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Öğe Çocukluk Çağı Olgularda Siringomiyeli: Erişkin Olgulardan Farklılıklar(2023) Aydın Ozturk, Pınar; Yilmaz, Adem; Onal, Selami CagataySiringomiyeli, spinal kord içerisinde kistik boşlukların gelişmesi ve omurilik kompresyonu sonucu nörolojik bulguların ortaya çıkabildiği klinik bir tablodur. Konjenital bir patolojiye bağlı geliştiği düşünülse de semptomatik olması genellikle erişkin yaşları bulmaktadır. Siringomiyelide yavaş ilerleyen, progresif bir klinik ön plandadır. Çocuklarda omurga anomalileri ve skolyoz en önemli bulgulardır. Pediatrik grupta spinal disrafizm birlikteliği sıktır. Genellikle Tip 1 Chiari malformasyonu, spinal travma ve spina bifida ile ilişkilidir. Siringomiyelinin doğal seyri belirsiz olsa da ilerleyici klinik bulguları olan hastalarda cerrahi önerilmektedir. Cerrahide öncelik etiyolojinin düzeltilmesi olsa da tedavi yanıtının yetersiz olduğu ya da idiopatik olgu gruplarında sirinks kavitesine yönelik girişimler planlanabilir. Cerrahide amaç beyin omurilik sıvısı döngüsünün düzenlenmesidir.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 Investigation of the Effects of Dexpanthenol on Brain Tissue in Experimental Global Cerebral Ischemia-Reperfusion Injury(Turkish Neurosurgical Soc, 2025) Sahin, Sarp; Engin, Recai; Karatoprak, Durmus Emre; Iclek, Ismail; Onal, Selami CagatayAIM: To investigate the protective and therapeutic effects of dexpanthenol in experimental global cerebral ischemia-reperfusion injury. MATERIAL and METHODS: Thirty-two female Wistar-Albino rats were used, and the rats were divided into four groups (sham, sschaemia reperfusion [IR], IR+dexpantol [IR+DXP] and DXP+IR), with eight animals in each group. At the end of 72 hours of reperfusion, the rats were decapitated after performing the rotarod and accelerrod tests, their brain tissues were removed and histopathologically examined, and superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), and malonyldialdehyde (MDA) levels were evaluated. RESULTS: In this study, motor skill functions deteriorated in the ischemia-reperfusion (IR) group compared to the sham group, while significant improvements were observed in both the IR+DXP and DXP+IR groups (p<0.05). There were no notable differences in CAT, SOD, and GPx enzyme levels among the groups (p>0.05); however, malondialdehyde (MDA) levels increased in the IR group and decreased significantly in the IR+DXP group (p<0.05). Similarly, glutathione (GSH) levels were lower in the IR group but higher in the IR+DXP group (p<0.05). Neuronal degeneration also significantly increased in the IR group but decreased in the IR+DXP group (p<0.05). CONCLUSION: Overall, these findings suggest that dexpanthenol has a neuroprotective effect, particularly when administered during reperfusion, effectively improving motor skills and reducing neuronal damage.Öğe Long-term mortality outcomes and mortality predictors in patients with myelomeningocele(Elsevier, 2024) Deniz, Sahin Kenan; Turgut, Hatice; Deveci, Fatih; Kaya, Hueseyin; Gokce, Ismail Kursad; Ozdemir, Ramazan; Onal, Selami CagatayObjective: Despite advances, myelomeningocele remains a major cause of mortality and disability. This study aims to analyze factors influencing mortality and suggest ways to reduce it. Methods: We reviewed 173 patients who underwent surgery for myelomeningocele from January 2010 to December 2021. Variables affecting mortality were categorized into patient-related and indirectly related factors. Data were collected through patient file reviews and phone interviews with parents. Results: Mortality is influenced by multiple factors: female gender (3.2-fold increase), paraplegia (3.1-fold increase), absence of tethered cord release surgery (9.4-fold increase), scoliosis (4.2-fold increase), and renal failure (5.28-fold increase). Defect size and father's education level also significantly impact mortality. The overall mortality rate was 20.8 %, with hydrocephalus being the leading cause. Conclusion: Mortality and disability in myelomeningocele patients remain high, with over 50 % of deaths being preventable. Effective management could significantly improve mortality rates. Long-term studies are crucial for advancing research in this field.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.
