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Biomedical subjects

E Timurkaynak

Publications and source records attributed to E Timurkaynak.

At least 19 recordsLinked to original sources
PubMed2003

Schwannoma of the lateral ventricle: eight-year follow-up and literature review.

Intracerebral and intramedullary schwannomas are uncommon; but, in general, spinal intramedullary schwannomas are more frequent than intracerebral schwanomas. We present a case of right lateral ventricle schwannoma in a 21-year-old man and review the associated literature. The 21-year-old right-handed man presented with loss of the left-eye vision approximately 8 months before referral to an ophthalmologist. The patient was immediately subjected to computed tomography (CT) scan, which showed an enhanced lesion with cystic component in the right occipital horn of the lateral ventricle. And consecutively, he was admitted to our department. The tumor was evacuated via craniotomy with marked improvement in his clinical state. The postoperative course was uneventful and postoperative CT control showed no residue. On MRI control no recurrence was noted after a follow-up period of 8 years. Intracerebral schwannoma is a rare, benign neoplasm. It is usually located superficially or adjacent to a ventricle. Characteristic imaging features include cyst formation, calcification, and evidence of peritumoral edema or gliosis. The recognition of this benign and potentially curable neoplasm and its differentiation from other neoplasms, some of which have less favourable outcomes, is of obvious importance.

Adult↗
PubMed2003

Dysembryoplastic neuroepithelial tumor in the left lateral ventricle.

Extracortical location of dysembryoplastic neuroepithelial tumor (DNT) is rare. We present a case of DNT localized in the left lateral ventricle of a 21-year-old female patient. Magnetic resonance imaging of the brain showed a round mass lesion in the floor of the anterior horn of the left lateral ventricle. The lesion was hypointense on T (1)-weighted images and slightly hyperintense on T (2)-weighted images without contrast enhancement. Total removal of the yellowish-white colored soft tumor was performed through a transcallosal approach. Histologically, the tumor was of simple type of DNT that was composed of small oligodendrogliocytes clustered tightly about perivascular spaces with neurons floating in mucoid pools showing an eosinophilic fibrillary matrix in the background. The recognition of DNT with an unusual location in lateral ventricle has therapeutic and prognostic significance since DNT is curable by surgical excision and radiation therapy is of no obvious benefit.

Adult↗
PubMed2003

Effect of mannitol in experimental spinal cord injury: an ultrastructural and electrophysiological study.

BACKGROUND: Although many experimental and clinical studies were performed on the pathophysiology and treatment of spinal cord injury (SCI), the electrophysiological and ultrastructural changes of the spinal cord were not precisely evaluated. AIMS: To investigate the effect of mannitol on Somatosensory Evoked Potentials (SSEP), postoperative neurological recovery and ultrastructural findings after an experimental SCI. SETTING: The experimental microsurgery laboratory of a university hospital. DESIGN: A prospective, randomized animal study. MATERIAL AND METHODS: Sprague-Dawley rats were used and divided into three groups (Groups I-III) for this study. Those in Group I were control animals who underwent laminectomy only, and non-traumatized spinal cord samples were obtained 2 weeks later. SCI was produced in Groups II and III using clip compression technique, and cord samples were obtained 2 weeks later. The rats in Group II received 2 g/kg of 20% mannitol intraperitoneally, immediately and three hours after trauma was induced; and those in Group III received the same amount of 0,9% NaCl in the same manner. Preoperative and postoperative SSEP records at the end of 2 weeks were obtained. Electron microscopy examination of the cord samples was done at 2 weeks postoperatively. STATISTICAL ANALYSIS USED: Fischer's Exact Test. RESULTS: SSEP records, ultrastructural findings and clinical recovery showed that minor neural damage and significant recovery occurred in Group II. CONCLUSION: This study demonstrates that the administration of 2 g/kg of 20% mannitol produces significant improvement in the neural structures and protects the spinal cord following injury.

Animals↗
PubMed2003

The effect of cranioplasty on cerebral hemodynamics: evaluation with transcranial Doppler sonography.

