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Gliosarcoma is a rare subtype of glioblastoma, IDH wild type. Its characteristic features are a biphasic configuration with mixed glial and mesenchymal components. Here in, we present a rare case of Gliosarcoma that has been operated in our clinic in the last 10 years. Patients with gliosarcoma pathology results were collected from the ones operated in our faculty within 10 years. Patients from all age groups were included in the study. 1 of 11 gliosarcoma cases was described in detail. Seven of the cases were male, while 4 were female. Regarding tumor location, six 6 were located in the right, while 5 were in the left hemisphere. The average survival time of all 11 patients was 11 months. In 6 cases, the initial pathologic diagnosis was gliosarcoma, while in 5 cases, it was glioblastoma, and in the 2nd case, the pathology result was gliosarcoma. Gliosarcomas have a worse prognosis in terms of survival. Clinically, it is not possible to distinguish between glioblastomas and gliosarcomas. Treatment proceeds in the same way. [ABSTRACT FROM AUTHOR]

The cervical segment of an internal carotid artery (cICA) usually has a straight vertical course without any branching. In the present study, variations of the cICA were evaluated based on the three-dimensional volume-rendered neurovascular images. The computed tomography angiography images of 56 patients diagnosed with subarachnoid hemorrhage (SAH) were evaluated retrospectively. Two separate researchers, blinded to each other and clinical information of the patients, evaluated the courses of cICA bilaterally. The variations were classified as tortuosity, kinking, and coiling. A total of 112 cICA segments of 56 patients were evaluated. The cICA variations were present in 21.4% of patients and 17.9% of segments. There was tortuosity in 5 (8.9%) patients, kinking in 4 (7.1%) patients, and coiling in 6 (10.7%) patients. Of 41 patients with aneurysmal SAH, there were a cICA variation in 8 (19.5%) patients. A cICA variation was detected in 4 (26.7%) of 15 patients with idiopathic SAH. The cICA variation ratio in SAH patients was concordant with studies performed in different patient groups. Although the ratio was slightly higher in idiopathic SAH patients, there was no statistical significance between the aneurysmal and idiopathic SAH groups. The coiling was more frequent in SAH patients compared to previous studies. The cICA variations tend to be bilateral in SAH patients. [ABSTRACT FROM AUTHOR]

Without electrocautery, many modern surgical interventions are practically impossible. In neurosurgery, bipolar cautery forceps has been evolved to not only be an auxiliary, but as a principal instrument wielded by the dominant hand of the surgeon to navigate through the most delicate tissue that there is. The purpose of this study is to introduce our original bipolar forceps designed exclusively for microneurosurgical interventions and compare its feasibility with a standard bipolar forceps tip. This study has been conducted on two fresh cadaveric cow brains under the operating microscope. The coagulative and ablative effects of the hemispheric bipolar forceps tip (HBFT) have been histologically compared with those of the standard bipolar forceps tip (SBFT). Likewise, their efficacies as a dissection instruments have been compared via performing dissections from the parietal surface down to the corpus callosum. HBFT proved less traumatic to the uninvolved brain tissue during dissection. Also, histological analyses have revealed that ablative effects of the HBFT are more confined to the bleeding point, more effectively sparing the uninvolved brain tissue. Results of this experimental study suggest that HBFT is a better instrument to be used in microneurosurgical interventions, along with other surgical disciplines where selective diathermy is critical. [ABSTRACT FROM AUTHOR]

