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Introduction: In this study, it was aimed to determine OX40 gene expression level on pathology sections obtained from PA tissues, and the level of circulating OX40L in peripheral blood samples of patients. Furthermore, it was aimed to evaluate the findings depending on the type, histopathological, and immunohistochemical features of the tumor. Methods: The study was conducted with two groups (Study/Control). The study group (Group 1) consisted of patients (n=49) operated with the diagnosis of PA. The control group (Group 2) is the brain tissue samples obtained from patients (n=10) who underwent temporal lobectomy for the and treatment of epilepsy due to mesial temporal sclerosis. Results: We found out that the tissue OX-40 gene expression levels of patients with PA did not differ from the gene expression levels of the control group. There was no statistically significant difference was found as a result of the comparison of pituitary ox40-tissue parameter measurement value with patient finding characteristics. Discussion and Conclusion: PAs have altered cell behavior and epigenetic modifications that lead to various prognostic patterns and responses to treatment. As the disease progresses, up-and down-regulation of immune factors promotes the interaction between the immune system and tumor cells. Thus, it serves as a potential target for new diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Objective: In this study, we will present you a series of lumbar disc herniation (LDH) cases of pediatric age that we had operated using the microdiscectomy method. Methods: Nine pediatric patients who underwent surgical treatment with microdiscectomy with the diagnosis of LDH by a single surgeon between July 2013 and December 2018 were followed up for approximately 1 year postoperatively, and postoperative low back and leg pain was evaluated with visual analog scale (VAS) score, and operation satisfaction at 1 year was evaluated with MacNab criteria. Results: The mean age in our study was 14.6. In our study, five patients were operated from L4-5, four patients from L5-S1. The mean of preoperatif VAS was 8.00±0.70, while the mean of postoperatif VAS was 2.00±0.86. The difference between VAS scores was statistically significant (p=0.007). According to the MacNab score in all of our patients, recovery was evaluated as well and excellent. Conclusion: Microdiscectomy is a safe and effective treatment for pediatric LDH. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and reliability of microscopic bilateral decompression with unilateral laminectomy in geriatric lumbar spinal stenosis (LSS) patients and to compare the results with the younger patients. Methods: LSS patients who underwent micro-bilateral decompression with a unilateral approach (BiDUA) between May 2015 and June 2019 at (blinded) were retrospectively reviewed. Patients demographic characteristics, pre- and postoperative clinical and radiological features, pain scores and surgical details were evaluated. They were also grouped according to their age to compare the surgical efficacy and reliability in different age groups. Results: Fifty seven patients were included in our study. There were 28 males and 29 females. Mean age was 65.75±8.96 (46-82). Thirty one (54.4%) patients were 66 years or older. All patients complained of lower back pain and exhibited neurogenic claudication. Twenty nine patients (50.9%) received single-level, whereas 28 patients (49.1%) required double-level surgery. All patients's neurogenic claudication-improved postsurgery. Nine patients experienced postoperative complications (5 dural injuries, 3 superficial wound infections and 1 cerebrospinal fluid fistula). There were statistically significant differences in both back pain and leg pain following surgery. However, there were no statistically significant differences in either visual analog scale back pain or leg pain scores between the age groups. Conclusion: Although the surgical treatment of LSS involves greater risks in elderly patients, we found no statistically significant difference in the complication rate between age groups following micro-BiDUA, which supports the efficacy and safety of micro-BiDUA for elderly patients. [ABSTRACT FROM AUTHOR]

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Background: Subdural empyemas (SDEs) are rare intracranial infections mostly secondary to sinusitis. Incidence of SDEs is 5-25%. Interhemispheric SDEs are even rarer, which makes their diagnosis and treatment difficult. Aggressive surgical interventions and wide-spectrum antibiotics are needed for treatment. In this retrospective clinical study, we intended to evaluate the results of surgical management supported by antibiotics in patients with interhemispheric SDE., Methods: Clinical and radiological features, medical and surgical management and outcomes of 12 patients treated for interhemi-spheric SDE have been evaluated., Results: 12 patients were treated for interhemispheric SDE between 2005 and 2019. Ten (84%) were male, two (16%) were female. Mean age was 19 (7-38). Most common complaint was headache (100%). Five patients were diagnosed with frontal sinusitis prior SDE. Initially, three patients (27%) underwent burr hole aspiration and ten patients (83%) underwent craniotomy. In one patient both were done in the same session. Six patients were reoperated (50%). Weekly magnetic resonance imaging and blood tests were used for follow-up. All patients received antibiotics for at least 6 weeks. There was no mortality. Mean follow-up period was 10 months., Conclusion: Interhemispheric SDEs are rare, challenging intracranial infections that have been related to high morbidity and mor-tality rates in the past. Both antibiotics and surgical interventions play role in treatment. Careful choice of surgical approach and repeated surgeries if necessary, accompanied by appropriate antibiotic regimen, leads to good prognosis reducing morbidity and mortality.

Background: Supratentorial midline epidural hematoma is rare but challenging in diagnosis and management. Indication for surgery can arise even following hospital admission. Being familiar to the presentation and watching out for direct and indirect signs on axial computed tomography (CT) such as suture diastasis or fracture traversing midline are essential to plan multi-planar CT enabling exact diagnosis including form and mass effect of hematoma., Methods: Nine patients with midline epidural hematoma including two pediatric patients underwent surgery between 2013 and 2018. Pre-operative and post-operative patient status, radiological features, and surgical technique were analyzed., Results: Four patients had deteriorating consciousness levels and two patients had paraparesis. All had fractures traversing midline and epidural hematomas with significant mass effect. They were operated through separated craniotomies around the midline and midline bone strip was used for dural tenting and as support for natural closure of bone flaps. No post-operative complications were developed. All patients were discharged with Glasgow Outcome Score of 5., Conclusion: Because of the rarity of the lesion and small number of patients, definitive conclusions may be misleading but we think that, in experienced hands, midline epidural hematomas can safely be operated on and, preservation of midline bone strip pro-vides easier bleeding control.