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Öğe Anatomic and radiologic analysis of the atlantal part of the vertebral artery(ELSEVIER SCI LTD, 2009) Cengiz, Sahika Liva; Cicekcibas, Aynur; Kiresi, Demet; Kocaogullar, Yalcin; Cicek, Onur; Baysefer, Alper; Buyukmumcu, MustafaThe horizontal third segment (V3h) of the vertebral artery (VA) in 7 cadavers (14 sides) was dissected and the anatomical measurements recorded. Measurements from 24 healthy individuals (48 sides) were taken for comparison using multislice CT scanning. The distance between the medial Lip of the VA V3h and the line passing through the mid point of the posterior tuberculum of the atlas was marked as length A. The distance between the medial tip of the VA V3h and the point penetrating the dura mater was classified as length B. The angle between these lines was the alpha (a) angle. Measurements were taken when the head was in a neutral position, as well as in maximum right and left rotation, extension and flexion. In cadavers, the mean alpha angle (+/- S.D.) was 82.42 +/- 10.34 degrees and 83.21 +/- 10.81 degrees on the right and left side, respectively. On multislice CT scanning, the mean a angle was 81.64 +/- 10.15 degrees on the right and 83.77 +/- 10.65 degrees, on the left. These angles varied with the position of the head. (C) 2008 Elsevier Ltd. All rights reserved.Öğe Beneficial Effects of Levosimendan on Cerebral Vasospasm Induced by Subarachnoid Haemorrhage: An Experimental Study(Taylor & Francis Ltd, 2010) Cengiz, Şahika Liva; Erdi, Mehmet Fatih; Tosun, Murat; Atalık, Esra; Avunduk, Mustafa Cihat; Sönmez, Fatma Cavide; Mehmetoğlu, İdris; Baysefer, AlperBackground: The aim of this study was to investigate the ability of levosimendan to prevent cerebral vasospasm in a rabbit model of subarachnoid haemorrhage (SAH). Animals and methods: Eighteen New Zealand white rabbits were allocated into three groups randomly. SAH was induced by injecting autologous blood into the cisterna magna. (Group 1 = control: sham surgery group, Group 2 = SAH alone group, Group 3 = SAH plus levosimendan group). Histopathological examination was performed on day 3 as described. Intravenous levosimendan dose (initially 12 mu g kg(-1) infusion, continuously for at least 10 minutes and then continued with a dose of 0.2 mu g kg(-1) min(-1)) treatment was started after the induction of SAH. Three days later, the animals were sacrificed. Results: In pathological investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between all groups (p < 0.005). Malondialdehyde level was also found significantly low in the levosimendan group compared with the SAH group. Conclusion: Intravenous levosimendan treatment was found effective by increasing the pathological luminal area and reducing muscular wall thickness measurements. This is the first study to show that intravenous administration of levosimendan is effective in preventing cerebral vasospasm induced by SAH in rabbits.Öğe A case report of firearm bullet settling into the thoracic spinal canal without causing neurological deficit or vertebral bone destruction(SPRINGER, 2007) Kalkan, Erdal; Keskin, Fatih; Cengiz, Sahika Liva; Baysefer, AlperObjective The main objective of this study was to present a case of gunshot injury in which a bullet particle settled into the inferior-thoracic epidural canal, which was neurologically intact, without causing any vertebral bone destruction. Summary and background data There has been no previous report in the literature regarding a foreign body settling into the vertebral canal following gunshot injury without causing any bony destruction. Case report A 40-year-old male patient was hospitalized in emergency service with the complaints of severe pain in his back and both legs secondary to a gunshot wound. The entrance wound of the traversing projectile was located at the level of the tenth costa at the inferior of the right scapula. Neurological examination revealed no motor deficit. His lung X-ray was normal at radiological examination. Direct radiograph determined a bullet nucleus on the medium line at thoracolumbar level T-12. Intracanalicular bullet nucleus was found at posterior epidural at the T-12 level on thoracic CT, myelography and CT myelography. No vertebral bone destruction was seen in the direct radiograph studies and serial CT. T12 total laminectomy was performed and epidural foreign body removed. The patient, whose pains ameliorated during the postoperative process, was discharged without any neurological deficit. Conclusion We prefer removal of firearm particles settling into the spinal canal in view of possible later complications such as infection and the toxic effect of the metallic particles, unless there appears any risk of neurological detriment to the patient.