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Öğe Calcified intracranial hydatid cyst: Case report(2011) Köktekir, Ender; Erdem, Yavuz; Gökçek, Cevdet; Karatay, Mete; Yılmaz, Ali; Bayar, Mehmet Akif; Sümer, SuaBu çalışmada; 26 yaşında, çiftlik işleri ile uğraşan, asemptomatik intrakraniyal hidatik kisti olan bir olgu sunulmaktadır. Kafa travması nedeni ile yapılan radyolojik incelemelerde kalsifiye intrakraniyal hidatik kist saptanan hasta cerrahi tedavi ile kitlenin tamamen çıkartılması sonrası nörolojik defisiti olmadan taburcu edildi. İntrakraniyal hidatik kistlerin kalsifikasyonu oldukça nadirdir. Bilgisayarlı beyin tomografisi ve kraniyal magnetik rezonans incelemeleri operasyon öncesi tanı için oldukça önemlidir. Radyolojik incelemeler esnasında membran detaşmanının, kist duvarında kalsifikasyonun ve kist içi membranların varlığı hidatik kist varlığına işaret eder. (Turkiye Parazitol Derg 2011; 35: 220-3)Öğe The Effect of Bevacizumab on Spinal Epidural Fibrosis in a Postlaminectomy Rat Model(TURKISH NEUROSURGICAL SOC, 2012) Karatay, Mete; Erdem, Yavuz; Koktekir, Ender; Erkoc, Yavuz Seim; Caydere, Muzaffer; Bayar, Mehmet AkifAIM: Spinal epidural fibrosis is an inherent result of surgical trauma after laminectomy. The conditions in which epidural fibrosis is excessive are in the etiology of failed back syndrome. There have been many attempts to prevent formation of epidural fibrosis. Bevacizumab which is an anti-angiogenic medication, inhibits the effect of VEGF and thereby decreases the new blood vessel formation and as a result prevents adhesions. This study shows the effect of bevacizumab on spinal epidural fibrosis developing after laminectomy in rats. MATERIAL and METHODS: In this study, 20 Wistar rats were used. Rats were divided into two groups; a control group, and a bevacizumab group. Three-level laminectomy was performed on the rats. Rats in the control group only had the laminectomy. In the bevacizumab group, 2.5 mg/kg bevacizumab diluted in 0.9% NaCl with a factor of 1:10 impregnated on cotton was applied on the dura topically for 5 minutes. Three weeks later, rats were sacrificed for histopathologic examination. Epidural fibrosis tissue was graded following sacrifice. RESULTS: Statistically, it was found that the bevacizumab group had significantly less epidural fibrosis compared to the control group (p<0.05). CONCLUSION: Bevacizumab reduced the spinal epidural fibrosis significantly that developed in rats after laminectomy via its anti-VEGF effect by blocking VEGF receptors.Öğe Intramedullary schwannoma of conus medullaris with syringomyelia(ELSEVIER SINGAPORE PTE LTD, 2017) Karatay, Mete; Koktekir, Ender; Erdem, Yavuz; Celik, Haydar; Sertbas, Idris; Bayar, Mehmet AkifIntramedullary schwannomas of the spinal cord are rare tumors. They are most commonly observed in the cervical region; however, few have been described in the conus medullaris. The association of intramedullary schwannomas with syringomyelia is also rare. In this report, we present a case of intramedullary schwannoma of the conus medullaris with syringomyelia, which was treated surgically. (C) 2017 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.Öğe A Long Term Evaluation of Result of Surgically Treated Lower Cervical Spine Trauma of 83 Patients: A Retrospective Study(JOURNAL NEUROLOGICAL SCIENCES, 2013) Celik, Haydar; Koktekir, Ender; Karatay, Mete; Erdem, Yavuz; Gokcek, Cevdet; Yasitli, Ugur; Bayar, Mehmet AkifObjective: Retrospective evaluation of 83 patients who were surgically treated for lower cervical spine trauma. Materials and Methods: We retrospectively evaluated the 83 patients who operated because of lower cervical spine trauma in Ankara Training and Research Hospital Neurosurgery Clinic. All patients demographic data, type of trauma, cause of trauma, time of surgery, preoperative and postoperative neurologic grades were carefully evaluated. Only those who were closely followed up at least for 1 year, were included in the evaluation. The impact of surgical treatment on neurological status was assessed by using Frankel scale. Neurological improvement was assessed as mild, moderate and significant in respect to upgrade in Frankel scale in one step, two step and three or four step, respectively. Results: The number of male patients was 61 (73.5%) and the number of female patients was 22 (26.5%) The mean age was 45.1(+/-2,4). 49 patients had the other system injuries at the time of trauma. The most common cause of trauma was traffic accident (62,6%) and the most common mechanism was flexion injury (59%). The most common type of injury was dislocation (74,7%) and the C5 was the most frequently affected vertebra due to the trauma. 48 patients had various neurologic deficits at the time of admission (57,8%). Of these 48 patients 33 patients were surgically treated within the first 24 hours (68,75%) whereas 15 patients operated 24 hours later (31,25%). A total of 10 patients showed neurological improvement (12,04%). Although mild and moderate neurologic improvements were seen in patients who received early (<24 hours) or late (>24 hours) surgery, significant improvement was observed in patients who received surgery within 24 hours. The surgical approaches were anterior, posterior and combined in 73, 6 and 4 patients, respectively. Conclusion: Our study results indicate that the early surgical decompression and stabilization should be performed as soon as possible in patients with incomplete spinal cord injury. We also concluded that only anterior approach is an effective method in most patients who have cervical spinal trauma.