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Eser, Olcay (Balikesir Author), BACKGROUND: Symptomatic lumbar intervertebral disc herniation (LDH) is rare in children and adolescents. To date, the treatments available for child and adolescent LDH, and the effect of each treatment, have not been fully reviewed. OBJECTIVE: The purpose of this retrospective study is to report the etiology, familial history, presenting symptoms, level of herniation, duration of symptoms, radiological findings, as well as treatment methods and outcome. METHODS: We retrospectively reviewed medical records of all patients with inclusion criteria of being younger than 20 years. (10'19 years); we used magnetic resonance imaging (MRI) to confirm lumbar disc herniations between 2013 and 2016. All patients were followed up for a minimum of 12 months and discharged if they remained almost asymptomatic for 6 months. All patients were treated conservatively and 6 patients they have progressive neurological deficit and persistent back pain, were treated with surgical procedures. The Visual Analogue Scale (VAS), as well as the Oswestry Disability Scale (ODS) and the modified Ashworth Scale (AS) were used to analyze physical examination findings both before and after treatment. To detect lumbar disc degeneration, we used the modified Pfirrmann grading system with MRI. All statistical analyses were performed with commercially available SPSS 15.0 software, while p ≤ 0.05 was considered statistically significant. RESULTS: A total of 70 cases with lumbar disc herniation have been treated. The mean age was 17.14 ± 2.15 years (range 9'19 years). The male to female ratio was 35:35. The mean duration of symptoms was 7.21 ± 1.69 months. The follow-up duration was 17.31 ± 4.17 months. The most common level was L4'5 in 38 (54%) patients and the second was L5-S1 in 24 (34%) patients. Subligamentous protruded discs were found in 42 (60%), extruded in 6 (9%), and disc bulge with intact annulus in 22 (31%) cases. VAS before treatment was 6.05 ± 0.83, while at 6 months after treatment it was 3.1 ± 0.6. However, at the first-year examination, VAS was 2.17 ± 0.76. The ODS was indexed before treatment 42.03 ± 3.75, at 6 months being 25.01 ± 2.75 and at the first year 9.92 ± 2.67. VAS and the OSD were both significantly decreased after treatment (p < 0.05). CONCLUSIONS:Either conservative or surgical methods can be performed comfortably for adolescent lumbar disc herniations. We proposed surgical treatment for patients with incapacitating persistent low back pain or radicular pain that lasted more than 6 weeks, despite rest and medication. We also pursued the development of neurological deficits, including recurrent pain that disturbed routine life activities.

Hydatid cyst (HC) disease is a zoonotic disease caused by the larvae of Echinococcus granulosus. We report our experience of treating HC manifesting aggressive characteristics. Between January, 2010 and December, 2013, 40 patients underwent surgery for HC disease in our department. The subjects of this study were six patients whose disease followed an aggressive and invasive clinical course. The HC disease in these patients involved the vertebrae, chest wall, mediastinum, diaphragm, and lung, with destruction of the lung. There were four men and two women, with a mean age of 47 years (range 12–81 years). Treatment consisted of cystectomy and additional procedures, such as corpectomy and resection of the chest wall, approaching the liver and spleen with phrenotomy and lobectomy. One patient suffered prolonged biliary drainage, and another had a bronchopleural fistula and atelectasis. One patient died of empyema 1 month postoperatively. The mean hospital stay was 9 days. In some patients, HCs can act as an aggressive tumor, involving the surrounding tissues, organs, and even bony structures. Aggressive HCs may cause various sequelae and require extended surgical interventions in addition to cystectomy.

INTRODUCTION Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery. Here, the authors described an endoscopic transseptal subpericondrial hypophysectomy with minimal damage to normal anatomy and physiology and discussed advantages of this technique. METHODS The authors performed endoscopic transseptal subpericondrial hypophysectomy to 2 patients and evaluated intraoperative and postoperative results. RESULTS No complication was noted during surgery or postoperative period with endoscopic transseptal subpericondrial hypophysectomy technique. CONCLUSIONS Endoscopic transseptal subpericondrial hypophysectomy is a safe technique and, requires only a short surgery time and does not require the removal of any physiological tissue or cause any bleeding.

