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    Intracranial multiple tuberculomas: 2 unusual cases
    (Elsevier Science Inc, 2005) Guzel, A; Tatli, M; Aluclu, U; Yalcin, K
    Background: Tuberculosis (TB) is still a major public health problem that continues to be an important cause of morbidity and mortality at worldwide level. Only 1% of patients with TB develop an intracranial tuberculoma (Tbm), usually as part of miliary TB. The radiological findings are often nonspecific, and they are difficult to diagnose without an increased index of suspicion. Cases Descriptions: In this report, we presented 2 unusual patients with intracranial multiple Tbms, one of whom is a 32-year-old woman who did not have pulmonary TB or other primary origin of TB. Her diagnosis was established histopathologically, and she was treated with antituberculous chemotherapy. The other patient is a 12-year-old girl who has pulmonary TB with portal hypertension together with liver cirrhosis. Her diagnosis was established with clinical, radiological, and laboratory findings, and she was treated with antituberculous chemotherapy for 18 months. Conclusions: Intracranial Tbms have become rare in developed countries, but TB is still a very common infectious disease at worldwide level. Therefore, diagnosis should be kept in mind when confronted with brain space-occupying lesions, especially in the immunocompromised or malnutritional hosts such as liver cirrhosis. When no other active extracranial tuberculous process is found, the diagnosis should be confirmed by a biopsy before beginning antituberculous treatment, which is rapidly effective. We have not encountered in the literature such a case of multiple intracranial Tbms associated with liver cirrhosis in an adult patient. (c) 2005 Elsevier Inc. All rights reserved.
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    Pediatric orbital multifocal cavernous hemangiomas associated with bilateral arachnoid cysts of the middle cranial fossa - Case report and review of the literature
    (Amer Assoc Neurological Surgeons, 2005) Tatli, M; Guzel, A; Keklikci, U; Guzel, E
    Cavernous hemangiomas of the orbit are benign vascular growths that commonly occur in adults and account for 6% of all intraorbital tumors. Multifocal intraorbital cavernous hemangiomas are quite rare. The reported incidence of arachnoid cysts accounts for only 1% of lesions that occupy intracranial space, and they are nearly always sporadic and single. So far, the authors have not encountered any study reporting the coexistence of bilateral arachnoid cysts of the middle cranial fossa and orbital multifocal cavernous hemangiomas. In this report, they describe a 10-year-old boy with such a hemangioma that included the eyelid, conjunctiva, and retrobulbar space. His was the first case of a surgically treated pediatric orbital multifocal cavernous hemangioma associated with bilateral arachnoid cysts of the middle cranial fossa. An association between arachnoid cysts, intracranial cavernous malformations, and bilateral arachnoid cysts and metabolic disorders has been reported. The authors report on the coexistence of orbital multifocal cavernous hemangiomas and bilateral arachnoid cysts of the middle cranial fossa. Based on these observations, they believe that all patients with bilateral temporal arachnoid cysts should be screened for genetic disorders. In addition, the possibility of orbital cavernous malformations should be kept in mind for the follow-up period, and patients should be evaluated for possible symptoms of this condition.
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    Spontaneous acute subdural hematoma following contralateral calcified chronic subdural hematoma surgery: An unusual case
    (Karger, 2006) Tatli, M; Guzel, A; Altinors, N
    Calcified chronic subdural hematoma (CCSDH) is a well-known disease to many neurosurgeons but only few cases have been reported regarding its surgical complications. We report a spontaneous acute subdural hematoma following contralateral CCSDH surgery in a 16-year-old boy and discuss its possible mechanisms. The first few days of the postoperative period, especially for the cerebral atrophy cases, should be monitored carefully and a control computerized tomography scan should be performed early for possible complications. To our knowledge, spontaneous acute subdural hematoma following contralateral CCSDH surgery has not been reported previously.