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Öğe Angiographic Morphology of Anterior Communicating Artery Aneurysms and Their Association with Rupture Risk(Turkish Neurosurgical Soc, 2021) Kaya, Veysel; Kolu, Mehmet; Kaya, Ahmet Turan; Gezer, Mehmet; Sarac, Kaya; Tetik, Bora; Yildirim, Ismail OkanAIM: To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features. MATERIAL and METHODS: In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images. RESULTS: There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p<0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p<0.005). CONCLUSION: In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms.Öğe Automated Classification of Brain Tumors by Deep Learning-Based Models on Magnetic Resonance Images Using a Developed Web-Based Interface(Duzce Univ, Fac Medicine, 2021) Tetik, Bora; Ucuzal, Hasan; Yasar, Seyma; Colak, CemilObjective: Primary central nervous system tumors (PCNSTs) compose nearly 3% of newly diagnosed cancers worldwide and are more common in men. The incidence of brain tumors and PCNSTs-related deaths are gradually increasing all over the world. Recently, many studies have focused on automated machine learning (AutoML) algorithms which are developed using deep learning algorithms on medical imaging applications. The main purposes of this study are -to demonstrate the use of artificial intelligence-based techniques to predict medical images of different brain tumors (glioma, meningioma, pituitary adenoma) to provide techicalsupport to radiologists and -to develop a user-friendly and free web-based software to classify brain tumors for making quick and accurate clinical decisions. Methods: Open-sourced T1-weighted magnetic resonance brain tumor images were achieved from Nanfang Hospital, Guangzhou, China, and General Hospital, Tianjin Medical University, To construct the proposed system which web-based interface and the deep learning-based models, the Keras/Auto-Keras library, which is employed in Python's programming language, is used. Accuracy, sensitivity, specificity, G-mean, F-score, and Matthews correlation coefficient metrics were used for performance evaluations. Results: While 80% (2599 instances) of the dataset was used in the training phase, 20% (465 instances) was employed in the testing phase. All the performance metrics were higher than 98% for the classification of brain tumors on the training data set. Similarly, all the evaluation metrics were higher than 91% except for sensitivity and MCC for meningioma on the testing dataset. Conclusions: The results from the experiment reveal that the proposed software can be used to detect and diagnose three types of brain tumors. This developed web-based software can be accessed freely in both English and Turkish at http://biostatapps.inonu.edu.tr/BTSY/.Öğe Comparison of posterior cranial fossa morphometric measurements in Chiari type I patients with and without syrinx cavity on magnetic resonance imaging(Int Scientific Information Inc, 2022) Dogan, Gulec Mert; Sigirci, Ahmet; Tetik, Bora; Pasahan, Ramazan; Onal, Cagatay; Arslan, Ahmet K.Purpose: To compare the posterior fossa measurements of Chiari type I malformation (CHM1) patients with and without syrinx and with a control group. Material and methods: The patients with syrinx were divided into 2 groupd according to syrinx width/cord width (S/C) ratios: group 1 - S/C ratio < 50%; group 2 - S/C ratio > 50%. The length of the clivus, the AP length of the foramen magnum, the AP length of the posterior fossa, the perpendicular distance between the McRae line and (a) the splenium of corpus callosum, (b) the pons, and (c) the fastigium of the 160 patients and of the 160 control patients were statistically compared. In addition, the measurements of the patients with and without syrinx, according to the S/C ratio, were statistically compared. Results: Syrinx was present in 59 (36.8 %) of the 160 patients. The S/ C ratio was < 50% in 30 (50.9 %) of them, and S/C ratio > 50% in 29 (49.1%) of them. All the measurements in the patient group, except of the AP length of the foramen magnum, were statistically significantly lower than in the control group (p = 0.001). There was no significant difference in the measurements of the patients with syrinx group 1 and the patients without syrinx, but the AP length of posterior fossa was statistically significantly lower in the patients with syrinx group 2 than the patients without syrinx (p = 0.03). Conclusion: The S/C ratio can be a guide to the underlying aetiology.