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Öğe Brain metabolite changes on proton magnetic resonance spectroscopy in children with poorly controlled type 1 diabetes mellitus(Springer, 2005) Sarac, K; Akinci, A; Alkan, A; Aslan, M; Baysal, T; Özcan, CThe metabolite changes in the brains of children with poorly controlled type 1 diabetes mellitus (DM) were investigated by proton magnetic resonance spectroscopy (MRS). A total of 30 subjects and 14 age-matched healthy volunteers underwent single-voxel MRS (TE: 136). The duration of disease, medication, presence of hypoglycaemia episodes and the level of haemoglobin A1C (HbA1C) in the patients were noted. Voxels were placed in the pons, left basal ganglion (LBG) and left posterior parietal white matter (PPWM). N-acetylaspartate (NAA)/creatinine (Cr) and choline (Cho)/Cr ratios were calculated. The average HbA1c level was 11.9 +/- 3.4 (8.2-19.4). The average number of keto-acidosis episodes was 1.9 +/- 2.2 (0-9) and the average number of daily insulin injections was 2.8 +/- 0.97 (2-4). MRS revealed lower NAA/Cr and Cho/Cr ratios in the pons and lower NAA/Cr ratio in the PPWM of patients with DM than in control subjects. No significant correlation was observed between the number of hypoglycaemia episodes and metabolite ratios. Metabolic abnormalities have been observed by MRS in the brain of poorly controlled type 1 DM children. These metabolic changes, in particular in the pons region, include a decrease in NAA, indicating neuronal loss or functional impairment, and likely explanations for a decrease in Cho may be dynamic changes in membrane lipids and/or decreased membrane turnover.Öğe Brain MR spectroscopy in children with a history of rheumatic fever with a special emphasis on neuropsychiatric complications(Elsevier Sci Ireland Ltd, 2004) Alkan, A; Kutlu, R; Kocak, G; Sigirci, A; Emul, M; Dogan, S; Aslan, MPurpose: To investigate whether there are metabolite changes in basal ganglia of children with complete healing of rheumatic fever (RF), history of Syndenham chorea (SC) and obsessive compulsive-tic disorder (OCTD) developed after RF when compared with healthy controls and each other. Material and methods: A total of 49 children with history of RF and 31 healthy controls were included into the study. All patients and control group underwent a detailed neuropsychiatric evaluation. Children with the history of RF were classified into-three groups as; group 1: with history of RF without neuropsychiatric complications (NCRF), group 2: only with history of SC (HSC), group 3: with HSC and OCTD (OCTD). After MR imaging, single voxel MR spectroscopy was performed in all subjects. Voxels (15 x 15 x 15 mm) were placed in basal ganglia. N-acetyl aspartate (NAA)/creatin (Cr), and choline (Cho)/Cr ratios were calculated. Results: OCTD were detected in 13 children with HSC. NAA/Cr ratio was found to be decreased in these children when compared with NCRF (n:29), HSC without OCTD (n:7) and control groups (n:3 1). No significant difference was found in metabolite ratios of children with HSC without OCTD when compared with NCRF and control groups. There were no significant differences in Cho/Cr ratio between patient and control groups. Conclusion: Although MR imaging findings was normal, MR spectroscopy findings (decreased NAA/Cr ratio) in our study support the neuronal loss in basal ganglia of children with OCTD and could indicate the development of permanent damage. (C) 2003 Elsevier Ireland Ltd. All rights reserved.Öğe Cerebral diffusional changes in the early phase of anthrax: Is cutaneous anthrax only limited to skin?(W B Saunders Co Ltd, 2006) Karakas, HM; Bayindir, Y; Firat, AK; Yagmur, C; Alkan, A; Kayabas, UObjectives. Characteristics of cerebral diffusion in the acute period of the anthrax infection were investigated to understand the pathophysiology of the disease. Methods. Six cutaneous anthrax patients (mean age: 33.3, SD: 18.1) and six healthy control subjects (mean age: 33.7, SS: 19.6) were examined at the acute phase of the infection with diffusion weighted imaging on 1.5 T scanner. ADC values were measured from five different cerebral locations. T-tests, Logistic regression and ROC curves were used. Results. Anthrax patients were significantly different than controls regarding cortical ADC values (p < 0.05). Logistic regression model accurately classified five out of the six anthrax cases (83.3%). A cut-off value of 574 mm(2)/s x 10(-3) was found by using ROC curve coordinates. A sensitivity of 100% and a specificity of 67% were attained by means of this value. Conclusions. This study shows the existence of cerebral parenchymal. changes at microstructural. level in cutaneous anthrax without neurological findings. These changes are possibly related to the components of the toxin. Our results support the general but unproven opinion that anthrax treatment does not change the existence and the effects of the toxin. Pathophysiological. mechanisms towards classification should therefore be reviewed. (c) 2005 The British Infection Society. Published by Elsevier Ltd. All rights reserved.