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Öğe Analysis of 107 civilian craniocerebral gunshot wounds(Springer-Verlag, 2002) Özkan, Ü; Kemaloglu, MS; Özates, M; Aydin, MDIn this study, we present a retrospective analysis of 107 cases due to civilian craniocerebral gunshot wounds that were treated by the medical faculty of Dicle University during a period of 7 years (January 1993 to January 2000). Twenty patients died at the hospital, and the deaths were determined to result from direct effects of brain damage. Coma was the best prognostic guideline. Diffuse brain damage and ventricular injury, particularly infections, were associated with poor outcome.Öğe Cerebral hydatid disease(E M H Swiss Medical Publishers Ltd, 2004) Biikte, Y; Kemanoglu, S; Nazaroglu, H; Özkan, Ü; Ceviz, A; Simsek, MObjective: Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions even in the countries where the disease is endemic. The aim of this paper is to describe the characteristic features of cerebral hydatid disease in computed tomography (CT) and magnetic resonance imaging (MRI). Methods: We retrospectively reviewed the CT and MR imaging findings of 18 patients with pathologically confirmed cerebral hydatid disease over a period of 13 years (1990-2002). Results: The study group consisted of 17 cases of Echinococcus granulosus and 1 case of Echinococcus multilocularis (alveolaris). They were 12 male (66.7%), and 6 female patients (33.3%), ages ranging from 7 to 50 years with an average age of 20.3 years. Headache, vomiting and seizures were the predominant symptoms. Papilloedema was present in 14 patients (77.7%). Common CT and MR imaging findings of E. granulosus lesions were well-defined, smooth thin-walled, spherical, homogeneous cystic lesions with no contrast enhancement, no calcification, and no surrounding oedema. The lesion seen with E. multilocularis was a well-defined multiseptated mass consisting of solid and cystic components with calcification in the solid portion. Cystic lesions with surrounding hyperintensity of perifocal oedema with complete or incomplete rim enhancement were seen in two patients, and were labeled as complicated and infected cysts. Conclusion: Although cystic cerebral hydatid disease is well demonstrated by CT and MR examinations, CT is superior in detecting calcification in the cyst, when present, MR is better in demonstrating cyst capsule, detecting multiplicity and defining the anatomic relationship of the lesion with the adjacent structures, and it is more helpful in surgical planning.Öğe CT of the brain in tuberculous meningitis.: A review of 289 patients(Munksgaard Int Publ Ltd, 2000) Özates, M; Kemaloglu, S; Gürkan, F; Özkan, Ü; Hosoglu, S; Simsek, MMPurpose: In this retrospective study, CT findings of 289 patients with tuberculous meningitis (TBM) are presented and diagnostic criteria are discussed. Material and Methods. The medical records of patients who were diagnosed as having central nervous system tuberculosis were investigated. Cranial CT investigations of 289 patients with TBM were reviewed. Of these 289 patients. 214 were children and 75 adults. 157 patients were male and 132 were female. CT images were obtained with and without i.v. contrast administration. Results: CT findings were normal in 35 patients and abnormal in 254. The abnormalities were hydrocephalus (172 children, 32 adults), parenchymal enhancement (56 children, 6 adults), contrast enhancement of basal cisterns (32 children, 17 adults), cerebral infarct and focal or diffuse brain edema (29 children, 10 adults), and tuberculoma (9 children, 5 adults). Conclusion: CT is pathologic in the great majority of patients with TBM and is helpful in assessing the complications associated with the disease.Öğe Gigantic intracranial mass of hydatid cyst(Springer, 2001) Özkan, Ü; Kemaloglu, MS; Selçuki, MA child (8 years old) with a gigantic mass of intracranial hydatid cysts (95x90x75 mm) is presented. The first manifestation was difficulty in walking, which was followed by symptoms of raised intracranial pressure. A craniotomy was performed, and more than 25 hydatid cysts were removed. The literature is reviewed and the incidence of gigantic mass of cerebral hydatid cyst is compared in the published reports.