observed. There was no operative mortality and morbidity, but two patients died at 2 and 3 years after the surgery. Conclusion: Teratomas can be diagnosed early with antenatal ultrasound. They are detected postnatally in the setting of hydrocephalus and macrocephaly. CT and MRI show a multiloculated, heterogeneous solid-cystic mass with both lipids and calcification. The prognosis is poor, with death usually occurring shortly after birth, although there are rare reports of prolonged survival up to 3.5 years following tumor resection. Early diagnosis is important, and it is necessary for appropriate family counseling regarding the morbidity and mortality of fetuses diagnosed with tumors

Desmoplastic infantile ganglioglioma: Report of an unusual case with a cranial defect

Desmoplastic infantile ganglioglioma (DIG) is a rare tumor that typically occurs in infants under the age of 24 months. These tumors commonly have a good prognosis after surgical resection despite their aggressive radiological appearances. Clinical signs are due to the large size of the tumor and include increased head circumference, bulging fontanel, sunset sign and seizures. We report an unusual DIG case who presented with parietal bulging associated with a bony defect. The patient was thought to have a leptomeningeal cystic formation, but on his cranial magnetic resonance imaging (MRI), we observed a centrally and homogeneously gadolinium-enhanced lesion fixed to the dura by its solid component. A surgical gross total resection was performed, and no residual tumor was observed on follow-up

Hipofiz abselerinin tanı ve tedavisi: Olgu serisi ve literatür değerlendirilmesi

AMAÇ: Hipofiz absesi merkezi sinir sistemi (MSS) infeksiyonu, kitle etkisi ve endokrin bozuklukları ile karakterize bir hastalıktır. Bu apseler genellikle kan beyin bariyerinin yıkıldığı hematojen yolla yayılan paranasal sinüzit, sepsis gibi durumulara bağlı oluşur. Bu yazıda literatür ışığında preoperatif tanısı pitüiter apse olan dört olgu tartışılmaktadır. YÖNTEM ve GEREÇLER: Ayrıntılı klinik, hormonal incelemeleri ve görüntüleme testleri takiben hipofiz adenomu ve diğer sellar patolojileri olan 210 olgu Göztepe Eğitim ve Araştırma Hastanesi Beyin Cerrahisi kliniğinde ameliyat edildi. BULGUlAR: Tüm hastalar tanı sırasında ateş, toksemi ve endokrin bozukluklarının sistemik belirtilerini gösterdi. Bu olgularda, hastalığın preoperatif tanısı karakteristik MRG bulguları sayesinde yapıldı. Bu dört olgu transnazal transsfenoidal yaklaşımla opere edildi ve histopatolojik, mikrobiyolojik çalışmalar cerrahi numunelere yapıldı. SONUÇ: Hipofiz apseleri yüksek mortalite riskinden sorumlu nadir bir hastalık grubudur. Mortalite ve morbidite erken cerrahi drenaj ve uygun antibiyotik tedavisi ile azaltılabilir. Ayrıca, bu durumlarda hipofizer yetmezlik, cerrahi komplikasyonlar ve enfeksiyon yönünden yakından takip edilmelidir.AIM: Pituitary abscess is a disorder characterized with central nervous system (CNS) infection, mass effect, and endocrine dysfunction. These abscesses generally occur due to hematogenous spread in conditions such as paranasal sinusitis, sepsis, and where the blood brain barrier breaks down. This paper aims to discuss four cases of preoperatively diagnosed pituitary abscess in the light of the literature. MATERIAL and METHODS: Following detailed clinical and hormonal examinations and imaging tests, 210 cases of pituitary adenoma and other sellar pathologies were operated on at the Neurosurgery clinic of G&ouml;ztepe Training and Research Hospital. Results: All the patients showed fever, systemic signs of toxemia and endocrine dysfunction at the time of diagnosis. In these cases, a preoperative diagnosis of the disease was made thanks to characteristic MRI findings. The four cases were operated by the transnasal transsphenoidal approach and histopathological and microbiological studies were performed for surgical specimens. CONCLUSION: Pituitary abscesses are rare disorders responsible for a high mortality risk. Mortality and morbidity can be reduced by early surgical drainage and appropriate antibiotic treatments. Additionally, these cases should be closely followed-up in terms of pituitary insufficiency, surgical complications and infection

Focal megalencephaly: Intraoperative ultrasound imaging in epilepsy surgery

WOS: 000348275900021PubMed ID: 26578502Hemimegalencephaly is a rare neuronal migration disorder that can be defined as abnormal neural and glial proliferation localized to all or part of a cerebral hemisphere. Most patients demonstrate intractable epilepsy, with early onset before 1 year of age. Surgical resection is one of the treatment options. In recent years, many advanced intraoperative techniques have been used for brain surgery for various pathologies. Intraoperative ultrasonography is a time-saving and noninvasive method for intraoperative imaging. In this report, we present the use of intraoperative ultrasonography in a patient with focal megalencephaly as an anatomical navigation with the functional navigation system, electrocorticography. In this report, we present the use of intraoperative ultrasonography in a patient with focal megalencephaly as an anatomical navigation with the functional navigation system, electrocorticography

Relation of apparent diffusion coefficient with Ki-67 proliferation index in meningiomas

WOS: 000368418500004PubMed ID: 26537690Objective: The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and apparent diffusion coefficient (ADC) values of low-grade and atypical/anaplastic (high-grade) meningiomas. Methods: Pre-operative diffusion-weighted imaging and histopathological evaluation of 44 patients with meningiomas were performed retrospectively. Regions of interest (ROIs) were manually drawn on the ADC images. In total six ROI measurements were taken in three consecutive slices, and the average of the mean ADC value was used. The relationship between the ADC and Ki-67 values was investigated, and the ADC values of the low-grade and high-grade meningiomas were compared. Results: 31 (70%) patients had low-grade the meningiomas. 10 (23%) patients had atypical and 3 (7%) had anaplastic meningiomas. ADC values of the low-grade and high-grade meningiomas were 0.81 +/- 0.12 x 10(-3) and 0.66 +/- 0.08 x 10(-3) mm(2) s(-1), respectively. Ki-67 proliferation indexes were 2.19% +/- 1.14% for low-grade and 11.20% 6 9.80% for high-grade meningiomas. A statistically significant negative correlation between Ki-67 proliferation index and ADC values of the low-grade and high-grade meningiomas was detected (r(2) - 0.326, p < 0.001). High-grade meningiomas had lower ADC values than that of low-grade meningiomas. There was statistically significant difference between the ADC values of the lowgrade and high-grade meningiomas (p < 0.001). Conclusion: Our data provide an inverse correlation between the ADC and Ki-67 proliferation index values of meningiomas. ADC values can be used for histopathological characterization of the meningiomas and presurgical planning. Advances in knowledge: The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and ADC values of low-grade and atypical/ anaplastic (high-grade) meningiomas. In addition, we compared the ADC and Ki-67 proliferative index values of the low-grade and atypical/anaplastic (high-grade) meningiomas. We concluded that there was an inverse correlation between the ADC and Ki-67 proliferation index values in meningiomas, and we have found statistically significant difference between the ADC values of the lowgrade and high-grade meningiomas. ADC values can be used for histopathological characterization of the meningiomas and pre-surgical planning