Öğe The cisternal segment of the abducens nerve in man: three-dimensional MR imaging(Elsevier Sci Ireland Ltd, 2004) Alkan, A; Sigirci, A; Ozveren, AF; Kutlu, R; Altinok, T; Onal, C; Sarac, KPurpose: The goal of this study was to identify the abducens nerve in its cisternal segment by using three-dimensional turbo spin echo T2-weighted image (3DT2-TSE). The abducens nerve may arise from the medullopontine sulcus by one singular or two separated rootlets. Material and methods: We studied 285 patients (150 males, 135 females, age range: 9-72 years, mean age: 33.3 +/- 14.4) referred to MR imaging of the inner ear, internal auditory canal and brainstem. All 3D T2-TSE studies were performed with a 1.5 T MR system. Imaging parameters used for 3DT2-TSE sequence were TR:4000, TE:150, and 0.70 mm slice thickness. A field of view of 160 mm and 256 x 256 matrix were used. The double rootlets of the abducens nerve and contralateral abducens nerves and their relationships with anatomical structures were searched in the subarachnoid space. Results: We identified 540 of 570 abducens nerves (94.7%) in its complete cisternal course with certainty. Seventy-two cases (25.2%) in the present study had double rootlets of the abducens nerve. In 59 of these cases (34 on the right side and 25 on the left) presented with unilateral double rootlets of the abducens. Thirteen cases presented with bilateral double rootlets of the abducens (4.5%). Conclusion: An abducens nerve arising by two separate rootlets is not a rare variation. The detection of this anatomical variation by preoperative MR imaging is important to avoid partial damage of the nerve during surgical procedures. The 3DT2-TSE as a noninvasive technique makes it possible to obtain extremely high-quality images of microstructures as cranial nerves and surrounding vessels in the cerebellopontine cistern. Therefore, preoperative MR imaging should be performed to detect anatomical variations of abducens nerve and to reduce the chance of operative injuries. (C) 2003 Elsevier Ireland Ltd. All rights reserved.Öğe Clinical significance of N-acetyl-L-aspartate resonance in ovarian mucinous cystadenoma(Lippincott Williams & Wilkins, 2006) Hascalik, S; Celik, O; Sarac, K; Alkan, A; Mizrak, BMagnetic resonance spectroscopy (MRS) provides a noninvasive measurement of the biochemistry of living tissue. We report spectroscopy analysis of a 26-year-old woman affected by right ovarian lesion diagnosed as mucinous cystadenoma. MRS was performed by the point-resolved spectroscopy technique with a long echo time (TE) (136 msec). MRS measurements were performed on the two distinct component of the right ovarian tumor. The classification of metabolite peaks area in this study was performed according to the technique described by Okada et al. The features of proton MRS studies are discussed. As well as strongly elevated lactate and N-acetyl-L-aspartate signals, the tumor spectrum showed lipid resonances. Proton MRS imaging may be helpful for the investigation of the underlying pathophysiology of ovarian mucinous cystadenomas.Öğe Comparison of MRI graded cartilage and MRI based volume measurement in knee osteoarthritis(E M H Swiss Medical Publishers Ltd, 2004) Baysal, O; Baysal, T; Alkan, A; Altay, Z; Yologlu, SObjectives: The aim of this study was to investigate the relationship between the femoral, tibial and patellar cartilage volume and MRI grading of the articular cartilage in patients with knee OA. Methods: Articular cartilage volumes of 65 postmenopausal women were determined by processing images acquired in the sagittal plane using a fast spin echo proton density-weighted sequence. The articular cartilages were divided into 5 compartments including lateral and medial tibial, lateral and medial femoral and patellar compartments. The articular cartilages were graded using a modified Outerbridge classification. Grade 0 indicated intact cartilage, grade 1 chondral softening with normal contour, grade 2 superficial fraying, grade 3 surface irregularity and