Öğe DİRSEK DÜZEYİNDE ULNAR SİNİR SIKIŞMASINDA BASİT DEKOMPRESYON UYGULANAN HASTALARIN KLİNİK VE CERRAHİ SONUÇLARI(2020) Paşahan, Ramazan; Tetik, BoraÜst ekstremitede en sık izlenen tuzak nöropati karpal tünel sendromu (KTS) iken ikinci sıklıkta görülen tuzaknöropati ise ulnar sinir sıkışmasıdır. Ulnar sinir sıkışması, en sık dirsek seviyesinde ve/veya guyon kanalındagerçekleşir. Hastalar genellikle ön kolda ağrı, elin 5. parmak ve 4. parmağın yarısında uyuşma ve elin intrensekkaslarında güç kaybı şikayetleri ile başvurmaktadır. Bu şikâyetler ile başvuran hastalarda klinik muayenedeprovakasyon testlerinden yararlanılır. En sık kullanılan provakasyon testleri; Tinel Testi ve Ulnar SinirDekompresyon Testlerdir. En önemli yardımcı tanı testi Elekromyelografidir. Hastalığın tedavisinde konservatiftedavi ve/veya cerrahi tedavi uygulanır. Hafif ulnar sinir basısı olan hastalarda konservatif tedavi ile %50-60arasında başarı elde edilebilir. Konservatif tedaviye rağmen bulgularda azalma izlenmeyen hastalarda cerrahitedavi önerilmektedir. Geç tanı almış hastalarda kas atrofilerine bağlı olarak pençe el deformitesi gelişimi vekalıcı defisit gelişebileceğinden cerrahi zamanlama önem arzetmektedir. Çalışmamızda İnönü Üniversitesi BeyinCerrahisi Kliniği’nde 2016-2020 tarihleri arasında basit ulnar sinir dekompresyonu yapılan 12 hastanın yaş,cinsiyet, provakasyon testleri, muayene bulguları, elektromyelografi bulguları, ek hastalıkları literatür eşliğindetartışılmış ve cerrahi sonuçları bildirilmiştir.Öğe DİRSEK DÜZEYİNDE ULNAR SİNİR SIKIŞMASINDA BASİT DEKOMPRESYON UYGULANAN HASTALARIN KLİNİK VE CERRAHİ SONUÇLARI(2020) PAŞAHAN, Ramazan; Tetik, BoraÜst ekstremitede en sık izlenen tuzak nöropati karpal tünel sendromu (KTS) iken ikinci sıklıkta görülen tuzak nöropati ise ulnar sinir sıkışmasıdır. Ulnar sinir sıkışması, en sık dirsek seviyesinde ve/veya guyon kanalında gerçekleşir. Hastalar genellikle ön kolda ağrı, elin 5. parmak ve 4. parmağın yarısında uyuşma ve elin intrensek kaslarında güç kaybı şikayetleri ile başvurmaktadır. Bu şikâyetler ile başvuran hastalarda klinik muayenede provakasyon testlerinden yararlanılır. En sık kullanılan provakasyon testleri; Tinel Testi ve Ulnar Sinir Dekompresyon Testlerdir. En önemli yardımcı tanı testi Elekromyelografidir. Hastalığın tedavisinde konservatif tedavi ve/veya cerrahi tedavi uygulanır. Hafif ulnar sinir basısı olan hastalarda konservatif tedavi ile %50-60 arasında başarı elde edilebilir. Konservatif tedaviye rağmen bulgularda azalma izlenmeyen hastalarda cerrahi tedavi önerilmektedir. Geç tanı almış hastalarda kas atrofilerine bağlı olarak pençe el deformitesi gelişimi ve kalıcı defisit gelişebileceğinden cerrahi zamanlama önem arzetmektedir. Çalışmamızda İnönü Üniversitesi Beyin Cerrahisi Kliniği’nde 2016-2020 tarihleri arasında basit ulnar sinir dekompresyonu yapılan 12 hastanın yaş, cinsiyet, provakasyon testleri, muayene bulguları, elektromyelografi bulguları, ek hastalıkları literatür eşliğinde tartışılmış ve cerrahi sonuçları bildirilmiştir.Öğe DİRSEK DÜZEYİNDE ULNAR SİNİR SIKIŞMASINDA BASİT DEKOMPRESYON UYGULANAN HASTALARIN KLİNİK VE CERRAHİ SONUÇLARI(2020) PAŞAHAN, Ramazan; Tetik, BoraÜst ekstremitede en sık izlenen tuzak nöropati karpal tünel sendromu (KTS) iken ikinci sıklıkta görülen tuzak nöropati ise ulnar sinir sıkışmasıdır. Ulnar sinir sıkışması, en sık dirsek seviyesinde ve/veya guyon kanalında gerçekleşir. Hastalar genellikle ön kolda ağrı, elin 5. parmak ve 4. parmağın yarısında uyuşma ve elin intrensek kaslarında güç kaybı şikayetleri ile başvurmaktadır. Bu şikâyetler ile başvuran hastalarda klinik muayenede provakasyon testlerinden yararlanılır. En sık kullanılan provakasyon testleri; Tinel Testi ve Ulnar Sinir Dekompresyon Testlerdir. En önemli yardımcı