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Öğe Diagnostic value of bed-side ultrasonographic evaluation by anterior approach in spine disorders? A preliminary report(Sociedad Luso-Espanola Neurocirugia, 2003) Evliyaoglu, C.; Ayberk, G.; Sargin, H.; Keskil, S.A preliminary investigation was planned so as to evaluate the effectiveness of ultrasonography for bedside evaluation of patients with suspected spinal pathology. Its application by anterior approach in 37 cases showed that herniated disc material, bone, epidural fat, scar tissue, tumoral masses and their relation to the interspace and dural sac could be visualized. A short description of the sonographic appearance of normal and pathological structures was also given in comparison to Computed Tomography or Magnetic Resonance images. Ultrasonographic examination was inadequate in five of the patients due to obesity, meteorism or diminution of the intervertebral disc space. Advantages of this technique are the availability almost in every hospital, the ease of obtaining images at various angles, avoiding the use of x-rays and the low price. The disadvantages are its relatively poor definition as compared to Computed Tomography or Magnetic Resonance Imaging and its inability to see through bone.Öğe Imaging problems and clinical findings in adolescent lumbar disc herniation: A retrospective study(Georg Thieme Verlag Kg, 2002) Keskil, S.; Seçkin, Z.; Ayberk, G.; Tosun, H.; Tokyay, M.; Kiliç, C.Objectives: Disc degeneration probably begins in childhood although low back pain and radicular leg pain is not as common a complaint as in adults. However as yet no explanation exists for the appearance of advanced degenerative changes seen occasionally in patients in their twenties. Patients and methods: We report 12 adolescents between the ages of 15 and 20 among a total of 1068 cases with radiologically demonstrated lumbar disc herniations treated between March 1991 and March 1996. Results: Most of their findings were in good agreement with earlier and more recent reports. The only different findings worth commenting upon were the common presence of multiple level disc herniations, and the occasional presence of a so called "fractured epiphysial plate". Conclusion: Depending on magnetic resonance imaging findings coupled with computed tomographic images: we suppose that the so called "fractured bone fragments of the vertebral epiphysial rim impinging on the spinal canal at multiple levels" and "wedges of bone attached to the disc end plate and associated bony defects in the margins of the posterior vertebral bodies" reported to be demonstrated on computed tomographic (CT) images may in fact be false images. Inappropriately angled CT scan slices may cut partly through the epiphysial ring which has totally been distracted backwards together with the firmly attached avulsed disc annuli, designated as an "epiphysial avulsion"; giving rise to the mistaken interpretation as a "fractured epiphysial ring" appearance. Such a mechanism may also involve the posterior longitudinal ligament, which is firmly attached to the neighboring annuli, accounting for the common multilevel involvement.Öğe Redundant ventriculomegaly associated with brain abscess(Elsevier Doyma Sl, 2002) Keskil, S.; Ayberk, G.; Seçkin, Z.; Kizartici, T.; Kilic, C.Although brain abscess had a high mortality rate, improvements in radiologic imaging facilities, bacteriological techniques and antibiotics have resulted in a mortality of about 5%(16.11,31). Our aim was to emphasize the recently observed increase in the incidence of ventriculomegaly associated with brain abscess among the patients operated on in our hospital during five years. The causes and management of this well-known complication of brain abscesses was also discussed.Öğe Spontaneous resolution of "protruded" lumbar discs(Georg Thieme Verlag Kg, 2004) Keskil, S.; Ayberk, G.; Evliyaoglu, C; Kizartici, T.; Yucel, E.; Anbarci, H..Decreasing size of disc material that has herniated, whether "contained" or "protruded" has previously been described and sometimes this can be so complete that residual material is barely visible. In a retrospective clinical survey, from among almost 2180 consecutive patients admitted during 1994-2002 with low back pain; due to our low follow-up ratios and high price of the magnetic resonance imaging (MRI), only 42 patients with a lumbar disc protrusion could be found who had two MRI scans obtained at least five weeks apart. Among these, 4 patients were spotted with a totally resolved disc protrusion. T-2-weighted MRI images were suggesting shrinkage due to dehydration and regression within the annulus of protruded disc fragments that had not fully migrated. Our patients are further examples for total resolution of the large "protruded" disc without any treatment; and since concomitant disc protrusions at other levels persisted, the resolution of these discs is supposed to be spontaneous.