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Öğe Development of severe hyponatremia due to cerebrospinal fluid leakage following meningomyelocele surgery in a newborn(Amer Assoc Neurological Surgeons, 2018) Gokce, Ismail Kursad; Turgut, Hatice; Ozdemir, Ramazan; Onal, Selami CagatayCerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.Öğe Development of severe hyponatremia due to cerebrospinal fluid leakage followingmeningomyelocele surgery in a newborn(Amer assoc neurologıcal surgeons, 5550 meadowbrook drıve, rollıng meadows, ıl 60008 usa, 2018) Gokce, Ismail Kursad; Turgut, Hatice; Ozdemir, Ramazan; Onal, Selami CagatayCerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.Öğe The effect of defect size on mortality and morbidity in patients with neural tube defect(2022) Turgut, Hatice; Ozdemir, Ramazan; Gokce, Ismail Kursad; Kaya, Huseyin; Onal, Selami CagatayAim: Neural tube defects (NTD) occur due to errors in the closing of neural canal in embryo. All over the world, the incidence of all forms of NTD varies between 1.4 and 2 in every 1000 live births. The aim of the present study was to investigate the short term prognosis, accompanying anomalies and complications in patients with NTD and to evaluate the relation between defect sizes. Material and Methods: Patients who applied to Inonu University Neonatology Department between January 2010 and December 2017 with the diagnosis of NTD and were operated on were included in the study. Babies who died within the first 24 hours were excluded from the study. Patients were divided into two groups according to the size of NTD; < 5 cm (Group 1) and ≥ 5 cm (Group 2). Approval for the study was obtained from local ethics committee. Results: Overall 133 infants were included in the study. Mean birth weight was 3155 ± 531 g and mean duration of pregnancy was on 38.1 ± 1.8 weeks. Of NTD’s 82% was located in lumbosacral region. 90.2% of the patients underwent operation within the first 24 hours. Parameters such as hydrocephalus, need for shunt, need for flap in tissue defects, the rate of postoperative complications, duration of hospitalization, mortality and the use of antibiotics were found to be at a higher rate in cases whose defect size was ≥5 cm than in those whose defect size was < 5 cm (p < 0.005). Postoperative complications developed in 48.1% of the patients. The most common complications were observed to be cerebrospinal fluid (CSF) leakage (24.1%) and bladder dysfunction (7.5%). Conclusion: In patients with NTD, as the size of the defect increases, additional interventions, complications, hospitalization rates and mortality increase as well. Therefore, it is recommended that health care personnel should take care against problems in the management of this group of patients and inform familes beforehand on these issues.Öğe Our Clinical Algorithmic Approach for Meningomyelocele Defects Reconstruction with Fasciocutaneous Flaps(Turkish Neurosurgical Soc, 2021) Algan, Mehmet Fatih; Firat, Cemal; Bekircan, Kagan; Kilinc, Hidir; Onal, Selami CagatayAIM: To evaluate fasciocutaneous flaps used for reconstruction of meningomyelocele defects in our clinic and to suggest an algorithm for flap selection. MATERIAL and METHODS: A retrospective analysis of 45 patients with meningomyelocele, who underwent repair with fasciocutaneous flaps, was carried out. Preoperative and postoperative photos were analyzed. The defect areas were measured by Adobe Photoshop CC. Limberg flap, bilateral Limberg flaps, bilateral bipedicled advancement flaps, bilobed flap and reading man flap were performed. RESULTS: Wound dehiscence and partial necrosis occurred in 8 patients. All wounds were managed conservatively and healed successfully. No other complications were observed. The mean defect size for all patients was 36 cm(2). The mean defect size was 45.3 cm(2) in bilateral bipedicled flaps cases; 33.5 cm(2) in bilateral Limberg flaps cases; and 19.6 cm(2) in the unilateral Limberg flap cases. According to the algorithm, a unilateral Limberg flap or bilobed flap or reading man flap can be used for the defects smaller than 25 cm(2); bilateral Limberg flaps can be used for the defects between 25 and 35 cm(2); and bilateral bipedicled advancement flaps can be used for the defects larger than 35 cm(2). CONCLUSION: Fasciocutaneous flaps can be preferred in meningomyelocele defect reconstruction due to the easy planning of flaps, easy and fast flap elevation, and low complication rates due to their reliable circulation. The measurement of the defect area allows this algorithm selecting a flap in a more practical way.Öğe Spontaneous spinal epidural hematoma: a case report(Elsevier Science Bv, 2010) Yucel, Neslihan; Akgun, Sinem Feride; Tekin, Yusuf Kenan; Onal, Selami Cagatay; Alkan, AlpaySpontaneous spinal epidural hematoma is a rare clinical disorder that might result in permanant neurological deficit and death when left untreated. We present a 34 year old male admitted to our emergency department with back pain and paraplegia, and being diagnosed with spontaneous spinal epidural hematoma.