tanı testi Elekromyelografidir. Hastalığın tedavisinde konservatif tedavi ve/veya cerrahi tedavi uygulanır. Hafif ulnar sinir basısı olan hastalarda konservatif tedavi ile %50-60 arasında başarı elde edilebilir. Konservatif tedaviye rağmen bulgularda azalma izlenmeyen hastalarda cerrahi tedavi önerilmektedir. Geç tanı almış hastalarda kas atrofilerine bağlı olarak pençe el deformitesi gelişimi ve kalıcı defisit gelişebileceğinden cerrahi zamanlama önem arzetmektedir. Çalışmamızda İnönü Üniversitesi Beyin Cerrahisi Kliniği’nde 2016-2020 tarihleri arasında basit ulnar sinir dekompresyonu yapılan 12 hastanın yaş, cinsiyet, provakasyon testleri, muayene bulguları, elektromyelografi bulguları, ek hastalıkları literatür eşliğinde tartışılmış ve cerrahi sonuçları bildirilmiştir.Öğe Effects of apocynin on sciatic nerve injury in rabbits(Taylor & Francis Ltd, 2023) Durak, Mehmet Akif; Ozhan, Onural; Tetik, Bora; Yildiz, Azibe; Aksungur, Zeynep; Vardi, Nigar; Turkoz, YusufWe investigated the effects of apocynin (APO) on experimental sciatic nerve compression injury in rabbits. We used 21 male rabbits divided randomly into three groups of seven. The control group was subjected to sciatic nerve compression with no further intervention. The APO treated group was subjected to compression injury and 20 mg/kg APO was administered daily for 21 days by intraperitoneal injection beginning the day after the injury. The sham group was treated with APO without injury. The control group exhibited shrinkage of axons, disruption of myelin sheaths and loss of nerve fibers. The damage for the control group was significantly greater than for the sham group. The severity of histopathology was decreased in the APO treated group compared to the control group, as was the oxidative stress index. Our findings suggest that APO treatment may contribute to healing of sciatic nerve damage.Öğe Efficacy of tocilizumab therapy in severe COVID-19 pneumonia patients and determination of the prognostic factors affecting 30 days mortality(Marmara Univ, Fac Medicine, 2022) Delen, Leman; Kasapoglu, Umut Sabri; Gok, Abdullah; Cagasar, Ozlem; Tetik, Bora; Oksuz, ErsoyObjective: In coronavirus disease - 19 (COVID-19) patients, cytokine storm develops due to the increase of pro-inflammatory cytokines. Tocilizumab (TU.), has been used in the treatment of COVID-19 patients and successful results have been obtained. The aim of this study was to determine the efficacy of TCZ and also investigate the prognostic factors affecting the success of treatment and mortality in COVID-19 patients treated with TCZ. Patients and Methods: Between March 2020 and August 2021, a total of 326 confirmed severe COVID-19 pneumonia patients, treated in the intensive care unit, were included in the study. Results: The mean age of the patients was 63.02 +/- 11.58 years, and 203 (62.3%) of the patients were male. Patients treated with TCZ had a longer survival time compared with the standard therapy (p=0.012). It was found that type of respiratory support (HR:2.19, CI:1.10-4.36, p=0.025) and hyperlactatemia on the day of TCZ therapy admission (HR:2.93 CI:1.53-5.64, p=0.001) were the significant and independent prognostic factors of survival in severe COVID-19 pneumonia patients treated with TCZ. Conclusion: Tocilizumab therapy improved 30-days survival in critically ill COVID-19 pneumonia patients. Also, among the patients with TCZ, types of respiratory support and hyperlactatemia on the day of TCZ admission were the independent prognostic factors.Öğe Epidemiological Markers in Adult Glial Tumors: A Single-Center Experience and The Utility of the Classification System(Kare Publ, 2022) Bayatli, Eyup; Tetik, Bora; Buyuktepe, Murat; Tokdemir, Nurhan; Guner, Yahya Efe; Guney, Yildiz; Ugur, Hasan CaglarOBJECTIVE This study aimed to investigate the etiology of gliomas and determine the utility of the World Health Organization (WHO) classification of central nervous system tumors. METHODS Patients aged >= 18 years who underwent surgery or were followed up for filial tumors between January 2017 and January 2020 and whose pathology reports indicated grade II-IV gliomas were included