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    Combined occipital, transtentorial, supracerebellar, transsinus approach for pineal region teratoma
    (Turkish Neurosurgical Society, 2006) Cengiz Ş.L.; Üstün M.E.; Avunduk M.
    An 11-year-old boy with a large pineal region mass was admitted to our clinic. The preliminary diagnosis was teratoma. Tumor resection was carried out via combined occipital, transtentorial, supracerebellar, transsinus approach. The tumor tissue was completely resected, and no operative complication other than transient Parinaud syndrome was noted. The histological diagnosis was teratoma, grade 2. After three courses of chemotherapy, the patient underwent external irradiation. He remained asymptomatic with no signs of recurrence 15 months after the surgery. The combination of occipital, transtentorial, supracerebellar, transsinus approach provides excellent views and workspace above and below the tentorial notch. Transverse sinus section is not mandatory for this approach, but sectioning of the unilateral transverse sinus and the tentorium along the rectal sinus allows retraction of the falx and the underlying brain to the opposite side. Thus, a much wider horizontal and vertical projection is obtained. This approach enables more extensive tumor removal for large pineal region tumors.
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    Neuropathy similar to Miller Fisher syndrome associated with primary Sjogren's syndrome: Response to intravenous immunoglobulins
    (Medknow Publications and Media Pvt. Ltd, 2006) Genç E.; Genç B.; Avunduk M.; Kozak H.; Ilhan N.
    There is a diverse clinical spectrum of peripheral nervous system involvement in Sjogren's syndrome (SS). Most of the peripheral neuropathies in SS are typically sensory. In this report, we present a case who showed signs similar to those of the Miller Fisher variant of Guillain Barre syndrome, associated with SS. The patient demonstrated a rapid improvement both clinically and electrophysiologically, after high dose intravenous immunoglobulin therapy.