Eser, Betül (Balikesir Author), "AIM: It has been proposed that apoptosis is effective on intervertebral disc degeneration. This study is the first study in which both polymorphisms and expressions of apoptotic genes in patients with intervertebral disc degeneration (IVDD) are evaluated together. The aim of our study is to determine whether polymorphisms and expressions of apoptotic genes involved in both pathways are related with grades of IVDD or not. MATERIAL and METHODS: Blood and tissue samples of 100 patients diagnosed with lumbar disc degeneration were collected. Patients were divided into 2 groups according to their radiological degeneration grades; grade 2 (mild), and grade 3 and 4 (severe). Polymorphisms in Fas (rs 2234767), Bcl-2 (rs 1801018) and Bax (rs 4645878) genes were determined with real-time PCR. Expressions of these genes were analyzed immunohistochemically following histological degeneration scoring.RESULTS: Whereas no relationship was found among polymorphisms of Fas and Bax genes and their expressions, we have determined a relationship among GG genotype of Bcl-2 and their expressions. Additionally, the ratio of Bax-positive cells was related with IVDD grades. Moreover, radiological degeneration grades were compatible with histological degeneration scores. CONCLUSION: GG genotype of Bcl-2 gene may influence the level of its expression and may be effective on the development of IVDD. Additionally, expression of Bax gene may be related with different grades of IVDD.", Research Fund of Balikesir University

A 29-year-old female presented with a brain abscess with subdural empyema in the left parafalcine region caused by Finegoldia magna. There was a partial clinical response to surgery and antibiotic therapy. An acute enfarctus developed after abscess drainage surgery in occipital lobe. We think that infarction developed due to transtentorial herniation and with the mass effect of brain abscess. F magna may be detected in many cases like soft tissue infections, septic arthritis, osteomyelitis, endocarditis and necrotizing pneumonia. Actually this is the first report of brain abscess in which F magna was found upon bacterial culture.

Eser, Olcay (Balikesir Author), Femoral nerve palsy seconder to iliacus hematoma has been rarely reported in terms of blood coagulation abnormalities, either from anticoagulant medications or from hemophilia. The clinical symptoms vary from femoral neuropathy to fatal hypovolemic shock with increased used of anticoagulant agents; femoral nerve palsy subsequent to hemorrhage within the iliopsoas muscle has become a frequent clinical problem. In our case, a 73-year-old male patient presented to hospital with left leg pain and weakness. Lumbar magnetic resonance imaging (MRI) and abdomen computed tomography (CT) showed a left-sided iliopsoas hematoma. An extraperitoneal inguinal incision (Gibson incision) was made. The hematoma was superior of the external iliac artery in the iliopsoas muscle. It was nearly 8 cm deep and was drained and evacuated. After the operation, the left leg pain decreased, and the weakness of left leg improved (3/5).

Background: We aimed to demonstrate the positive effects of the serine protease inhibitor aprotinin on neural ischemia-reperfusion injury and apoptosis in a rat model. Methods: There were 18 rats divided into 3 groups: group A (sham, n = 6), group B (ischemia-reperfusion, n = 6), and group C (ischemia-reperfusion + aprotinin, n = 6). The systolic blood pressure of the group B and C rats was decreased to 40% to 50% of the normal level by taking blood from the femoral vein to develop hemorrhagic shock. The blood was retained and given to the remaining group B and C rats for reperfusion 20 minutes after the procedure. In group B, isotonic solution and, in group C, aprotinin was administered to the rats 5 minutes before reperfusion. After the rats were killed, the brain tissue samples were fixed for histopathologic examination. Brain tissue superoxide dismutase, malondialdehyde, and tissue myeloperoxidase level and apoptotic cell analyses were performed in all groups. Results: Superoxide dismutase level decreased from group A to group B and increased from group B to group C (p < 0.05). Malondialdehyde and myeloperoxidase levels and apoptotic cells increased from group A to group B and decreased from group B to group C (p < 0.05). Conclusion: The results suggest that the systemic use of aprotinin in ischemic neural tissue prevents reperfusion injury and also protects the morphologic, functional, and biochemical integrity of the neural tissue.

