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Öğe Assessment of cases with intracranial hydatid cyst: A 23-year experience(Ege Nöroloji Derneği, 2014) Turan, Yahya; Yılmaz, Tevfik; Göçmez, Cüneyt; Kamaşak, Kağan; Kemaloğlu, Serdar; Tekin, Recep; Hattapoğlu, Salih; Bozkaya, Halil; Çalışkan, Alper; Ceviz, AdnanObjective: Brain is involved in 1-2% of hydatid cyst infections. A cranial location is rare. In this study, we aimed to assess clinical findings, radiological investigations, and treatment modalities of cases with intracranial hydatid cyst. Materials and Method: The present study included 26 patients operated for cerebral hydatid cyst disease between January 1990 and October 2012. Results: Seventeen patients were male and 9 were female. The mean age of the study population was 20.3 years (range 7-50 years). Headache and nausea were the most common clinical symptoms. The lesions were demonstrated by computed tomography (CT) and magnetic resonance imaging (MRI) as large, smooth, thin walled, spherical-shaped, cystic homogenous lesions with the same density as cerebro spinal fluid, which showed no edema or contrast uptake. Two patients were complicated or infected cysts with perifocal edema and contrast uptake. In 20 patients, the cysts were removed completely with Dowlings technique, by rectifying cysts without rupturing. Eleven patients with ruptured cysts during operation, recurrent or systemic hydatid cyst were treated medically. Conclusion: Medical therapy appears effective in hydatid cyst disease. Cerebral hydatid cysts should be excised totally without rupturing them. Preoperative imaging techniques are central to surgical planning. Intracranial hydatid cyst should be remembered when CT or MRI shows a cystic lesion, especially in countries where hydatid cyst is endemic.Öğe Assessment of Cases With Intracranial Hydatid Cyst: A 23-Year Experience(2014) Ceviz, Adnan; Kemaloğlu, Serdar; Hattapoğlu, Salih; Çalışkan, Alper; Tekin, Recep; Bozkaya, Halil; Gocmez, CüneytAmaç: Kist hidatik enfestasyonlarının %1-2'sinde beyin tutulumu olur. Kranial yerleşimyetişkinlerde nadirdir. Bu çalışmada intrakraniyal kist hidatik olguların; klinik bulguları,radyolojik görüntülemeleri ve tedavilerin irdelemeyi amaçladık.Materyal ve metod: Bu çalışma Ocak 1990- Ekim 2012 yılları arasında serebral kist hidatiknedeniyle opere edilmiş olan 26 hastayı içermektedir.Bulgular: Hastaların 17'si erkek ve 9'u kadın olup, yaş ortalaması 20,3 (yaş aralığı 7-50) idi.Baş ağrısı ve kusma en sık görülen klinik semptomlardı. BT ve MRG'de büyük düz, inceduvarlı, sferikal şekilli, BOS ile aynı dansiteye sahip olan ve perifokal ödem içermeyen,kontrast tutmayan kistik homojen lezyonlar şeklinde gösterildi. Hastaların 2 tanesi komplikeveya enfekte kist olup bunlarda perifokal ödem ve kontrast tutulumu vardı. 20 hastada kistlerrüptüre olmaksızın Dowling teknigi ile doğurtularak total olarak çıkarıldı. Cerrahi sırasındakist hidatiği rupture olan, rekürrensi olan ya da sistemik hidatik kisti olan 11 hasta medikaltedavi aldı.Sonuç: Medikal tedavinin kisthidatikte etkili olduğu görünüyor. Serebral kisthidatiklerrüptüre olmadan total çıkarılmalıdır. Preoperatif görüntüleme yöntemleri cerrahi planlamadaçok önemlidir. Özellikle Kisthidatik hastalığının endemik olduğu ülkelerde, BT veya MRG'dakistik bir lezyon görüldüğü zaman, İntrakranial Kist hidatik akılda tutulması gereken birhastalıktır.