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Chiari malformation (CM) is characterized by herniation of the cerebellar tonsil(s) and/or medulla oblongata into the spinal canal, resulting in various morphometric abnormalities. The current study aimed to evaluate the magnetic resonance imaging (MRI) findings and morphometric features of the craniocervical region in patients who underwent surgery for CM. Demographic and radiological data were collected from 59 patients who underwent surgery for CM and a control group of 58 randomly selected nonsurgical patients. For between-group comparisons, Continuous variables were described as the mean (±SD) or median (IQR) and categorical variables as frequency (%). The mean age of the control group participants was 33.38 years. The mean age of patients in the CM group at the time of surgery was 33.83 years. The diameter of the foramen magnum, the maximum anteroposterior diameter of the C1 vertebra, the maximum diameter of the spinal canal at the C2 vertebra, and the atlantodental interval were all positively correlated with the total cerebellar tonsil length [r=0.54, 0.37, 0.42, 0.71]. Comparisons of total cerebellar tonsil length with other morphological and clinical variables, including contact between the brainstem and clivus, basilar invagination, preoperative hydrocephalus, remnant cartilage between the odontoid and C2 corpus, and associated craniovertebral junction anomalies, revealed no other significant correlations. CM is associated with many structural anomalies in the brain. However, there is relatively little detail in the existing literature on the morphometric parameters associated with the malformation. The findings of this study provide insights for future research and contribute to knowledge of the morphometric features of CMs in general and CMs in patients requiring surgical management in particular. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Study Design: The retrospective analysis of intramedullary hemangiopericytomas (HPCs) was performed, and the entity was discussed in accordance with the literature findings. Purpose: This study aimed at defining distinctive characteristic features of intramedullary HPC with respect to surgical approach and prognosis. Overview of Literature: Intramedullary HPCs are extremely rare tumors. They originate from capillary pericytes, supposedly follow the vessels over the spinal cord, and infiltrate deep into the spinal cord without a distinct plane. Their treatments and prognosis are not well-defined in the literature. Methods: Our database was retrospectively reviewed for the cases of HPCs. Later on, a literature search was performed to reveal all reported cases of intramedullary HPCs. The following key words were searched in PubMed databases: "hemangiopericytoma and intramedullary," "hemangiopericytoma and spine (spinal) and intradural," and "hemangiopericytoma and spinal cord." The articles were reviewed for patients' demographics features, imaging characteristics, tumor-specific factors (surgical technique, pathological descriptions, and world health organization grades), and postoperative course and prognosis (adjuvant therapies, recurrences, complications, and mortalities). Results: A total of seven patients (three male and four female) was reached, with their ages ranging from 15 to 80 years (mean, 32.5 years). The tumors were located majorly in thoracic region (5/7, 71.4%), and only two cases were in the cervical region (2/7, 28.6%). All tumors were completely removed, and only two cases received radiotherapy. No recurrence was reported. Conclusions: Complete resection of the intramedullary HPCs seems to be the best management strategy for long-term and recurrence- free survival and in alleviating further need for radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Intracranial subdural hematomas (SDH) are quite rare complications of spinal anesthesia and epidural analgesia (SA/EA). Characteristics of the incident in obstetric patients were investigated. Methods: The PUBMED database was searched for three sets of key words: "subdural hematoma and spinal anesthesia", "subdural hematoma and epidural analgesia", "pregnancy and subdural hematoma and epidural anesthesia". The literature findings and our clinic series was reported. Results: The study reached at 26 obstetric cases between the age of 17 and 46 years (mean: 30.7 years). The majority of the patients (65.3%) were giving their first children. There were (34.7%) acute, (23%) sub-acute and (42.3%) chronic cases. Bilateral SDH was seen in 50% of epidural, 30.7% of the total cases. Patients, giving vaginal delivery, were more prone to have acute and sub-acute hematomas (61.5%), compared to Cesarean Section (CS) (53.8%). The mean duration of diagnosis was 379 hours. Patients managed conservatively in 42.3% of the cases. 3/9 of acute cases could be treated conservatively. Patients had favorable outcomes in 88.4%. Conclusions: Delayed diagnosis incurring patients at risk and high level of suspicion and vigilance were needed particularly in patients with headache lasting more than 5 days or nonpostural in character, associated with neurological findings. [ABSTRACT FROM AUTHOR]