In this study, we aimed to delineate the mode of neuroprotective action of FK-506, and demonstrated that FK-506 could decrease oxidative stress and apoptotic cell death in an in vivo rat model of neural ischemia-reperfusion after hemorrhagic shock. Thirty rats were used as experimental subjects and divided into five equal groups. Group A rats (sham group, n = 6) were anesthetized and craniotomies were performed for collecting brain tissue samples. In group B ischemia-reperfusion (I/R + 1 h, n = 6), group C (I/R + 24 h, n = 6), group D (I/ R + 1 h FK-506, n = 6) and group E (I/R + 24 h FK-506, n = 6), systolic blood pressure of the rats decreased to 40–50% of the normal level via bleeding from the femoral vein. Thus, a hemorrhagic shock and ischemic neural tissue model was formed. The bloodwas retained and given to the remaining animals in groups B, C,Dand E via femoral vein for reperfusion 20 min after the procedure. In group D and E, 1 mg/kg FK-506 in 0.5 ml isotonic solution was administered to the rats 5 min before reperfusion. Group B and D rats were sacrificed after 1 h and group Cand E rats were sacrificed 24 h after reperfusion; the rats were sacrificed via bleeding associated with intracardiac puncture. Craniotomy was also performed in groups B, C, D and E and brain tissue samples were fixed using neutral buffered 10% formaldehyde solution for immunohistopathological examination as in group A. Brain tissue superoxide dismutase (SOD) activities, malondialdehyde (MDA) levels, tissue myeloperoxydase (MPO) activities and apoptotic cell analyses with Apo 2.7 immunohistochemically were also performed in all groups. The result of the study revealed that the SOD activities were lower for groups B (I/R + 1 h) and C (I/ R + 24 h) than for group A (sham group) (p < 0.05). In addition, SOD activities were higher in groups D (I/ R + 1 h FK-506) and E (I/R + 24 h FK-506) than in groups B (I/R + 1 h) and C (I/R + 24 h) (p < 0.05). MDA levels, MPO activities and the number of apoptotic cells were lower in group A (sham group) than in groups B (I/R + 1 h) and C (I/R + 24 h) (p < 0.05). In addition to these MDA levels, MPO activities and the number of apoptotic cells were higher in groups B (I/R + 1 h) and C (I/R + 24 h) as compared to groups D (I/R + 1 h FK-506) and E (I/R + 24 h FK-506) (p < 0.05). The results suggest that the prophylactic use of FK-506 in an in situ ischemic neural tissue may prevent reperfusion injury.

Kocatepe University, Faculty of Medicine, Departments of Neurosurgery1, Otorhinolaryngology2 and Pathology2, Afyonkarahisar, Turkey Paranasal sinus osteomas are benign slow growing tumors, occasionally known to cause complications for a long time. Frontobasal extension of paranasal sinus osteoma is an uncommon localization. We present a 20 year-old-man admitted to our clinic with a complaint of pus drainage and wound from forehead for 2 weeks. The radiological images of the patient revealed a mass mimicking osteoma and extending into the frontal sinus and frontobasal area with a chronic infection. The patient was initiated antibiotics for 2 weeks and the mass was extirped through the destructed anterior wall of frontal sinus. The histopathological diagnosis was osteoma and the patient was discharged uneventfully at the 7th day after the operation