Öğe Bel fıtığını taklit eden spinal epidural abse(2007) Şentürk, Senem; Güzel, Aslan; Geyik, Mehmet Faruk; Ceviz, AdnanBrusellozise bağlı spinal epidurel abse (SEA) oldukça nadir görülmekte olup bulguları bel fıtığını taklit edebilir. Bu olgularda en uygun tedavinin ne olduğu hala tartışmalıdır. Öncelikle konservatif tıbbi tedavinin tercih edilmesi, cerrahi tedavinin tıbbi tedaviye yanıt alınamaması durumunda uygulanması önerilmektedir. Bu yazıda siyatalji yakınmaları ile başvuran ve lumbosakral spinal manyetik rezonans görüntüleme (MRG)'sinde spondilodiskitisle birlikte L5-S1 disk aralığı düzeyinde, sol Sİ sinir köküne bası yapan epidural abse saptanan 23 yaşında erkek hasta sunulmaktadır. Radyolojik bulguları ve brusella tüp aglütinasyon testi ile brusellar SEA tanısı alan hastada tıbbi tedavi ile klinik ve radyolojik olarak tam düzelme sağlanmıştır. Brusella SEA'sine bağlı siyatalji yakınmaları bulunan olgularda hafif nörolojik defisit bulguları varlığında dahi tıbbi tedavi öncelikle denenebilir.Öğe Beyin cerrahisi yoğun bakım ünitesi enfeksiyon etkenleri ve antibiyotik duyarlılıkları(Dicle Üniversitesi Tıp Fakültesi, 2009) Güzel, Aslan; Aktaş, Gökhan; Çelen, Mustafa Kemal; Tatlı, Mehmet; Özekinci, Tuncer; Üstün, Cemal; Özkan, Ümit; Satıcı, Ömer; Ceviz, AdnanAmaç: Yoğun bakım ünite (YBÜ)’lerinin sıkça saptanan etkenlerinin ve bunların duyarlı oldukları antibiyotiklerin bilinmesi bunlara yönelik uygulanacak tedavilerin planlanmasında yarar sağlayabilir. Bu çalışmada nöroşirürji kliniği YBÜ’sinde alınan kültürlerden izole edilen etkenler ve antibiyotik duyarlılıklarının belirlenmesi amaçlandı. Gereç ve Yöntem: Dicle Üniversitesi Araştırma Hastanesi Nöroroşirurji Kliniği’nde 2001-2005 yılları arasında değişik etyolojilerle yatırılıp, nöroroşirurji YBÜ’sinde 48 saatten uzun süre takip edilmiş hastaların dosyaları retrospektif olarak incelenerek alınan kültürler değerlendirildi. Bulgular: Beş yıllık sürede ameliyat edilen toplam 2197 hastanın 457’sinin NYBÜ’sinde izlendiği ve bunlardan toplam 1155 kültür örneğinin alındığı belirlendi. NYBÜ’sinde izlenen 123 olgudan alınan 317 kültürü pozitif örneğin 73’ü beyin omurilik sıvısı, 45’i yara yeri aspiratı, 47’si derin trakeal aspirat (DTA), 96’sı idrar, 27’si kan, 29’u damar yolu kateter ucu incelemeleriydi. En sık Staphylococcus aureus, koagülaz negatif stafilokok (KNS) bakterileri saptandı. BOS, kan ve yara yeri örneklerinden KNS, idrar örneklerinden Eschericha coli; DTA’dan Klebsiella pneumoniae; kan kateterlerinden Pseudomonas aureginosa en sık üreyen bakterilerdi. İzole edilen Gram pozitif suşların hiç birinde vankomisine direnç saptanmadı. Gram negatif suşlarda ise en etkili antibiyotiğin imipenem olduğu belirlendi. Sonuç: Nöroşirürji YBÜ’sinde en sık S aureus, KNS ve P. aureginosa, bakterilerinin izole edildi. Enfeksiyon kontrol önlemlerinin sıkı uygulanmasıyla bu infeksiyon oranlarında düşme sağlanabilir.Öğe Brain abcesses: Clinical analysis of twenty-five cases(Ege Üniversitesi, 2014) Yılmaz, Tevfik; Gül, Aylin; Turan, Yahya; Aydın, Pınar; Göçmez, Cüneyt; Kamaşak, Kağan; Hattapoğlu, Salih; Ceviz, AdnanObjective: The aim of this study is to determine the clinical, radiological, and surgical characteristics of brain abscesses and to share our experience in their management. Method: Medical records of 25 patients with brain abscess were retrospectively reviewed. The clinical picture, radiological examinations, treatment methods, and patient outcomes were analysed. Results: Of 25 patients included in our study, 16 (64%) were male and 9 (36%) were female. The age range was 2 months to 60 years, with a mean age of 12 years. Fifteen patients had a predisposing condition. The main source of the abscess was extension of an ear or nose infection to brain (n=9; 36%). In 10 (40%) patients the source could not be shown. Eighteen (72%) patients had a solitary abscess