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Öğe Bone wax can cause foreign body granuloma in the medulla oblongata(Carfax Publishing, 2004) Ates, Ö; Çayli, SR; Gürses, IBone wax is commonly used in neurosurgical practice as a haemostatic and sealing agent. It is a safe agent, but may lead to adverse effects such as infection, epistaxsis, allergic reaction or foreign body granuloma. There are very few reported cases of the neurological complications of remnant bone wax in the subdural or subarachnoid space. The authors report the case of a foreign body granuloma infiltration through the medulla oblongata due to remnant bone wax in the subarachnoid space after posterior fossa decompressive surgery.Öğe Intraventricular solitary fibrous tumor(Lippincott Williams & Wilkins, 2004) Koçak, A; Çayli, SR; Saraç, K; Aydin, NEOBJECTIVE AND IMPORTANCE: Intracranial solitary fibrous tumours, have described previously, but intraventricular solitary fibrous tumors are extremely rare. We present what is, to our knowledge, the first reported case of solitary fibrous tumor in the third ventricle. CLINICAL PRESENTATION: A 63-year-old man presented with weakness of his lower extremities and headaches. Computed tomography and magnetic resonance imaging of the brain revealed an enhancing mass in the posterior part of the third ventricle. INTERVENTION: The tumor originated from the wall of the left internal cerebral vein and extended to the posterior part of the third ventricle. Nearly total excision was performed via an infratentorial-supracerebellar approach. CONCLUSION: The differential diagnonis of intracranial solitary fibrous tumors includes fibroblastic meningioma, meningeal hemangiopericytoma, neurofibroma, and schwannoma. The differential diagnosis in the present case was greatly helped by the immunohistochemical and ultrastructural findings, along with a disease-free 3.5-year follow-up. These findings are presented with reference to previous.Öğe Is there a clinical correlate to the histological and radiological evidence of inflammation in trans-ligamentous extruded and sequestered lumbar disc herniaton?(Taylor & Francis Ltd, 2004) Çayli, SR; Koçak, A; Alkan, A; Kirimlioglu, HThe pain of lumbar disc herniation is related to direct compression of the nerve root and to the foreign-body inflammatory response to the herniated disc material. In this study, we attempted to identify disc-related inflammation in trans-ligamentous extruded and sequestered lumbar disc herniation using gadolinium-DPTA-enhanced T1-weighted and short-time inversion recovery ( STIR) magnetic resonance imaging. We assessed how these results related to each other, and to patients' clinical status, and to immunohistochemistry findings in disc specimens removed at surgery. Forty-one patients with transligamentous extruded or sequestered disc herniation were investigated clinically and radiologically. Twenty-five patients who did not respond to initial medical treatment or who had progressive neurological deficits underwent discectomy. Specimens of disc material removed during surgery were studied immunohistochemically and inflammatory cell types were identified. The other 16 patients showed good response to treatment, and were given further medical therapy and monitored for a mean of 6.3 months of follow-up. All radiological diagnoses in the operated cases were confirmed at surgery. There were no significant differences among the rates of detection of inflammation by contrast MRI, STIR technique, and immunohistochemistry in the surgical treated cases. In the medically treated cases, the frequency of radiological evidence of inflammation on the initial contrast enhanced T1-weighted and STIR images was similar to the frequency observed on the most recent scans done during follow-up. The study showed that the radiological and immunohistochemical evidence of inflammation in these cases does not correspond with patients' clinical pain profiles over time. It also revealed that STIR and contrast T1W are equally reliable for detecting inflammation in trans-ligamentous extruded or sequestered lumbar disc herniation. In future, studies that focus on physical and chemical mechanisms of pain in lumbar disc herniation in larger series of conservatively and surgically treated patients may clarify the link between inflammation and radicular pain in these types of disc herniation.Öğe Mature spinal teratoma associated with thickened filum terminale -: Case report(Japan Neurosurgical Soc, 2005) Ates, Ö; Çayli, SR; Koçak, A; Alkan, A; Önal, Ç; Usta, UA 30-year-old man presented with an intradural spinal teratoma with thickened filum terminale manifesting as urinary and sexual disturbances, and low back pain persisting for 4 years. Spinal magnetic resonance imaging revealed thickened filum terminale containing a heterogeneously enhanced intradural lesion extending from the L-3 to L-4 levels and in contact with the conus medullaris. The filum terminale was incised and the tumor was totally resected. The histological diagnosis was mature teratoma consisting of three germ cell layers. The patient's complaints had completely resolved 6 months later.