Objective: In this article our aim was to emphasize the possibility of development of epidural abscess after repeated injections in a patient into the spinal epidural space. Methods: Lumbar magnetic resonance imaging (MRI) was performed due to worsening of low back pain, inability to walk, fever and sweating. Surgical drainage of the abscess was carried out by bilateral L5 hemi-partial laminectomy. Antibiotic therapy was recommended for two months and neurological examination was normal after 6 months. Results: Two months after repeated injections, the patient was admitted to our clinic with the complaint of low back pain, inability to walk, fever and fatigue. T2-weighted magnetic resonance (MR) examination of the lumbosacral spine showed spinal epidural abscess at L5-S1 level and concomitant intervertebral discitis. Staphylococcus aureus grew on cultures. Conclusion: The frequent use of invasive procedures into the spinal cord such as epidural injections increases the incidence of abscesses whic...

Eser, Olcay (Balıkesir Author), Trauma is a common cause of pneumocephalus, or air in the cranial cavity, and of pneumorrhachis, or the presence of intraspinal air. After spinal surgery, occurrence of pneumocephalus, especially with pneumorrhachis, is extremely rare. We report the case of a patient who developed pneumocephalus and pneumorrhachis after lumbar disc surgery and pedicle screw fixation. There was no cerebrospinal fluid leakage during surgery. On postoperative day 1, the patient complained of headache, nausea, and dizziness. Brain and lumbar computed tomography scans revealed pneumocephalus and pneumorrhachis. With conservative treatment, the patient's complaints resolved within 10 days., yok

Objective: In this study we aimed to investigate the ef­ficacy, long term result and associated complications of Halo Vest treatment for patients with upper cervical spine fractures. Methods: This study included 13 patients (11 men and 2 women) who applied Halo Vest treatment for traumatic upper cervical vertebral fracture between 2006 and 2011. We reviewed the radiological and clinical findings of pa­tients before and after the treatment. Results: Six of 13 patients had odontoid type 3 fracture, 2 patients had odontoid type 2 fracture with C1 type 1 fracture, 2 patients had odontoid type 2 fracture with Jef­ferson fracture, one patient had type 2 hangman fracture and two patients had unclassified C2 corpus fractures. The mean follow-up time with Halo Vest was 14 weeks (10-21 weeks). Ten patients had bone fusion and the mean time of bone fusion was 12 weeks. Conclusions: Halo Vest treatment for upper cervical spine fracture is a safe and effective method but the pa­tients comfort and satisfaction are low. J Clin Exp Invest 2013; 4 (2): 171-174, Amaç: Bu çalışmada üst servikal vertebra fraktürü nede­niyle cerrahi uygulanmayan hastalarda Halo Vest uygu­lamasının etkinliğini, uzun dönem sonuçlarını, eşlik eden komplikasyonlarını ve hasta memnuniyetini araştırdık. Yöntemler: 2006-2011 yılları arasında travma sonrası üst servikal vertebra fraktürü nedeniyle kliniğimizde Halo Vest uygulanan 11\'i erkek 2\'si bayan toplam 13 hasta ça­lışmaya alınmıştır. Hastaların işlem öncesi ve sonrası kli­nik ve radyoljik bulguları da analiz edilmiştir. Bulgular: Halo Vest uygulanan 13 hastanın 6 tanesinde izole odontoid Tip 3 kırığı, 2 tanesinde odontoid Tip 2 ve C1 Tip 1 kırığı, 2 tanesinde odontoid Tip 2 ve Jefferson kırığı, 1 tanesinde Tip 2 asılmış adam kırığı ve 2 tane­sinde de sınıflandırılamayan C2 korpus kırığı mevcuttu. Hastalar Halo Vest immobilizasyon ile ortalama 14 hafta (10-21 hafta) takip edilmiştir. 10 hastada füzyon gelişmiş olup ortalama süre 12 haftaydı. Sonuç: Üst servikal vertebra fraktürlerinde Halo Vest uy­gulaması güvenilir ve etkili bir tedavi yöntemi olmakla bir­likte, hasta konforu ve memnuniyeti düşüktür.