while 7 (28%) had multiple abscesses. No proliferation was observed in bacteriological cultures in 13 (52%) patients. No recurrences were seen in patients undergoing abscess excision with craniotomy. Conclusion: A brain abscess is a surgical emergency. Abcess excision with cranitomy is an effective treatment method in brain abcess cases. The most important sources of brain abcess were neigboring ear and nose infections. Diagnosis and treatment of these infections can prevent formation of brain abcess.Early diagnosis and treatment of cases with brain abscess can save patients from life-threatening complications of this disease.Öğe A Case of Growing Skull Fracture with Appearance of the Sinking Skin Flap Syndrome(Ortadogu Ad Pres & Publ Co, 2011) Ercan, Serdar; Senturk, Senem; Guzel, Aslan; Ceviz, AdnanA growing skull fracture is a late complication of a traumatic linear skull fracture. Untreated growing skull fractures can be associated with headache and progressive neurological deficits. In this case report, an unusual growing skull fracture mimicking sinking skin flap syndrome is presented. An 11-year-old girl, who had had a linear skull fracture 6 years previously, presented with headache, progressive left hemiparesis and right parietal scalp swelling on supine position. The scalp overlying the bone defect was sinking on upright position like the sinking skin flap syndrome. The growing skull fracture, revealed on the plain X-ray and computed tomography, was treated by duraplasty and cranioplasty with methylmetacrilate. The symptom of headache resolved and her walk improved after the treatment.Öğe Choroid Plexus Papilloma and Factor XIII Deficiency: Case Report(Karger, 2018) Ozturk, Pinar Aydin; Sanri, Omer; Yilmaz, Adil; Arpa, Abdurrahman; Ozturk, Unal; Ceviz, AdnanFactor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity. We present an 8-month-old female patient who developed subdural hematoma after ventriculoperitoneal shunt surgery but not bleeding after choroid plexus papilloma due to FXIII deficiency. (C) 2018 S. Karger AG, BaselÖğe CT and MR imaging of chronic subdural haematomas: a comparative study(E M H Swiss Medical Publishers Ltd, 2010) Senturk, Senem; Guzel, Aslan; Bilici, Aslan; Takmaz, Ilker; Guzel, Ebru; Aluclu, M. Ufuk; Ceviz, AdnanQuestions under study/principles: This study was designed to compare CT and MR appearances of chronic subdural haematomas as well as CT- and MR-guided measurements of haematoma thicknesses. Methods: CT and MR images of 48 chronic subdural haematomas of 34 patients were reviewed retrospectively. The thickness measurements and imaging characteristics of haematomas were compared. Results: Levelling was observed in 25% of haematomas, and most of them (60%) had intra-haematomal membranes. All membranes could be delineated by MR imaging, whereas only 27% were defined by CT. Mixed density (52%) and T1 hyperintensity (59%) were commonly observed in membraned haematomas, but the difference was not statistically significant. Haematomas were measured significantly thicker on MR images. All patients had been treated with burr-hole craniotomy and irrigation. Conclusions: MR imaging is more sensitive than CT in determining the size and internal structures of chronic subdural haematomas.