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To elucidate the prognosis, frequency, and diverse nature of pathologies for calvarial tumors among different age groups.Seventy-six patients who underwent surgery for calvarial lesions between January 2007 and March 2021 are included in this study. Clinical data were obtained retrospectively from patients' electronic records. Radiological images and surgical notes are reviewed to determine the extent of the tumor and resection.Among 76 patients, 33 (43.4%) were male and 43 (56.6%) were female. The mean age was 36.0 years (range: 1-81 years) at the time of initial operation. Children consisted 28.9% (n = 22) of the patients. In children, 59.1% (n = 13) had tumor-like pathologies, while 27.3% (n = 6) had benign pathologies, and 13.6% (n = 3) had malignant tumors. In the adult population, 42.6% (n = 23) had malignant tumors, 31.5% (n = 17) had benign tumors, 16.7% (n = 9) had tumor-like pathologies, and 9.2% (n = 5) had intermediate-grade tumors. F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan was performed in 16 patients, 10 cases underwent whole-body bone scintigraphy (WBBS), and 4 cases underwent both. Among these examinations, 16 (80%) of the FDG-PET scans and 5 (35.7%) of the WBBS scans revealed an extracranial pathological lesion. A calvarial tumor was diagnosed in 13 of 18 cases of metastatic lesions (72.2%) before the primary tumor detection.Lesions of the calvarium include malignant tumors, intermediate grade tumors, tumor-like lesions, and benign tumors. These masses may be the first presentation in patients with underlying primary tumors. In our study, the malignant tumor rate in the calvaria was 34.2%, and 72.2% of the metastatic tumors were diagnosed with a calvarial resection before the primary tumor was found. Operating a calvarial lesion and making an early diagnosis is crucial for the treatment of the primary lesions.

Background: Neuroenteric cysts (NCs) are benign, rare congenital lesions which are most commonly found in the lower cervical and upper thoracic segments. Even though these are benign lesions, it may present with fatal neurologic deterioration particularly in pediatric patients. Case Report: We here report a 16-year-old boy who has unique manifestation with acute tetraplegia and respiratory arrest in emergency room. According to English literature, this is the first case of cervicomedullary intradural neuroenteric cyst which causes acute tetraplegia and respiratory arrest in a child. Conclusion: The NCs can be manifested with unpredictable, life threating clinical presentation. The exact pathophysiology of an acute neurological deterioration is still unclear, however prolonged latent period with minor symptom should be considered carefully in child population.

Objective To study the microsurgical anatomy of the occipital artery (OA) to determine the optimal segment for use as a conduit in revascularization bypass surgery. Methods Twelve sides of 6 cadaveric heads that had been injected with colored silicone were exposed using C-shaped postauricular incision. The OA was dissected from its point of origin to the proximal part of the distal segment. For each segment, the diameters and length were measured, and its branches and proximity to the recipient vessel (V3) were examined. Results The mean diameters were 2.6 mm at the digastric segment, 2.04 mm at the point where it exits the mastoid sulcus, 2.0 mm, at the point just before the last descending muscular branch, and 1.8 mm and 1.5 mm after the branch and attached to the superior nuchal line, respectively. The length of the OA from the point where it exits the mastoid sulcus to the point at which it revealed the last descending muscular branch was 53 mm, and the distance of this section to the V3 was 31 mm. Conclusions In pathologies necessitating vertebral artery revascularization surgery, it is possible to easily mobilize the OA with a C-shaped postauricular incision in the lateral suboccipital region. To reach a more appropriate segment in terms of diameter, length, and easy anastomosis, V3 sulcal and OA suboccipital segments are more suitable. Thus, if bypass surgery is indicated in cases of vertebrobasilar ischemia, the suboccipital segment of the OA may be an ideal choice and considered as an artery that can be used in “SOS” conditions.

Objective The main aim of this study placed on cadavers was to compare the data related to geniculate ganglion (GG) dehiscence and dimension obtained from computed tomography (CT) with dissection values. Methods This study was conducted on 20 temporal bones obtained from 10 cadavers (4 female, 6 male) aged between 45 and 92 (71.50 ± 15.98) years. All the measurements related to GG dimension were performed with a CT scanner and microdissection. Results The size of GG including its area, length, and width did not show statistically significant differences in terms of sex, side, and assessment method (CT and cadaveric dissections). The dehiscent GG was observed in 6 (30%) and 5 (25%) out of 20 temporal bones in CT and cadaveric dissections, respectively. The presence and absence of GG dehiscence in CT and dissection were similar in 75%. Conclusions Our findings based on dissection data suggest that radiologic evaluation of dehiscent GG detection might be erroneous by 25%, which highlights that surgeons should be careful when lifting the dura to prevent GG injury during middle cranial fossa surgical approaches. On the other hand, there was no statistical difference between CT and dissection measurements related to GG dimension.