Şimşek, Nejdet (Balikesir Author), PURPOSE: To evaluate the central nervous system toxicity of cisplatin and neuroprotective effect of selenium. METHODS: Twenty-one male Wistar albino rats were divided into three groups: control (C), cisplatin (CS), cisplatin and selenium (CSE, n=7 in each group). Cisplatin (12 mg/kg/day, i.p.) was administered to CS and CSE groups for three days. Furthermore, CSE group received 3mg/kg/day (twice-a-day as 1.5 mg/kg) selenium via oral gavage five days before cisplatin injection and continued for 11 consecutive days. The same volumes of saline were administered to C group intraperitoneally and orally at same time. RESULTS: Heterochromatic and vacuolated neurons and dilated capillary vessels in the brain were observed in the histochemical examinations of cisplatin treated group. Rats that were given a dose of 3mg/kg/day selenium decreased the cisplatin induced histopathological changes in the brain, indicating a protective effect. In addition, cytoplasmic staining of the cell for bcl-2, both cytoplasmic and nuclear staining for bax were determined to be positive in the all groups. Bax positive cells were increased in the CS group compared to C group, in contrast to decreased bcl-2 positivity. CONCLUSION: Selenium limited apototic activity and histological changes due to the cisplatin related central neurotoxicity.

Eser, Olcay (Balikesir Author), Objective : In this study, we aimed to investigate the underlying ethiological factors in chiari malformation (CM) type-I (CMI) via performing volumetric and morphometric length-angle measurements. Methods : A total of 66 individuals [33 patients (20-65 years) with CMI and 33 control subjects] were included in this study. In sagittal MR images, tonsillar herniation length and concurrent anomalies were evaluated. Supratentorial, infratentorial, and total intracranial volumes were measured using Cavalieri method. Various cranial distances and angles were used to evaluate the platybasia and posterior cranial fossa (PCF) development. Results : Tonsillar herniation length was measured 9.09 +/- 3.39 mm below foramen magnum in CM group. Tonsillar herniation/concurrent syringomyelia, concavity/defect of clivus, herniation of bulbus and fourth ventricle, basilar invagination and craniovertebral junction abnormality rates were 30.3, 27, 18, 2, 3, and 3 percent, respectively. Absence of cisterna magna was encountered in 87.9% of the patients. Total, IT and ST volumes and distance between Chamberlain line and tip of dens axis, Klaus index, clivus length, distance between internal occipital protuberance and opisthion were significantly decreased in patient group. Also in patient group, it was found that Welcher basal angle/Boogard angle increased and tentorial slope angle decreased. Conclusion : Mean cranial volume and length-angle measurement values significantly decreased and there was a congenital abnormality association in nearly 81.5 percent of the CM cases. As a result, it was concluded that CM ethiology can be attributed to multifactorial causes. Moreover, congenital defects can also give rise to this condition.

The aim of this study is to investigate the putative neuroprotective effect of alpha-lipoic acid (LA) on spinal ischemia/reperfusion (I/R) injury in rabbits.Thirty-five adult female New Zeland rabbits, weighing 2,000-3,500 g (mean: 2,800), were divided randomly into five groups of seven rabbits each (n: 7) as Group 1: sham, only laparotomy; Group 2 (İ/R): I/R; Group 3 (LA): I/R and 100 mg/kg of LA; Group 4 (MP): I/R and 30 mg/kg of methylprednisolone (MP); and Group 5 (LA + MP): I/R and 100 mg/kg of LA plus 30 mg/kg of MP.A statically significant effect of LA, MP, and LA plus MP on lowering malondialdehyde levels both in the blood and in the cerebrospinal fluid (CSF) has been observed. Nitric oxide is significantly decreased in the blood and spinal cord tissues, and also in the CSF but it is not significant. Superoxide dismutase, catalase, and glutathione levels were increased by LA administration.LA exhibits antioxidant efficacy in spinal cord I/R injury, but it cannot decrease the oxidative stress. The histopathological result of the present study also demonstrated that LA has neuroprotective effect in spinal cord injury.