Öğe Deneysel meninjitte lipit peroksitleriyle antioksidanların rolü ve seftriakson- diklofenak sodyum ile etkileşimi(1997) Ceviz, Adnan; Hoşoğlu, Salih; Koçyiğit, Yüksel; Atamer, Aytaç; Atamer, Yıldız; Mete, MahmutDeneysel olarak akut bakteriyel menenjit (ABM) oluşturulan sıkanların beyin dokusunda, lipit peroksidasyonunun bir göstergesi olan malondialdehit (MDA), antiperoksidant glutatyon (GSH_), glutatyon peroksidaz (GSH-Px) değişiklikleriyle, tedavi olarak 6 gün uygulanan seftriakson ve diklofenak sodyum'un bu parametrelere etkisi incelendi. Toplam 46 sıçan, kontrol (n=10), meninjit (n=7), seftriakson (30 mg/kg/gün, n=14) ve seftriakson+diklofenak sodyum (30mg/kg/gün + 0.5 mg/gün,, n=15) olmak üzere 4 gruba ayrıldı. Kontrol ve meninjit grubu dışındaki sıçanlara altı gün süresince anti-enflamatuvar ve antibiyotik uygulandı, meninjit grubuna sadece 0.4 mg/gün serum fizyolojik intraperitoneal olarak verildi. Uygulama sonunda tüm hayvanlar öldürülerek doku örnekleri alındı. Kontrollere göre, tüm grupların MDA düzeylerinin önemli derecede yüksek (p < 0.001) olduğu, GSH düzeylerinin düştüğü (p <0.001) gözlendi. Meninjit (M) ve seftriakson (5) gruplarının GSH - px aktivitelerinde sırasıyla p < 0.005; p < 0.05 düzeyinde düşük olduğu, seftriakson + diklofenak sodyum (S+D) grubunda anlamlı bir farklılık olmadığı saptandı. Meninjit grubuna göre; S ve S+D gruplarının MDA düzeylerinin önemli derecede düştüğü (p < 0.005; p < 0.001), GSH-Px aktivitelerinin yükseldiği (p <0.02; p » 0.001) gözlendi. S+D grubunun GSH düzeyleri de önemli derecede yüksek (p < 0.001) bulunurken, S grubunda herhangi bir farklılık bulunmadı. Sonuçta; akut bakteriyel meninjitte lipit peroksidlerinin arttığı, GSH ve GSH-Px sisteminde bozukluklar olduğu, seftriakson-diklofenak sodyum uygulamasının tedavide yararlı etkiler sağladığı gözlenmiştir.Öğe Effect of new traction technique of prone position on distraction of lumbar vertebrae and its relation with different application of heating therapy in low back pain(Ios Press, 2007) Cevik, Remzi; Bilici, Aslan; Gur, Ali; Sarac, Ayseguel Jale; Yildiz, Hidir; Nas, Kemal; Ceviz, AdnanObjective: In medicine, traction is used for act of pulling force for producing distraction or separation between two or more parts of body. However, it is limited to the cervical or lumbar spine in physiotherapic application. We aimed to investigate effect of new traction technique on anatomic structures of lumbar vertebrae, and its' relation to different application of heating therapy. Method: Ninety five consecutive patients with persistent low back pain participated in this study. Traction applied on new table in prone position. Heating therapy applied concomitantly with traction (group I, n: 32) and sham traction (group III, n: 31), and before traction (group II, n: 32). Lateral lumbosacral radiographs were obtained before and during traction. Results: Significant distraction in each disc space; decreasing in both lumbosacral angles and increasing in L1-S1 total distance were found with lying on new table without traction in three groups. Significant widening of all disc spaces and L1-S1 total distances were also obtained during traction in group I, while there were significant widening in L1-L2 anterior, L3-L4 anterior and posterior, L5-S1 posterior disc spaces, and L1-S1 anterior and posterior total distances during traction in group II and in posterior disc space of L5-S1 during sham traction in group III as compared to lying on table without traction. Conclusion: This is a preliminary study to investigate efficacy of new traction technique in prone position. Significant increasing in lumbar intervertebral disc spaces and changes in other anatomic structures were obtained on new table. Efficacy of traction application seemed to be increased by synchronized heating therapy. Creation of negative intradiscal pressure is important to suck back herniated disc material with distraction of lumbar vertebrae in prone position. Future clinical studies should be carried out to investigate efficacy of this traction technique in treatment of low back pain.