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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 Coexistence of a cerebellopontine epidermoid cyst with a pituitary adenoma(Elsevier Science Bv, 2002) Kemaloglu, S; Ozkan, U; Ziyal, I; Bukte, Y; Ceviz, AWe report on an 18-year-old girl with the coexistence of an epidermoid cyst in the cerebellopontine angle (CPA) with a pituitary adenoma. The clinical course and histopathological characteristics were reviewed. The patient presented with headache, vision loss and amenorea. Computerised tomographic (CT) scan and magnetic resonance imaging (MRI) examinations demonstrated a solid sellar lesion with supra-sellar extension. There was another mass lesion in the CPA with prepontine extension. The tumours were removed surgically. Histopathological examination revealed an epidermoid cyst in the prepontine area and a pituitary adenoma in the sellar region. This has been the second case to be reported in the literature with the coexistence of ail epidermoid cyst and a pituitary adenoma. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe The effect of urokinase in preventing the formation of epidural fibrosis and/or leptomeningeal arachnoiditis(Elsevier Science Inc, 1997) Ceviz, A; Arslan, A; Ak, HE; Inaloz, SBACKGROUND Epidural fibrosis and leptomeningeal adhesion formation are among the common causes of failed back surgery syndrome. Urokinase has been commonly used in treating aneurysmal subarachnoid hemorrhage and intracerebral hematoma. METHODS In a rat model, the potential of local urokinase in preventing the production of epidural fibrosis due to bleeding was investigated. RESULTS A reduction of approximately 48% in leptomeningeal adhesion formation with the use of urokinase was demonstrated. Adhesion score was 2.300 in the control group and 0.700 in the urokinase treated group on day 42 of the postoperative period. CONCLUSIONS It can be concluded that urokinase has the important effect of preventing the formation of leptomeningeal adhesion, but many more extensive studies clearly need to be done before such material can be clinically used. (C) 1997 by Elsevier Science Inc.Öğe Effects of nimodipine and ofloxacin on staphylococcal brain abscesses in rats(Ecv-Editio Cantor Verlag Medizin Naturwissenschaften, 1997) Ceviz, A; Inalöz, SS; Çiçek, R; Sari, I; Gül, K; Sanli, AThe therapeutic effects of nimodipine (GAS 66085-59-4) and ofloxacin (GAS 82419-36-1) were investigated against experimental brain abscess formation in rats. Nimodipine, a 1,4-dihydropyridine derivative, is chemically related to nifedipine but the smooth muscle relaxant effect preferentially acts on cerebral arteries. Ofloxacin is a member of 4-Quinolone broad spectrum antibiotics. Ninety-six male Sprague-Dawley rats were inoculated intracortically with Staphylococcus aureus and then different groups were treated with either saline. ofloxacin or the combination of ofloxacin and nimodipine. The rate of brain abscess formation and mortality were considerably decreased by nimodipine and ofloxacin therapy. Combination therapy was found histologically to be considerably more effective than ofloxacin alone against brain abscess formation in rats.Öğe Growth rate of cerebral hydatid cyst, with a review of the literature(Springer, 2001) Kemaloglu, S; Ozkan, U; Bükte, Y; Acar, M; Ceviz, AThis extremely rare case was one of secondary solitary cerebral echinococcosis associated with possible cerebral thromboembolism. A 7-year-old girl living in a rural area was admitted to our hospital with a history of headache, right-sided hemiparesis, and dysphasia. She had been treated 6 months previously for a cerebral infarct, diagnosed from sudden altered consciousness and a myoclonic generalised convulsion. The growth rate determined for the cerebral hydatid cyst was about 4.5 cm during the 6-month period. In children a parasitic cyst can be the source of a cerebral embolus, particularly in areas where hydatid disease resulting from cardiac echinococcosis is endemic.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 Management of spinal brucellosis and outcome of rehabilitation(Nature Publishing Group, 2001) Nas, K; Gür, A; Kemaloglu, MS; Geyik, MF; Çevik, R; Büke, Y; Ceviz, AStudy Design: Review of cases. Objective: To review cases of brucellosis in order to clarify diagnostic guidelines, treatment regimes and prognsis. Setting: University Hospital, Turkey. Methods: Study of 11 patients (9 male, 2 female) with either brucellar spondylitis or epidural brucellar abscess. Diagnosis made on clinical presentation, laboratory findings, radiographic evidence and a minimum brucellar anti body of 1:160, a positive bacteriological culture and/ or histological finding of inflammation of granulomatous tissue. All patients were treated with a combination of oral antibiotics. Surgery was performed in 8 patients. Results: At least 6 months antibiotic therapy using Rifampicin and Doxycycline is recommended. Surgery is indicated in the presence of spinal instability, cord compression or radiculopathy. In our series eight patients required surgery. Conclusion: The patients complaining of back pain, particularly in endemic areas should be University Hospital, Turkey. Study of II patients (9 male, 2 female) with either brucellar spondylitis or epidural investigated as possible cases of brucellosis.