Öğe Histopathologic changes in oculomotor nerve and ciliary ganglion in aneurysmatic compression injuries of oculomotor nerve(Georg Thieme Verlag Kg, 2004) Özkan, Ü; Aydin, MD; Gündogdu, C; Önder, ABackground: Bilateral common carotid artery ligation (BCCAL) increases vertebrobasilar blood flow and leads to increased luminal pressure, luminal enlargement, wall thinning, convolutions and sometimes aneurysm formation in posterior circulation arteries, especially the posterior communicating arteries (PcomA). PcomA aneurysms compress the oculomotor nerves. The principal aim of this investigation is to examine the histopathologic results of the compressive effect of PcomA aneurysms on the oculomotor nerves (OMN) and on ciliary ganglions (CG). Methods: When we observed the effects of BCCAL on the posterior circulation arteries of the brain in fifteen ligated rabbits after sacrifice, we noticed aneurysm formation on these arteries in three rabbits. These aneurysms developed on the PcomAs compressed the oculomotor nerves. These compressed nerves and normal oculomotor nerves together with their ciliary ganglions were examined histopathologically. Results: A PComA aneurysm developed in three rabbits from 15 ligated animals and these aneurysms compressed the oculomotor nerves on the same side. Partial peripheral necrosis and axonal loss were seen on the compressed oculomotor nerves. Concomitantly, cellular loss and necrosis were also observed on their ganglions. Conclusion: Bilateral common carotid artery ligation may lead to PcomAs and these aneurysms could compress the oculomotor nerves. Compression injuries of oculomotor nerve may cause cellular injury and necrosis on both oculomotor nerves and ciliary ganglions.Öğe Lumbar epidural brucellar abscess causing nerve root compression(Stockton Press, 1999) Ozates, M; Özkan, Ü; Bükte, Y; Ceviz, A; Sari, I; Simsek, MObjectives: To evaluate the usefulness of MR sequences for the differential diagnosis of spinal brucellar abscesses which mimic lumbar disc herniation. Methods: We analyzed six patients with brucellar abscesses. who had symptoms mimicking lumbar disc herniation. The study group consisted of three women. and three men who were 15 - 67 (mean = 37) years old. Patients were imaged in the axial and sagittal planes with a I.0-T MR scanner using a spine coil. Results: The level of abscesses were accurate in 100% (six of six)of patients with MR imaging. MRI examinations revealed an extradural soft tissue mass which were iso- to hypointense compared to spinal cord on T1WI and hyperintense on T2-weighted images. By contrast study, diffuse homogeneous or slightly heterogeneous enhancements were seen. Conclusion: Lumbar extradural brucellar abscess can have lumbar disc disease symptoms. MRI may non-invasively and rapidly reveal the presence of spinal abscess and degree of extension to the spinal canal. Extradural brucellar abscess should be included in the differential diagnosis of radicular symptoms caused by disc herniation.Öğe Quadruplets hydatid cysts in brain ventricles(Elsevier, 2002) Aydin, MD; Özkan, Ü; Altinörs, NAn 18-year-old male patient with a hepatic hydatic cyst was admitted with cephalgia and gait disturbances. Radiological examination showed a cystic lesion in his liver and four cystic masses, 2-8 mm in diameter, in the right lateral brain ventricle. All cysts were removed without rupture by way of a right transparietal-transventricular approach, using an ellipsoid forceps designed by ourselves. Albendazole was given postoperatively. Postoperative outcome was excellent in this case except for transient left hemiparesis. To our knowledge, this is the first case of four hydatid cysts in the lateral brain ventricle. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe Spinal subdural tuberculous abscess(Stockton Press, 2000) Özates, M; Özkan, Ü; Kemaloglu, S; Hosoglu, S; Sari, IObjectives: Spinal subdural abscess Is rare and only 45 cases have been described to date. In this report, we present an additional spinal subdural tuberculous abscess. Method: Tuberculous meningitis was diagnosed with clinical and laboratory findings in a 45-year-old man. A spinal subdural abscess was demonstrated using MRI. Presence of the abscess was revealed by surgical intervention. The diagnosis was confirmed by pathological examination. Results: The patient had been treated for tuberculous meningitis 2 years previously. The disease recurred when anti-tuberculous therapy was prematurely discontinued, During the second treatment, the patient also underwent a ventriculo-peritoneal shunt operation for hydrocephalus. Dizziness and weakness of both legs developed after the postoperative period. Spinal MRI showed a. spinal subdural abscess as a iso-intense mass with spinal cord in the T1 and T2 weighted images, ring like enhancement and compression on the spinal cord at T3-T4 level. The patient underwent surgery and the abscess was drained. Conclusion: Tuberculosis may cause a spinal subdural abscess and although it is a rare disorder, when encountered MRI is very useful in the diagnosis.Öğe Synovial cyst at the intervertebral foramina causing lumbar radiculopathy(Nature Publishing Group, 2001) Kemaloglu, S; Nas, K; Gür, A; Bukte, Y; Ceviz, A; Özkan, ÜObjective: To determine the presence of intraforaminal synovial cysts resulting in nerve root compression. Methods: A 26 year old man presenting with left leg pain was admitted. He had no motor, sensory, or reflex changes. Magnetic resonance imaging (MRI) and MRI-myelography showed an intra and extra foraminal, extradural, cystic lesion at L4 vertebra on the left side. Results: At surgery there was a cystic mass pressing on the nerve root, and no connection or communication with the dural structures could be found. Conclusion: Synovial cysts are uncommon extradural degenerative lesions. Intraspinal synovial cysts occur most often at the L4-5 level, but they have been reported in all areas of the spine except the intraforaminal region and the sacrum.Öğe Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus(Karger, 2002) Kemaloglu, S; Özkan, Ü; Bukte, Y; Ceviz, A; Özates, MHydrocephalus is a common complication of tuberculous meningitis (TBM) in children. The aims of this study are to review our experience of hydrocephalus in childhood TBM and to evaluate the effect of the timing of ventriculoperitoneal shunting (VPS) on the final outcome. In this study, 156 patients with TBM and hydrocephalus were reviewed retrospectively between 1990 and 2000. Patients' ages ranged from 6 months to 15 years, with a mean age of 4.1 years. There were 85 boys, and the male-to-female ratio was 1.19:1.0. Sixty-two percent of the children were younger than 6 years old. VPS was performed 2 days after the diagnosis in 100 patients, and in the remaining 56 patients, 3 weeks after the diagnosis. The average follow-up period was 8.5 months. Good recovery or minor sequelae was seen in 82 patients (52.6%), and 51 died (12.3%). The timing of the VPS procedure and cerebral complications had an effect on the final outcome. Early VPS gave a better outcome in mild and moderate hydrocephalus (p = 0.040). This study has shown that early surgical procedure for mild/moderate hydrocephalus has a positive effect on the morbidity and mortality of hydrocephalus in childhood TBM (p = 0.014, p = 0.040, respectively). In severe hydrocephalus, there was a tendency for early shunting to have a positive effect on morbidity, although this did not reach statistical significance. Copyright (C) 2002 S. Karger AG, Basel.Öğe Widespread post-traumatic acute spinal subdural haematoma(Nature Publishing Group, 2002) Özkan, Ü; Kemaloglu, MS; Aydin, M; Selçuki, MStudy design: A case report of acute post-traumatic spinal subdural haematoma (ASSH). Objective: To report a rare post-traumatic problem. Setting: Dicle University Hospital, Diyarbakir, Turkey. Method: A 3-year-old boy was admitted to our clinic with paraplegia 24 h after falling from a height of about 5 meters. Investigation revealed all acute spinal subdural haematoma. Results: Following surgery there was marked improvement. The rehabilitation of the patient continues. Conclusion: MRI is the most valuable diagnostic method. In each case diagnosed as ASSH. prompt evacuation should be performed before irreversible neurological damage occurs.