Öğe Congenital Cranial and Spinal Dermal Sinuses: A Report of 3 Cases(Health Communications Inc, 2006) Kalkan, Erdal; Karabağlı, Pınar; Karabağlı, Hakan; Baysefer, AlperThree cases of congenital dermal sinus are presented-2 female and I male. Frontal, thoracic, and lumbosacral congenital dermal sinuses were explored. All patients presented with skin findings, but no neurologic deficits. The case with frontal localization was associated with a corpus callosum lipoma and dermoid tumor, and the patient presented with recurrent meningitis. The case with sacral localization was associated with an epidermoid tumor. Morphogenetic, clinical, and radiologic aspects of these cases are discussed. The midline should be carefully examined whenever a child suffers from meningitis. Dermal sinus tracts should be excised prophylactically.Öğe Deoxy-ribonucleic acid repair genes XRCC1 and XPD polymorphisms and brain tumor risk(RIYADH ARMED FORCES HOSPITAL, 2008) Cengiz, Sahika L.; Acar, Hasan; Inan, Ziyaeddin; Yavuz, Servet; Baysefer, AlperObjectives: To evaluate whether polymorphisms in the deoxy-ribonucleic acid (DNA) repair genes XRCC1 and XPD, have efficacy in the development of brain tumors. Methods: This is a case-population based study, including 135 cases of brain tumors, and 87 population based age- and gender-matched healthy controls. We examined the role of XRCC1 Arg399Gln gene and XPD Lys751Gln gene polymorphisms, in the context of brain tumor risk for the Turkish population between 2004 and 2007 at Selcuk University, Konya, Turkey. Patients with brain tumors were Subdivided into glial tumors (n=71), meningiomas (n=35), pituitary adenomas (n=21), and metastases to the brain (n=8). The diagnoses of brain tumors in all patients were analyzed by histopathological examination. Genomic DNA of leukocytes for polymerase chain reaction analysis was isolated. Results: Association of genotype of both XRCC1 Arg399Gln and XPD Lys751Gln genotypes with tumor types, tumors according to brain subtypes were, 71 (52.6%) meningiomas, 35 glial (25.9%), 21 (15.55%) pituitary adenomas, and 8 (5.9%) metastases to the brain. Between subtypes of tumors, there was a significant difference in XRCC1 Arg399Gln genotypes, and not in XPD Lys751Gln genotypes. Conclusion: The results indicated no elevated risk for brain tumors in individuals with the XRCC1 Arg399Gln and XPD Lys751Gln polymorphism risk.Öğe Efficacy of Adcon-L gel or Healon-GV in epidural fibrosis after lumbar microdiscectomy(RIYADH ARMED FORCES HOSPITAL, 2007) Cengiz, Sahika L.; Baysefer, AlperObjective: To evaluate the efficacy of anti-adhesion barrier agents following lumbar microdiscectomy. Methods: Healon GV or Adcon-L was applied to a laminectomy defect overlying the duramater in 60 patients assigned to 3 randomized groups: Group I Adcon-L (n=21), Group II - Healon GV (n=21), and Group III - control group, no adhesion barrier used (n=18). We conducted this study between 2004 and 2006 at Selcuk University, Konya, Turkey. Results: No significant difference was found between the 3 groups either in the outcome measurements according to visual analogue score and the Oswestry Disability Index or in the radiological evaluation of epidural fibrosis by application of those anti-adhesion barrier agents. When comparing group III with groups I and II, we could not find a statistically significant difference in the clinical results and in the outcome measures (p > 0.01). Conclusion: The epidural application of popular anti-adhesion barriers, after lumbar microdiscectomy was not found to be effective regarding outcome measures in human spinal surgery.