Öğe Middle cerebral artery aneurysm associated with Behcet's disease -: Case report(Japan Neurosurgical Soc, 2004) Koçak, A; Çayli, SR; Ates, Ö; Saraç, KA 37-year-old man with Behcet's disease suffered secondary subarachnoid hemorrhage and intracerebral hematoma in the right temporal lobe caused by a ruptured aneurysm of the right middle cerebral artery. The aneurysm was successfully clipped. Aneurysm formation is common in the visceral arteries in Behcet's disease, but extremely rare in the intracranial arteries. Vasculitis may be involved in the etiology of intracranial aneurysms in patients with Behcet's disease.Öğe Post-traumatic early epilepsy in pediatric age group with emphasis on influential factors(Springer, 2006) Ates, Ö; Öndül, S; Önal, Ç; Büyükkiraz, M; Somay, H; Çayli, SR; Gögüsgeren, MAObjective: Posttraumatic epilepsy in the pediatric age group is mostly seen within the first week. An acute posttraumatic epileptic fit, which may induce secondary insults, should be hindered. The aim of the study is to define the risk factors for posttraumatic early epilepsy (PTEE) and the indications for prophylactic therapy. Methods: In this survey, a total of 1,785 pediatric patients-under the age of 16-are studied. The majority of the patients (1,655) were treated in Haydarpa Numune Hospital within the years 1993-1999. The rest, which consists of 130 patients, were treated in Inonu University Turgut Ozal Medical Center between the years 2001 and 2003. The patients were categorized according to age, gender, neurological manifestations, type of trauma, cranial pathology, number and type of epileptic fits, the interval between trauma and convulsion, electroencephalogram findings, and antiepileptic therapy. All these factors were challenged due to their effect on the evolution of PTEE. Results: Only 149 cases had PTEE (8.4%). There was no correlation between gender and the incidence of PTEE. The data showed that 11.7% of the patients at or under the age of 3 (p=0.00072), 30.8% of the patients with severe head injury (Glasgow Coma Scale=3-8; Children's Coma Scale = 3-8; p=0.00000), 19.3% of the patients with depressed skull fractures (p=0.00038), 13.7% of the patients with intraparenchymal hemorrhage (p=0.0000072), and 21.6% of the patients with cerebral edema (p=0.000008) had PTEE. Only 20% of the patients with PTEE had a Glasgow Outcome Scale (GOS) of 3 or less (p=0.0000075). Conclusion: Those patients at or under the age of 3, with severe head injury, cerebral edema, intraparenchymal hemorrhage, or depressed skull fracture, have a higher incidence of PTEE. Moreover, because the GOS of these patients are prone to be worse, antiepileptic therapy in acute stage may be effective in preventing the secondary brain damage.Öğe Spinal epidural abscess caused by brucellosis -: Two case reports(Japan Neurosurgical Soc, 2005) Ates, Ö; Çayli, SR; Koçak, A; Kutlu, R; Önal, RE; Tekiner, ABrucellosis is still an important public health problem in the Mediterranean countries, including Turkey, and is most probably underdiagnosed or underreported. Two rare cases of extradural brucellar granuloma causing spinal cord compression in the thoracic and cervical regions were identified by magnetic resonance imaging. The abscesses were totally excised surgically. Medical treatment was given immediately after diagnosis, but delayed neurosurgical intervention resulted in partial neurological recovery in one patient although the other showed complete neurological recovery. Abscess formation may cause myelopathy due to extradural compression of the spinal cord. Failure to correct this condition may cause irreversible impairment of motor functions. Magnetic resonance imaging should be performed periodically in patients with brucellosis and suspected vertebral involvement to monitor for epidural granuloma formation and prevent extradural cord compression.Öğe Spinal pneumorrhachis(Taylor & Francis Ltd, 2003) Çayli, SR; Koçak, A; Kutlu, R; Tekiner, AThe term pneumorrhachis refers to the presence of air in the spinal canal. There are only a few previously reported cases in the literature. A case of air within the cervical and lumbar subarachnoid spaces, and a second case of air within the cervical subarachnoid space due to traumatic pneumocephalus are presented in this study.Öğe An unusual presentation of neurotuberculosis(Amer Assoc Neurological Surgeons, 2001) Çayli, SR; Önal, Ç; Koçak, A; Onmus, SH; Tekiner, ATuberculosis continues to be a major public health concern, especially in developing countries. Many types of neurotuberculosis have been described, but there is only one previously reported case of subdural empyema caused by tuberculous bacilli. A 1-year-old boy who had been treated for pulmonary tuberculosis was referred to the authors' institution with a diagnosis of right frontoparietal extraaxial abscess formation. Computerized tomography and magnetic resonance imaging revealed an extraaxial abscess with no evidence of calvarial infection. A craniotomy was pet-formed to drain the pus, which was located subdurally. A polymerase chain reaction test yielded positive results, and histopathological examination revealed caseation. Antituberculous treatment was started after a diagnosis of subdural empyema with related neurotuberculosis had been made. At the end of a 12-month course of medical therapy, the patient was well with no evidence of tuberculosis.