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Biomedical subjects

Yusuf Erşahin

Publications and source records attributed to Yusuf Erşahin.

At least 19 recordsLinked to original sources
PubMed2006

Endoscopic aqueductoplasty.

OBJECTIVE: Endoscopic aqueductoplasty (EA) was considered as a good alternative to endoscopic third ventriculostomy (ETV) in selected patients. A personal experience on EA is presented in this paper. MATERIALS AND METHODS: Forty-five patients with primary or secondary aqueductal stenosis underwent EA with or without a stent between June 2000 and June 2005. Age, gender, diagnosis, endoscopic procedures, complications, and outcome were reviewed. EA was considered successful when patients with noncommunicating hydrocephalus became shunt-free. When the patient did not need a fourth ventricular shunt after the EA with or without a stent, it was considered to be successful in patients with isolated fourth ventricle. RESULTS: Fifteen patients were older than 18 years of age. EA, EA with stent, EA with ETV, and EA with stent in addition to ETV were performed in 11, 6, 11, and 17 patients, respectively. Out of 45 patients who had undergone EA with or without stent and ETV, 31 (69%) benefited from the endoscopic procedures. The type of the endoscopic procedure, diagnosis, and the age of the patients did not significantly affect the outcome. CONCLUSION: EA with a stent can be performed in patients with isolated fourth ventricle and in patients with aqueduct stenosis in which ETV is not feasible. EA can be dangerous and useless in aqueduct stenosis (AS), and EA with ETV is even more useless. Those patients who have undergone EA should be closely followed up for a long period of time because restenosis of the aqueduct and stent migration may happen years after endoscopic surgery.

Adolescent↗
PubMed2006

Percutaneous computed-tomography-guided biopsy of the spine: 229 procedures.

OBJECTIVES: Percutaneous biopsy of the spine is an effective and well-evaluated procedure. Only very few series containing more than a hundred patients have been reported so far and there is no agreement about the factors affecting the diagnostic rate. We aimed to find out if there is any factor influencing the success rate of the spinal biopsy using our biopsy series. METHODS: Two hundred and twenty-nine procedures were performed in 201 patients between November 2001 and August 2005. All procedures were performed under computed tomography guidance. The side was chosen according to the extension of the lesion. When the lesion was in the midline or extended to both sides, we preferred to obtain biopsy from the right side. The puncture point and the needle trajectory were planned on both lateral computed tomography scout scan and axial scans. RESULTS: We found that the diagnostic rate was not affected by the variables such as age, gender, type and diameter of the biopsy needle, diagnosis as well as lesion localization and level. The success rate of the repeat biopsies was considerably lower than the first procedures. CONCLUSIONS: The diagnostic rate is not affected by any of the variables but the approach, chosen can vary with the level, localization, and lesion characteristics.

Adolescent↗
PubMed2005

Hemodynamic and electrolyte changes in patients undergoing neuroendoscopic procedures.

OBJECTS: Intraoperative hemodynamic alterations and postoperative electrolyte disturbances related to endoscopic third ventriculostomy (E3V) have been reported. We aimed to evaluate prospectively those changes in patients undergoing neuroendoscopic procedures. METHODS: This study was carried out in 24 patients who underwent neuroendoscopic intervention. Sevoflurane was used for the induction and maintenance of anesthesia. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation, end-tidal CO2, and body temperature values were recorded according to the stages of the operation. Blood gas and blood chemistry analyses were performed before and after endoscopic procedure and were repeated on the third postoperative day. CONCLUSIONS: There were no significant differences in intraoperative HR and MAP. Bradycardia occurred only in 1 of the 24 patients during the dilatation. In conclusion, we suggest the use of 0.9% NaCl for intravenous fluid replacement and a warm lactated ringer solution for ventricular irrigation during E3V to prevent intraoperative hemodynamic changes and postoperative electrolyte disturbances.

Adolescent↗
PubMed2005

Craniopharyngiomas in children: Turkey experience.

