Yazar "Akyol, M. E." seçeneğine göre listele

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    Hydrocephalus in encephalocele
    (Verduci Publisher, 2022) Akyol, M. E.; celegen, I.; Basar, I.; Arabaci, O.
    OBJECTIVE: Encephalocele is a rare congenital neural tube defect (NTD) characterized by herniation of intracranial contents through a defect in the skull. In our study, encephalocele was diagnosed in our clinic and its association with hydrocephalus was evaluated. The effect of this association on the prognosis was discussed. PATIENTS AND METHODS: Patients who underwent surgery and follow-up with the diagnosis of encephalocele in the neurosurgery clinic of our hospital in an 8-year period from 2013 to 2021 were retrospectively examined. RESULTS: Patient records were obtained from the case notes of patients who underwent excision and repair for encephalocele. Of the 78 patients included in the study, 88.4% underwent surgery in the neonatal period. Moreover, 47% of the patients are male, and 31% are female. Encephalocele was present in 62.8% of patients and meningocele in 37.2%. Furthermore, 82.1% of encephalocele sacs were located in the occipital region. Chiari type 3 malformation was present in 57.6% of patients. Hydrocephalus developed in 56.4% of patients. There was an additional syndrome in 10.3% of the cases. The most common additional syndromes were corpus callosum dysgenesis with 39.7% and colpocephaly with 29.5%. The additional disease was present in 43.6% of patients. Preoperative and postoperative examination findings of more than half of patients were normal, but 33.3% were apathetic. Furthermore, 67.9% of patients, who underwent complete repair, survived, and 32.1% died. Hydrocephalus was present in 73.5% of patients with encephalocele (p < 0.05). Hydrocephalus developed in 77.8% of patients with Chiari type 3 malformation (p < 0.05). Hydrocephalus was found in 88.0% of patients with Ex (p < 0.05). CONCLUSIONS: Encephalocele, which is a subgroup of NTD, differs clinically by its location and accompanying additional anomalies. In encephaloceles, the risk of morbidity and mortality can only be reduced with the multidisciplinary approach. Hydrocephalus and Chiari type 3 malformation are common in patients with encephalocele. These associations adversely affect the prognosis of the disease. Further research should be conducted on the evaluation of risk factors of NTD and methods of prevention from NTD. In this regard, we recommend that the training be repeated at certain intervals and that people's awareness should be raised.
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    Treatment and outcomes of patients with metastatic spinal cord compression: a double-center study
    (Verduci Publisher, 2023) Aycan, A.; Eren, B.; Tas, A.; Celik, S.; Guzey, F. Karagoz; Kuyumcu, F.; Akyol, M. E.
    OBJECTIVE: Spinal metastases may only affect the bone tissue and result in spi-nal instability or may additionally result in epi-dural compression, leading to neurological defi-cits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord com-pression (MESCC) due to the advances in surgical techniques and instrumentation. In this study, we evaluated patients with MESCC regarding neuro-logical status, pain status, and survival rates, and presented our experience managing MESCC.PATIENTS AND METHODS: Clinical and ra-diographic records of 53 patients diagnosed with MESCC between January 2011 and March 2017 were retrospectively evaluated. The study included patients with a pathological diagnosis of primary cancer, those who complained of spi-nal metastasis, and those who had indications of MESCC on Magnetic Resonance Imaging (MRI). Bone structure and spinal stability were evaluat-ed using assessed Computed Tomography (CT), and metastatic spread was considered using as-sessed Positron Emission Tomography (PET) in suitable cases. For each patient, the presence of a tumor compressing the spinal cord, age, gen-der, preoperative, and postoperative American Spinal Injury Association scores (ASIA), Toku-hashi prognostic score (TPS), affected spinal segment, pathological diagnosis, preoperative, and postoperative Visual Analog Scale (VAS), the status of spinal stability, follow-up period, and complications were evaluated.RESULTS: Forty-five patients (82.2% of them were women) underwent surgery with a mean age of 58.29 & PLUSMN; 15.14 years. The most frequent type of primary tumor was multiple myeloma (33.9%), followed by lung (24.6%), gastric (7.5%), and prostate (5.7%). The most common site of metastasis was the thoracic region (43.4%), fol-lowed by lumbar (24.5%), multiple (24.5%), and cervical (5.7%). The analysis indicated that a sig-nificant difference was found between the sur-vival rates of the TPS categories.CONCLUSIONS: Common symptoms of MES-CC include spinal pain and neurological defi-cit below the level of the injury. Prompt surgi-cal treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radio-therapy (RT), should be recommended after sur-gical treatment.