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Copyright of Clinical Neuroscience / Ideggyógyászati Szemle is the property of LifeTime Media Kft. 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.)

Background: Midline closure defect malformation (NTD) is a congenital fusional defect of the posterior segments of spinal vertebrae which is associated with high morbidity and mortality. Fetuin-A, Osteopontin, total antioxidant and oxidant levels are unknown in patients with midline closure defects. In this study, the levels of these parameters in patients with NTD and their relationship with the disease were investigated. Methods: The study included 165 patients (0-5 age group) with OHD (Study group, n = 80) and healthy children of similar age (Control group, n = 85). Patients with OHD were divided into three groups as Spina Bifida Occulta (Group I, n = 22), Spinal Meningocele or Myelomeningocele (Group 2, n = 26) and Hydrocephalus (Group 3, n = 31). One-way Kolmogorov-Smirnov test was used to determine whether the distributions were normal or not. Ki-square, student t test, Mann-Whitney U test and Kruskal-Wallis variance tests were used in the comparisons between the groups. Total antioxidant status (TAS) and total oxidant status (TOS) were measured spectrophotometrically. Oxidative stress index (OSI) was calculated with the ratio of TOS to TAS. Results: TAS levels were similar between patient and control groups (p = 0.230). TOS and OSI levels were higher in patients, and fetuin-A and osteopontin values were higher in the control group (for all, p <0.05). TAS levels were similar between patient groups, however, TOS, fetuin-A, osteopontin values were significantly different (p <0.05 for all). The levels of TOS, OSI and Fetuin-A were decreasing steadily from group I to III, whereas osteopontin levels were the highest in the group I and the lowest in the group 2. Conclusion: OHD closure defect occurs during intrauterine period. In the embryogenesis stage, it is a malformation which results in inadequate closure of the midline spinal cord because of inadequate development of neural tissue from the ectodermal layer and because of inadequate development of the bone and skin from the mesodermal layer which surrounding the spinal cord. This insufficient closure can occur anywhere in the neural tube. They require biological and chemical active substances to complete the histogenesis and organogenesis of the neural tube. Therefore, it is thought that TOS, OSI, Fetuin-A and Osteopontin values may play a role during embryological development of OHD patients. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress may induce brain injury. Thiols are one of the most important antioxidant agents, and thiol/disulphide (SH/SS) homeo stasis is a novel oxidative stress marker. The goal of the study was to investigate the relationship of thiol levels and SH/SS homeostasis with head trauma in pediatric patients. Methods: This prospective study was conducted in 85 consecutive pediatric patients aged < 18 years with isolated head trauma and 58 age- and gender-matched healthy controls in the Emergency Department (ED). Results: The mean age was 4.40 ± 3.03 years for the patient group and 4.75 ± 1.81 years for the controls (p > 0.05). There were no significant differences in biochemical parameters including serum albumin, urea, alanine aminotransferase, total bilirubin, uric acid, high-sensitivity C-reactive protein (hs-CRP), and white blood cells (WBC) in the patient and control groups (for each, p > 0.05). The thiol (SH) level was significantly higher in the patient group than in the controls (388.83 ± 51.949 vs. 369.04 ± 37.62 µmol/L; p = 0.009). The total thiol (TT) level was somewhat higher in the patient group, but the difference was not significant (416.11 ± 47.29 vs. 405.08 ± 35.27 µmol/L; p = 0.113). The disulphide (SS) level was lower in the patient group (p < 0.001). The SS/SH and SS/TT ratios were significantly lower in the patient group, while the SH/TT ratio was significantly higher (p < 0.001). Conclusions: Analysis of serum thiol levels and SH/SS homeostasis might be useful in order to determine the head trauma in pediatric patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Osteoporosis / Turk Osteoporoz Dergisi 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.)

Copyright of Journal of Harran University Medical Faculty / Harran Üniversitesi Tıp Fakültesi Dergisi is the property of Harran University Medical Faculty 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.)

Desmoplastic infantile gangliogliomas are very rarely encountered, large supratentorial masses, derived from neuroepithelial origin, which have cystic and solid components and contain cells with astrocytic and ganglionic differentiation. These tumors are benign tumors of childhood that become symptomatic when they reach giant sizes. Sixty cases of desmoplastic ganglioglioma have been reported to date. In the present study, a case of giant desmoplastic infantile ganglioglioma in a 22-month-old patient is presented, which had an aggressive radiological appearance in the midline and presented with atypical symptoms. [ABSTRACT FROM AUTHOR]

Desmoplastic infantile gangliogliomas are very rarely encountered, large supratentorial masses, derived from neuroepithelial origin, which have cystic and solid components and contain cells with astrocytic and ganglionic differentiation. These tumors are benign tumors of childhood that become symptomatic when they reach giant sizes. Sixty cases of desmoplastic ganglioglioma have been reported to date. In the present study, a case of giant desmoplastic infantile ganglioglioma in a 22-month-old patient is presented, which had an aggressive radiological appearance in the midline and presented with atypical symptoms. [ABSTRACT FROM AUTHOR]

Background and Purpose:

Syringomyelia is a neurological condition in which a longitudinal fluid-filled cavity is formed within the spinal cord. It usually occurs in the cervical region and is associated with Chiari malformation, infections, trauma, and tumors of the spinal cord. However, syringomyelia associated with cervical disc disease (SCD) is very rare and only a few cases have been reported so far. This case report presents the clinical and radiological findings of 13 cases of SCD to describe the properties of SCD and explore the nature of the relationship between syringomyelia and cervical disc disease.