Objective: Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

The aim of this study was to investigate whether enhanced stimulation voltage could be a predictor of the extent of injury in acute compressive peripheral nerve trauma.The femoral nerves were exposed on both sides, in 11 anesthetized rabbits. Supramaximal stimulation voltage was used to produce a maximal-amplitude compound muscle action potential (CMAP) from the quadriceps femoris muscle. Afterward, the left femoral nerve was clipped for 1 minute, and the right femoral nerve for 5 minutes to produce an acute compressive injury. Immediately after removal of the clip, the proximal and distal sides of the clippage site were stimulated by gradually increased voltage until CMAPs were obtained. The same procedure was repeated at the 30th and 60th minutes. The ratio of the CMAP amplitudes obtained from proximal and distal stimulation was measured to establish a classification.The stimulation voltages and amplitudes of the CMAPs before clippage were similar with the after-clippage values obtained from distal stimulation (p0.05), but the after-clippage values obtained from proximal stimulation were different in both sides (p0.05). Doubled stimulation voltage was enough to obtain CMAPs on the left side, but eightfold the initial level was required on the right side. The amplitude ratios recovered to preinjury levels in all of the subjects on the left side, but only two showed recovery on the right side (p0.001). Histopathologically, there was axonal compression without discontinuity on the left side, whereas the fibers were dispersed on the right side.Stimulation voltage was found to discriminate the severity of the lesion in experimental peripheral nerve injury. Proximal to distal amplitude ratio seems to be a prognostic factor when the injury is less severe.

Tuberculous osteomyelitis of the spine is most commonly seen in lower thoracic and lumbar vertebrae. Cervical spine tuberculosis is a very rare condition, and it represents a very small part of all patients with Pott's disease. We present a case with thoraco-cervical Pott's disease, with left-sided neck mass and left arm and hand weakness and numbness. The patient had a paraspinal abscess under the sternocleidomastoid muscle that was compressing the brachial plexus.

A 45-day-old infant presented with a rare case of intracerebral hematoma complicated with brain abscess which developed after vitamin K deficiency. He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma. He started to suffer convulsions. The patient underwent surgery. A brain abscess was discovered with an intracerebral hematoma. The intracerebral hematoma and abscess were evacuated and antibiotic therapy was initiated. Convulsions became rare and were controlled with midozalam administration. Follow-up computed tomography after 6 months showed encephalomalacic changes in the temporoparietal area. If feeding depends only on human milk, the amount of vitamin K prophylaxis given to neonates should be increased to support vitamin K related factors.

AIM: The aim of this study is to determine the structural changes of electromagnetic waves in the frontal cortex, brain stem and cerebellum. MATERIAL and METHODS: 24 Wistar Albino adult male rats were randomly divided into four groups: group I consisted of control rats, and groups II-IV comprised electromagnetically irradiated (EMR) with 900, 1800 and 2450 MHz. The heads of the rats were exposed to 900, 1800 and 2450 MHz microwaves irradiation for 1h per day for 2 months. RESULTS: While the histopathological changes in the frontal cortex and brain stem were normal in the control group, there were severe degenerative changes, shrunken cytoplasm and extensively dark pyknotic nuclei in the EMR groups. Biochemical analysis demonstrated that the Total Antioxidative Capacity level was significantly decreased in the EMR groups and also Total Oxidative Capacity and Oxidative Stress Index levels were significantly increased in the frontal cortex, brain stem and cerebellum. IL-1 beta level was significantly increased in the EMR groups in the brain stem. CONCLUSION: EMR causes to structural changes in the frontal cortex, brain stem and cerebellum and impair the oxidative stress and inflammatory cytokine system. This deterioration can cause to disease including loss of these areas function and cancer development. Turkish Neurosurgery Society Scientific Research Committee This study was supported by the Turkish Neurosurgery Society Scientific Research Committee. The authors alone are responsible for the content and writing of the paper.

