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Öğe Atretic parietal cephalocele(Karger, 2007) Guzel, Aslan; Tatli, Mehmet; Er, Uygur; Bavbek, Murad[Abstract Not Available]Öğe Atypical clinical presentation of idiophatic thoracic spinal cord herniation(Lippincott Williams & Wilkins, 2008) Senturk, Senem; Guzel, Aslan; Guzel, EbruStudy Design. Case report. Objective. To report an adult female patient with idiopathic spinal cord herniation presenting with pain without symptoms of myelopathy. Summary of Background Data. Idiopathic spinal cord herniation is a rare but increasingly recognized cause of myelopathy that can be successfully diagnosed with the almost pathognomonic findings on magnetic resonance imaging. There are over 90 cases that were treated surgically reported in the literature. Methods. A 38-year-old woman presented with a 6-month history of chest pain radiating through to the back in bilateral T4 dermatome. Her neurologic examination was normal. Magnetic resonance study revealing ventral displacement and adherence of spinal cord at T4 level led to the diagnosis of idiopathic spinal cord herniation. Mild spinal cord atrophy with the dilatation of dorsal subarachnoid space was determined. Results. The patient is observed-up on conservative treatment for pain. Conclusion. Idiopathic spinal cord herniation is 1 of the causes of unexplained atypical thoracic pain with or without signs and symptoms of myelopathy. Magnetic resonance imaging is recommended to establish the diagnosis in patients, particularly age ranged from 36 to 59, whose clinical and laboratory findings are inconclusive.Öğe Bilateral symptomatic petrous apex effusion(Springer, 2010) Yildirim, Muzeyyen; Senturk, Senem; Guzel, Ebru; Guzel, Aslan; Topcu, IsmailPetrous apex effusions can present with aural fullness, hearing loss and dizziness. Although they can be followed-up when asymptomatic, clinical management of symptomatic patients is controversial. In this study, we present clinical and radiological findings of a 24-year-old patient with bilateral petrous apex effusion. She had been complaining of bilateral aural fullness and dizziness for 2 years. Radiological examinations revealed bilateral petrous apex effusion. After medical treatment, her symptoms gradually disappeared. In all previous published studies, unilateral petrous apex effusions were reported. To our best knowledge, this is the first patient with trapped fluid in bilateral petrous apex.Öğe Bilateral temporal arachnoid cysts associated with tuberous sclerosis complex(Sage Publications Inc, 2007) Tatli, Mehmet; Guzel, AslanThe association between tuberous sclerosis complex and intracranial abnormalities such as hemimegalencephaly, schizencephaly, intracranial arterial aneurysms, and corpus callosum agenesis/dysplasia has been reported in the recent literature. However, the association between tuberous sclerosis complex and bilateral temporal arachnoid cysts has not been reported. A case of an 8-year-old boy with a mental impairment and epileptic seizures that began 5 years earlier is presented. The neuro-radiological findings are consistent with tuberous sclerosis complex associated with bitemporal arachnoid cysts. His epileptic seizures were treated with antiepileptic medications. To the authors' knowledge, this is the first reported case of tuberous sclerosis complex associated with bilateral arachnoid cysts of the temporal region. In such cases, arachnoid cysts may exacerbate the clinical picture.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 Cervical Spinal Meningioma Mimicking Intramedullary Spinal Tumor(Lippincott Williams & Wilkins, 2009) Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioglu; Sav, AydinStudy Design. Case report. Objective. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Summary of Background Data. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. Methods. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. Results. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Conclusion. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.