Background/aim: The aim of this study was to investigate the possible toxicity of the Ankaferd Blood Stopper (ABS) on the neural system. Materials and methods: Thirty Sprague Dawley rats were randomized into ABS (n: 15) and control (n: 15) groups. Following the anaesthetic induction, total laminectomy was performed to the lower thoracic, and upper lumbar areas in both groups and medulla spinalis was exposed. Two myelotomies were performed on the medulla spinalis. One millilitre ABS was applied to the incision site in the ABS group, and one millilitre 0.9% saline solution was applied in the control group. Rats were observed for 15 days regarding general behaviour, neurological signs, mobility, and signs of infection. Sixteen days later, all rats were decapitated under anaesthesia. Medulla spinalis was removed en bloc from all rats and was stained with Heamatoxylin & Eosin and luxol fast blue. Results: There was no significant difference between the ABS group and the control group regarding oedema, gliosis, the intensity of inflammatory cells, the presence of neuronal degeneration, neuron counts, and myelin degeneration. Conclusion: No clinical or histopathological evidence for the neurotoxic effect of the ABS was observed in the present study. Our findings might precipitate the use of ABS on human subjects regarding medulla spinalis surgery. [ABSTRACT FROM AUTHOR]

Background/aim: Cerebral vasospasm is a term that refers to prolonged, slowly progressing but reversible pathological narrowing of cerebral arteries occurring several days after subarachnoid hemorrhage (SAH), usually accompanied by a decrease in perfusion distal to the affected artery. Leptin is an endogenous polypeptide hormone that can be carried freely and bound to protein in the blood. Materials and methods: We investigated the superiority of topical application of leptin that may make a contribution to the development of new treatment modalities for unconscious patients in brain injury intensive care units and its preventive effect, which is considered to have multifactorial pathogenesis on cerebral vasospasm occurring after SAH via stereological studies of the basilar artery. Results: When mean serum leptin levels of the groups were compared, statistically significant differences were observed between the control and topical leptin-treated groups in favor of the treated groups with respect to serum leptin levels (P < 0.05). In the topical leptin-applied group, a significant difference in favor of vasodilatation was observed in the measurements of the basilar artery luminal area (P < 0.05). Conclusion: In accordance with the results, the topical administration of leptin can be used in the prevention of vasospasm, especially in unconscious patients with subarachnoid hemorrhage. [ABSTRACT FROM AUTHOR]

Background: The primary aim of this study was to investigate the diagnostic values of serum S100 calciumbinding protein B (S100B) and proenkephalin (P-ENK) levels in brain damage caused by traumatic brain injury (TBI). Methods: We prospectively collected serum blood samples of 58 adult patients admitted to our emergency department due to TBI. Serum S100B and P-ENK levels were measured and compared according to clinical findings and outcomes of the patients. Results: When patients with brain injury were compared to controls, statistical significance was determined in both S100B and P-ENK levels. According to the receiver operating characteristic (ROC) analysis, cut-off values for serum S100B and P-ENK levels for the differential diagnosis of patients with and without brain damage were found to be 785.944 ng/mL and 2.445 ng/mL, respectively. There was a statistical significance in both S100B and P-ENK levels when patients who were discharged and those who died were compared. Conclusions: Serum S100B and P-ENK levels are found to be elevated in patients with TBI when compared to controls. Additionally, serum levels of both markers are found to be elevated in patients with multiple lesions when compared to patients with a single lesion. Serum S100B and P-ENK levels may also be used as predictors of mortality in patients with TBI. [ABSTRACT FROM AUTHOR]

