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    Comparison of glasgow coma scale and full outline of unresponsiveness (four) score: a prospective study
    (TURKISH NEUROSURGICAL SOC, 2019) Bayraktar, Yesim Serife.; Sahinoglu, Mert.; Cicekci, Faruk.; Kara, Inci.; Karabagli, Hakan.; Duman, Ates.; Celik, Jale Bengi.
    AIM: To assess reliability by comparing the Full Outline of Unresponsiveness (FOUR) scores and Glasgow Coma Scale (GCS) values assigned by specialists from two different fields to patients in the Anesthesiology and Reanimation and Neurosurgery intensive care units. MATERIAL and METHODS: This study was conducted between March 2017 and June 2017 at Selcuk University Faculty of Medicine, Departments of Anesthesiology and Reanimation and Neurosurgery. Seventy-nine patients aged 18-65 years who were treated for at least 24 hours in the intensive care unit were independently assessed by two raters, an anesthesiologist and a neurosurgeon,using FOUR and GCS. The Kolmogorov-Smirnov normality test was applied for continuous variables, and SPSS 20.0 version software was used for data analyses. RESULTS: There were no significant differences between FOUR scores and GCS values given by the two raters. The mortality rate among patients with low scores on both FOUR and GCS was higher than the hospital mortality rate. CONCLUSION: Considering that FOUR score allows a more detailed neurological evaluation than GCS, and our findings suggest that FOUR score is more useful for patients who are unconscious or dependent on mechanical ventilation.
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    Proximalmigration of a lumboperitoneal shunt into the cerebello medullary cisterns
    (ELSEVIER, 2020) Gezer, Burak.; Karabagli, Hakan.; Koktekir, Ender.; Sahinoglu, Mert.
    Background: Lumboperitoneal (LP) shunt is a type of treatment commonly used in the surgical treatment of pseudotumor cerebri, comorbid hydrocephalus, cerebrospinal fluid (CSF) fistula. Despite the promising results of the LP shunt blockage of %7 and %14 migration rate of complications have been reported. Migration can be rarely observed in the spinal subarachnoid space or even in the intracranial area. We report a case where the LP shunt migrated upward to the cerebellomedullary cisterns. Case Description: A 37-year-old female patient underwent lumboperitonel shunt surgery for pseudotumor cerebri. After the LP shunt surgery, the patient's complaints of headache and blurred vision disappeared. The patient admitted to polycyclic at the postoperative first month with neck pain and neck sucking sensation. Cerebellomedullar cysterna shunt tip was seen in brain CT. The patient was operated again and the proximal end of the shunt was lowered to Lumbar 1 level under C-Arm Scope device control. Then, we fixed the subcutaneous tissue of the shunt of the LP shunt with the help of a non-resorbable suture and stitches. Conclusions: LP shunt distal migration is more common, such proximal migrations are rarely reported in the literature. LP shunt displacement must be due to defective or insufficient anchoring devices of the LP shunt tube. We think that great care must be taken to fix the LP shunt properly with the help of suture collars with an unresorbable suture at three places to the subcutaneous tissue.