Öğe Effects of nimodipine and nigella sativa on oxidative stress and apoptosis in serum and brain tissue of rats with experimental head trauma(Turkish Neurosurgical Soc., 2021) Kamasak, Kağan; Başarslan, Kağan; Dağlı, Ahmet Turan; Ögden, Mustafa; Alabalık, Ulaş; Ekinci, Adnan; Ceviz, AdnanAIM: To investigate whether Nimodipine (N) and Nigella sativa (NS) oil have protective, antioxidant effects in brain injury caused by experimental head trauma. MATERIAL and METHODS: Fifty albino Wistar rats were randomly divided into 5 groups that underwent experimental head trauma. Oxidative parameters were compared in the serum and brain tissue of the different groups. In addition, apoptosis and caspase-3 immunoreactivity were evaluated by histopathological examination. RESULTS: Serum total antioxidant status (TAS) levels were significantly increased in N and N+NS groups when compared with controls (p=0.001, p<0.01). Tissue TAS levels were significantly higher in the NS and N+NS groups compared to controls (p=0.001, p<0.01). Total oxidant status levels in the brain tissue were significantly higher in the NS group than in the control group (p=0.021). CONCLUSION: N and NS were shown to significantly reduce the occurrence of oxidative stress in secondary brain injury due to head trauma. We also found that apoptosis levels decreased in response to N, NS and N+NS treatments after head trauma.Öğe The effects of systemically administered methylprednisolone and recombinant human erythropoietin after acute spinal cord compressive injury in rats(Springer, 2006) Cetin, Abdurrahman; Nas, Kemal; Bueyuekbayram, Hueseyin; Ceviz, Adnan; Oelmez, GoenuelThe study design was to decrease the damage of spinal cord on the experimentally induced acute spinal cord injury in rats. The objective of this study was to evaluate whether recombinant human erythropoietin (rHu-EPO) and methylprednisolone (MPSS) improve neurological function and histopathological changes if systemically administered after traumatic spinal cord injury. This study included 48 rats that underwent experimental SCI. Forty-eight animals were randomly divided into six groups. Animals constituted a moderate compression of 0.6 N that was produced by application of an aneurysm clip at level T3 for 1 min. rHu-EPO (1,000 and 3,000 U (Unit) per kg of body weight i.p.) and MPSS (30 mg/kg) were administered 5 min after injury, and control group was saline treated. (1) Control group (n=8), (2) MPSS group (n=8), (3) rHu-EPO 1,000 U group (n=8), (4) MPSS + rHu-EPO 1,000 U group (n=8), (5) rHu-EPO 3,000 U group (n=8), and (6) MPSS + rHu-EPO 3,000 U group (n=8). The neurological function and histopathology were evaluated at 24 and 72 h. According to the neurological functional test scores significant improvements between the control group and the other groups that had taken medical treatment were observed (P < 0.001). Histopathologically severe ischemic findings were observed in the control group. A significant decrease in ischemic damage was detected in MPSS + rHu-EPO 3,000 U group (P < 0.001). The most significant neurological functional and histopathological improvements were observed after systemical administration of MPSS + rHu-EPO 3,000 U and rHu-EPO 3,000 U. Furthermore, the MPSS + rHu-EPO 3,000 U group provides the most improved neurological functional and histopathological recovery.