Biomedical subjects

Ali Savas

Publications and source records attributed to Ali Savas.

8 recordsLinked to original sources

PubMed2006

Central nervous system lymphoma in a patient with Sjogren's syndrome and autoimmune thyroiditis (Hashimoto's thyroiditis).

We present a case of central nervous system (CNS) lymphoma in a patient with Sjogren's syndrome (SS) and autoimmune thyroiditis (Hashimoto's thyroiditis) overlap. A 60-year-old woman, who had the diagnosis of SS for 16 years, had been admitted for visual loss, fever, weight and appetite loss for 3 months. Cranial magnetic resonance imaging was in accordance with CNS lymphoma, and biopsy from right parietal region showed diffuse large B-cell lymphoma of the CNS. This is the first report of diffuse large B-cell lymphoma of the CNS in SS and autoimmune thyroiditis (Hashimoto's thyroiditis) overlap.

Biopsy↗

PubMed2006

Spinal intradural-intramedullary cavernous malformation. Case report and literature review.

Cavernous angiomas or cavernomas are uncommon vascular malformations of the central nervous system and spinal involvement is much rarer especially in pediatric patients. We report a case of spinal intradural-intramedullary cavernous angioma in a 14-year-old male child. The cavernoma was located at the level of C6-C7 at the dorsal part of the spinal cord. The diagnosis was made with MRI and the patient underwent surgical treatment. The cavernoma was totally removed with laminotomy and microsurgical techniques. Somatosensory evoked potential monitoring was also used peroperatively. The clinical, radiological and surgical features of this rare case were presented and discussed with reference to the literature.

Adolescent↗

PubMed2006

Neuronavigation-assisted transoral-transpharyngeal approach for basilar invagination--two case reports.

Two patients presented with congenital basilar invagination manifesting as progressive myelopathy. Both patients underwent surgery using a neuronavigation-assisted transoral-transpharyngeal approach. The Brain-LAB Vector Vision navigation system was used for image guidance. The registration accuracies were 0.9 and 1.3 mm. After decompression, posterior stabilization was performed. Both patients had an uneventful postoperative course. The transoral-transpharyngeal approach with the neuronavigation system provides safe exposure and decompression for basilar invagination.

Adult↗

PubMed2005

The trigeminal tract and nucleus procedures in treatment of atypical facial pain.

BACKGROUND: Atypical facial pain (AFP) is a throbbing pain situated deep in the eye and malar region, often radiating to the ear, neck, and shoulders. The pain generally is not within any dermatomal or anatomical boundaries. Atypical facial pain is distinct from trigeminal neuralgia and its variants. Therefore, the treatment of AFP should be specified. There is also no consensus in the treatment of AFP. Two different treatment procedures on the trigeminal tract and nucleus in a series of cases with AFP are presented. METHODS: Between 1989 and 2005, 17 patients with AFP, in whom previous therapies had failed, underwent computed tomography (CT)-guided percutaneous trigeminal tractotomy-nucleotomy (TR-NC). One patient with unfavorable response to TR-NC underwent trigeminal dorsal root entry zone (DREZ) operation. RESULTS: In the series with AFP, pain relief was achieved in all of the 17 cases. TR-NC provided maximum to inadequate degrees of pain relief in 16 of 17 patients. Dorsal root entry zone operation provided partial relief in 1 case. Neither mortality nor serious permanent complication was observed in the series. CONCLUSION: Neurosurgical procedures such as TR-NC or trigeminal DREZ operation may be effective in the treatment of intractable AFP. The primary choice of operation should be TR-NC because this procedure is minimally invasive. Trigeminal DREZ operation, which affects a larger spread area, may follow if TR-NC fails. The indications and procedure of choice should be individually tailored, depending on the type of pain, underlying pathology, and experience of the surgeon.

Adult↗

PubMed2005

An analysis of stereotactic biopsy of brain tumors and nonneoplastic lesions: a prospective clinicopathologic study.