Öğe İntraventriküler oligodendrogliomalar(2005) Kalkan, Erdal; Torun, M. Fuat; Cengiz, Şahika L.; Erdi, M. Fatih; Baysefer, AlperAmaç: Oligodendrogliomalar nöroepitelyal tümörlerden olup, tüm intrakranial tümörlerin %1-4’nü, tüm glial tümörlerin ise %4-8’ini oluştururlar. Primer intraventriküler oligodendrogliomalar ise nisbeten daha nadir bildirilmektedir. Bu yazıda kliniğimizde opere edilen iki primer intraventriküler oligodendroglioma olgusu sunularak klinik özellikleri tartışılmıştır. Olgu sunumu: Klinik ve radyolojik olarak primer intraventriküler yerleşimli iki oligodendroglioma olgusu opere edildi. Olgu 1 elektif şartlarda opere edilerek nörolojik defisitsiz taburcu edilirken; olgu 2 Glaskow Koma Skoru 5 olarak acil şartlarda opere edilmiş ve postoperative 5.gün eksitus olmuştur. Sonuç: İntraventriküler lezyonlara yaklaşımda primer oligodendrogliomalar akla getirilerek total cerrahi rezeksiyon amaçlanmalıdır.Öğe The lumbar roots and pedicles: a morphometric analysis and anatomical features(ELSEVIER SCI LTD, 2008) Torun, Fuat; Tuna, Hakan; Buyukmumcu, Mustafa; Caglar, Sukru; Baysefer, AlperThe objective of this study was to conduct a morphometric analysis of the lumbar nerve roots and surrounding structures. In this investigation, the lumbar roots were studied in 14 cadavers (70 lumbar vertebrae). Lumbar pedicle heights and widths were measured at every level of the lumbar vertebrae. The largest mean root diameter was 5.6 mm (L5 root) and the smallest 3.5 mm (L1 root). With regard to the root-dura exit angle, the widest was measured at L1 as 26.2 +/- 1.6 degrees and the narrowest at L5 as 16.3 +/- 2.4 degrees. The widest lumbar pedicle was measured at L5 as 17.1 +/- 4.2 mm and the narrowest at L1 as 8.4 +/- 1.8 mm. The longest lumbar pedicle was measured at L2 as 15.3 +/- 2.2 mm and the shortest at L4 as 13.8 +/- 2.3 mm. Quantitative measurements of lumbar root diameters, their exit angles from the dura, and lumbar pedicle heights and widths in anatomical dissection models may help us to gain a deeper understanding of the pathologies of this region and positively influence the success of surgical interventions. (c) 2007 Elsevier Ltd. All rights reserved.Öğe Primary lumbar vertebral hydatid cyst(CHURCHILL LIVINGSTONE, 2008) Kalkan, Erdal; Torun, Fuat; Erdi, Fatih; Baysefer, AlperSpinal hydatid cyst is a serious and rare infectious disease. We report a case of spinal hydatid cyst at the second lumbar vertebra, and we discuss the clinical presentation, diagnosis and surgical treatment of vertebral hydatid cyst. (C) 2007 Elsevier Ltd. All rights reserved.Öğe Primary spinal intradural extramedullary hydatid cyst in a child(AMER PARAPLEGIA SOC, 2007) Kalkan, Erdal; Cengiz, Sahika L.; Cicek, Onur; Erdi, Fatih; Baysefer, AlperBackground/Objective: Spinal hydatid cyst is a serious form of hydatid disease affecting less than 1% of the total cases of hydatid disease. We present a case of pathologically confirmed primary intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease. Case Report: An 8-year-old boy presented with back pain, left leg pain, and difficulty in walking. The patient had no other signs of systemic hydatid cyst disease. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after the surgical removal. Conclusion: Although extremely rare, primary intradural extramedullary hydatid cyst pathology might be the cause of leg pain and gait disturbance in children living in endemic areas.Öğe Thoracic Epidural Cavernous Haemangioma: A Case Report(2006) Torun, Fuat; Kalkan, Erdal; İlik, Kemal; Erdi, Fatih; Baysefer, AlperKavernöz hemangiomalar, craniospinal sinir sisteminin nadir görülen benin vasküler malformasyonlarıdır. Epidural spinal kavernöz hemangiomalar, intraserebral ve vertebral sistemin diger lokalize kavernöz hemangiomalarından daha nadir görülür. Bu yazımızda spinal kavernöz hemangiomaların klinik görüntüsü ve ayırıcı tanısı tartışılmıştır.Öğe An unusual association of optic hydrops and Reiter's syndrome(RIYADH ARMED FORCES HOSPITAL, 2007) Cengiz, Sahika L.; Baysefer, AlperThe association of optic hydrops and Reiter's syndrome in the literature has not been mentioned previously. This syndrome characteristically consists of 3 manifestations: arthritis, urethritis, and conjunctivitis. A 42-year-old woman with a history of Reiter's syndrome presented with progressive vision disturbance in her left eye and with headache. Orbital MRI demonstrated enlarged perioptic nerve subarachnoidal space on the left side.