Öğe Coexisting subarachnoid hemorrhage and subdural hematoma mimicking acute anterolateral myocardial infarction(Churchill Livingstone Inc Medical Publishers, 2007) Iltumur, Kenan; Tamam, Yusuf; Karahan, Zulkuf; Guzel, Aslan; Altindag, RojhatIschemic electrocardiographic changes, elevations in cardiac-specific markers such as troponin and creatinine phosphokinase NIB, segmental wall motion abnormalities, and myocardial dysfunction may occur after central nervous system events such as subarachnoid hemorrhage, subdural hematoma, and ischemic stroke. The pathophysiology remains unclear, but a catecholamine-induced neurocardiogenic injury has been mentioned as a causative factor. We reported a case of coexisting subarachnoid hemorrhage and subdural hematoma with ischemic electrocardiography changes, increases in cardiac-specific enzymes, and a regional wall motion abnormality despite normal epicardial coronary arteries. It is very important to differentiate neurogenic stunned myocardium from myocardial dysfunction caused by coronary artery disease in patients with intracranial hemorrhages for appropriately managing the treatment of cases. (c) 2007 Elsevier Inc. All rights reserved.Öğe Comparison of the effects of maternal protein malnutrition and intrauterine growth restriction on redox state of central nervous system in offspring rats(Elsevier, 2007) Tatli, Mehmet; Guzel, Aslan; Kizil, Goksel; Kavak, Vatan; Yavuz, Murat; Kizil, MuratBoth maternal protein malnutrition and intrauterine growth restriction (IUGR) have deleterious effects on brain development, but a comparison of these effects has not been previously reported. The objectives of this study were to investigate and compare the effects of both factors on the oxidative status of the central nervous system (CNS), including the spinal cord, in offspring rats. We evaluated various parameters of oxidative status and antioxidant enzyme activities of superoxide dismutase and catalase (CAT) in different regions of the CNS from 60-day-old rats subjected to prenatal and postnatal protein restrictions [middle protein restriction 12%, severe protein restriction (SPR) 4%] or IUGR produced by uterine artery ligation. Furthermore, we compared these study groups to each other and to control rats fed an isocaloric 24% protein diet. Results were analyzed using one-way ANOVA followed by Tukey's post hoc test. Both protein restrictions and IUGR altered various parameters of oxidative status. In all evaluated structures, protein restrictions resulted in increases in thiobarbituric acid-reactive substances level and index of lipid peroxidation (P < 0.001), and in decreases in antioxidant enzyme activities (P < 0.005). IUGR also increased lipid peroxidation levels in the blood samples (P < 0.04) and protein oxidative damage in the cerebellum and cerebral cortex (P < 0.005); however, no effects were detected on the spinal cord. The greatest decrease in CAT activity was in the cerebellum of rats fed with SPR diet (P < 0.001). This study suggests that not only severe but also middle protein malnutrition have deleterious effects on CNS structures, including the spinal cord. Protein restriction has a greater effect on the redox state of the CNS than IUGR. (c) 2007 Elsevier B.V. All rights reserved.Öğe Could platelet aggregation ratio be an indicator for differential diagnosis of transient ischemic attack and cerebral ischemic stroke?(Karger, 2006) Tatli, Mehmet; Guzel, Aslan; Akyuz, Aytekin; Batun, SabriBackground: Platelet aggregation plays an important role in the pathogenesis of thromboembolic cerebrovascular disease. Platelet aggregation ratio (PAR) and its derivates have been used successfully to identify the effectiveness of antiplatelet agents and their optimum dosage in patients suffering from stroke. However, we failed to find any study using PAR as a predictive factor in differential diagnosis of ischemic cerebrovascular diseases. In this study, we aimed to investigate PAR in patients with acute ischemic stroke and transient ischemic attack (TIA), comparing their neuroradiological features, and whether PAR values could be an indicator for differential diagnosis of TIA and cerebral ischemic stroke. Methods: The study consisted of 75 adult patients who were admitted with suspected stroke and 25 control healthy individuals. All patients were diagnosed with acute ischemic stroke or TIA and the diagnoses were confirmed by clinical examination and computed tomography (CT). The stroke group consisted