OBJECTIVES: Craniopharyngiomas are the most frequently encountered suprasellar tumors in children. Although they have a benign histology, total resection without morbidity is very difficult. METHODS: We aimed to review the results of pediatric craniopharyngioma patients treated in eight institutions in Turkey. There were 51 boys and 36 girls, ranging in age from 20 months to 18 years (mean 10.2 years). The most frequent symptom was headache, followed by visual disturbances. Hydrocephalus was seen most frequently in tumors greater than 4 cm in size (P=0.002). Hydrocephalus was associated with the decreased gross total resection (P=0.043). The recurrence (28%) was significantly higher in patients with subtotal and partial tumor removal (P=0.010). Bad outcome was significantly associated with tumor dimension (P=0.039); the greater the tumor dimension, the worse the outcome. Outcome was significantly better in patients older than 10 years (P=0.032). Gender, tumor type and location, presence of hydrocephalus and calcification, histological type of craniopharyngioma, and surgical approach did not have a significant effect on the outcome. CONCLUSIONS: The treatment should be individualized and a multidisciplinary approach should be used. The goal of surgery should be gross total removal without mortality and with acceptable morbidity.

Adolescent↗
PubMed2005

Thrombosis and thrombophilebitis of the internal jugular vein as a very rare complication of the ventriculoatrial shunt.

A 21-year-old man presented with a sausage shaped mass lesion, located in the right anterolateral region of the neck. He had been operated on for hydrocephalus and thoraco-lumbar myelomeningocele at the age of 10 days and 2 months, respectively. Although he was asymptomatic at the age of 10 years, ventriculoatrial (VA) shunt was considered non-functional. Doppler ultrasound showed thrombosis of the right internal jugular vein. Cervical magnetic resonance imaging displayed thrombosis and thrombophilebitis of the right internal jugular vein with loss of flow pattern. VA shunt was removed under general anesthesia and shunt material sent for culture. Staphylococcus aureus grew from the culture of shunt material. A cephalosporin (cefuroxime axetil) was administered and the neck mass disappeared in 4 weeks. He has been symptom free for the last 5 years. VA shunts for hydrocephalus have some well-defined specific complications. In this paper, a case with VA shunt related thrombosis and thrombophilebitis of internal jugular vein was presented and management of VA shunt related cardiovascular complications were discussed.

Adult↗
PubMed2005

Pineal tumors.

Explore the source record for details and available documents.

Adolescent↗
PubMed2004

Delayed repair of large myelomeningoceles.

INTRODUCTION: Repair of myelomeningoceles larger than 5 cm in diameter is not easy. We describe a simple technique. PATIENTS AND METHODS: The patients with a large myelomeningocele sac were included in this study. Ten patients with a large myelomeningocele underwent surgical repair using this technique. The skin was incised in the midline proximal to the myelomeningocele sac. The incision was carried caudally and away from the midline to open the sac after identifying the fascia. The incision is carried circumferentially around the neural placode and the skin is saved as much as possible. About a 1-cm-width of the dura mater beneath the skin is left to ease the subcutaneous suturing. The dura is sutured in the midline. The skin is undermined bilaterally in the plane between the muscle and subcutaneous fat and closed with interrupted sutures in the midline. CONCLUSION: This simple technique is appropriate for the closure of large myelomeningoceles and does not need more extensive and complex procedures.

Child, Preschool↗
PubMed2004

The incidence of inguinal complications after ventriculoperitoneal shunt for hydrocephalus.

AIM: This study outlines the incidence of acquired clinical inguinal manifestations (CIM) in infants undergoing ventriculoperitoneal (VP) shunt procedures, and the possible underlying mechanisms in the development of these pathologies. MATERIAL AND METHODS: The charts of children who had undergone VP shunt procedures for hydrocephalus between 1992 and 2002 were reviewed. All patients were contacted by a telephone interview, and they were invited to be examined in the outpatient clinic of paediatric surgery for the development of groin manifestation. RESULTS: Eighty-eight patients responded to the inquiry. Twenty-one (23.8%) patients developed a CIM. Three of them were premature infants. The mean interval between the shunt procedure and the diagnosis of CIM was 5.3 months (20 days to 48 months). Nineteen of the patients who developed a CIM were in the 0- to 12-month age group when the VP shunt procedures were initially performed. Ten CIM occurred on the right (47%), 7 on the left (33%) and 4 were bilateral (20%). The rate of bilateral patency as an operative finding was 76%. There was one recurrence (4.8%). CONCLUSION: The younger the age at which the VP shunt was performed, the higher the incidence of CIM. Bilateral manifestations were higher than in the normal population. Increased intra-abdominal pressure by accumulation of fluid in combination with the high patency rate of processus vaginalis possibly plays a role in the development of CIM in VP shunt patients. Bilateral repair should be considered even when CIM is unilateral. Special care should be given to repair procedures since the recurrence rate is relatively high.

Child, Preschool↗
PubMed2003

Radiotherapy-induced secondary cranial neoplasms in children.