thinning and grade 4 full thickness cartilage loss. The grades of articular cartilage were compared with cartilage volume measurements. Results: In medial femoral cartilage, grade 1 had more volume compared to grade 0 cartilage (p: 0.017). In medial tibial cartilage, grade I had more volume compared to grade 0 and grade 2 cartilage (p: 0.045 and p: 0.027, respectively). In patellar cartilage, grade I cartilage had significantly more volume than grade 0 cartilage (p: 0.007). In lateral tibial and femoral cartilages, no significant difference was observed between grade 0 and grade 1 cartilage. Conclusions: Cartilage volume correlates well with MR grading of articular cartilage. The higher the grade of the cartilage the less the volume, with the exception of grade 1 lesions. Grade 1, reflects oedema in the cartilage and has a conflicting effect on volume measurement. The combination of MRI based volume measurement and grading of articular cartilage may provide an accurate method for the non-invasive evaluation and follow-up of articular cartilage.Öğe Delayed myelination in a rhizomelic chondrodysplasia punctata case: MR spectroscopy findings(Elsevier Science Inc, 2003) Alkan, A; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Sarac, KRhizomelic chondrodysplasia punctata is a member of genetic peroxisomal disorders. Delayed myelination, which is probably related to the inadequacy of plasmalogens biosynthesis, is an important feature of this disorder. Direct assessment of neuropathologic aspects of RCDP syndrome such as neuronal degeneration and delayed myelination is possible with MR spectroscopy. In this report, MR spectroscopy findings (decreased Cho/Cr and increased Ins-Gly/Cr ratios and increased levels of mobile lipids) of a rhizomelic chondrodysplasia punctata case supporting delayed myelination are presented. This is the second report of MR spectroscopy examination of the specific brain metabolic changes associated with rhizomelic chondrodysplasia punctata. (C) 2003 Elsevier Science Inc. All rights reserved.Öğe Doppler waveforms and blood flow parameters of the superior and inferior mesenteric arteries in patients having Behcet disease with and without gastrointestinal symptoms -: Preliminary data(Amer Inst Ultrasound Medicine, 2003) Sigirci, A; Senol, M; Aydin, E; Kutlu, R; Alkan, A; Altinok, MT; Yologlu, SObjective. To evaluate hemodynamic changes in mesenteric arteries in patients with Behcet disease with and without gastrointestinal symptoms. Methods. Doppler sonography of mesenteric arteries was performed in 25 symptomatic and 15 asymptomatic patients having Behcet disease and in 25 healthy control subjects. The peak systolic, minimal, and mean velocities, resistive and pulsatility indexes, inner diameter, cross-sectional area, and blood flow volume of mesenteric arteries were evaluated. The results were compared between patient groups and controls. Results. The mesenteric artery flow was significantly greater in patients in the symptomatic group than in those in the asymptomatic group or in controls. In the superior mesenteric artery, mean velocity and mean blood flow volume (0.35+/-0.18 m/s and 711+/-404 mL/min, respectively; P<.0001) in the symptomatic group were significantly higher than in the asymptomatic group (0.16±0.07 m/s and 305±168 mL/min, respectively) or in controls (0.15±0.07 m/s and 290±123 mL/min, respectively). The mean peak systolic velocity (1.23±0.47 m/s; P<.005) in the symptomatic group was significantly higher than in controls (0.93+/-0.23 m/s). In the inferior mesenteric artery, mean velocity and mean blood flow volume (0.25+/-0.10 m/s and 139+/-79 mL/min) in the symptomatic group were significantly higher than in the asymptomatic group (0.16+/-0.07 m/s; P<.006; and 78±26 mL/min; P<.007) or in controls (0.17+/-0.07 m/s; P<.0031; 83±48 mL/min; P<.004). Conclusions. In this study, symptomatic patients with gastrointestinal Behcet disease were associated with a significant increase in mesenteric artery flow that could be evaluated easily on spectral patterns of arteries during Doppler sonography. The Doppler sonographic findings also revealed that intestinal involvement in patients with Behcet disease without gastrointestinal symptoms is not significantly different from that of healthy controls.