BACKGROUND: The purpose of cranioplasty is not only cosmetic repair but also neurological improvement. The effect of cranioplasty on the cerebral hemodynamics flow has not been investigated by ultrasonographic techniques. AIMS: To investigate changes of cerebral hemodynamics after cranioplasty in patients with cranial defect using transcranial Doppler sonography (TCDS). SETTING: The Departments of Neurosurgery and Radiology of a university hospital. DESIGN: A prospective clinical study. MATERIAL AND METHODS: We prospectively examined the cerebral hemodynamics with TCDS pre- and postoperatively in 18 patients with cranial defect who underwent cranioplasty. All postoperative studies were done between the 7th and 15th day after cranioplasty. The anterior cerebral artery was examined through the transtemporal and transorbital windows, the middle cerebral artery through the transtemporal window, and the posterior cerebral artery through the transforaminal window. Bilaterally, the peak systolic, end diastolic and mean blood flow velocities of these arteries were measured. STATISTICAL ANALYSIS: Wilcoxon matched-pairs signed-ranks test. RESULTS: Before cranioplasty all the velocities ipsilateral to the cranial defect were significantly low, while in the contralateral side they were near normal. Ipsilateral low cerebral blood flows increased and reached normal levels (P<0.05) after cranioplasty. During the follow-up, neurological improvement was observed. CONCLUSION: Cranioplasty is carried out not only for preserving normal appearances and physical barrier but also for neurological improvement. This should be explained by the normalization of cerebral hemodynamics.

Adult↗
PubMed2002

Endovascular treatment of kissing aneurysms at the fenestrated basilar artery. Case report with literature review.

BACKGROUND: Basilar artery fenestrations are most commonly located in the proximal basilar trunk close to the vertebrobasilar junction and may harbor saccular aneurysms. Surgical treatment of such aneurysms has been reported in several cases previously, despite the difficulty of the surgical approach. Endovascular treatment may provide a more convenient treatment alternative in such cases. This case is also interesting in that two discrete aneurysms arise from each limb of the fenestration. CASE REPORT: A 20-year-old man presented with acute subarachnoid hemorrhage. He had two kissing aneurysms at the fenestrated proximal basilar artery as demonstrated by MRA and selective angiography. The two aneurysms were successfully treated with GDCs via the contralateral vertebral arteries. One-year control angiogram showed stable occlusion. CONCLUSION: Aneurysms at the fenestrated basilar artery may be effectively treated with endovascular coil occlusion. The occurrence of multiplicity and the treatment alternatives are discussed, with relevant literature review.

Adult↗
PubMed2001

Microsurgical anatomy of the orbital part of oculomotor nerve.

The microsurgical anatomy of the oculomotor nerve through its intraorbital course and branching was studied in 30 specimens obtained from 15 cadaver heads fixed in formalin. The superior and inferior divisions of the oculomotor nerve were shown and neural and vascular relationships of each division were examined, then some measurements were performed. In this part of the oculomotor nerve, some critical key points to the various orbital approaches were determined and microanatomic relationships of the orbital contents were revised.

Humans↗
PubMed2001

Orbital manifestation of multiple myeloma: case report.

Orbital involvement is a rare manifestation of multiple myeloma. Therefore, the correct diagnosis and appropriate management are usually difficult and generally require biopsy. We report a 60-year-old woman having multiple myeloma with orbital involvement. Right orbitozygomatic craniotomy was carried out and the mass lesion was removed. After the histological examination, the diagnosis of multiple myeloma was confirmed. The clinical course and the treatment modalities of this entity are discussed in view of the literature.

Craniotomy↗
PubMed2000

The human tail associated with intraspinal lipoma: case report.

A case of a tail in a 9-month-old baby is reported. Computed tomography and magnetic resonance imaging clearly demonstrated the presence of spina bifida and lipoma continuous from the tail to the spinal canal. A few medical-historical aspects are discussed. The human tail may be related to spinal dysraphism and requires detailed neuroimaging investigation and microsurgery.

Animals↗
PubMed2000

Subdural and intraventricular traumatic tension pneumocephalus: case report.

Simple pneumocephalus most frequently arises as a complication of a head injury in which a compound basal skull fracture with tearing of the meninges allows entry of air into the cranial cavity. It can also follow a neurosurgical operation. Tension traumatic pneumocephalus with intraventricular extension is an extremely rare, potentially lethal condition that requires prompt diagnosis and treatment. We report the case of subdural and intraventricular accidental tension pneumocephalus occurring in a 26-year-old man as a result of skull fracture. This case is combined with rhinorrhea and meningitis that suggest some difficulties to treat. The operative procedure associated with medical treatment was performed and a good result was obtained.

