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Copyright of Konuralp Medical Journal / Konuralp Tip Dergisi is the property of Duzce University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Endoscopic third ventriculostomy (ETV) has become the method of choice in the treatment of hydrocephalus. Age and etiology could determine success rates (SR) of ETV. The purpose of this study is to assess these factors in pediatric population.Methods: Retrospective study on 51 children with obstructive hydrocephalus that underwent ETV was performed. The patients were divided into three groups per their age at the time of the treatment: < 6, 6-24, and > 24 months of age. All ETV procedures were performed by the same neurosurgeon.Results: Overall SR of ETV was 80% (40/51) for all etiologies and ages. In patients < 6 months of age SR was 56.2% (9/16), while 6-24 months of age was 88.9% (16/18) and > 24 months was 94.1% (16/17) (p = 0.012). The highest SR was obtained on aqueductal stenosis. SR of posthemorrhagic, postinfectious, and spina bifida related hydrocephalus was 60% (3/5), 50% (1/2), and 14.3% (1/7), respectively. While SR rate at the first ETV attempt was 85.3%, it was 76.9% in patients with V-P shunt performed previously (p = 0.000).Conclusions: Factors indicating a potential failure of ETV were young age and etiology such as spina bifida, other than isolated aqueductal stenosis. ETV is the method of choice even in patients with former shunting. Fast healing, distensible skulls, and lower pressure gradient in younger children, all can play a role in ETV failure. Based on our experience, ETV could be the first method of choice for hydrocephalus even in children younger than 6 months of age. [ABSTRACT FROM AUTHOR]

Our study was conducted to compare structural changes of brain exposed to 500 mg/kg valproic acid sodium (VA) at 10 days of gestation and 2×600 mg/kg VA at 9 days of gestation for Chiari-like malformation (CLM). Brains, each still in the cranium, were placed under the dissecting microscope in such a way that the midsagittal surface for angular morphology was seen, and video images were recorded for both study groups. Distances and angles in each brain were then measured on video image photographs both manually and by means of a computer. The vertebral arch distances following exposure to 500 mg/kg VA at 10 days of gestation were measured. VA on day 9 of gestation group was not followed by significantly different angular morphology or point-to-point distances from those in fetuses exposed to saline. In contrast, the angle formed between the frontal pole and cerebellum at the pons is more -acute in animals treated with VA 500 mg/kg on day 10 of gestation than in controls, but the distances were not reduced. However, the group exposed to VA 500 mg/kg on day 10 of gestation appeared to have sustained only minimal effects on the vertebral arch distances; specifically, spina bifida aperta was not produced in this group. These analyses may indicate that the anterior neural tube is more sensitive to the mechanism of action by which VA produces neural tube defects (NTDs) than is the posterior neural tube. Also, we can conclude that in these rat models, experimental CLM does not correspond to the Chiari malformation (CM) type 2. An animal model has its own species specificity and teratogenic environment, and the embryopathogenesis of NTD in the experimental animal model may not be directly applicable to the human condition. [ABSTRACT FROM AUTHOR]

Aim: Ultrasonic surgical aspirators are surgical instruments operated with high frequency sound waves. The brain and/or spinal cord tumors can be removed safely with minimal damaging to neurovascular structures by using tissue-selective ultrasonic aspirators. Besides its benefits to the patient, by shortening the duration of operation, it may also provide cost savings in terms of hospital management. The aim of this study is to evaluate the utility and feasibility of ultrasonic aspirator in central nervous system tumors. Material and Methods: Forty patients who apply to the Department of Neurosurgery at Duzce University Medical Faculty between March 2013 and September 2017 due to brain or spinal cord tumor and operated for a brain or spinal cord tumor were included. Ultrasonic aspirator was used during the operations, and duration of operations were recorded. Results: The total operation time was compared between the groups that their operations performed by using ultrasonic aspirator and by not using it. The mean operation time was significantly higher in the group performed operations by using ultrasonic aspirator (253.8±87.5, 195.4±48.7, p=0.014). Whereas ultrasonic aspirator usage did not change the duration of operation in patients with glioblastoma (237.8±56.3, 235.5±31.9, p=0.689). Conclusion: Technological instruments, that become a part of surgical treatment, are devices that ensure maximum efficiency with minimum damage. However, these devices require prior training on how to use them. Training of healthcare staff in the use of ultrasonic aspirator is very important. Further studies are needed following the training of the assistant healthcare staff in this subject. [ABSTRACT FROM AUTHOR]