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    ADC evaluations of the hippocampus and amygdala in multiple sclerosis
    (Asean Neurological Assoc, 2014) Inal, Mikail; Daphan, Birsen Unal; Bilgili, Yasemin Karadeniz; Turkel, Yakup; Kala, Ibrahim
    Background & Objective: Diffusion-weighted MR imaging and apparent diffusion coefficient (ADC) values provide significant structural information about tissues in multiple sclerosis (MS). The goal of this study was to evaluate the ADC values in the hippocampus and amygdala in MS. Methods: Thirty-eight patients with MS and 41 healthy individuals were included in the study. ADC values were measured bilaterally from three different points in the hippocampus and amygdala in MS patients and were compared with those of the controls. An analysis of varianceposthoc test was used to analyse the differences among mean ADC values between MS and control groups. Results: The mean ADC values of both sides of the hippocampus and the left amygdala in MS patients were lower than the control group. The mean ADC values of the right amygdala in MS patients were lower than the control group, but the difference was not statistically significant. Conclusion: We observed restricted diffusion in the hippocampus and amygdala in MS patients contrary to information in the literature.
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    ADC evaluations of the hippocampus and amygdale in multiple sclerosis
    (ASEAN Neurological Association, 2014) Inal, Mikail; Daphan, Birsen Unal; Bilgili, Yasemin Karadeniz; Turkel, Yakup; Kala, Ibrahim
    Background & Objective:Diffusion-weighted MR imaging and apparent diffusion coefficient (ADC) values provide significant structural information about tissues in multiple sclerosis (MS).The goal of this study was to evaluate the ADC values in the hippocampus and amygdala in MS. Methods:Thirtyeightpatients with MS and 41 healthy individualswere included in the study. ADC values were measured bilaterallyfrom three different pointsin the hippocampus and amygdala in MS patients and were compared with those of the controls. An analysis of varianceposthoc test was used to analyse the differences among mean ADC values between MS and control groups.Results:The mean ADC values of both sides of thehippocampus and the left amygdala in MS patients were lower than the control group. The mean ADC values of the right amygdala in MS patients were lower than the control group, but the difference was not statistically significant.; Conclusion:We observed restricted diffusion in the hippocampus and amygdala in MS patients contrary to information in the literature. © 2014, ASEAN Neurological Association. All rights reserved.
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    Investigation of the calcification at the petroclival region through Multi-slice Computed Tomography of the skull base
    (Churchill Livingstone, 2016) Inal, Mikail; Muluk, Nuray Bayar; Burulday, Veysel; Akgul, Mehmet Huseyin; Ozveren, Mehmet Faik; Celebi, Umut Orkun; Daphan, Birsen Unal
    Objectives: The aim of this paper was a retrospective investigation of calcification at the petroclival region using Multi-slice Computed Tomography (MSCT). Methods: One hundred thirty skull bases were reviewed. The images were acquired with a 64 slice CT (MSCT). At first images were taken at the axial plane; and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these 3-dimensional images (3-D imaging). Petrosphenoidal ligament (PSL) (Gruber's ligament) and posterior petroclinoid ligament (PPCL) calcifications were evaluated as "none, partial or complete calcification" for the right and left sides. Results: In the right PSL, there were partial calcifications in 9.8% and complete calcifications in 2.3%. Calcification ratio was 9.8% partial and 2.9% complete in the left PSL. In the right side, there were 26.6% partial and 5.2% complete calcifications of PPCL. In the left side, there were 29.5% partial and 4.6% complete PPCL calcifications.. PPCL calcification was detected more in males compared to females in the right and left sides. In older patients, left PSL; right and left PPCL calcification were detected more. Conclusion: PPCL calcifications cannot be differentiated from PSL calcifications in MSCT slices. The distinction can be easily done in 3-D views. The presence of ossified ligaments may make surgeries in this region difficult, and special care has to be taken to avoid injuries to structures which pass under these ossified ligaments. Particularly in elderly patients, the appropriate surgical instrument for the PSL calcifications should be prepared preoperatively. If PSL is calcified, 6th cranial nerve palsy may not occur even though increased intracranial pressure syndrome is present. Whereas, in lateral trans-tentorial herniations, 3rd cranial nerve palsy occurs in earlier periods when PSL is calcified. Moreover, in sub temporal and transtentorial petrosal approaches, knowing the PSL calcification preoperatively is important to avoid damaging the 6th cranial nerve during surgery. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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    Magnetic resonance imaging and computed tomography for diagnosing semicircular canal dehiscence
    (Churchill Livingstone, 2016) Inal, Mikail; Burulday, Veysel; Muluk, Nuray Bayar; Kaya, Ahmet; Simsek, Gokce; Daphan, Birsen Unal
    Objectives: We investigated the semicircular canal (SC) dehiscence using temporal computed tomography (CT) and magnetic resonance (MR) imaging. Methods: We retrospectively reviewed 114 (228 ears) consecutive MR images and CT scans of the temporal bones for dehiscence of the SCs. In the 1.5 Tesla (T) MR imaging, T1 and T2-weighted images were obtained. Dehiscence of the SCs was defined by absence of high attenuation bone coverage on the CT scans, and absence of low-signal bone margins on the MR images. Results: Superior SC dehiscence was detected in 4 (1.8%) ears using CT scans and 5 (2.2%) ears using MR imaging. Posterior SC dehiscence was detected in 4 (1.8%) ears using CT scans and 4 (1.8%) ears using MR imaging. In the non-dehiscent cases, there was hypointense bone coverage between the canal and the cerebrospinal fluid (CSF). However, in the cases of semicircular canal dehiscence, hypointense bone tissue did not appear between the canal and the CSF in the MR imaging. Conclusion: If there is clinical doubt about the presence of SC dehiscence, we recommend that MR imaging be conducted first. When dehiscence is not seen in the MR, a CT examination should be performed. MR imaging is preferred primarily, because it does not contain ionizing radiation. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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    Superior Mesenteric Artery Syndrome Accompanying With Nutcracker Syndrome: A Case Report
    (Kowsar Publ, 2014) Inal, Mikail; Daphan, Birsen Unal; Bilgili, Mirace Yasemin Karadeniz
    Introduction: Superior mesenteric artery syndrome is an uncommon cause of duodenal obstruction, and its manifestations are generally associated with compression on the third part of the duodenum between the abdominal aorta and superior mesenteric artery. Case Presentation: In this report, a patient is described presenting with epigastric pain and weight loss due to superior mesenteric artery syndrome. The patient has also nutcracker syndrome, which is the compression of the left renal vein between the aorta and the superior mesenteric artery at its origin. Conclusions: In addition to an appropriate clinical history, CT findings indicating decreased aortomesenteric angle and a shortened aortomesenteric distance can suggest the diagnosis for both the superior mesenteric artery syndrome and accompanying nutcracker syndrome.