in the study. Patients with missing data, pathology results incompatible with grade II-IV gliomas, and unavailable standard molecular/genetic tumor profiles were excluded from the study. RESULTS The results of the standard histopathological and molecular/genetic analyses were evaluated retrospectively without any additional examinations. Data from 259 patients were evaluated. Of these, 8 patients who did not meet the criteria for glioma pathology and 27 patients with not otherwise specified molecular pathological examination results were excluded from the study. Patients were evaluated in detail regarding demographic and admission data, pathology analysis, potential risk factors, and survival results. CONCLUSION Many factors, particularly high blood glucose levels, sedentary lifestyle, and radiofrequency electromagnetic field exposure, appear to have a relationship with glioma etiology. 'There is a major heterogeneity and lack of standardized efficient laboratory procedures that may interfere with reliable standard molecular results. False positive molecular markers consist a major classification issue and methods that reflect the requirements of the WHO classification may themselves be inadequate to establish a profile with adequate sensitivity. The development of more practical and accessible methods in addition to standardized, rapid, and reliable methods for testing multiple markers at an acceptable cost is urgently needed.Öğe Evaluating Anxiety and Stress Coping Skills and Related Variables of Mothers with Mentally Retarded Children(2016) Selçuk, Engin Burak; Zırhlı Şelçuk, Şenay; Tetik, Bora; Kayhan, Duygu; Özel Özcan, Özlem; Karataş, MehmetAbstract: Aim: Our aim is to compare the socio-demographic characteristics of mothers with mentallydisabled children with those without, and to evaluate anxiety levels and ability of these mothers tocope with stress.Materials and Method: Our study is designed as a cross-sectional descriptive study. We includedthe mothers of 110 children with mental disabilities as the study group, and mothers of 117children in a primary school without any mental disabilities as the control group. Sociodemographic data of all the mothers participating in the study were recorded and Beck AnxietyInventory and The Ways of Coping Scale were applied.Results: The mean age of the study group was 31.2±3.45 years in the study group and28.62±2.25 years in the control group; there was no statistical difference between the groups(p=0.215). Monthly household income was statistically significantly lower in the study group(p=0.005). The average Beck Anxiety Inventory score of the mothers with mentally disabledchildren was 29.88±12.68, and that of the control group was 28.76±16.86; there was nostatistically significant difference between the groups (p=0.578). The average Ways of CopingScale score of the mothers of mentally disabled children was 70.83±13.49 and average score ofthe control group was 73.64±16.20; there was no statistically significant difference (p=0.158).However, the average scores of mothers with mentally handicapped children of the threesubscales of Ways of Coping Scale, including Submissive Approach, Seeking for Social Supportand Optimistic Approach, were significantly higher than the control group (p: 0.001, 0.001, 0.005,respectively).Conclusion: We suggest that mothers of mentally disables children should be followed up closelyand supplied with psychosocial support, and rehabilitation services; even, measures to improvetheir economic situation should be taken.