SCD was diagnosed in 13 using MRI findings, including coexistence of syringomyelia and cervical disc disease, presence of narrowed cervical subarachnoid space secondary to the cervical disc herniation or cervical local kyphosis associated with cervical disc degeneration or herniation, and the cervical disc herniation or segmental kyphosis and syrinx should be located within the same levels. The MRI findings were used to grade the syrinx and determine whether the cervical disc herniation or local kyphosis was located at the proximal or distal end of the syrinx.

All patients had single-level disc herniation or kyphosis, the most common level being C5&ndash;6 (n = 6), followed by C6&ndash;7&nbsp;(n = 4) and C4&ndash;5 (n = 3). Eight patients had a distal type (disc disease located in the proximal end of the syrinx) SCD while five had the proximal variety (cervical disc disease located in the distal end of the syrinx). The average length of the syrinx was two vertebral segments. Surgery was performed in five cases and some degree of syrinx resolution was observed in all of them.
Discussion &ndash; The main cause of syringomyelia is obstruction of cerebrospinal fluid (CSF) pathways; total obstruction could cause distal syrinx, whereas partial obstruction could cause proximal or distal syrinxes. Restoration of CSF pathways may result in some degree of resolution of syringomyelia. A causal association may exist between cervical disc disease and cervical syringomyelia but needs further exploration.

SCD is a mild form of syringomyelia with symptoms primarily arising due to disc herniation or local kyphosis. The surgical treatment of the cervical disc disease is sufficient and results in a syringomyelia resolution of some degree.

Aortic dissection is an acute lethal cardiovascular condition. A 67-year-old hypertensive woman was admitted to our Emergency Department with an abrupt onset of tearing pain in the interscapular area. A thoracic computed tomography scan with contrast showed chronic type B aortic dissection. The patient was transferred to intensive care and medical therapy was initiated. Upon spread of the pain to the lumbar area, the dissection was thought to have progressed. The patient, being hemodynamically stable, was examined using ultrasonography, and the dissection did not show any progression. In the neurological examination for the lumbar pain, the lumbar processus spinosus was found to be sensitive, and the sciatic nerve stretch test was positive at 30 degrees. Magnetic resonance imaging revealed spondylolisthesis and a centrally located disc herniation at the L3-4 level. No operation for the dissection was planned, but discectomy and fusion surgery was scheduled. Since the patient refused surgery, she was discharged with medical therapy. Our aim in this report was to emphasize the importance of spondylolisthesis mimicking the progression of dissection in the differential diagnosis of a chronic type B aortic dissection case.

Introduction: Encephalocele, midline defect of cranial bone fusion, occurs most frequently in the occipital region. Airway management in pediatric patients with craniofacial disorders poses many challenges to the anesthesiologist. The purpose of this study is to describe the airway problems encountered for such cases, and describe how these problems were managed., Materials and Methods: We reviewed the charts of occipital encephalocele newborn that were treated by surgical correction in Harran University Hospital during 2006-2008. The collected data were categorized into preoperative, intraoperative, and postoperative data., Results: The mean age of the patients was 5.17 days. Of these 17 patients, eight patients (47.1%) had hydrocephaly, one patient (5.8%) with Dandy Walker syndrome. Micrognathia, macroglossia, restriction in neck movements were recorded as the reasons in six cases each. No major anesthetic complication was found., Conclusions: We reported perioperative management in 17 occipital encephalocele infant. Comprehensive care during peroperative period is essential for successful outcome.

Intradural disc herniation is a serious and rare complication of intervertebral disc rupture. The preoperative diagnosis of intradural disc herniation is still difficult despite new neuroradiologic investigation possibilities including computerized tomography and magnetic resonance imaging and it is usually diagnosed by during surgery. Here we present an intradural disc herniation case at the level of L1-L2 with accompanying significant myelopathic neurologic deficits. A 50-year-old female patient was admitted to the hospital with pain and weakness in both legs. Her neurological examination revealed paraparesis. Magnetic resonance imaging showed an extruded disc hernia of central localization at the L1-L2 level. She underwent total laminectomy at the level of L1-L2 and her intradural disc fragment was extirpated by microsurgical methods.

Cavernous malformations are benign vascular lesions of the central nervous system that lack intervening normal brain parenchyma. They can be seen almost anywhere that normal vasculature is available. Lesions are raspberry-like, thin-walled vascular sinusoids without smooth muscles containing hemosiderin deposits. Cerebral cavernous malformations are characterized by small bleedings. Their size varies from a few millimeters to 2- 3 centimeters. Giant cases are rare. Also referred to as cavernoma, these lesions rarely lead to intracerebral hematomas that threaten life. In this report, we have presented a 14-year-old patient with a giant cavernoma leading to a life-threatening massive intracerebral hematoma.