Öğe Duplication of the abducens nerve at the petroclival region: An anatomic study(Oxford Univ Press Inc, 2003) Ozveren, MF; Sam, B; Akdemir, I; Alkan, A; Tekdemir, I; Deda, HOBJECTIVE: During its course between the brainstem and the lateral rectus muscle, the abducens nerve usually travels forward as a single trunk, but it is not uncommon for the nerve to split into two branches. The objective of this study was to establish the incidence and the clinical importance of the duplication of the nerve. METHODS: The study was performed on 100 sides of 50 autopsy materials. In 10 of 11 cases of duplicated abducens nerve, colored latex was injected into the common carotid arteries and the internal jugular veins. The remaining case was used for histological examination. RESULTS: Four of 50 cases had duplicated abducens nerve bilaterally. In seven cases, the duplicated abducens nerve was unilateral. In 9 of these 15 specimens, the abducens nerve emerged from the brainstem as a single trunk, entered the subarachnoid space, split into two branches, merged again in the cavernous sinus, and innervated the lateral rectus muscle as a single trunk. In six specimens, conversely, the abducens nerve exited the pontomedullary sulcus as two separate radices but joined in the cavernous sinus to innervate the lateral rectus muscle. In 13 specimens, both branches of the nerve passed beneath the petrosphenoidal ligament. In two specimens, one of the branches passed under the ligament and the other passed over it. In one of these last two specimens, one branch passed over the petrosphenoidal ligament and the other through a bony canal formed by the petrous apex and the superolateral border of the clivus. in all of the specimens, both branches were wrapped by two layers: an inner layer made up of the arachnoid membrane and an outer layer composed of the dura during its course between their dural openings and the lateral wall of the cavernous segment of the internal carotid artery. This finding was also confirmed by histological examination in one specimen. CONCLUSION: Double abducens nerve is not a rare variation. Keeping,such variations in mind could spare us from injuring the Vlth cranial nerve during cranial base operations and transvenous endovascular interventions.Öğe Early MRI findings in stab wound of the cervical spine(Springer-Verlag, 2002) Alkan, A; Baysal, T; Saraç, K; Sigirci, A; Kutlu, RMR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings.Öğe Early- and late-state subacute sclerosing panencephalitis: Chemical shift imaging and single-voxel MR spectroscopy(Amer Soc Neuroradiology, 2003) Alkan, A; Sarac, K; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Baysal, TBACKGROUND AND PURPOSE: Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, inflammatory neurodegenerative disease. Our aim was to determine the metabolic abnormalities of brain in early- and late-stage SSPE by using MR spectroscopy and to assess areas of involvement in the early stages when MR imaging findings were normal. METHODS: Children with stage II (n = 3) or III (n = 3) SSPE and 10 healthy, age-matched children underwent MR imaging, multivoxel MR spectroscopy, and short-echo single-voxel MR spectroscopy (SVS). Areas of involvement in the brain were determined with chemical shift imaging. For SVS, 2 x 2 x 2-cm voxels were placed in the frontal subcortical white matter (FSWM) and parieto-occipital white matter (POWM). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, and NAA/Cho ratios were calculated. RESULTS: Comparisons of NAA/Cr, Cho/Cr, Ins/Cr and NAA/Cho ratios between patients and control subjects showed significant differences in FSWM and POWM (P <.0l). In patients with SSPE, NAA/Cr ratios in POWM were significantly less than those in FSWM (P <.0l). NAA/Cr ratios in patients with stage II SSPE and those in the control group were not significantly different; this may reflect the absence of neuronal loss. Decreased NAA/Cr, increased Cho/Cr and Ins/Cr ratios, and increased lactate and lipid peaks were found in patients with stage III SSPE. CONCLUSION: MR spectroscopy showed findings suggestive of inflammation in stage II and findings of demyelination, gliosis, cellular necrosis, and anaerobic metabolism in stage III. MR spectroscopy could be a promising technique for early diagnosis and treatment planning in cases of SSPE.Öğe En-plaque tuberculomas of tentorium in a pregnant woman(Springer-Verlag, 2003) Alkan, A; Parlak, M; Baysal, T; Sigirci, A; Kutlu, R; Altinok, TEn-plaque tuberculoma is a rare manifestation of CNS tuberculosis and presents as a solitary, focal, caseous plaque-like lesion. It is difficult to differentiate en-plaque like meningeal tuberculoma from true primary or secondary meningeal neoplasia. Good response to antituberculosis treatment in a patient with tuberculosis history and typical MR findings confirm the diagnosis. We present the follow-up MR imaging findings of a case in which an enplaque tuberculoma on tentorium was diagnosed during pregnancy in a patient with a history of tuberculosis. To the best of our knowledge, enplaque tuberculomas of tentorium during pregnancy have not been reported before.