Öğe Evaluation of the skin flora after chlorhexidine and povidone-iodine preparation in neurosurgical practice(Elsevier Science Inc, 2009) Guzel, Aslan; Ozekinci, Tuncer; Ozkan, Umit; Celik, Yusuf; Ceviz, Adnan; Belen, DenizBackground: Currently, there are various antiseptics used for cleaning the skin before surgery, but there is no standard procedure in practice. Chlorhexidine and povidone-iodine are the most preferred compounds among antiseptics. Both are proved to be safe and effective for skin disinfection. In this study. our aim was to investigate the combined effects of chlorhexidine and povidone-iodine oil the skin's flora before neurosurgical intervention, consecutively. Methods: Randomly, 50 cranial and 50 spine neurosurgery cases were assigned to the Study. The first culture was obtained after hair removal and before cleaning the skin with any antiseptic. The second culture was obtained after the skin had been cleaned with chlorhexidine for 3 minutes. Then, the skin was cleaned twice with povidone-iodine for 30 seconds, and the third and fourth cultures were taken from the skin incision area. Bacteria were identified by means of standard laboratory identification methods. Positive culture results were compared statistically among order Of Cultures obtained. Results: In the first culture evaluation, 39 (33 cnS, 6 Staphylococcus aureus) of 50 cranial samples and 37 (33 cnS, 4 S aureus) of 50 spine samples showed reproduction. In the second culture, 9 cranial and 5 spine samples showed reproduction of cnS. In the third and fourth Cultures, no growth was observed (P < .001). Conclusion: Three minutes' cleaning of the incision area with chlorhexidine, followed by 30-second cleaning with povidone-iodine, could be a sufficient disinfection procedure for preoperative preparation of the skin in patients undergoing a neurosurgical procedure. (C) 2009 Elsevier Inc. All rights reserved.Öğe İdrar inkontinansı ile birlikte lomber intraspinal sinovyal kist: Olgu sunumu ve literatür incelemesi(2013) Yılmaz, Tevfik; Kamaşak, Kağan; Hattapoğlu, Salih; Ceviz, Adnan; Turan, Yahya; Gocmez, CüneytSinovyal kistler epidural kompresif sendromları olan olgu-larda nadiren görülmektedir. Radiküler semptomlarla diskhernilerini taklit edebilen intraspinal lezyonlardır. Yirmi se-kiz yaşında bayan hasta, altı aydır süren bel ağrısı, biraydır idrar kaçırma ve son iki haftadır giderek artan sağ bacak ağrısı ve uyuşma gibi radiküler şikayetlerle baş-vurdu. Fizik muayenesinde; gastrokinemius kasında güçkaybı (4/5), sağ L5,S1 hipoestezisi ve idrar inkontinansı tespit edildi. Manyetik rezonans görüntülemede, L5-S1 seviyesinde intraspinal kist görüldü. Olguya bilateral L5hemiparsiyel laminektomi, foraminotomi ve kist eksizyonuyapıldı. Hastanın özellikle idrar inkontinansı olmak üze- re postoperatif erken dönemde şikayetleri geriledi, bir yıl sonraki kontrol muayenesinde hiç bir şikayetinin olmadığı, motor ve duyu kaybının da tamamen düzeldiği gözlendi.Öğe Intradiploic Meningioma With Inward and Outward Extensions in a Rheumatoid Arthritis Patient(Journal Neurological Sciences, 2010) Er, Uygur; Guzel, Aslan; Tatli, Mehmet; Ceviz, Adnan; Sav, AydinBackground: Meningiomas usually arise from clusters of arachnoidal cap cells. Originating of a meningioma in an intraosseous region is rare condition. There are several theories about occurrence of these types of meningiomas. Here we report a case of an intradiploic meningioma in a rheumatoid arthritis patient and discuss the mechanism of developing intraosseous meningiomas, differential diagnosis of intraosseous lesions of calvarium, relations of rheumatoid arthritis and extensions of meningioma outside the diploe. Case description: A sixty three-year-old female patient who had been under the treatment for rheumatoid arthritis was admitted to the hospital with a swelling around her right eye. Bony window of preoperative CT showed an expansile right sphenoid bone lesion. The mass was excised with internal and external tables of the temporal bone by craniectomy. Conclusion: We advocate a wide resection, followed by cranioplasty with acrylic. If the subtotal resection is possible, residual lesion should be followed for adjuvant radiation therapy.