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Öğe Cystic meningiomas: Report of three cases(Turkish Neurosurgical Society, 2006) Tatli M.; Güzel A.; Göksel H.M.Although intracranial meningiomas are usually solid and firm tumours, some are associated with diagnostically confusing cysts. In this article, we present our experience from three of our patients with cystic meningiomas and discuss the characteristics of these lesions. We detected type two cysts in our first and third cases, and a type one cyst in the second case, according to the Nauta classification. Contrast enhancement of the cyst wall was detected in our third case and an atypical meningioma was diagnosed histopathologically. We conclude that the contrast enhancement of the cyst wall might be a predictive factor for a malignant meningioma. The cyst wall should be completely removed in these patients to prevent tumour recurrences.Öğe Intracranial hemorrhage in newborns due to vitamin K deficiency(2006) Katar S.; Özbek M.N.; Güzel A.; Devecioğlu C.; Ecer S.The late hemorrhagic disease of the newborn results from vitamin K deficiency and the bleeding in these patients is usually intracranial. In this study, clinical and laboratory findings of 10 cases with intracranial bleeding are described. Of these 10 patients, nine had not been given prophylactic vitamin K, while one had received prophylaxis. Eighty percent were male and their age was between 8 and 29 days. All patients were term newborns, with one born in hospital and nine at home. There was no history of medication use, diarrhea or trauma, and all newborns were solely breast-feeding. Prothrombin, partial thromboplastin and coagulation times were prolonged in all cases. Four hours after intravenous administration of vitamin K (2 mg), all these values returned to normal levels. Intracranial bleeding was evacuated surgically in one patient. Two patients died. In conclusion, we believe that every newborn should receive prophylactic vitamin K. In addition, it appears that a second dose of vitamin K is required during the first month of life due to the possibility of late hemorrhagic disease of the newborn despite initial prophylaxis.Öğe Intradiploic meningioma with inward and outward extensions in a rheumatoid arthritis patient(2010) Er U.; Güzel A.; Tatli M.; Ceviz A.; Sav A.Background: 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 Oral ketamine administration for radiation therapy in children(Scientific Publishers of India, 2017) Doğan E.; Güzel A.; Zincircioğlu S.B.; Arslan M.Ş.; Çelik F.; Yildirim M.B.; Yildirim Z.B.Background: Radiotherapy is a reliable and effective treatment for various malignancies and can be used for both curative and palliative/prophylactic ends. In order to achieve accuracy, reliability and success in the implementation of radiotherapy, it is imperative that patients adapt to the treatment and remain motionless. Material and methods: In this study, the records of anesthetic agents utilized in 26 patients aged 2-10 being treated by external beam radiotherapy were examined. Results: Radiotherapy under anesthesia was implemented in a total of 56 sessions conducted on 26 patients. During the radiotherapy applications, only 10 (17%) sessions required the use of an extra dose of ketamine. The radiotherapy session duration was 6.3 ± 2.4 minutes. (The anesthesia start time was 20.5 ± 4.6.) Additionally, the patients' recovery time from anesthesia was found to be 68.6 ± 6.2. 61.5% of the patients were administered prophylactic cranial radiotherapy due to acute lymphoblastic leukaemia (ALL). Before and after the procedure, hemodynamic and respiratory parameters were found to be stable. Conclusion: Since a combination of oral ketamine and midazolam provides effective sedation and comfort and can be administrated easily, we believe that it can be safely used in radiotherapy procedures on children. © 2017, Scientific Publishers of India. All rights reserved.Öğe Retrograde intubation in the patient with cystic tumor located at the base of tongue(2013) Çelik F.; Tokgöz O.; D?an E.; Güzel A.; Çiftçi T.; Tüfek A.Retrograde intubation is one of the methods used to maintain an airway in the event of a difficult intubation. Retrograde intubation has been successfully carried out on patient for whom intubation was not possible with a direct laryngoscope and fiber optic bronchoscope. The central venous catheter needle and guide wire are the materials that are the most practical to prepare and access for the retrograde intubation. To conclude, In conclusion, retrograde intubation may be good alternative to invasive airway management such as surgical tracheostomy for difficult or impossible intubations because it can be performed easily, quickly, and successfully.Öğe Simultaneous choriocarcinoma metastases to brain, spine and lung(2007) Güzel A.; Tatli M.; Zileli M.Cerebral metastasis of choriocarcinoma is well documented. However, multifocal metastasis of choriocarcinoma is an extremely rare event. A 20-year-old married woman was admitted through A & E presented with spastic paraplegia and sensory deficit below T4 level. She was not having any obstetric or gynaecological problems. Magnetic resonance imaging revealed bilateral multiple lesions in the lungs and an extradural mass of T2-T3 vertebrae, along with metastatic haemorrhagic cerebral lesions. The patient was operated and histopathology revealed choriocarcinoma. She died on the 5th postoperative day in intensive care unit due to massive haemoptysis. Lung and brain haemorrhages of metastatic choriocarcinoma are indicators of a poor outcome in gestational trophoblastic neoplasia. To our knowledge, this is the first reported case of multifocal choriocarcinoma metastases in brain, thoracic spine and lungs.
