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    Cerebrospinal fluid and serum levels of growth hormone, insulinlike growth factor 1, insulinlike growth factor binding protein 3, and ghrelin in patients with bacterial and tuberculous meningitis
    (2012) Akinci A.; Gungor S.; Yucel G.; Gungor S.; Ozerol H.I.
    BACKGROUND: The somatotropic hormone levels change in acute and prolonged critical illnesses such as tuberculous meningitis (TbM). This study aimed to determine the cerebrospinal fluid (CSF) and serum levels of growth hormone (GH), insulinlike growth factor 1 (IGF-1), insulinlike growth factor-binding protein 3 (IGFBP-3), and ghrelin in patients with TbM and to compare the results with those of the patients with bacterial meningitis (BM) and of healthy controls. METHODS: Nine patients with TbM and 14 patients with BM between the ages of 7 and 12 years were enrolled in this study. The control group was composed of 14 patients with no central nervous system infections. Growth hormone, IGF-1, and IGFBP-3 levels in serum and CSF were measured by enzyme-linked immunosorbent assay, and ghrelin levels were measured by radioimmunoassay. RESULTS: Growth hormone and IGF-1 levels in serum and CSF were significantly lower in the TbM group than in the BM and control groups (P < 0.05). Insulinlike growth factor-binding protein 3 levels were lower in the TbM and BM groups than in the control group (P < 0.05). Ghrelin level in the TbM group was significantly higher than in the BM and control groups (P < 0.05). CONCLUSIONS: Levels of growth factors such as GH and IGF-1 were lower in TbM than in other central nervous system infections. These data suggest that IGF-1, which is known to have a neuroprotective effect, may be the cause of neuronal loss and cerebral atrophy in TbM. Copyright © 2012 by Lippincott Williams & Wilkins.
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    Clinical and imaging findings in childhood posterior reversible encephalopathy syndrome
    (Iranian Child Neurology Society, 2018) Gungor S.; Kilic B.; Tabel Y.; Selimoglu A.; Ozgen U.; Yilmaz S.; Sigirci A.
    Objective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days’ duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome. © 2018, Iranian Child Neurology Society. All rights reserved.
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    Pericallosal lipoma: A rare cause of persistent headache
    (Scientific Publishers of India, 2016) Kilic B.; Gungor S.
    Objectives: Intracranial lipomas are very rare tumors with an incidence of approximately 0.1% of intracranial tumours. They are mostly localized in the pericallosal region. The importance of this report is that it is the first case in childhood that indicates an association between persistent headache and pericallosal lipoma in the literature. Case report: We observed an eleven year old male patient who was admitted to our pediatric emergency department because of a persistent headache that his cranial magnetic resonance imaging demonstrated to be a lipoma in the pericallosal region, occupying both anterior and posterior locations around the corpus callosum without any corpus callosum or other central nervous system anomalies. Conclusion: Intracranial lipomas are usually asymptomatic and rare. They can be detected from computer tomography and magnetic resonance imaging. They are usually benign but may require surgery in symptomatic cases. © 2016 Current Pediatric Research. All Rights Reserved.