Öğe Evaluation of the gluteus medius muscle after a pelvic support osteotomy to treat congenital dislocation of the hip(Journal Bone Joint Surgery Inc, 2005) Inan, M; Alkan, A; Harma, A; Ertem, KBackground: Many authors have reported that the pelvic support osteotomy prevents a Trendelenburg gait by restoring the biomechanics of the abductor muscle in patients with congenital dislocation of the hip. However, we are not aware of any studies in which the hip abductor muscles were examined following pelvic support osteotomy. The purpose of this study was, first, to use magnetic resonance imaging to measure alterations in the length and volume of the gluteus medius muscle after pelvic support osteotomy and, second, to determine which factors influence the results of the Trendelenburg test. Methods: Eleven patients with a history of congenital hip dislocation who had been treated with a pelvic support osteotomy were examined clinically with the Harris hip score and the Trendelenburg test, radiographically to measure limb-length discrepancy and valgus angulation of the proximal part of the femur, and with magnetic resonance imaging to measure changes in the gluteus medius length and volume. Results: The pelvic support osteotomy achieved a functional and painless hip in all eleven patients. Five of the eleven patients had a persistently positive Trendelenburg gait at the time of the last follow-up visit, at an average of three years after the osteotomy. The muscle volumes were restored to 43% to 89% of the muscle volumes on the normal contralateral side, and the postoperative muscle volume correlated significantly with the result of the Trendelenburg test (r = -0.63; p = 0.03). There was a positive association between age and the result of the Trendelenburg test (p = 0.01): four of the five patients who had a positive test were at least thirty-one years of age at the time of the operation. There was no correlation between the Trendelenburg test and the change in the length of the gluteus medius muscle, which averaged 19.2 mm in the patients with a positive test and 19.3 mm in those with a negative test. Conclusions: Patient age at the time of the operation and the postoperative change in the volume of the gluteus medius muscle have a significant influence on the result of the Trendelenburg test after a pelvic support osteotomy. Moreover, our study demonstrated that restoration of the muscle volume after a pelvic support osteotomy is not sufficient to prevent a Trendelenburg gait in older patients with congenital dislocation of the hip.Öğe Giant axonal neuropathy: MRS findings(Sage Publications Inc, 2003) Alkan, A; Kutlu, R; Sigirci, A; Baysal, T; Altinok, T; Yakinci, CGiant axonal neuropathy (GAN) is a rare genetic disease of childhood involving the central and peripheral nervous systems. Axonal loss with several giant axons filled with neurofilaments is the main histopathological feature of peripheral nerve biopsies in this disease. Routine neuroimaging studies reveal diffuse hyperintensities in cerebral and cerebellar white matter. In this case report, the authors present the brain magnetic resonance spectroscopic features (normal N-acetylaspartate/creatine and increased choline/creatine and myoinositol/creatine ratios), which might indicate the absence of neuroaxonal loss and the presence of significant demyelination and glial proliferation in white matter, of an 11-year-old boy diagnosed with GAN.Öğe Glutaric aciduria type I diagnosed after poliovirus immunization: Magnetic resonance findings(Elsevier Science Inc, 2002) Alkan, A; Baysal, T; Yakinci, C; Sigirci, A; Kutlu, RGlutaric aciduria type I is an uncommon inborn error of metabolism. It is a serious disease, often with a fatal outcome. Magnetic resonance imaging findings and the clinical course of monozygotic twin females with glutaric aciduria type I who were admitted with acute encephalopathic crisis symptoms 3 days after immunization for poliovirus are presented in this report. Magnetic resonance imaging findings revealed hyper-intensity in the putamen, head of the left caudate nucleus, and globus pallidus, periventricular white matter (on T-2-weighted images), arachnoid cysts in bilateral temporal regions, and enlargement of the sylvian fissures. Glutaric aciduria type I should be included in the differential diagnosis of patients with acute encephalopathic crisis occurring shortly after poliovirus immunization. Typical magnetic resonance findings guide urinary organic acid analysis in these patients. (C) 2002 by Elsevier Science Inc. All rights reserved.