of 45, and the TIA group of 30 consecutive patients. The patients included in this study had noncardioembolic stroke. PAR values were measured on admission in all groups, according to the modified method of Wu and Hoak. The statistical significance of differences was evaluated using one-way ANOVA, the unpaired Student t test and the Bonferroni and Tamhane post hoc tests. Results: Differences in PARs between the control and TIA groups, control and stroke groups and stroke and TIA groups were significant (p < 0.001). Nevertheless, in each group, differences between genders were not statistically significant. Initial CT scan demonstrated early infarction sign in 26 stroke patients (57%); however, in 19 stroke patients, it was not detected. Differences in PARs between TIA and stroke patients, whose initial CT scan findings were negative, were found to be significant. However, differences in PARs between CT negative stroke patients and positive stroke patients were not significant. Conclusion: We believe that the use of PAR values in the assessment of acute ischemic stroke and TIA could open up a new perspective in the management of such patients. In differential diagnosis, PAR values have to combine with neurological examination and CT scan signs. The current test is not able to differentiate vascular occlusive diseases in other organs from vascular occlusive problems in the brain. Further study is needed to determine the sensitivity and specificity of this test in all patients and to confirm the prognostic value in stroke patients. Copyright (c) 2006 S. Karger AG, Basel.Öğe 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 The effects of intravenous immunoglobulin on cerebral ischemia in rats: An experimental study(Sage Publications Inc, 2016) Tunik, Selcuk; Aluclu, Mehmet Ufuk; Acar, Abdullah; Akkoc, Hasan; Guzel, Aslan; Alabalik, Ulas; Akkus, MuratStroke is one of the major reasons of death in the United States and related to adult disability. Despite aggressive research, the treatment approaches of stroke still remains a major clinical problem. Intravenous immunoglobulin (IVIg) is a polyspecific Ig G preparation obtained from plasma of several thousand healthy people (donors). IVIg is an important treatment approach and used for several disorders. The aim of this study was to investigate the potentially beneficial effects of IVIg therapy in experimentally induced ischemia in middle cerebral artery occlusion (MCAo) models of rats. A total of 30 adult male Sprague Dawley rats were used. The rats were divided into two equal groups, each consisting of 15 randomly selected rats: control group (n = 15) and IVIg group (n = 15). Intraluminal filament method was used for establishment of cerebral ischemia. Intraluminal filament was withdrawn after 2 h of MCAo and reperfusion started again and passed to therapeutic stages for all the groups. Physiologic saline solution of 0.5 ml/kg was administered to the control group and 400 mg/kg IVIg was given to the IVIg group rats intravenously. In neurological evaluation, the worst score was determined as 3 and the best score as 0. After routine process, the brain tissue was prepared histopathological investigation. The IVIg group showed significantly better recovery with respect to the control group by neurological examination. The observation of specimens obtained from IVIg groups showed that findings correlate with grade 1 and -2 histopathologically. Nevertheless, ischemic amendments were observed to comply with grade 3 in ischemic areas in control group. IVIg therapy can be used in the treatment of ischemic stroke patients.Öğe Effects of maternal protein malnutrition and intrauterine growth restriction on redox state of the central nervous system in offspring rats(Wiley-Liss, 2007) Tatli, Mehmet; Guzel, Aslan; Kizil, Goksel; Kavak, Vatan; Yavuz, Murat; Kizil, Murat[Abstract Not Available]Öğe The Effects of Valproic Acid on Sciatic Nerve of Fetal Rats and Protective Effects of Folic Acid and Vitamin E(Soc Chilena Anatomia, 2009) Aluclu, Mehmet Ufuk; Tuncer, Mehmet Cudi; Guzel, Aslan; Aluclu, Mustafa Arif; Akkus, MuratWe aimed to investigate the potential harmful effects of maternal valproic acid (VPA) on fetal sciatic nerve, and the protective effects of vitamin E (Vit E) and folic