Adult↗
PubMed2000

Multiple oligodendroglioma: case report.

An 18-year-old female patient was hospitalized with headache and disturbance of consciousness. Magnetic resonance imaging (MRI) revealed a tumor in the left parieto-occipital lobe. The tumor was totally removed, and postoperative radiation therapy was administered locally at 50 Gy. Ten months later, she experienced sudden onset of unconsciousness and headache. Computed tomography (CT) and MRI demonstrated multiple mass lesions in the whole brain. Following the systemic chemotherapy, removal of the largest tumor was performed. Histological examination proved all excised tumors to be oligodendroglioma without evidence of malignant change.

Adolescent↗
PubMed1999

Inferolateral microsurgical approach to the orbit: an anatomical study.

Using detailed cadaveric dissection this study has demonstrated the increase in exposure by using the inferolateral microsurgical approach for neurosurgical and ophthalmological access. The approach to surgical exploration of this region is divided into three steps. The neural, muscular and vascular structures of each step are discussed. We think that, with an intimate understanding of the anatomy of the orbit, many large intraorbital lesions located in the muscle cone and the inferior nasal compartment of the orbit can be safely removed through inferolateral orbitotomy.

Humans↗
PubMed1999

Orbital foreign bodies after penetrating gunshot wounds: retrospective analysis of 22 cases and clinical review.

We conducted a retrospective analysis of 22 patients having orbital penetrating gunshot wounds treated over a 4-years period. The neurological status and the site of injury for each patient are evaluated in this study. We propose a practical protocol in the management of these orbital foreign bodies. Surgical treatment was performed in 4 patients (had functional deficit) with medial orbitotomy in 2, lateral orbitotomy in 1, and superior orbitotomy in 1. 3 of them are improved, in one case the blindness has been continued. 18 patients were treated conservatively and all of them are improved. All patients were followed-up for 2 years with cranial X-rays and CT scans. Neurological sequelae were regressed which existed before the surgery. In conservatively treated cases, infection, migration and functional deficit were not seen. In conclusion, orbital penetrating gunshot wounds must be evaluated precisely by the surgeon and this evaluation sets the guidelines for management. The operation should be reserved for the patients in whom the necrotic soft tissues or orbital damages restrict ocular movements.

Adult↗
PubMed1998

Lateral approach to the orbit: an anatomical study.

The authors have identified and described three lateral approaches to the intraorbital portion of the optic nerve in cadavers. The structures exposed via the superior, inferior or central approaches were directed through the lateral orbital wall. The superior approach in which the lateral rectus muscle is retracted inferiorly exposes the superolateral aspect of the orbit. The inferior approach in which the lateral rectus muscle is retracted superiorly, provided the inferolateral aspect of the optic nerve from the globe to the muscle cone. The central approach in which the lateral rectus muscle was disinserted and retracted provided excellent exposure of the structures of the lateral part of the orbit and the optic nerve. There were no structures blocking access to the ciliary ganglion and two third anterior optic nerve and lateral surface of the globe. The structures encountered in these approaches are demonstrated under magnification in cadavers, and the exposure of the optic nerve is discussed.

Facial Muscles↗
PubMed1997

Intrasellar gangliocytoma resembling pituitary adenoma.

Cushing's disease resulting from intrasellar gangliocytomas is very rare and only three cases have been reported to date. All of the cases were female. We present a fourth case of Cushing's disease resulting from intrasellar gangliocytoma. Computed tomography and magnetic resonance imaging scans showed a pituitary macrotumor with suprasellar extension. A greenish-gray colored homogenous tumor was subtotally removed by a transcranial approach. Histological diagnosis was gangliocytoma. To the best of our knowledge, this is the first reported instance of a tumor causing Cushing's disease in a man in the absence of a pituitary adenoma component.

Adenoma↗
PubMed1986

Microsurgical anatomy and operative approaches to the lateral ventricles.

The anatomy needed to plan microoperative approaches to the lateral ventricles was examined in 20 cadaveric cerebral hemispheres. The neural, arterial, and venous structures in the walls of the lateral ventricles and the relationship of the lateral ventricles to the third ventricle and basal cisterns were examined. The operative approaches to the lateral ventricle are reviewed.

Arteries↗