Aim: To compare endovascular and surgical treatment methods for cerebral aneurysms focusing on mortality., Material and Methods: The study included 187 patients who had undergone aneurysm treatment. The patients were divided into four groups according to their treatment modality and subarachnoid hemorrhage status: patients with endovascular treatment and bleeding aneurysms (EVG-b), patients with endovascular treatment and non-bleeding aneurysms (EVG-nb), patients with surgical clipping and bleeding aneurysms (SCG-b), and patients with surgical clipping and non-bleeding aneurysms (SCG-nb). The Hunt?Hess scores, Fisher grade, aneurysm morphology, and length of stay (LOS) were compared between groups., Results: There was no significant difference in the mortality rate between EVG-b and SCG-b at the end of the first year (23.5% and 39.7%, respectively; p > 0.05). A significantly shorter LOS was observed in EVG-b than in SCG-b (11.5 days and 15 days, respectively; p=0.027). Fusiform aneurysms were associated with higher patient mortality, whereas saccular aneurysms were associated with a 1.9-fold higher survival (p=0.037; 95% confidence interval: 0.83?4.74). The rate of closure of non-bleeding aneurysms was 93.4%. Complete embolization was verified in all bleeding aneurysms. In EVG-nb, the morbidity rate was 5%, the mortality rate was 3%, and the mean LOS was 2.86 days., Conclusion: Both treatment methods showed similar mortality rates, but hospital stays were shorter after endovascular treatment.

The diagnostic spectrum for scalp lesions is extensive and comprises either benign or malignant features. Cornu cutaneum (CC) is a well-recognized condition; however, its origin and natural course are not always obvious. We present the case of a 78-year-old male patient who was diagnosed with intracranial meningioma in 2014 and who subsequently refused treatment. He presented a new scalp lesion, resembling a horn, in the vertex region 1.5 years after his last follow-up. The lesion was excised, and the patient was histopathologically diagnosed as having CC caused by squamous cell carcinoma. CC can be easily recognized when it resembles animal horn; however, it can assume different shapes that require a physician to be vigilant. Moreover, a lesion’s benign or malignant nature is not obvious in all cases. Hard, protruding scalp lesions should be examined for CC, and a histopathological evaluation should be performed to make a definitive diagnosis.

Background: Injuries caused by motorcycle accidents have been reported in several studies with an examination from a general trauma point of view. However, to our knowledge, there is no detailed study specific to central nervous system injuries. This research was focused on central nervous system injuries associated with motorcycle accidents., Methods: The medical records of 540 patients who were admitted to the emergency department between 2008 and 2016 as the result of a motorcycle accident were retrospectively evaluated. Data were collected from electronic medical records, follow-up forms, and radiological images. Information on patient age, gender, type and site of injury, helmet use, alcohol level, Glasgow Coma Scale score on admission, length of stay in the intensive care unit and hospital, neurological status on discharge, and follow-up was collected and analyzed., Results: A total of 486 of 540 patients (90%) were male, 54 (10%) were female, and the mean age was 31+-18 years (range: 2-85 years, median: 25 years). Cranial injuries were detected in 320 cases (59%). The distribution of cranial injuries was: epidural hemorrhage (12.6%), subdural hemorrhage (15.2%), depressed fracture (10.4%), linear fracture (23%), skull base fracture (5.5%), diffuse axonal injury (9.3%), subarachnoid hemorrhage (25.2%), intracerebral hemorrhage (13.5%), and contusion (26.3%). Spinal fractures were detected in 52 cases (9.6%). Twenty-two (4.07%) of the spinal fractures were observed in the cervical region, 10 (1.85%) in the thoracic region, and 20 (3.7%) in the lumbar region. The mean length of stay in the hospital was 8.2+-4 days and 7 days in the intensive care unit. Sixty-eight patients (12.6%) died. Traumatic cranial entities other than linear fracture were associated with an elevated level of mortality. A Glasgow Coma Scale score of 6 or less was associated with significant mortality (68%)., Conclusion: A detailed report of motorcycle accident-associated central nervous system injuries is provided. The use of protective equipment, such as helmets, significantly reduced the rate of cerebral injury and death.

Aim: To compare the results of lumbar puncture (LP) and shunt tapping in pediatric patients with suspected ventriculoperitoneal shunt infection., Material and Methods: Medical records of pediatric patients with suspected shunt infections were retrospectively analyzed. All patients had cerebrospinal fluid samples obtained either via shunt tapping, LP or both. The diagnosis of infection was made when at least one cerebrospinal fluid had positive culture results. The patients with negative cerebrospinal fluid culture results were followed up for at least 6 months to monitor the occurrence of central nervous system infection., Results: There were 20 patients in the study (12 males, 8 females). Cerebrospinal fluid was obtained by shunt tapping in 11, by lumbar puncture in 9 and by both methods in one patient. Thirteen patients [ Shunt tapping: 5/11 (45%), LP: 7/9 (78%), Both: 1) ] were diagnosed with shunt infection on the basis of cerebrospinal fluid culture. Seven patients with negative cerebrospinal fluid culture were found to have infections unrelated to shunts and did not show evidence of cerebrospinal fluid infection during the follow-up period. Although the percentage of detecting the infection was higher in LP group, both groups showed negative predictive value of 100%., Conclusion: Both shunt tapping and LP are effective in establishing the diagnosis of shunt infection in suspected patients.