acid (FA) on fetal rats. Valproic acid (400 mg/kg), folic acid (400 mg/kg) and vitamin E (250 mg/kg) were administered to rats on each of gestation days 8-10. All fetuses were collected on gestation day 20. With thin sections of biopsies, sciatic nerve of fetuses were stained with uranyl acetat and were examined under transmission electron microscope. The fetuses (n:36) were divided into five groups: control, vpa, vpa+fa, vpa+vit e and vpa+fa+vit e groups. In each group; drug procedure, surgical procedure and histological methods were performed. Later, weights and lengths of fetuses in each group were compared and analyzed by One-Way Anova test. Administration of single doses of valproic acid (400 mg/kg) resulted in weight and length loss between control and vpa group. However, length and weight differences between the other groups were not significant. The histopathological findings of control group was normal. In vpa group, it showed extensive degenerative changes especially in myelin coat. In addition, most prominent finding in this group was condensation of collagen fibers in extensively demyelinated samples, while moderately effected areas were relatively normal. Both vpa+fa and vpa+vit e groups exhibited similar ultrastructural changes, reflecting minimal to moderate degenerative changes. In vpa+fa+vit e group had almost the normal structure. Administration of single doses of valproic acid (400 mg/kg) resulted in a deteriorative effect on sciatic nerve at ultrastructural level. Administration of FA and Vit E had a protective effect to prevent the degenerative changes to a certain degree. Combination of FA and Vit E together following VPA administration had a more potent protective effect. The objective of the present study is to analyze histopathologic changes which may occur in a high risk experimental model after the administration of valproic acid. In addition, protective roles of the administration of folic acid and vitamin E are assessed.Öğe Evaluation of erythroprotein effects on cerebral ischemia in rats(Maghira & Maas Publications, 2007) Aluclu, Mehmet Ufuk; Acar, Abdullah; Guzel, Aslan; Bahceci, Selen; Yaldiz, MehmetObjective: Majority of severe disabilities in adults are caused by stroke. The aim of our study is to learn the effects of erythropoietin (EP), on infarct size in cerebral ischemia and to determine neurological behavioral scores and histopathological evaluation. Material & Methods: In this study 30 adult Sprague-Dawney rats were used. Cerebral ischemia was constituted by intraluminal filament method with a 4-0- nylon suture. Reperfusion was started after two hours of middle cerebral artery occlusion. The rats were randomly divided into two groups as follow: control and EPO groups. Saline 0.9% (0.5 ml/kg) and EPO (5000 U/kg) was administered intraperitoneally in the groups. Three coronal slices in two millimeters thickness were obtained from cerebrum, cerebellum and brain stem, and were stained with a 2% solution of triphenyltetrazolium chloride. Transparent sheets were placed over each section and the areas of the brain and infarct were measured. The neurological scores were determined at 24(th), 48(th) and 72(nd) hours after reperfusion. Results: Percent of ischemic area (%) in cerebrum, cerebellum and brain stem level in EPO groups were less than those of control group (p<0.0001). In addition, we determined that EPO group was better than controls of neurologic score and histopatologically after cerebral ischemia. Conclusions: We concluded that EPO may decrease ischemic area in experimental cerebral ischemia in rats and it seems that EPO may be beneficial.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 An experimental Staphylococcus aureus meningitis model for investigating induced leptomeningeal and subpial inflammation in rats(Maghira & Maas Publications, 2007) Guzel, Aslan; Er, Uygur; Tatli, Mehmet; Aluclu, Ufuk; Ozekinci, Tuncer; Nergiz, Yusuf; Ahishali, BulentOBJECTIVE: To evaluate leptomeningeal and subpial inflammatory responses of experimental Staphylococcus aureus bacteriemia following intraperitoneal and intravenous applications and to compare the inflammatory reactions in different regions of central nervous system. MATERIAL AND METHODS: Forty anesthetized rats were divided into