Eser, Olcay (Balikesir Author), Kronik subdural hematom genellikle erişkin hastalığı olmakla birlikte çocuklarda nadirdir.Bu yazıda 9 yaşında erkek hastada futbol oynarken kafasına top çarpmasına bağlı gelişen araknoid kist ile ilişkili kronik subdural hematom olgusunu sunduk. Mental durum değişikliği veya nörolojik bozukluk gözlenmedi.Tek burr hole ile hematom drenajı yapıldı. Bir hafta sonra, hasta saçlı deride şişlik şikayetiyle kliniğimize başvurdu. Fizik muayenede verteksten başlayan subkütanöz fluktuasyon mevcuttu. Yazarlar kronik subdural hematomun ameliyat sonrası döneminde gelişen nadir bir komplikasyonunu ve araknoid kist ile ilişkili spora bağlı kronik subdural hematom olgusu bildirmektedir., Chronic subdural hematoma is predominantly a disease of the elderly and is rare in children. We report here a rare case of chronic subdural hematoma associated with arachnoid cyst in a 9-year-old child due to ball struck to his head while he was playing football. No altered mental state or focal neurological deficits were observed. The hematoma drainage was performed with one burr-hole. One week later, the patient was admitted to our clinic with complaint of scalp swelling. Physical examination revealed subcutaneous fluctuation beginning from the vertex. The authors reported a case of sports related chronic subdural hematoma in association with arachnoid cyst and a rare complication of subdural hematoma during postoperative period.

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by anterior and lateral ossification of the vertebral body. We present a case report of central cord syndrome in a patient with DISH after minor trauma. The patient was treated surgically. We also discuss symptomatology and the common mechanism of cord injury in DISH.

Intradural disc herniations, which comprise between 0.1% and .1% of all disc herniations, are very rare [1]. Intraradicular disc erniation was first described in 1984 and only 21 cases have een reported since then [1–6]. This is a rare condition that canot be diagnosed preoperatively and can cause failed back surgery. ntraradicular lumbar disc herniation is generally diagnosed during urgery. In this report, we present the case of a 43-year-old female atient who had severe lower back and left leg pain. Lumbar magetic resonance imaging (MRI) showed an extruded disc fragment ompromising the dural sac at the L1–L2 level. This is the first case f intraradicular lumbar disc herniation at the L1–L2 level to be escribed in the literature.

We investigated the protective effects of avocado/soybean unsaponifiables (ASU) on the prefrontal cortex (PFC) after global brain ischemia/reperfusion (I/R) injury in rats.Rats were randomly divided into three experimental groups as follows: Group I was control rats, Group II was ischemia rats, Group III was Isch + ASU rats. Brain ischemia was produced via four-vessel occlusion model. These processes followed by reperfusion for 30 min for both II and III groups. Rats were sacrificed and their brains were removed immediately. Malondialdehyde (MDA) and superoxide dismutase (SOD) were measured in left PFC, levels of TNF-α concentration were measured in the plasma. The number of apoptotic neurons was assayed in histological samples of the right PFC.MDA and TNF-α levels as well as the number of apoptotic neurons were observed to have decreased significantly in Group III compared to Group II, while SOD activities have been found to have increased significantly in Group III in comparison to Group II, significantly.We think that ASU might have an antioxidant and neuroprotective effects in brain I/R injured rats.

