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Öğe Bilateral Subdural Hematoma After Ventriculoperitoneal Shunt Surgery(Emergency Medicine Physicians Assoc Turkey, 2019) Yuksel, Ulas; Akkurt, Ibrahim; Ogden, Mustafa; Bakar, Bulent; Keskil, SemihBackground: Bilateral subdural hematoma (SDH) following ventriculoperitoneal (V/P) shunt application was discussed in present case. Case Report: 8-year-old girl was operated due to thoracolumbar meningomyelocele immediately after birth. V/P shunt was inserted in right posterior parietal region due to hydrocephalus when she was 3 month-old. At age of 3 years, V/P shunt dysfunction was considered, and second V/P shunt was inserted in left posterior parietal region. One year after, patient was reevaluated, and CT images showed bilateral subacute SDH. Hematoma evacuation was not considered, but right ventricular catheter was ligated. At four years follow-up, no additional neurological impairment was observed in patient and CT scan revealed that SDHs were retracted greatly. Concusion: It should be kept in mind that SDH could develop after V/P shunt surgery. Additionally, it could be said that one of most important factor in determination of treatment of this complication was primarily neurological examination findings of patient.Öğe Biochemical markers in the prognosis of intracranial hemorrhages(Cukurova Univ, Fac Medicine, 2018) Yuksel, Ulas; Ogden, Mustafa; Akkurt, Ibrahim; Bakar, Bulent; Kisa, Ucler; Ozveren, Mehmet FaikPurpose: The aim of this study was to determine prognosis of patients with intracranial hemorrhage by examining routine laboratory findings. Materials and Methods: Patients were divided into three groups according to hemorrhage type (subarachnoid hemorrhage, spontaneous intracerebral hematoma, subdural hematoma). Then serum sodium, potassium, C-reactive protein, blood leukocyte count and neutrophil percentage values were measured pre- and postoperatively. Results: Twenty-eight patients (10 female, 18 male) were included in study. There was no difference among groups in terms of all parameters. However, postoperative leukocyte counts were higher than preoperative values in intracerebral hematoma group; and postoperative sodium levels were higher than preoperative values in subarachnoid hemorrhage group. There was found negative correlation between Glasgow Outcome Scale scores and preoperative neutrophil, preoperative and postoperative sodium values in subarachnoid hemorrhage group. A negative correlation was found between Glasgow Outcome Scale scores and preoperative C-reactive protein values in subdural hematoma group. Conclusion: Study results suggested that pre-and postoperative serum sodium values in subarachnoid hemorrhage; age, Glasgow Coma Scale score, pre-and post-operative C-reactive protein values in spontaneous intracerebral hematoma; and preoperative C-reactive protein values in subdural hematoma were considered to be predictors of patient prognosis.Öğe Cerebral ischaemia/reperfusion injury could be managed by using tramadol(Taylor & Francis Ltd, 2018) Akkurt, Ibrahim; Cetin, Cansel; Erdogan, Ahmet Melih; Dincel, Gungor Cagdas; Ceylan, Asli Fahriye; Kisa, Ucler; Bakar, BulentObjectives: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury. Methods: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1 beta, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-alpha, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically. Results: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result. Discussion: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques.Öğe Effectiveness of the Biophysical Barriers to the Peridural Fibrosis in Rat Laminectomy Model(Taylor & Francis Inc, 2019) Akkurt, Ibrahim; Bakar, Bulent; Dincel, Gungor Cagdas; Yildiran, Fatma Azize Budak; Ogden, Mustafa; Nursoy, Egemen; Sari, ElifPurpose: Peridural fibrosis which could occur after the spinal surgery could adhere neural tissue closely and may cause to neural entrapment symptoms and require surgical reintervention. Aim of the study: Present study was designed to reduce occurrence of peridural fibrosis in rat laminectomy model by using biophysical barriers called hyaluronic acid (HAS) dural barrier, activated polyethylene glycol and polyethylene imine (PEG) dural barrier, and platelet-rich plasma (PRP). Materials and methods: In this study, 2 of 26 male Wistar albino rats (325-350 g body weight), which were not included into study groups were sacrificed by removing their total blood and their blood was used for preparation of PRP, and remaining rats were randomly delivered into four groups called SHAM, HAS, PEG, and PRP groups. Then L3-4-5 laminectomy was performed to all animals and experimental agents were administered to the selected groups mentioned above. Spinal colons of all animals were removed gross total after 6-week period and investigated histopathologically. Additionally, real-time-polymerase chain reaction was used to obtain collagen type I and type III, transforming growth factor-1 beta, and tumor necrosis factor-alpha gene expressions. Results: All results demonstrated that polyethylene glycol and polyethylene imine dural barrier and PRP could decrease peridural fibrosis formation efficiently in rat. Conclusion: Present study results suggested that to reduce or block formation of peridural fibrosis, either polyethylene glycol and polyethylene imine dural barrier or PRP could be used effectively in human subjects after they will be closely investigated in future studies.Öğe Performing the screw fixation from C3 to odontoid process in a patient with Klippel-Feil syndrome and type II odontoid fracture(Wolters Kluwer Medknow Publications, 2018) Ogden, Mustafa; Yuksel, Ulas; Akkurt, Ibrahim; Bakar, BulentA 56-year-old female patient was admitted with a history of pain during neck movements after cervical injury. Computerized tomography scan revealed type II odontoid fracture and fusion anomaly between C2 and C3 vertebrae. At surgery, the anteroinferior part of C2 vertebra corpus could not be reached; therefore, transodontoid screw was advanced from C3 vertebra toward odontoid process. At follow-up examination, the complaints of the patient had recovered, and fracture line was completely fused. Advancing screw from C3 to odontoid process via anterior cervical approach could be thought an alternative treatment option in the patient with short neck caused from vertebra fusion anomaly and/or obesity.
