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Öğe Carotid canal and optic canal at sphenoid sinus(Springer, 2019) Asal, Nese; Muluk, Nuray Bayar; Inal, Mikail; Sahan, Mehmet Hamdi; Dogan, Adil; Arikan, Osman KuersatIn the present study, we investigated the relationship between sphenoid sinus, carotid canal, and optic canal on paranasal sinus computed tomography (PNSCT). This study was performed retrospectively. PNSCT images of 300 adult subjects (159 male, 141 female). Sphenoid sinus (pneumatisation, dominancy, septation, inter-sinus septa deviation), anterior clinoid process pneumatisation, Onodi cell, carotid and optic canals (width, dehiscence, classification) were measured. In males, type 3 pneumatised sphenoid sinus (in both sides) and in females type 2 pneumatised sphenoid sinus (right side) and type 3 pneumatised sphenoid sinus (left side) were detected more. Anterior clinoid pneumatisation was present 47.2% in males and 39.7% in females. In male group, more septation (i.e. 22.6%, 3 septa) in sphenoid sinus were detected. Onodi cell was present 26.6 and 19.1% in males and females, respectively. Carotid canal protrudation to the sphenoid sinus wall was present 23.9-32.1% in males and 35.5-36.2% in females. Dehiscence in carotid canal was detected more in females (34%) compared to males (22%). Optic canal protrudation was 33.3 and 30.5% in males and females. Type 4 optic canal was detected more in both gender. Optic canal dehiscence was detected 11.3 and 9.9% in males and females. Carotid and optic canal diameters were higher in males. In pneumatised sphenoid sinuses and in females, type 3 carotid canal (Protrudation to SS wall) (bilaterally) and type 1 optic canal type (No indentation) (ipsilateral side) were detected more. In elderly patients, carotid and optic canal width increased. When carotid canal protrudation was detected, there was no indentation in optic canals In pneumatised SS, carotid canal protrudation was observed with a greater risk in surgery. However, type 1 (non indentation) optic canal was present in highly pneumatised SS with lower risk for the surgery. In women, the risk of carotid canal protruding (about 1/3) is greater than that of males, and carotid canal dehiscence rates are also higher in females. Therefore, physicians should be very careful during the preparatory stages of the sphenoid sinus surgery. Otherwise, it may not be possible to prevent lethal carotid artery bleeds.Öğe Critical Stenosis of the Internal Carotid Artery: Variability in Vertebral Artery Diameters and Areas of Cerebral Chronic Infarction in Computed Tomography(Lippincott Williams & Wilkins, 2019) Sahan, Mehmet Hamdi; Asal, Nese; Muluk, Nuray Bayar; Inal, Mikail; Dogan, AdilObjectives: We investigated unilateral and bilateral cervical internal carotid artery (ICA) stenosis according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST). Methods: We retrospectively investigated ICA stenosis on Head&Neck Computed Tomography Angiography (CTA); and their simultaneous brain computed tomography images were also evaluated. In unilateral ICA stenosis group (n = 36), 17 of them had right ICA stenosis and 19 left ICA stenosis. In bilateral stenosis group, there were 24 patients. ICA stenosis was evaluated according to NASCET and ECST methods. We also evaluated vertebral artery dimension, plaque density and cerebral infarct (Cerebral kortex, white matter, basal ganglion-thalamus). Results: Unilateral ICA stenosis according to the NASCET was 70.64% to 73.68% (right-left) and according to the ECTS was 65.52% to 71.15% (right-left). For bilateral stenosis, ICA stenosis according to the NASCET was 67.70 to 67.91 (right-left); according to the ECTS was 62.45% to 62.15% (right-left). Vertebral artery dimensions were 3.26 to 3.72 mm (right-left) in unilateral ICA stenosis; and 3.52 to 3.71 mm (right-left) in bilateral ICA stenosis. In bilateral stenosis group, mixt plaque; and in unilateral stenosis group, hard plaque was detected. In unilateral stenosis, white matter and basal ganglion-thalamus infarcts; in bilateral ICA stenosis, cerebral cortical infarct was detected. Left-vertebral artery diameter increased in higher L-ECTS ICA stenosis (unilateral) group. Conclusion: Increase in left vertebral artery diameter in unilateral L-ECTS ICA stenosis may be related to increase of the collateral flow by vertebral arteries to support brain blood-flow.