Öğe Hallermann-Streiff syndrome associated with complete agenesis of the corpus callosum(Sage Publications Inc, 2005) Sigirci, A; Alkan, A; Biçak, U; Yakinci, CHallermann-Streiff syndrome is a rare clinical entity with unknown etiology characterized by a birdlike face, microphthalmia, a beaked nose, hypotrichosis, and proportional small stature. We present a 4-year-old boy in whom magnetic resonance imaging showed complete agenesis of the corpus callosum, which has not been presented in the literature.Öğe In vivo proton magnetic resonance spectroscopy in the evaluation of the endometrium(Wiley, 2004) Sarac, K; Celik, O; Hascalik, S; Alkan, A; Mizrak, BBackground The purposes of this study were to compare proton magnetic resonance (MR) spectroscopic evaluation of the endometrium with histology obtained by endometrial biopsy in women undergoing diagnostic curettage and to determine whether screening with MR spectroscopy (MRS) might be useful in the evaluation of the endometrium. Methods. Twenty-three consecutive women who were scheduled for endometrial biopsy were included in the study. The women were evaluated by MRS, performed immediately before the endometrial biopsy. The MRS results were compared with the histological findings obtained from the endometrial biopsy. Results. All of the cases were proven by pathological examination, and their diagnoses were secretory endometrium (I I cases), proliferative endometrium (seven cases) and disordered proliferative endometrium (five cases). The characteristically obtained signals of choline (Cho) and lipid were detected in all subjects in the secretory endometrium group. In the same group, eight patients showed lactate signals and six showed creatine (Cr) signals. In the disordered proliferative endometrium group, four patients showed lipid plus Cho signals. Two patients in the same group demonstrated both lactate and Cr signals. All patients in the proliferative endometrium group showed Cho signals, two patients demonstrated lactate plus Cho signals, and none of the patients in this group showed lipid and Cr signals. Conclusion. Proton magnetic resonance spectra can register certain metabolic differences in human endometrium in its different stages.Öğe Infantile Sandhoff's disease: Multivoxel magnetic resonance spectroscopy findings(B C Decker Inc, 2003) Alkan, A; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Sarac, KSandhoff's disease is a rare, genetic lysosomal storage disease leading to delayed myelination or demyelination. Although neuroimaging findings in this disease have been reported previously, magnetic resonance spectroscopy findings have not been reported. In this report, we present magnetic resonance imaging and magnetic resonance spectroscopy features of two cases with Sandhoff's disease. Magnetic resonance spectroscopy revealed findings indicating widespread demyelination in both cases and neuroaxonal loss and anaerobic metabolism in the second case. Magnetic resonance spectroscopy could provide useful information in the explanation of the clinical picture of cases with Sandhoff's disease.Öğe Intraorbital encephalocele: An important complication of orbital roof fractures in pediatric patients(Karger, 2003) Cayli, S; Kocak, A; Alkan, A; Kutlu, R; Tekiner, A; Ates, O; Sahinbeyoglu, BOrbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2-4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging. Copyright (C) 2003 S. Karger AG, Basel.Öğe Intratesticular arteriovenous malformation - Color Doppler sonographic findings(Amer Inst Ultrasound Medicine, 2003) Kutlu, R; Alkan, A; Soylu, A; Sigirci, A; Dusak, AArteriovenous malformations (AVMs) of male genitalia are rare. In the literature there are reports of AVMs involving the scrotum,(1,2) penis,(3) spermatic cord,(4) testis, and epididymis(5) and interventional. treatment of scrotal AVMs.(6) In our literature search, we found no report about intratesticular AVMs. In this report we present the sonographic features of a small intratesticular AVM, which was incidentally found in a patient during scrotal examination for infertility evaluation. This rare entity should be considered in the differential diagnosis of intratesticular masses.
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