Öğe EVALUATION OF PATIENTS ADMISSING EMERGENCY CARE SERVICES FROM THE POINT OF VIEW OF FAMILY MEDICINE(2020) Kayhan Tetik, Burcu; Tetik, Bora; Karaoğlan, Aytaç; Alpağan, Cem; Mete, Burak; Paksoy, NurAbstract: Objectives: Inappropriate use of Emergency Department (ED) for non-urgent complaints compromises the functioning of ED and has been increasing day by day. In this study, we examined the annual data of the patients who admitted to the Emergency Department in order to determine the ratio of appropriate usage according to the definitive diagnoses of the patients and to help forward new policies regarding this issue. Materials and Methods: Files of patients, who admitted to our ED between January 1 and December 31 , 2017, were examined. Data were evaluated by SPSS software version 22 , and the analyses were performed by using the Chi-square test. A value of p <0.05 was accepted to be statistically significant. Results: We found that 72.20% (n: 42785\59282) of the people who admitted to the ED during one year had admitted for complaints that should be addressed in the primary healthcare centers or specialist policlinics and only 19.2% (n: 11359\59282) of the ED visits were appropriate. We also found that the most frequent reasons for ED visits were respiratory system symptoms and pain. Conclusion: We found that the vast majority of the patients admitted to the emergency department were not actually urgent. We suggest that measures such as effectuation of the referral system for effective use of the family medicine system, use of triage in emergency departments, and extra fees for using the emergency department inappropriately can be implemented to reduce the workload in emergency services.Öğe Fenitoin Kullanımı Sonrası Gelişen DRESS Sendromu: Olgu Sunumu(2017) Tetik, Bora; Oğuzoğlu, Serdar Ali; Kayhan Tetik, Burcu; Saraç, GülbaharÖz: DRESS Sendromu ateş, cilt döküntüsü, iç organ tutulumu ve hematolojik anormalliklerle karakterize akut başlangıçlı, hayatı tehdit eden, nadir görülen, ilaca bağlı bir aşırı duyarlılık reaksiyonudur. En sık nedeni aromatik antikonvülzan kullanma sonrası görülmektedir. Bu olguda fenitoin kullanımı sonrasında ikinci haftada ateş yüksekliği ve cilt döküntüleri başlayan kırk dört yaşında bir erkek hasta sunulmuştur. Olgu, fenitoin tedavisinin kesilmesi sonrasında sistemik kortikosteroid ve destek tedavisi ile başarılı bir şekilde tedavi edilebilmiştir. Birinci basamakta aile hekimi, hastalarının akut ve kronik sağlık sorunlarını aynı anda yönetebilmelidir. Olgumuzda olduğu gibi akut başlangıçlı ateşe yaklaşımda bir aile hekimi hastasını iyi yönetebilmeli ve beraberinde cilt döküntüleri de gördüğünde kullandığı ilaçları da sorgulayarak DRESS Sendromunu akla getirmelidir.Öğe KARPAL TÜNEL SENDROMU TANISI KONULAN HASTALARDA PROVAKATİF TESTLERİN VE BOSTON SKALASININ ETKİNLİĞİNİN DEĞERLENDİRİLMESİ(2022) Paşahan, Ramazan; Tetik, BoraAMAÇ: Üst ekstremitede en sık görülen periferik sinir tuzaklanması el bilek bölgesinde median sinir tuzaklanmasıdır ve karpal tünel sendromu (KTS) olarak adlandırılır. Tanı; anamnez, fizik muayene, Boston skala (fonksiyonel ve duyusal skorlama) ve EMG ile konmaktadır. Cerrahi tedavi kararı verilmesinde; ameliyat öncesi ve sonrasının klinik ve/veya semptomların karşılaştırılmasında skorlama sistemi önemlidir. Çalışmamızda KTS tanısı alan hastaların ameliyat öncesi provakatif testler (Falen ve Tinel testi) ve Boston skalası ile ameliyat sonrası Boston skalasının etkinliği tartışılmıştır.GEREÇ VE YÖNTEM: İnönü Üniversitesi Beyin Cerrahisi kliniğinde 01.01.2016 - 01.05.2020 tarihleri arasında KTS tanısı alan toplam 152 hastadan TOS (torasik outlet sendromu), travma ,servikal disk hernisi olmayan 41 hasta dahil edildi. Mini open cerrahi uygulandı. Hastalar; yaş, cinsiyet, taraf bulgusu, EMG, provakatif testler, Boston skalası ve eşlik eden ek hastalıklar açısından değerlendirildi. İstatistiksel olarak Shapiro-Wilk testi, Mann-Whitney U testi, Bağımsız örneklerde t testi, ki-kare testi, Kruskal Wallis testi, Tek Yönlü Varyans analizi kullanıldı. (p<0,05) değeri istatistiksel olarak anlamlı kabul edildi. Analizlerde IBM SPSS Statistics 25.0 programı kullanıldı.BULGULAR: Çalışmaya dahil edilen 41 hastanın, 6’sı (14.6%) erkek, 35’i (85.4%) kadındı. EMG’de orta şiddet 23 hasta (%56,1), ağır KTS 15 hasta (36,6) ve çok ağır 3 hasta (%7,3) tespit edildi. Hastaların ameliyat öncesi ve ameliyat sonrası ortalama Semptom Şiddet Skalası, Fonksiyonel Kapasitesi sırası ile 34±3, 12±2, ve 28±5, 11±3 ‘dür Tinel testi 25 (%61) hastada pozitif, Falen Testi 22 (%53,7) hastada pozitifti. Ameliyat öncesi Provakif testler, Boston skalası ile ameliyat sonrası Boston skalası arasında istatistiksel olarak anlamlı ilişki saptandı ( p<0,05).SONUÇ: KTS ‘de tanı ve / veya tedavide gecikme kas atrofilerine ve fonksiyon kayıplarına neden olmaktadır. Bu hastalık grubunda provakatif testler, boston skalasının iyi tanımlanması cerrahi karar vermede gecikmeyi önleyeceği ve ameliyat sonrası boston skalasının takiplerde yararlı olacağı düşüncesindeyiz.