Öğe The Diagnostic Value of CT-guided Percutaneous Co-axial Trans-thoracic Biopsy (PCTTB) and Evaluation of the Pathologic Examination(Bentham Science Publ Ltd, 2019) Sahan, Mehmet Hamdi; Inal, Mikail; Muluk, Nuray Bayar; Dogan, Adil; Atasoy, PinarBackground: We investigated thoracic masses with Computed Tomography (CT)-guided Percutaneous Co-Axial Trans-Thoracic Biopsy (PCTTB). Methods: The retrospective data of 86 patients to whom CT-guided PCTTB bad been applied were obtained. Eighty-four cases and their pathologic results were included in the study. Localization and appearance of the lesions, pathologic results, and complications were evaluated. Results: Diagnostic sensitivity of CT-guided PCTTB was 97.6%. In 60.7% of the cases, malign lesions and, in 39.3% of the cases, benign lesions were diagnosed. The mass size was on average greater than 2 cm, and one mass was detected as being more than >= 2 masses. Mainly, irregular contours were observed. Most of the malign tumors were primary malign tumors on both sides (91.7% on the right side and 88.9% on the left side). Squamous Cell Carcinoma (SCC) was the most often detected malign tumor on the right side, and adenocarcinoma was the most often detected malign tumor on the left side. In masses localized on the left inferior lobe, metastasis was often detected. When the number of the mass was >= 2 and the mass had the appearance of consolidation, metastasis was usually detected. Small and large masses were mainly localized on right and left upper lobes. In the small mass group, 75.0% of the cases were benign, and, in the large mass group, 64.5% of the cases were malign (p=0.031, chi(2)=4.666). Pneumothorax was the most commonly occurring complication (23.8%). In masses localized on the right lower lobe, the pneumothorax ratio increased in benign masses compared to malign masses. The hemorrhage detection rate was 13.0%, and hemoptysis occurred in 14.2% of the cases. Hemorrhage was detected during 11.8% of the large mass biopsies. In females, hemorrhage occurred more often than in males (p=0.026, 7 r= 0.244). Conclusion: CT-guided PCTTB is a safe method to utilize for lung biopsies. Co-axial method increased the diagnostic accuracy of CT-guided percutaneous trans-thoracic biopsies. A single cut also decreased the complication rates.Öğe Evaluation of the Optic Nerve by Strain and Shear Wave Elastography in Patients With Migraine(Wiley, 2019) Sahan, Mehmet Hamdi; Dogan, Adil; Inal, Mikail; Alpua, Murat; Asal, NeseObjectives To investigate the optic nerve's elastic properties using shear wave and strain elastography in patients with migraine compared to healthy individuals. Methods The migraine group consisted of 30 patients (16 with visual auras and 14 without auras) who had previously had a diagnosis of migraine. These were age and sex matched with healthy participants to form the control group. The findings from shear wave and strain elastography in the groups were compared. The elastographic examination was performed with a 6-15-MHz multifrequency linear array transducer. Results The evaluation involved 30 patients with migraine (3 male and 27 female), whose mean age +/- SD was 34.63 +/- 10 years, and 30 healthy participants (3 males, 27 females), whose mean age was 36.4 +/- 10.5 years. In strain elasticity patterns, a statistically insignificant hardening of the optic nerve in the patients with migraine was observed (P = .052). Analysis of the shear wave elastic modulus values (9.8 +/- 3.34 and 12.3 +/- 5.25 kPa; P = .03) revealed that differences between the healthy participants and patients with migraine were statistically significant. The results for elasticity patterns and the shear modulus suggested that the differences between migraines with and without visual auras were insignificant (P > .05). A positive correlation was discovered between the duration of the disease and the shear modulus in the patients with migraine (r = 0.496; P < .01). Conclusions Histopathologic changes in the optic nerve may be seen in patients with migraine due to possible fibrotic changes. Elastographic techniques can be useful diagnostic tools for investigating these changes.Öğe Is there a relationship between basilar artery tortuosity and vertigo?(Elsevier Science Bv, 2019) Burulday, Veysel; Dogan, Adil; Akgul, Mehmet Huseyin; Alpua, Murat; Cankaya, ImranObjective: The aim of this study was to investigate the relationship between basilar artery (BA) tortuosity, hypogenesis/agenesis of the vertebral artery (VA), and vertigo, with the use of magnetic resonance imaging (MRI). Patients and methods: This case-control study included patients admitted to the outpatient clinics, who were aged 18-80 years, without any known systemic diseases. All patients were evaluated with a 1.5-tesla MRI system. BA Tortuosity, VA agenesis, and VA asymmetry were noted. BA diameter (central) and length (longitudinal) were measured. Results: A total of 154 vertigo patients (46 M, 108 F; mean age of 48.95 +/- 17.3 years) and 346 control subjects (112 M, 234 F; mean age of 