Öğe Intradiploic meningioma with ınward and outward extensions in a rheumatoid arthritis patient(2010) Sav, Aydın; Er, Uyğur; Güzel, Aslan; Tatlı, Mehmet; Ceviz, AdnanAmaç: Meningiomalar genellikle araknoid cap hücre kalıntılarından gelişirler. İntraosseöz meningioma gelişimi nadirdir. Bu tip meningioma gelişimi için bir kaç teori mevcuttur. Bu yazıda römatoid artritli bir hastada gelişen intradiploik meningiomayı sunarak, gelişim mekanizmalarını, ayırıcı tanısını, römatoid artrit ile ilişkisini ve kalvaryum dışına uzanımını tartışmayı amaçladık.Olgu sunumu: Römatoid artrit nedeniyle tedavi altında olan altmış üç yaşındaki kadın hasta sağ göz etrafında şişlik ile başvurdu. Bilgisayarlı tomografide ekspansil sağ sfenoid kemik lezyonu izlendi. Kitle kraniyotomi ile çıkarıldı.Sonuç: Bu tip olgularda geniş rezeksiyon ve akrilik kraniyoplasti önermekteyiz. Kısmi çıkarım ancak olanaklı ise radyasyon tedavisi uygun olur.Öğe Kaza ile üzerine cisim düşmesine bağlı hastaneye başvuran hastaların değerlendirilmesi(Dicle Üniversitesi, 2015) Turan, Yahya; Uysal, Cem; Korkmaz, Mustafa; Yılmaz, Tevfik; Göçmez, Cüneyt; Özevren, Hüseyin; Gören, Süleyman; Ceviz, AdnanAmaç: Özellikle çocuklarda olmak üzere ev, iş ve dış ortamlarda meydana gelen kazalar, yaralanma ve ölüm nedenlerinin başında gelmektedir. Bu çalışmada amaç, kaza ile üzerine cisim düşmesine bağlı hastanemize baş- vuran hastaların değerlendirilmesidir. Yöntemler: Bu çalışmamızda kaza ile üzerine cisim düş- mesine bağlı 2012-2014 yılları arasında hastanemize başvuran 135 hastanın dosyaları retrospektif olarak incelendi. Bu hastaların yaş, cinsiyet, olayın nedeni olarak üzerine düşen cismin türü, yeri, zamanı ve ölüm nedenleri analiz edildi. Bulgular: Hastaların 82 ( %60,7)’i erkek, 53 (%39,3)’ü kadın ve yaş ortalaması 18,8 (0-79 yıl) olarak bulundu. En fazla hasta %57,8 (78 hasta) ile çocuk yaş grubunda ( 0-18 yaş) bulunmaktadır. Düşen cismin türü bakımından değerlendirildiğinde sırasıyla %18,5 (25 hasta) ile televizyon, %15,6 (21 hasta) ile taş ve %11,1 (15 hasta) ile demirden yapılmış cisimler ilk üç sırayı paylaşmaktadır. Kazanın meydana geldiği yer olarak ele alındığında en fazla kazanın 85 vaka (%62,9) ile evde olduğu görülmektedir. Kazanın meydana gelme zamanına bakıldığında en fazla 93 vaka (%68,9) ile yaz mevsiminde meydana geldiği görülmektedir. Sonuç: Bu çalışmada elde edilen veriler, özellikle çocukların maruz kaldığı bu tür kazaları önleme programlarına katkı sağlamaktadır.Öğe Posterior epidural migration of a sequestered lumbar intervertebral disc fragment(Turkish Neurosurgical Society, 2017) Turan, Yahya; Yılmaz, Tevfik; Göçmez, Cüneyt; Özevren, Hüseyin; Kemaloğlu, Serdar; Teke, Memik; Sarıyıldız, Mustafa Akif; Ceviz, Adnan; Temiz, CüneytAIm: Posterior epidural migration of a sequestered lumbar intervertebral disc fragment (PEMSLIDF) is an extremely rare condition published so far only as case reports or small case series (ranging between 2 to 8 cases). Diagnosing this condition is often challenging and the diagnosis is usually made intraoperatively. The affected patients usually suffer cauda equina syndrome (CES). In the present study, we aimed to discuss the clinical and radiological findings, types and features of surgical