Öğe Posterior epidural migration of sequestered lumbar disc fragment causing cauda equina syndrome(Taylor & Francis Ltd, 2005) Tatli, M; Güzel, A; Ceviz, A; Karadag, ÖPosterior epidural migration of free disc fragments is rare, and posterior migration of the free fragments causing cauda equina syndrome is exceptionally rare. This report describes a 53-year-old man with disc fragment extrusion at the levels of L3-4 and a 54-year-old man with disc fragment extrusion at L5-S1 intervertebral space. The patients responded well to the operative therapy with complete relief of the symptoms. The pathological examination confirmed that the specimen was a degenerated intervertebral disc. Early surgery should be the first choice of therapy in patients with large posteriorly migrated sequestered disc fragments, to prevent severe neurological deficits such as cauda equina and conus medullaris syndromes.Öğe Recurrent bacterial meningitis: a 6-year experience in adult patients(W B Saunders Co Ltd, 1997) Hosoglu, S; Ayaz, C; Ceviz, A; Cumen, B; Geyik, MF; Kokoglu, OFTen adult patients with recurrent bacterial meningitis (RBM) of 22 episodes were diagnosed and treated at the Dicle University Hospital from January 1990 to December 1995. Apart from 22 episodes of RBM these patients had an additional 25 episodes treated at other hospitals. The RBM attacks developed after closed head trauma in four patients, asplenia and chronic otitis media in one patient, chronic otitis media and oto-mastoiditis in one patient, chronic maxillar sinusitis in one patient, chronic mastoiditis in one patients, and suppurative foci of facial bones caused by shrapnel pieces and no predisposing condition in one patient. In 10 RBM episodes, Streptococcus pneumoniae was isolated from cerebrospinal fluid (CSF) and/or blood culture, and in one episode Proteus vulgaris was isolated from CSF and otitis media suppuration, In the four episodes both cultures were negative, but direct microscopy showed Gram-positive diplococci on Gram-staining. Three of the patients died from meningitis-related complications.Öğe The results of rehabilitation on motor and functional improvement of the spinal tuberculosis(Editions Scientifiques Medicales Elsevier, 2004) Nas, K; Kemaloglu, MS; Çevik, R; Ceviz, A; Necmioglu, S; Bükte, Y; Cosut, AObjectives. - To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis. Method. - Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over 6 months of period, after spinal decompression and fusion. The main outcome measures were motor development of the patients who were evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was made according to American Spinal Injury Association (ASIA). Results. - The study population consisted of 47 patients (22 males and 25 females) mean aged 37.9 +/- 18.3 years (range 5-76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6 month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities; truncal and sacrospinal extensors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly (P < 0.001). The self-care and mobility categories of the MBI on admission; were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent. In conclusion. - Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis. (C) 2003 Elsevier SAS. All rights reserved.Öğe Spinal cord compression by primary amyloidoma of the spine(Yonsei Univ Coll Medicine, 2002) Nas, K; Arslan, A; Ceviz, A; Bilici, A; Gür, A; Kemaloglu, MS; Çevik, RIn this report, we presented a case of solitary spine amyloidoma, its clinical and radiological findings and management, and a review of the literature on vertebral amyloidosis.Öğe Spinal intradural neuroepithelial cyst associated with multiple congenital anomalies in a child(Springer Verlag, 1996) Ceviz, A; Bilici, A; Arslan, A; Temucin, M; Buyukbayram, HA case of spinal intradural neuroepithelial cyst is presented. The patient, who had thoracolumbar hypertrichosis, underwent magnetic resonance imaging which demonstrated a cystic lesion within spinal canal. The cystic lesion was removed surgically. Histological study proved it to be a neuroepithelial cyst. Spinal intradural neuroepithelial cyst associated with other congenital malformations is a rare condition.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 Tuberculous meningitis in adults: an eleven-year review(Int Union Against Tuberculosis Lung Disease (I U A T L D), 1998) Hosoglu, S; Ayaz, C; Geyik, MF; Kokoglu, OF; Ceviz, AOBJECTIVE: To assess the presentation, diagnosis and outcome of patients with tuberculous meningitis (TBM). DESIGN: The medical records of adults with TBM who were treated at Dicle University Hospital between January 1985 and October 1996 were reviewed. RESULTS: In total, 101 patients were identified and stratified according to the stage of disease at presentation. The mean duration of the symptoms of TBM before admission was 12 days. The majority of patients had headaches (96.0%), fever (91.1%), nuchal rigidity (91.1%), vomiting (81.2%), meningism (79.2%) and abnormal mental state (72.3%). The mean cerebrospinal fluid (CSF) leukocyte count was 0.38 x 10(9)/L, protein 1410 mg/L, glucose 2.0 mmol/L and CSF/blood glucose ratio 27%. Cranial computerized tomography (CT) scans were performed during the course of TBM in 64 patients. The results were normal in 6.3%, and abnormal in 93.7% of the cases; the most frequent abnormality found on CT was hydrocephalus (45.3%). Forty-four patients (43.5%) died. Minor neurological sequelae developed in 11 patients (10.9%), major sequelae in 10 (9.9%), and 31 patients (30.7%) completely recovered. There was no follow-up for five patients (5.0%). Five factors were important in predicting fatal outcome: stage III at presentation, low glucose levels, low CSF/blood glucose ratio, high protein levels, and CT scanning abnormality. CONCLUSION: TBM is a very critical disease in terms of fatal outcome and permanent sequelae: 43.5% of the patients died and only 30.7% experienced complete recovery. Early treatment may reduce fatal outcome and morbidity.Öğe What are the effects of microwave oven on pregnant and newborn rat brains?(Pergamon-Elsevier Science Ltd, 1996) Inaloz, SS; Dasdag, S; Bilici, A; Ceviz, A; Aslan, A; Ak, HE; Akkus, M[Abstract Not Available]