Öğe The Knowledge Level of Medical Personnel in Turkey about Complementary Nutrition(Iranian Scientific Society Medical Entomology, 2015) Kayhan Tetik, Burcu; Bozcuk Guzeldemirci, Gamze; Kilic, Melek; Aksoy, Hilal; Sonmez, Bilge; Selcuk, Engin Burak; Tetik, Bora[Abstract Not Available]Öğe Multi-parameter-based radiological diagnosis of Chiari Malformation using Machine Learning Technology(Wiley-Hindawi, 2021) Tetik, Bora; Dogan, Gulec Mert; Pasahan, Ramazan; Durak, Mehmet Akif; Guldogan, Emek; Sarac, Kaya; Onal, CagatayBackground The known primary radiological diagnosis of Chiari Malformation-I (CM-I) is based on the degree of tonsillar herniation (TH) below the Foramen Magnum (FM). However, recent data also shows the association of such malformation with smaller posterior cranial fossa (PCF) volume and the anatomical issues regarding the Odontoid. This study presents the achieved result regarding some detected potential radiological findings that may aid CM-I diagnosis using several machine learning (ML) algorithms. Materials and Methods Midsagittal T1-weighted MR images were collected in 241 adult patients diagnosed with CM, eleven morphometric measures of the posterior cerebral fossa were performed. Patients whose imaging was performed in the same centre and on the same device were included in the study. By matching age and gender, radiological exams of 100 clinically/radiologically proven symptomatic CM-I cases and 100 healthy controls were assessed. Eleven morphometric measures of the posterior cerebral fossa were examined using 5 designed ML algorithms. Results The mean age of patients was 29.92 +/- 15.03 years. The primary presenting symptoms were headaches (62%). Syringomyelia and retrocurved-odontoid were detected in 34% and 8% of patients, respectively. All of the morphometric measures were significantly different between the groups, except for the distance from the dens axis to the posterior margin of FM. The Radom Forest model is found to have the best 1.0 (14 of 14) ratio of accuracy in regard to 14 different combinations of morphometric features. Conclusion Our study indicates the potential usefulness of ML-guided PCF measurements, other than TH, that may be used to predict and diagnose CM-I accurately. Combining two or three preferable osseous structure-based measurements may increase the accuracy of radiological diagnosis of CM-I.Öğe Non-traumatic non-aneurysmal subarachnoid haemorrhage: Single institutional experience(202) Pasahan, Ramazan; Tetik, Bora; Guldogan, Emek; Durak, M. Akif; Yildirim, İsmail OkanAim: Despite the advanced diagnostic methods we use today, the rate of negative digital subtraction angiography (DSA) is 15% in patients diagnosed with subarachnoidal hemorrhage (SAH), and these types of hemorrhages are named as non-aneurysmal (NASAH). Various factors such as inadequate interpretation of the beginning angiography, vasospasm, thrombosis, intra-cerebral hematoma pressure may cause DSA to be negative. This study aims to determine the causes of bleeding in patients who were suffered from NASAH. Materials and Methods: The study evaluated 664 patients with SAH from 2010 to 2016. DSA was performed on these patients within the first 3 or 6 hours. Sixty-seven patients with DSA negative were included in the study group. The patients were divided into three groups as perimesencephalic subarachnoidal hemorrhage (PMSAH), non-perimesencephalic subarachnoidal hemorrhage (nPMSAH), CT negative subarachnoidal hemorrhage (CT negative SAH). These three groups were evaluated based on age, gender, Glascow coma scale (GCS), World Federation of Neurosurgical Societies (WFNS) grade, Hunt and Hess Classification and Fisher’s scale, hospitalization time duration, complications and computerized tomography (CT), and cervical and cranial MRI was performed on patients without correlation between DSA results if needed. Results: Of the 664 patients diagnosed with SAH, 67 (10.09%) had NASAH. Statistically significant differences were found between CT Negative SAH and PMSAH and CT Negative SAH and nPMSAH in terms of the variables of GCS during hospital admission and total duration of hospitalization. Statistically significant differences were found between CT Negative SAH and PMSAH and nPMSAH in terms of the variables of GCS during hospital discharge. There were statistically significant differences between the types in terms of WFNS Classification, Hunt and Hess Classification and Fisher’s Scala. Conclusion: We believe that this study will contribute to the literature about the necessity of performing additional radiologic imaging during clinical follow-up since belated diagnosis in patients with NASAH may increase mortality.Öğe Non-traumatic non-aneurysmal subarachnoidhaemorrhage: Single institutional experience(2021) Paşahan, Ramazan; Tetik, Bora; Güldoğan, Emek; Durak, M. Akif; Yıldırım, İ. OkanAbstractAim: Despite the advanced diagnostic methods we use today, the rate of negative digital subtraction angiography (DSA) is 15% in patients diagnosed with subarachnoidal hemorrhage (SAH), and these types of hemorrhages are named as non-aneurysmal (NASAH). Various factors such as inadequate interpretation of the beginning angiography, vasospasm, thrombosis, intra-cerebral hematoma pressure may cause DSA to be negative. This study aims to determine the causes of bleeding in patients who were suffered from NASAH.Materials and Methods: The study evaluated 664 patients with SAH from 2010 to 2016. DSA was performed on these patients within the first 3 or 6 hours. Sixty-seven patients with DSA negative were included in the study group. The patients were divided into three groups as perimesencephalic subarachnoidal hemorrhage (PMSAH), non-perimesencephalic subarachnoidal hemorrhage (nPMSAH), CT negative subarachnoidal hemorrhage (CT negative SAH). These three groups were evaluated based on age, gender, Glascow coma scale (GCS), World Federation of Neurosurgical Societies (WFNS) grade, Hunt and Hess Classification and Fisher’s scale, hospitalization time duration, complications and computerized tomography (CT), and cervical and cranial MRI was performed on patients without correlation between DSA results if needed.Results: Of the 664 patients diagnosed with SAH, 67 (10.09%) had NASAH. Statistically significant differences were found between CT Negative SAH and PMSAH and CT Negative SAH and nPMSAH in terms of the variables of GCS during hospital admission and total duration of hospitalization. Statistically significant differences were found between CT Negative SAH and PMSAH and nPMSAH in terms of the variables of GCS during hospital discharge. There were statistically significant differences between the types in terms of WFNS Classification, Hunt and Hess Classification and Fisher’s Scala.Conclusion: We believe that this study will contribute to the literature about the necessity of performing additional radiologic imaging during clinical follow-up since belated diagnosis in patients with NASAH may increase mortality.Öğe Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase(Sage Publications Inc, 2021) Yildirim, Ismail Okan; Kolu, Mehmet; Durak, Mehmet Akif; Tetik, Bora; Pasahan, Ramazan; Gurbuz, Sukru; Sarac, KayaBackground The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization. Methods This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed. Results The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.3%) patients; and two (6.6%) patients were symptomatic. A periprocedural asymptomatic intracranial hemorrhage was detected in two patients. At discharge, 17 (56.6%) patients were in good clinical condition, six (20%) were in a severe disability condition, and seven (23.3%) patients had died. At the final follow-up visit (mean: 18.9 months), 16 (76,2%) of 21 patients were in a good clinical condition and five (23.8%) had severe disabilities. Conclusions Y-stent assisted coiling in might be a feasible and promising option for treatment in acute phase in selected wide-necked ruptured intracranial aneurysms.