BACKGROUND: Secondary malignant neoplasms (SMN) in CNS tumor survivors has become problem of increasing concern over the last 20 years. These tumors usually occur in a different site from the primary brain tumor several years after treatment. CASE REPORT: We report secondary cranial malignant neoplasms in three patients who were treated with irradiation and chemotherapy for their primary brain tumors. The first case is a male survivor of an orbital rhabdomyosarcoma who developed a meningioma 8 years later. The other two cases are female survivors of ependymomas who were irradiated at the age of 3 and developed secondary gliomas 8 and 17 years after therapy respectively. CONCLUSION: Patients carry a risk of developing SMNs many years later since irradiation is still an important part of the treatment. An SMN may have a benign course, as in meningioma, or be a dilemma for the patient, as in glioblastoma.

Adult↗
PubMed2003

Computerized tomography-guided percutaneous transforaminodiscal biopsy sampling of vertebral body lesions.

OBJECT: The posterolateral approach is the common route for obtaining percutaneous biopsy samples in lumbar and thoracic vertebral bodies (VBs). This procedure, however, is associated with the risk of complications. Because of this, the authors devised a new method for percutaneous biopsy sampling of VB lesions. METHODS: The percutaneous computerized tomography (CT)-guided transforaminodiscal biopsy procedure was undertaken in 20 patients during a 10-month period. The VBs in 18 cases were successfully accessed using this technique. There were no procedure-related complications. CONCLUSIONS: Transforaminodiscal CT-guided spinal biopsy procedure is a safe and effective method for accessing VB lesions. It is possible to obtain a biopsy sample in the major part of the VB. This technique is a good alternative to the standard posterolateral approach.

Adolescent↗
PubMed2002

Single photon emission tomography following posterior fossa surgery in patients with and without mutism.

MATERIALS AND METHODS: We designed a prospective study to investigate single photon emission tomography (SPECT) findings in patients with or without mutism who had undergone posterior fossa surgery. These patients had a (99m)Tc-hexamethylpropyleneamine oxime-SPECT scan postoperatively. SPECT was performed between the 1st and 2nd week after surgery. The patients with cerebellar mutism had a second SPECT scan after regaining their power of speech. The patients were evaluated in terms of age, gender, preoperative and postoperative neurological and radiological findings, tumor size and location, vermian incision and histopathology. RESULTS: Six girls and 5 boys, ranging in age from 3 to 11 years who had undergone posterior fossa tumor surgery were included in this study as controls. Their tumors were located in the vermis and fourth ventricle in 8 patients, in the cerebellar hemisphere in 1, fourth ventricle in 1, and 1 patient had a fourth ventricular tumor extending the cerebello-pontine angle. The histopathology of the tumors was as follows: astrocytoma in 5 patients, ependymoma in 3, medulloblastoma in 1, dermoid tumor in 1, and choroid plexus papilloma in 1 patient. Postoperative cerebellar mutism developed in 2 girls and 1 boy whose ages ranged from 2 to 5 years. Pathological examination revealed 2 medulloblastomas and 1 ependymoma. Mutism developed 2 to 4 days after surgery. All of the patients with cerebellar mutism showed either clinical or radiological signs and symptoms of brain stem involvement. SPECT findings were similar in the patients with cerebellar mutism and in those without. CONCLUSIONS: SPECT findings are not specific enough to explain how cerebellar mutism occurs. Clinical signs of brain stem involvement seem to be a significant risk factor in the development of cerebellar mutism.

Cerebellar Neoplasms↗
PubMed2002

A new catheter for subduro-peritoneal shunting.

INTRODUCTION: Subduro-peritoneal (SP) shunting is one of the definitive treatment modalities in the management of chronic subdural collections. Different shunt types have been used in SP shunting. An effective and inexpensive catheter has been designed for SP shunting. This new catheter does not have a valve system. The proximal end of the catheter has a right angle after the first 5 cm. The distal end of the catheter is open and has no slits. The proximal right angle tip of the subdural tubing is inserted 5 cm. MATERIALS AND METHODS: Fourteen patients with symptomatic subdural fluid collection were treated with SP shunting using this shunt tube. RESULTS: Resolution of the subdural fluid collection took between 2 and 14 weeks. The SP shunt was easily removed in 4 patients. No complications occurred. Follow-up of the patients ranged from 3 to 12 months. CONCLUSION: This new catheter seems to be effective in the drainage of subdural fluid collections.

Aged↗