therapies, and outcomes of 9 patients with PEMSLIDF. MaterIal and Methods: This study included 9 (0.36%) patients with PEMSLIDF among 2470 patients who underwent lumbar disc hernia surgery between August 2002 and September 2012. The preoperative clinical and radiological properties of the patients were evaluated. The postoperative outcomes were assessed using neurological examination, radiological imaging, visual analog scale (VAS) and modified Odom criteria. Results: RESULTS: As far as we know, this study is the largest case series examining the characteristics of PEMSLIDF. Seven (77.8%) of our patients were male and 2 (22.2%) were female and they had a mean age of 49.5 years (range 28-70 years). The mean duration from symptom onset to hospital admission was 7.4 days. Seven patients had CES. All patients underwent sequestrectomy and discectomy via posterior microsurgery. The patient outcomes were evaluated by the Modified Odom criteria and the outcome was excellent in two (22.2%) patients, good in 4 (44.5%), fair in 2 (22.2%), and poor in 1 (11.1%). ConclusIon: The entire free fragment can usually be excised via the posterior microsurgery technique. Early surgical treatment is of great importance to prevent more serious neurological deficits.Öğe The results of rehabilitaion on motor and functional improvement of the spineal tuberculosis(2004) Nas, Kemal; Kemaloǧlu, Mustafa Serdar; Çevik, Remzi; Ceviz, Adnan; Necmioǧlu, Serdar; Bükte, Yaşar; Coşut, Abdülkadir; Şenyeǧit, Abdurraham; Gür, Ali; Saraç, Ayşegül Jale; Özkan, Ümit; Kırbaş, Gökhan; 0000-0001-9680-6268Objectives. - To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis. Methods. - Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over a period of 6 months, after spinal decompression and fusion. The main outcome measures were motor development of the patients was 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 make according to American Spinal Injury Association (ASIA). Results. - The study population consisted of 47 patients (22 males and 25 females) mean age 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 6th month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities, truncal and sacrospinal extansors 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. 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.Öğe Surgical Therapy of a Vertebral Artery Aneurysm With Saccular and Fusiform Segments(Lippincott Williams & Wilkins, 2014) Yilmaz, Tevfik; Turan, Yahya; Ceviz, AdnanVertebral artery aneurysms form a group of aneurysms having high rates of rebleeding, morbidity, and mortality, poor treatment outcomes, as well as low rate of surgical treatment. Examinations for subarachnoid bleeding revealed a vertebral artery aneurysm with a diameter of 12 mm in a 67-year-old man who presented with headache. The vertebral artery aneurysm with saccular and fusiform segments was shrunk and clipped via lateral left suboccipital approach. No neurologic deficit was present at the postoperative period. Control digital subtraction angiography showed complete shrinkage of aneurysm with continued blood flow and no residue. Clinical findings, treatments, and surgical approaches of VA aneurysms are different from anterior and posterior circulation aneurysms. Microneurosurgical clipping is the most effective treatment of vertebral artery aneurysms in suitable cases. Although endovascular intervention is commonly applied as therapeutic modality for patients with vertebral artery aneurysm, researchers have also emphasized that saccular vertebral aneurysms with fusiform extension can also be surgically treated in suitable cases.