The aim of this experimental study was to investigate the possible protective effect of dexmedetomidine (DEX) on traumatic spinal cord injury (SCI). Twenty-two New Zealand rabbits were divided into three groups: sham (no drug or operation, n = 6), Control [SCI + single dose of 1 mL saline intraperitoneally (i.p), after trauma; n = 8] and DEX (SCI + 1 microg/kg dexmedetomidine in 1 mL, i.p, after trauma, n = 8). Laminectomy was performed at T10 and balloon angioplasty catheter was applied extradurally. Four and 24 h after surgery, rabbits were evaluated by an independent observer according to the Tarlov scoring system. Blood, cerebrospinal fluid (CSF), tissue samples from spinal cord were taken for biochemical and histopathological evaluations. After 4 h of SCI, all animals in control or DEX treated groups became paraparesic. On the other hand, 24 h after SCI, partial improvements were observed in both control and DEX treated groups. Traumatic SCI leads to increase in the lipid peroxidation and decreases enzymatic or nonenzymatic endogenous antioxidative defense systems. Again, SCI leads to apoptosis in spinal cord. DEX treatment slightly prevented lipid peroxidation and augmented endogenous antioxidative defense systems in CSF or spinal cord tissue, but failed to prevent apoptosis or neurodeficit after traumatic SCI. Therefore, it could be suggested that treatment with dexmedetomidine does not produce beneficial results in SCI.

WOS: 000244192200010, PubMed: 16598483, Botulinum toxin (BTX) is a potent neurotoxin produced by Clostridium botulinum and has wide usage in different areas. The current study aimed to analyze the effects of C. botulinum toxin on the central nerve system in chick embryos. Forty fertile Hubbard Broil eggs, all at Stage 8 of development, were divided into four equal groups: Group 1 embryos (n=10), the control group, were explanted and grown for 18 h in a nutrient medium (thin albumin). Group 2 embryos (n=10) were grown in medium containing 5 U BTX, Group 3 embryos (n=10) in a medium containing 10 U BTX and Group 4 embryos (n=10) in medium containing 20 U BTX. After the incubation period, 80% of Group 1 and 2 embryos and 90% of Group 3 and 4 embryos had intact neural tubes (P > 0.05). The results of this study suggest that BTX had no additional effect on neural tube development in early chick embryos.

Introduction Ventriculoperitoneal shunt operations are the most common pediatric neurosurgical procedures in the treatment of hydrocephalus. However, ventricular shunting is frequently associated with a wide variety of complications. Umbilical perforation is an extremely rare complication of ventriculoperitoneal shunts. Case report We present an infant with umbilical abscess, meningitis, and umbilical perforation of the distal end of the ventriculoperitoneal shunt, which was placed for congenital hydrocephalus.

We report a rare case in which a metallic foreign object migrated to cervical intervertebral foramina. Only two cases have been reported.Plain films films and Computed Tomography of the cervical spine showed a foraminal metallic object

Objectives An unusual case of hydatid disease is reported. Review of the pertinent literature did not reveal any hydatid disease located simultaneously in both the intracranial and submandibular glands. This is the first case with hydatid disease occurring in both locations at the same time. Study Design The case of an 18-year-old is presented; the symptoms, findings, methods of diagnosis, and our approach for treatment are discussed; and the literature is reviewed. Results The intracranial lesion was completely excised by left-sided frontoparietal craniotomy, and the mass in the right side of the submandibular gland was removed through a submandibular approach at the same session. The intact cyst was completely excised. Histological examination of both lesions confirmed the diagnosis of hydatid cyst by Echinococcus granulosus. Postoperative recovery was uneventful, and the patient was discharged on the seventh day. Conclusions Hydatid cyst should be suspected during the evaluation of cervical masses, particularly in endemic regions. Hydatid disease infestations are best treated with complete excision of the intact cyst.

Case report.We report a rare case of epidural thoracal teratoma in a 7-month-old girl. A total laminectomy was performed via T6–T8 and the lesion was totally excised. Results and discussion. We describe the radiological, surgical and pathological findings in this patient and review the findings in other reported cases.

Six patients received 1 g and six other patients received 2 g of cefoperazone and sulbactam 15 minutes before lumbar disc surgery. Liquid chromatographic analysis of disc tissue revealed that only patients receiving the 2-g dose had mean tissue levels above the minimum inhibitory concentration for Staphylococcus aureus and epidermidis.