This study was aimed at evaluating the potential effects of acute subdural hematoma (ASDH) and diclofenac sodium (DS) therapy following ASDH on the rat hippocampus. Twenty-four male Sprague Dawley rats were used and divided into four groups. 0.1 ml of non-heparinized autologous blood from the tail vein of the animals in the non-treatment group (NTG) and treatment group (TG) was injected into the subdural space. The TG received intramuscular diclofenac sodium at a 15 mg/kg dose daily from the postoperative second hour to the seventh day after the operation. The control group (CG) and sham group (SG) were used for control and sham operations, respectively. On the postoperative eighth day, all animals were sacrificed, and the hippocampi of all animals were stereologically and histologically evaluated. Also blood samples of the animals were biochemically analyzed. As a result of the study, the mean number of neurons in CA1, CA2, and CA3 regions of the hippocampus and the total number of neurons were decreased in the hippocampus samples of the NTG and especially the TG subjects. When comparing the second blood samples, there was no difference between the levels of adrenaline and serotonin among the groups. However, after the operation, noradrenalin levels in the treatment group were found to be higher than those of the sham and control groups (p < 0.05). In the NTG and TG, histopathological findings were observed such as Nissl condensation as well as completely dead and indistinguishable neurons with abnormally shaped, shrunken cytoplasm and nuclei. Also necrotic areas on the specimens of the TG were seen. In immunohistochemical sections, c-FOS positivity was decreased in the NTG and especially the TG. Otherwise, PGC-1α positive cells were increased in the NTG and especially the TG. In this study, it was shown for the first time by means of stereological techniques that using DS after ASDH caused a decrease in the number of hippocampal neurons (CA1, CA2, and CA3 regions). [ABSTRACT FROM AUTHOR]

Introduction: We present a rare clinical condition of concomitant spinal subdural hematoma and cranial subarachnoid hemorrhage (SAH) related to oral anticoagulant therapy. Case Report: In this report, we present the case of a 78 -year- old female who was brought by an ambulance to the emergency department with sudden onset neurological deficit, which was eventually diagnosed as a simultaneous spinal subdural hematoma and SAH. Conclusion: The coagulation profile of patients should be screened in the context of anticoagulant therapy in appropriate or short time periods; an early clinical intervention will result in a greater likelihood of the patient's recovery. [ABSTRACT FROM AUTHOR]

Abstract: Estimation of the cell number after cortical venous ischemia/infarction induced by anterior and posterior anastomotic veins occlusion in a rat model is very important. Twenty male Sprague-Dawley rats were used in this experiment. Small burr-holes were made over the anterior (the crossing point of the line drawn from the posterior border of the orbital rim and the line drawn along the para-midline to the superior sagittal suture) and posterior (just inferior point of the posterior ending of the zygomatic arch) anastomotic veins. Bipolar coagulation technique and micro-scissor were used to sacrifice the venous vessels after final inspection and description. Specimens were evaluated by histopathological and unbiased stereological methods for microscopic evaluation and volumetric analysis, respectively. Significant cell loss was seen in the pyramidal and granule cells of the cornu ammonis and dentate gyrus of the hippocampus after venous ischemia. Cell loss was also pronounced when seen in the histological examination. The present results suggest that the sacrifice of anterior and posterior anastomotic veins can be used as an experimental rat model in the evaluation of pyramidal and granule cell loss in the hippocampus that often assesses the neural damage inflicted by this intervention. [Copyright &y& Elsevier]

The odontoid process of C2 projects upward from the superior roof of the body of C2. There is a confusion about the inferior border of the odontoid. The aims of this clinical study were to describe the inferior border of the odontoid process based on the remnant of dentocentral synchondrosis in adults, and the estimation of the odontoid/body ratio in pediatric and adult ages. Sixty-six cases were included for this study. Forty-four of them were in adult ages and the remaining 22 of them were in pediatric ages. The region of occiput, C1, C2, and C3, was examined with the magnetic resonance imaging (MRI) in all cases. The length of the odontoid process was estimated by using radiological images of MR from the tip of the odontoid to the remnant of dentocentral synchondrosis. The portion located under the level of synchondrosis was considered as the body of C2. The average length of the odontoid was 18. 6 mm in pediatric and 21. 3 mm in adult cases. In adult females, the length of the odontoid process (19. 1 mm in length) was smaller than those of adult males (23. 6 mm in length). The average ratio of odontoid/body was two in pediatric and 1.8 in adult cases. This study demonstrated that the neck of the odontoid segment at the level of superior articulating facets is not the synchondrosis between the odontoid process and the body of C2. The synchondrosis is located well below the level of superior articulating facets. It can be demonstrated with sagittal and coronal images of MR in both of pediatric and adult individuals. [ABSTRACT FROM AUTHOR]