45.12 +/- 17.0 years) were included. The mean age of the vertigo patients was significantly higher than that of the control group (48.95 vs 45.12 years) (p = 0.021). The rate of BA tortuosity was higher in patients with vertigo (p = 0.030). When the participants were divided into two groups according to median age ( < 45 vs. >= 45 years) there was no statistically significant difference between the groups in terms of VA asymmetry (p = 0.070) and hypogenesis/agenesis (p = 0.577). There was a statistically significant difference between the groups in respect of BA tortuosity (p = 0.033), BA diameter (p < 0.001), and BA length (p < 0.001). When the study populations were divided into two groups according to the presence of vascular tortuosity, the mean age, BA diameter, and BA length values were higher in the tortuosity ( + ) group (all p < 0.001). Conclusion: These results demonstrated that vertigo and BA tortuosity rates seem to increase with age. Likewise, BA diameter and length increased with age, although there was no significant relationship with vertigo. Patients with tortuosity were significantly older, and had higher rates of VA asymmetry/agenesis, and increased BA diameter compared to subjects without tortuosity.Öğe Olfactory bulbus volume and olfactory sulcus depth in migraine patients: an MRI evaluation(Springer, 2018) Dogan, Adil; Muluk, Nuray Bayar; Sahan, Mehmet Hamdi; Asal, Nese; Inal, Mikail; Ergun, UfukTo compare the measurements of olfactory bulb volume and olfactory sulcus depth in patients with migraine and a control group. The study included the cranial MRI (1.5 T) images of 200 adults diagnosed with migraine and a control group of 100 subjects without migraine. The control group mainly consisted of the patients with non-migraneous headache. The measurements were obtained from coronal T2-weighted images for standard olfactory bulb (OB) volume and olfactory sulcus (OS) depth. The OB volume and OS depth values were lower in the migraine group than in the control group. In the migraine group, left OB volume of the males was significantly lower than those of the females. In both the migraine and control groups separately, the left-side OB volume values and the right side OS depth values were significantly greater than those of the contralateral side. There were positive correlations between right and left OB volume, and right and left OS depth values. No change was seen in OB volume and OS depth values according to gender. In older patients, a decrease was determined in the right and left OB volume, and the left-side OS depth values. There was a negative correlation between osmophobia and OB volume values. In migraine patients with osmophobia, the OB volume values were significantly decreased. OB volume values were lower in migraine patients. When osmophobia was present, the OB volume was lower than that of the non-osmophobia migraine patients. Olfactory function monitoring with olfactory tests and olfactory volume monitoring on MRI can be recommended for all migraine patients to diagnose olfactory dysfunction earlier, especially those with osmophobia. Because their OB volume values were detected as lower than those of the migraine patients without osmophobia, it may be thought that blood flow changes and osmophobia may affect the olfactory bulb volume shrinkage in migraine patients.Öğe Olfactory bulbus volume and olfactory sulcus depth in psychotic patients and patients with anxiety disorder/depression(Springer, 2018) Asal, Nese; Muluk, Nuray Bayar; Inal, Mikail; Sahan, Mehmet Hamdi; Dogan, Adil; Buturak, Sadiye VisalObjectivesIn the present study, we investigated olfactory bulb (OB) volume and olfactory sulcus (OS) depth of the psychotic patients (predominantly schizophrenia) and patients with anxiety disorder/depression.MethodsThis study was conducted retrospectively. Group 1 consisted of 30 psychotic patients (predominantly schizophrenia) (19 males and 11 females). Group 2 consisted of 37 patients with anxiety disorder/depression (10 males, 27 females). Group 3 consisted of 30 non-psychotic and non-anxiety disorder/depression subjects (9 males and 21 females). OB volume and OS depth measurements were performed on Cranial MRI.ResultsOB volume (right and left) of the psychotic; and anxiety disorder/depression groups were significantly lower than those of the control group (p(adjusted)<0.0175). OS depth (Left) value of anxiety disorder/depression group was significantly lower than those of the control group (p(adjusted)<0.0175). In psychotic and anxiety disorder/depression groups, left OS depth values were significantly lower than those of the right side (p<0.05). In each of the males and females of the anxiety disorder/depression group, left OS