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Öğe Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2005) Evliyaoğlu, Çetin; Kizartici, T; Bademci, Gülşah; Ünal, B; Keskil, SIn neurosurgery, ceftriaxone is a widely used, third generation cephalosporin for the treatment of CNS infections and perioperational prophylaxis. Recent studies have demonstrated that ceftriaxone induces reversible precipitates in the gallbladder. This complication is referred to as '' biliary pseudolithiasis '', and it has symptoms similar to the raised intracranial pressure (ICP) symptoms of the perioperative period. Symptomatic biliary pseudolithiasis should be kept in mind in all pediatric neurosurgery cases under ceftriaxone therapy in order to prevent unnecessary postoperative investigations and surgery.Öğe Clinical experiences in neuronavigation(Ortadogu Ad Pres & Publ Co, 2007) Bademci, Gülşah; Berdan, Fatoş; Evliyaoğlu, Çetin; Keskil, SemihObjective: To evaluate the introduction of a neuronavigation system to our neurosurgical department as an increasingly important part of both planning and performing intracranial surgery. Material and Methods: From February 2005 to August 2006, 17 cranial neurosurgical operations with the aid of the Medtronic neuronavigation system were performed in the Department of Neurosurgery, Faculty of Medicine, University of Kirikkale. Duration of procedures, accuracy of targeting and processing the lesions, craniotomy spaces, duration of hospital stay, and postoperative neurologic status were evaluated. Results: Neuronavigation assisted operations accounted for 6.2% of elective surgeries in the selected time period. The mean deviation form accuracy for registration was 2.7 mm. Deep-seated small lesions comprised UP of the cases operated with neuronavigation assistance (33.3%). Although the duration of procedures and the duration of hospital stay seemed slightly higher for nueronavigation in comparison to the standard procedures it is more effective in the selection of the best position for the surgical approach, it reduces the time required for skin incision and craniotomy planning and cortex incision. Conclusion: Integration of high technology modalities to neurosurgery is becoming an increasingly used feature and provides useful information during surgery especially in small and multiple brain tumors located in eloquent brain areas.Öğe MR ile incelenen lomber disklerdeki difüzyon değerlerinin dejenerasyonla ve yaşla olan ilişkisi(2008) Yazgan, Hatice Çisel; Kara, Simay; Evliyaoğlu, ÇetinAmaç: Bu çalışmada lomber disklerdeki difüzyon değerlerinin dejenerasyonla ve yaşla olan ilişkisi ADC ölçümleriyle değerlendirildi. Gereç ve Yöntem: Bel ağrısı yakınmasıyla başvuran yaşları 14-64 arasında değişen 50 olguya (24 kadın, 26 erkek) difüzyon ağırlıklı MR görüntüleme uygulandı. T2 ağırlıklı sagital görüntülerde dejenere diskler belirlendi. Dejenere diskler hafif ve ağır olarak gruplandırıldı. Her bir disk düzeyi için ADC değerleri ölçüldü. Normal disklerin ortalama ADC değerlerinin anatomik düzeyle ve yaşla olan ilişkisi değerlendirildi. Dejenere disklerin ortalama ADC değerleri normal disklerle karşılaştırıldı. Bulgular Mann Whitney testi, Kruskal Wallis testi ve Sperman’s korelasyon katsayısıyla analiz edildi. Bulgular: Ortalama ADC değerleri normal disklerde 1.82 ± 0.20 x 10-3 mm2/sn, dejenere disklerde 1.30 ± 0.47 x 10-3 mm2/sn olarak bulundu (p< 0.01). Normal disklerde anatomik düzeyle ortalama ADC değerleri arasında anlamlı ilişki saptanmadı. Yaşla ortalama ADC değerleri arasında negatif korelasyon yönünden anlamlı ilişki mevcuttu. Sonuç: Dejenere disklerin ADC değerleri normal disklere göre belirgin olarak azalmıştır. Dejeneratif disk hastalığının değerlendirilmesinde difüzyon MR görüntüleme son derece faydalı bir yöntem olabilirÖğe Possible spontaneous "birth" of a hydatid cyst into the lateral ventricle(Springer, 2005) Evliyaoğlu, Çetin; Keskil, SemihIntroduction: Intraventricular hydatid cyst is an extremely rare entity. We report a solitary hydatid cyst in a lateral ventricle. Case report: A 7-year-old girl had a free floating intraventricular cyst, diagnosed by computerized tomography examination inside the enlarged left lateral ventricle of an associated Dandy Walker malformation. The patient underwent surgery and the cyst was removed. Conclusion: To our knowledge, this is the first case report in which the natural developmental phases of an intraventricular hydatid cyst have been observed.Öğe Pott's puffy tumor of the vertex years after trauma in a diabetic patient: case report(Sociedad Luso-Espanola Neurocirugia, 2005) Evliyaoğlu, Çetin; Bademci, Gülşah; Yücel, Engin; Keskil, SemihPott's puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma. This is the unique report of a Pott's puffy tumor located over the vertex of a type 1 diabetic patient with an unusual latency of 14 years following injury. A 27-year old man presented with pain and a soft swelling on his vertex. Magnetic resonance imaging demonstrated subperiosteal abscess in the vertex region associated with dural thickening and perisinusal irregularities of epidural space. Further history revealed that he had a trauma to the same location when he was 13 years old. Considering possible complications due to proximity of the lesion to the sagittal sinus, we retrained from aggressive surgical interventions. We treated our patient with a simple surgical abscess drainage followed by prolonged use of antibiotics and achieved complete therapy. The cellular and humoral elements of the immune system may be disrupted in diabetic patients resulting in such atypical courses and complications of infections. We want to emphasize both importance of the prompt diagnosis of Pott's puffy tumor as intracranial invasion may cause severe neurologic problems, and importance of a surgical intervention tailored for the individual lesion.Öğe Proximally situated osseous septum in complex spina bifida - Case report(Amer Assoc Neurological Surgeons, 2005) Bademci, Gülşah; Evliyaoğlu, Çetin; Keskil, SemihIn Type I split cord malformation (SCM) lesions, the osteocartilaginous spur and its dural sleeve are almost always located in the caudal extent of the median cleft. The authors present a case of lumbar myelomeningocele associated with a thoracic Type I SCM in which an osseous septum is uniquely situated in the proximal extent of the median cleft. Split cord malformations are cord-tethering lesions, which may be associated with a myelomeningocele that causes additional tethering, even in the opposite direction; therefore, both lesions should be treated. In view of this unique case, however, the surgical approach used for tethering lesions in such cases of complex spina bifida should perhaps be tailored. Whenever feasible, meticulous preoperative examination of a patient with spina bifida, including entire craniospinal magnetic resonance imaging followed with perioperative dynamic evaluation, is important for the effectiveness and safety of the surgery.