BACKGROUND: Appropriate management of progressive, unverified brain lesions should be guided by conclusive pathological diagnosis. Stereotactic biopsy (SB) is established as a less invasive surgical procedure that provides diagnosis. In this prospective study, we analyzed the diagnostic difficulties and risk of SB in the various brain mass lesions, the rate of conclusive pathological diagnosis, and the rate of and the reasons for discrepancy between the intraoperative smear results and conclusive paraffin diagnosis. METHODS: Using computed tomography (CT) and/or magnetic resonance imaging (MRI), 130 cases underwent SB procedure to assess intra-axial brain mass lesions. A CT-MRI fusion and a multiplanar image processing stereotactic program were used in cases who had lesions adjacent to the neurovascular and critical areas. The intraoperative evaluations were made with the smear preparations (SPs) of 1 or 2 biopsy specimens. The conclusive diagnosis was achieved by paraffin preparations of the remainder of the biopsies. The discrepancy between the smear results and the conclusive diagnosis was analyzed. RESULTS: Conclusive histopathologic diagnosis was achieved in 99.23% of the cases. A discrepancy between smear results and conclusive diagnosis was detected in 6.98% of the conclusively diagnosed cases. The major reasons for the discrepancy were necrosis and improper quality of the preparations. There was no mortality, and hemorrhage-related morbidity was observed in 1 case (0.7%). CONCLUSIONS: Necrosis and the improper quality of the smear preparations (SPs) can cause difficulties in establishing a histopathologic diagnosis in SB. Small tissue samples do not decrease the diagnostic yield with the new stereotactic technologies used by an experienced team consisting of a neurosurgeon, pathologist, and radiologist.

Adolescent↗

PubMed2005

Management of a hemidystonic patient with thalamotomy, campotomy and cervical dorsal root entry zone operation.

Several medical and surgical procedures have been presented for treatment of dystonia. Thalamotomy, pallidotomy, and campotomy are some of the surgical choices. This study presents a patient with dystonia who underwent a cervical dorsal root entry zone (DREZ) operation after thalamotomy and campotomy. A 23-year-old man who was resistant to medical treatment presented with left hemidystonia. Thalamotomy and campotomy were performed. The patient remarkably benefited from the procedure but dystonic complaints in his left arm continued. A cervical DREZ operation was performed 5 years after the first operation and the dystonic complaints decreased after the surgery. This article presents a new aspect for the treatment of dystonia. Based on the outcomes of the treatment, DREZ operation may be suggested as an alternative surgical treatment for patients with segmental dystonia located in the extremities.

Adult↗

PubMed2004

Unanticipated complication of percutaneous radiofrequency trigeminal rhizotomy: rhinorrhea: report of three cases and a cadaver study.

OBJECTIVE AND IMPORTANCE: Several neurosurgical procedures have been developed for the treatment of idiopathic trigeminal neuralgia: vascular decompression of the trigeminal root in the brainstem, percutaneous trigeminal ganglion procedures, and external beam radiosurgery. Percutaneous radiofrequency electrodes target the trigeminal fibers in the gasserian ganglion through the foramen ovale. Several complications of radiofrequency trigeminal rhizotomy (RF-TR) have been described, including puncture of the carotid artery, the cavernous sinus, and the cranial nerves. This study presents a very rare complication of percutaneous RF-TR, rhinorrhea, and attempts to define its mechanism. CLINICAL PRESENTATION: Of 2375 patients with idiopathic trigeminal neuralgia who underwent 2958 percutaneous RF-TR procedures, 3 developed subsequent rhinorrhea, which resolved spontaneously in 2 to 3 days. TECHNIQUE: Two formalin-fixed cadavers were dissected to demonstrate the relationship between the foramen ovale and the tuba auditiva and the mechanism of rhinorrhea. CONCLUSION: This article presents a very rare complication of RF-TR. Rhinorrhea and/or cerebrospinal fluid fistulae in the nasopharyngeal cavity are benign complications of RF-TR that result from puncturing both the membranous portion of the tuba auditiva (eustachian tube) and Meckel's cave with the rhizotomy needle.

Aged↗

PubMed2003

Microelectrodes.

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Electric Stimulation Therapy↗