depth values were significantly lower than those of the right side (p<0.05). In psychotic group, OS depth (left) values get lower in older patients (p<0.05).ConclusionDecreased OB volume in the psychotic patients and decreased OB volume and OS depth in anxiety disorder/depression patients were detected. Lower OB volume and OS depth are related to the olfactory loss/or olfactory impairment. Physicians should be aware of the olfactory deficits in psychotic patients (mainly schizophrenia) and patients with anxiety disorder/depression. When reduced OB volume is detected on MRI, psychosis, schizophrenia or depression should also be kept in mind and the patients should be evaluated in detail for these diseases.Öğe Pancreas and kidney changes in type 2 diabetes patients: the role of diffusion-weighted imaging(Tubitak Scientific & Technological Research Council Turkey, 2021) Sahan, Mehmet Hamdi; Ozdemir, Adnan; Asal, Nese; Karadeniz Bilgili, Yasemin Mirace; Dogan, Adil; Gungunes, AskinBackground/aim: The aim of this study was to compare renal and pancreatic apparent diffusion-coefficient (ADC) values of diabetic patients and control subjects and to examine their potential association with several diabetes-related clinical parameters. Materials and methods: A total of 80 sex-and age-matched patients were included in the study. Of them, 40 were patients with type 2 diabetes and 40 were nondiabetic participants. Abdominal diffusion-weighted MRIs of both groups were retrospectively reviewed. Diabetes-related clinical parameters were recorded. Results: The difference between the mean ADC values of the patient group and the control group was significant (p = 0.012). It was also found that the mean pancreatic ADC values of diabetic patients and the control group significantly differed (p = 0.02). Besides, there were positive correlations between the mean pancreatic ADC values and age, Hb1Ac level, treatment type, and disease duration (p < 0.05). While eGFR values positively correlated with the mean renal ADC values (p < 0.05), there were negative correlations between such values and age, serum creatinine level, and disease duration (p < 0.05). Conclusion: Renal and pancreatic ADC values of diabetic patients could potentially play a role, as markers of renal and pancreatic functions, in clinical decisions in the follow-up of such patients.Öğe Peripheral and Central Smell Regions in Migraine Patients using Maras Powder (Smokeless Tobacco): A Magnetic Resonance Imaging Evaluation(Thieme Medical Publ Inc, 2022) Dogan, Adil; Bayar Muluk, Nuray; Inanc, YilmazObjective In the present study, we investigated the efficacy of Mara powder (smokeless tobacco) use on smell regions in migraine patients. Methods The cranial magnetic resonance imaging images of 58 adult patients were included in this retrospective study. Thirty-eight of them were migraine patients (18 of them using Mara powder and 20 of them not using Mara powder) and 20 of them were healthy controls. Bilateral peripheral (olfactory bulb [OB] volume and olfactory sulcus depth) and central smell regions (insular gyrus area and corpus amygdala area) as well as nasal septal deviation were evaluated. Results In migraine patients (using or not using Mara powder), OB volumes, and in Mara powder using migraine patients, corpus amygdala areas were lower than those in the control group (p<0.05). In Mara powder-using migraine patients, left insular gyrus areas of the females were significantly lower than the males (p<0.05). Conclusion We concluded that the peripheral smell region of the OB volume decreased in migraine patients (using or not using Mara powder). However, the central smell region of corpus amygdala area decreased in Mara powder using migraine patients. Mara powder usage may increase vascular shrinkage, and the decrease in OB volume and corpus amygdala area becomes prominent. It can be said that Mara powder usage may cause a size decrease in the peripheral and central smell regions in migraine patients. Therefore, migraine patients and non-migrainous people should be noticed for the harmful effects of Mara powder on the vascular system and smell system in the aspects of OB volume and corpus amygdala area decrease.