Öğe Renal Hücreli Karsinomun Kolloid Kist Görünümünü Taklit Eden3. Ventrikül Metastazı: Olgu Sunumu(2015) Karatay, Mete; Koktekır, Ender; Erdem, Yavuz; Celık, Haydar; Bayar, Mehmet AkifÜçüncü ventrikülün en sık görülen lezyonları kolloid kistlerdir ve bu bölgeye metastazlar çok nadir gözlenir. Biz, görünümü kolloid kiste benzeyen, renal hücreli karsinomun 3. ventrikül koroid pleksusuna metastazı olan bir olguyu bildirdik. Elli üç yaşında, 12 yıl önce renal hücreli karsinom tanısı alan, erkek hasta; tek 3. ventrikül metastazı ve hidrosefali nedeni ile opere edildi. Aşırı intraoperatif kanama nedeni ile tümör tamamen çıkartılamadı. Histolojik sonuç, renal hücreli karsinom metastazı idi. Hasta rezidüel tümör içerisine ve oluşan kanama nedeniyle ameliyat sonrası 13. günde öldü. Bu tür hastalarda cerrahi girişimin yaratacağı ciddi komplikasyonları engellemek için stereotaktik radyocerrahi ve ventriküloperitoneal şant tedavisi daha uygun olabilir.Öğe Role of Tenoxicam in The Prevention of Postlaminectomy Peridural Fibrosis in Rats(2013) Karatay, Mete; Celik, Haydar; Koktekir, Ender; Karatay, Eylem; Sertbas, Idris; Yılmaz, Ali; Caydere, MuzafferAmaç: Spinal cerrahi sonrası peridural fibrozis bazı durumlarda başarısız bel sendromunun altında yatan neden olabilir. Peridural fibrozisin engellenmesi amacıyla bir çok materyal denenmiştir. Nonsteroidal anti-inflamatuar ilaçlar (NSAIDs) inflamatuar ve fibroblastik yanıtı engellerler. En etkili nonsteroidal anti-inflamatuar ilaçlardan biri olan tenoksicam bir oxicam türevidir. Bu çalışma tenoksicamın topikal uygulamasının ratlarda laminektomi sonrası gelişen spinal peridural fibrozisi önlemede etkili bir yol olduğunu göstermektedir. Yöntem ve Gereç: Bu çalışmada 20 adet Wistar cinsi rat kullanıldı. Kontrol ve tenoxicam olmak üzere ratlar 2 ayrı gruba ayrıldı. Ratlara 3 seviye laminektomi yapıldı. Kontrol grubuna sadece laminektomi yapıldı. Tenoxicam kullanılan gruba ise pamuğa emdirilmiş 0.5 mg/kg tenoxicam, 0.9% NaCl ile 1:10 sulandırılarak cerrahi alanda dura üzerine topikal olarak 5 dakika süre ile uygulandı. Üç hafta sonra, ratlar histopatolojik inceleme için öldürüldü ve peridural fibrozis dokusu sınıflandırıldı. Bulgular: Kontrol grubu ile karşılaştırıldığında ameliyat sonrası üçüncü hafta tenoxicam kullanılan grupta peridural fibrozisin istatiksel olarak anlamlı derecede azaldığı görüldü (p0,05). Sonuç: Tenoxicam laminektomi yapılmış ratlarda gelişen spinal peridural fibrozisi anlamlı derecede azaltmıştır.Öğe Role of Tenoxicam in The Prevention of Postlaminectomy Peridural Fibrosis in Rats(JOURNAL NEUROLOGICAL SCIENCES, 2013) Karatay, Mete; Celik, Haydar; Koktekir, Ender; Karatay, Eylem; Sertbas, Idris; Yilmaz, Ali; Caydere, MuzafferAim: The reason behind failed back syndrome in some cases may be peridural fibrosis following spinal surgery. Many attempts have been shown to stop formation of peridural fibrosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the inflammatory and fibroblastic response. One of the most effective nonsteroidal anti-inflammatory drugs is tenoxicam, an oxicam derivative. This study suggests that topical application of tenoxicam is an effective way of preventing spinal peridural fibrosis developing after laminectomy in rats. Material and Methods: In this study, 20 Wistar rats were used. Rats were divided into two groups; a control group, and a tenoxicam group. Three-level laminectomy was implemented on the rats. Rats in the control group only had the laminectomy. In the tenoxicam group, 0.5 mg/kg tenoxicam, which was watered down in 0.9% NaCl with a factor of 1:10 soaked on cotton, was applied on the dura topically for 5 minutes. Three weeks later, rats were killed for histopathologic examination and peridural fibrosis tissue was classified afterwards. Results: Statistically, it was found that three weeks after surgery, the tenoxicam group had significantly less peridural fibrosis compared to the control group (p<0.05). Conclusion: Tenoxicam significantly reduced the spinal peridural fibrosis that developed in rats after laminectomy.Öğe Solitary Metastasis of Renal Cell Carcinoma to the Third Ventricle Mimicking a Colloid Cyst: Case Report(TURKISH NEUROSURGICAL SOC, 2015) Karatay, Mete; Koktekir, Ender; Erdem, Yavuz; Celik, Haydar; Bayar, Mehmet AkifColloid cysts are the most common third ventricle lesions and metastasis to this area is rare. We presented a case of solitary metastasis from a renal cell carcinoma to the third ventricle choroid plexus mimicking a colloid cyst. A 53-year-old man, who had a history of renal cell carcinoma 12 years ago, was operated for single third ventricle lesion and hydrocephalus via a transcallosal approach. Total removal could not be performed due to intraoperative massive bleeding. Histological examination revealed a metastatic renal cell carcinoma.The patient died on the postoperative 13th day because of bleeding from the residual tumor. Stereotactic radiosurgery and ventriculoperitoneal shunting might be favorable in such cases in order to avoid serious complications.