four groups equal in number. The rats in group-I were given 1 ml suspension of Staphylococcus aureus intraperitoneally. Group-II was the control group of group I; it was administrated 1 ml 0.9% NaCl in water intraperitoneally. The rats in group-III were given the same amount of bacteria intravenously. Group IV was the control group of the group-III; it was administrated 1 ml 0.9% NaCl solution intravenously. The rats were sacrificed on the 21st day. Inflammatory changes of different regions of the central nervous system were examined under transmission electron microscopy. Statistical analysis was done by using variance analysis, Bonferroni, Tamhane post hoc, Student's t and univariate tests. RESULTS: Thoracic and occipital regions were the most vulnerable zones. Increasing of collagen tissue was the most detected inflammatory change. CONCLUSION: This experimental model can be used for inducing subpial and leptomeningeal inflammations and it maybe developed for investigations of pathogenesis of leptomeningitis during systemic infections.Öğe Factor X Deficiency Presenting with Bilateral Chronic Subdural Hematoma(Karger, 2010) Senturk, Senem; Guzel, Ebru; Bayrak, Aylin Hasanefendioglu; Bukte, Yasar; Guzel, AslanFactor X deficiency is a rare coagulation defect that can result in several hemorrhagic manifestations including central nervous system hematomas in infants and children. In this case report, we present computed tomography (CT) and magnetic resonance (MR) imaging findings of bilateral chronic subdural hematomas due to factor X deficiency. Cranial CT and MR imaging in a hypoactive 7-month-old male infant with right hemiparesis revealed bilateral chronic subdural hematomas at different stages. Laboratory findings showed a severe factor X deficiency, with a level of 0.7%. After fresh frozen plasma replacement, the patient was operated and the large hematoma on the left side evacuated. The patient recovered uneventfully and remained asymptomatic during the 1-year follow-up. Copyright (C) 2010 S. Karger AG, BaselÖğe Falls from height in childhood in Diyarbakir province: a questionnaire study combined with clinical data(Turkish Assoc Trauma Emergency Surgery, 2009) Guzel, Aslan; Ceylan, Ali; Tatli, Mehmet; Basogul, Mehmet; Ozer, Nuri; Kahraman, Recep; Salcan, TarikBACKGROUND In Diyarbakir, the rate of falls from height increases during summer months since people sleep on the unprotected balconies and roofs of their houses. We aimed to determine the frequency of falls from height and the related risk factors. METHODS We used questionnaire method and clinical data in this study. The questionnaire was administered in 1445 residences. Clinical data were obtained from files of patients hospitalized due to trauma in the Neurosurgery Clinic of Dicle University over the last six years. RESULTS In this questionnaire study, it was determined that 246 people had fallen, their average age was 15.4 years, 98% of them had fallen accidentally (mostly from 3.6 m height in summer months), mortality was 6.9%, and the prevalence of falls from height over the previous six years was 472/100,000. Of 464 patients who were hospitalized during the last six years, 326 were cases of fall from height and 59% of these patients were falls from a roof. The average age of these patients was 8.9 years, and average height of the fall was 4.2 m. CONCLUSION Falls from height, particularly from roofs in Diyarbakir, remain a serious problem in terms of public health.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 Large primary cerebral hydatid cysts in children(Riyadh Armed Forces Hospital, 2006) Tatli, Mehmet; Guzel, Aslan; Altinors, NurHydatid cyst disease in childhood is still a serious health problem in the rural areas of Turkey and other places where the parasite is endemic. The brain involvement rate varies from 1-2% in hydatid disease. Especially in children, hydatid cysts can grow to enormous sizes, and the cases can remain neurologically intact. In this report, a 7-year-old boy, a 15-year-old girl, and a 10-year-old girl, in whom large primary brain hydatid cysts were diagnosed radiologically and treated surgically, are presented. Severe headache in childhood should be taken into consideration carefully in countries where hydatid disease is seen.