Cerebellar liponeurocytoma (CLN) is a very rare tumor of central nervous system, classified as glioneuronal tumor by the latest classification of World Health Organization (WHO) in 2016. There are limited data in the literature about biologic behavior, growth pattern and radiological features of this tumor. In this case report, we operated a big calcified CLN patient who had denied any surgical procedures suggested by an another institute and had been followed for 4 years.

The painful torticollis only itself may be a major sign for the diagnosis of Grisel’s syndrome (GS). It is known as an inflammatory atlantoaxial rotatory subluxation following upper respiratory tract infections (URTI) and surgical otolaryngological procedures. The analysis of 16 pediatric GS patients were reviewed retrospectively by considering the diagnosis, the treatment modality, and the prognosis at the Department of Neurosurgery and Otorhinolaryngology in Mersin University, Faculty of Medicine between 2008 and 2018. In addition to the clinical cases, five cadavers were used to demonstrate atlantoaxial region, particularly the ligamentous complex and articulation of the atlas-axis, for the mechanism of these rare entities. The most common etiological factor of GS was URTI with 81.25% among 16 patients. Painful torticollis was the primary symptom of pediatric patients at admission. The X-Ray, computerized tomography (CT), and magnetic resonance imaging (MRI) investigations were used for the definitive diagnosis in the first week of admission, except one. No morbidity, mortality, and deformity were reported in this series. Early diagnosis is the principle of GS for avoiding of permanent neck deformity and complex surgical procedures. If GS can be diagnosed without any doubt by only considering patient’s history and clinical examination, CT scan is not recommended due to harmful effects of radiation. The treatment was achieved by reduction, external fixation under analgesia, or sedoanalgesia accompanying with antibiotic and anti-phylogistic treatment.

This study was designed to investigate the effects of bipolar and mononopolar electrocauterization on peripheral nerve tissue. The comparison on the deleterious effects of the different cautery modalities and the importance of probe tip placement are evaluated using electrophysiological, electron microscopic and biochemical assessment parameters. Ninety-eight male Wistar albino rats, each weighing 250–275 g, were randomly divided into 14 groups. Each group consisted of seven animals. Monopolar and bipolar electrocautery were performed at 15 watts. The application was performed either directly on the nerve or 1 mm lateral to the longitudinal axis of the nerve for ‘near the nerve groups’, respectively. The electrophysiological findings showed that the mean amplitudes were at the lowest value in the first day for all the groups. At the end of the 3rd week, we recognised that the electrophysiological recovery continued. Electron microscopic evaluation showed myelin disruption in all groups. Myelin disruption of healthy neurons was at the highest level in the 1st day of application in accordance with the electrophysiological findings. Biochemical evaluation revealed statistical significance between the control and the two of the ‘near the nerve groups’ (GIII and GV) for NO (nitrite and nitrate) serum level. The data of the present study might suggest that electrocautery, independent of the type and form of application, may result in significant damage in histological and electrophysological basis. Although the relative proportions cannot be ascertained, the time course of recovery suggests that both axon and myelin damage have occurred. The probable electrocautery damage may be of substantial importance for the situation that the nerves are displaced by tumor masses or atypical neural traces.

A skin patch composed of an electrospun nanofibrous membrane of a highly hygroscopic polymer, encasing a reversibly packaged antigen and adjuvant cocktail, promises a practical alternative to the current vaccine strategy. The proposed system would utilize the high density of antigen presenting (APC) cells found within the layers of human skin to elicit a vast adaptive immune response. The amount of contact between patches and skin has been said to directly affect the efficiency of load delivery. Incorporation of the immunogens often requires use of aqueous solvents associated with the beads-on-the-string morphology formation, which hinders the high surface area to volume ratio afforded by the electrospun membranes. The long-term goal of this research is to optimize the solution and process parameters to maximize the surface interaction with the skin for improved delivery of immunogens. In this study we attempt to utilize a novel method of morphology control through employment of the electrospinning process pausation. The scanning electron microscopy (SEM) examination indicated that stopping the electrospinning process at different intervals and for various durations impacts the generated morphology. The findings indicate that the surface area to volume ratio for the three-dimensional nonwoven membrane can be maximized through utility of process pausing.