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  • Küçük Resim
    Öğe
    Glioblastoma located in posterior fossa
    (2013) Bakar B.; Yazici I.; Kose E.A.; Ayva S.K.; Kasimcan M.O.
    A 63-year-old woman operated eight months ago for glioblastoma (GB) located in posterior fossa was admitted to emergency room for stuporous, nausea, vo-miting and headache. CT and MR showed recurrence of posterior fossa cystic-necrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF) fistula from the incision was occurred and contaminated by multidrug resistant Acinetobacter ba-umannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and child-ren; and it appears as two different subsets: de novo (primary type) and secondary glioblastomas. Although our patient's immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour was de novo because of no other brain involvement, staining with GFAP, vimentin, and nearly absent p53 mutation.
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    Öğe
    In spontaneous intracerebral hematoma patients, prediction of the hematoma expansion risk and mortality risk using radiological and clinical markers and a newly developed scale
    (Taylor and Francis Ltd., 2021) Bakar B.; Akkaya S.; Say B.; Yuksel U.; Alhan A.; Turğut E.; Ogden M.
    Objective: In patients with spontaneous intracerebral hematoma (ICH), early-stage hematoma expansion has been associated with poor prognosis in literature. This study aimed to develop predictive parameter(s) as well as a new scale to define hematoma expansion and short-term prognosis in patients with ICH. Methods: In 46 patients with ICH, Glasgow Coma Scale (GCS) scores, non-contrast CT (NCCT) markers (hematoma volume on admission and follow-up, hypodensity, intraventricular hemorrhage, blend and island sign, BAT score), and modified Rankin Scale scores were evaluated for predicting the hematoma expansion risk and mortality risk. Furthermore, a newly developed scale called the ‘HEMRICH scale’ was constituted using the GCS score, hematoma volumes, and some NCCT markers. Results: Roc-Curve and Logistic Regression test results revealed that GCS score, initial hematoma volume value, hypodensity, intraventricular haemorrhage, BAT score, and HEMRICH scale score could be the best markers in predicting hematoma expansion risk whereas GCS score, intraventricular haemorrhage, BAT score, hematoma expansion, and HEMRICH scale score could be the best markers in predicting mortality risk (p = 0.01). Moreover, Factor analysis and Reliability test results showed that HEMRICH scale score could predict both hematoma expansion and mortality risks validly (Kaiser-Meyer-Olkin test value = 0.729) and reliably (Cronbach’s alpha = 0.564). Conclusion: It was concluded that the GCS score, intraventricular haemorrhage, and BAT score could predict both hematoma expansion risk and mortality risk in the early stage in patients with ICH. Furthermore, it was suggested that the newly produced HEMRICH scale could be a valid and reliable scale for predicting both hematoma expansion and mortality risk. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
  • Küçük Resim
    Öğe
    Intradural lumbar disc herniation: A rare case
    (2013) Bakar B.; Kasimcan M.O.; Kose E.A.; Senyucel C.
    A 65-year-old man was admitted with radiating pain in right leg and saddle type anaesthesia with urination, defecation and ejaculation problems. Spinal MRI revealed a disc fragment that hugely extruded towards central spinal channel with marked cranial migration at L4-5 level on the T2 weighted sagittal image. It also demonstrated abrupt loss of continuity of the posterior longitudinal ligament (PLL). Then, he was taken for surgery. After a durotomy was performed, two pieces of cartilagenous tissue were removed en bloc. Three months later, his urination, defecation, ejaculation returned to nearly normal; and postoperative MRI revealed that operative site was clean and there was no residual disc material. We would like to emphasis on two points of MR findings about which increase the suspicious for intradural extension of these disc fragments. The first point is abrupt loss of continuity of the posterior longitudinal ligament. The second point is a sharp beak-like appearance on T2 weighted axial imaging. Prognosis is related to complete removal of the herniated material, cleaning of the intervertebral space, duration and characterization of the symptomatology.