Öğe Retrospectif Analysis of 1545 Patients: Neuroimaging in Headache(Gazi Univ, Fac Med, 2020) Say, Bahar; Ergun, Ufuk; Tunc, Mehmet; Alpua, Murat; Dogan, AdilObjective: Neuroradiological imaging is also used to differentiate between primary and secondary headaches. The aim of this study was to evaluate retrospectively the significant abnormal neuroradiological imaging results and rates in the primary headache group. In addition, it was also planned to analysis the results of all headaches with imaging and discuss the imaging in the headache with the literature. Methods: Medical records of headache patients of the neurology outpatient clinic at the tertiary care center were reviewed. Patients who required brain imaging and did not have any disease that could cause pathology in imaging were included. Neuroradiological images were grouped as brain computed tomography (CT), brain magnetic resonance imaging (MRI) and others. Results were normal, significant abnormal findings and others. Results: Total 1545 patients were included. Primary headache 992, secondary headache 91, painful cranial neuropathies and other headaches were observed in 462 patients. Significant abnormal radiological findings were found to be 4.3% in primary headache, 14.3% in secondary headache, and 6.6% in painful cranial neuropathy and other headaches. Significant findings in primary headache were Arnold Chiari Malformation, sinus thrombosis, intracranial mass, choroid plexus xanthogranuloma, hydrocephalus, vascular malformation. Conclusion: In this series, the rate of significant findings in neuroradiological imaging in primary headache is low. Secondary headaches require neuroimaging because of the presence of underlying life-threatening causes, although the rate of abnormal neuroradiological imaging is low. History, examination, and red flags in headache may lead to imaging, but patient and physician concerns may also increase imaging rates.Öğe Sonoelastographic evaluation of the sciatic nerve in patients with unilateral lumbar disc herniation(Springer, 2019) Celebi, Umut Orkun; Burulday, Veysel; Ozveren, Mehmet Faik; Dogan, Adil; Akgul, Mehmet HuseyinObjectiveThe aim of this study was to compare strain elastography (SE) and shear wave elastography (SWE) findings of the sciatic nerve in patients with unilateral lumbar disc herniation (LDH) and healthy control subjects.Materials and methodsThe study group included patients with complaints of unilateral sciatica for 3-12months, with foraminal stenosis due to one level of LDH (L4-L5 or L5-S1). An age- and gender-matched control group was formed of healthy subjects. Evaluations were performed on both the axial and longitudinal planes from the bilateral gluteal region using a 5-9MHz multifrequency convex probe.ResultsThere were 40 patients (20 male, 20 female) with a mean age of 43.112.7years in the study group, and 40 healthy subjects (22 male, 18 female) with a mean age of 42.9 +/- 10.7years in the control group (p>0.05). The sciatic nerve stiffness assessed on both the axial (12.3 +/- 3.7 kPA) and longitudinal (14.3 +/- 3.8 kPA) planes of the involved side was significantly higher than non-involved side (axial: 6.8 +/- 2.1 and longitudinal: 8.3 +/- 2.3 kPA) in the patient group (p<0.001).Conclusions p id=Par4 Patients with unilateral LDH have increased stiffness of the sciatic nerve compared to healthy control subjects. Although the findings in this preliminary study show that shear wave elastography can detect a change in sciatic nerve stiffness in patients with unilateral LDH, larger studies are required to determine the clinical utility of this technique.Öğe Ultrasound Elastography of the Median Nerve in Patients With Acromegaly: A Case-Control Study(Wiley, 2018) Burulday, Veysel; Dogan, Adil; Sahan, Mehmet Hamdi; Arikan, Senay; Gungunes, AskinObjectives The aim of this study was to compare the cross-sectional area and ultrasound elastographic findings of the median nerve of patients with acromegaly and healthy participants. Methods The acromegaly group comprised 15 patients with a previous diagnosis of acromegaly, and an age- and sex-matched control group included healthy participants. Strain elastographic and shear wave elastographic findings and the cross-sectional areas of the groups were compared. A 6-15-MHz multifrequency transducer was used for ultrasound evaluations. Results A total of 30 hands of 15 patients with acromegaly (7 male and 8 female) with a mean ageSD of 50.00 +/- 10.17 years and 40 hands of 20 healthy control participants (9 male and 11 female) with a mean age of 49.50 +/- 10.17 years were taken into consideration for statistical analyses. The cross-sectional area of the patients with acromegaly was significantly higher than that of the healthy controls (13.43 +/- 3.12 versus 8.32 +/- 1.94mm(2); P<.05). Median nerve stiffness was significantly increased in the acromegaly group compared with the control group (axial and longitudinal, 37.15 +/- 6.4 and 37.0 +/- 6.19 versus 18.7 +/- 4.1 and 19.2 +/- 3.58 kPa, respectively; P<.001). Conclusions These preliminary results have demonstrated that patients with acromegaly seem to have increased stiffness and cross-sectional area of the median nerve compared with healthy participants.
