Browsing by Author "Mete M."
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Item How necessary is computed tomography in pediatric minor head trauma?(2011) Mete M.; Duransoy Y.K.; Karabiyik O.; Özer F.D.; Selçuki M.Computerized tomography (CT) is very often used for head injury. Especially in childhood as related to the use of CT is known that a number of drawbacks. At the age of fifteen and under with minor head trauma, it is very difficult to assess whether CT is necessary. The purpose of this study was to assess the necessarity of CT in children who are at 15 years of age and under with minor head trauma. The records of 115 cases who applied with minor head trauma between October 2010-June 2011 to Nevşehir State Hospital Emergency Department, were examined retrospectively. Cases who are 15 years of age and under, with a score of Glascow Coma Scale 15, with a normal neurological examination and applied to emergency service after falls (falls from height, falling from a bicycle, falling on leisure activities), motor vehicle accident, crash and assault were included to study. Forty three (37.4%) were female and 72 (62.6%) were male, while the average age was 7. Among the symptoms, vomiting was the most frequent with 30.4%, while headache was in second place with 19.1%. When we look at the findings, soft tissue swelling was 29.6% in the first place. In all cases CT was taken. Ninety seven (84.4%) patients had normal CTs, while 18 (15.6%) patients had pathology in cranial CT. In cases with pathological cranial CT, 11 (61.1%) patients had linear fracture, 5 (27.7%) patients had depressed fractures, 1 (5.5%) patient had subdural hematoma plus linear fracture and 1 (5.5%) patient had plastering epidural hematoma. In these patients with pathologic cranial CT, 5 (27.7%) of them, (overall 4.3%) underwent surgery. In this study 29.4% of all patients with soft tissue swelling, and 83.3% of all patient with deep incision had pathological cranial CT. There were statistically significant difference between presence of soft tissue swelling, deep incision and pathological cranial CT. (Respectively p = 0.009 and p = 0.001). In children 15 years age and under with minor head trauma, cranial CT should be taken in the presence of soft tissue swelling and deep incision in physical examination. © 2011 OMU All rights reserved.Item Edaravone leads to increased internal luminal vascular circumference following subarachnoid hemorrhage in an animal model of vasospasm; [Edaravone hayvan vazospazm modelinde subaraknoid kanama sonrası damar i̇ç lümen çevresinde genişlemeye yol açmaktadır](Ege University Press, 2012) Mete M.; Özer F.D.; Duransoy Y.K.; Kocaman U.; Oran I.; Demirtaş E.; Selçuki M.Purpose: Cerebral vasospasm is the leading cause of morbidity and mortality following subarachnoid hemorrhage. Although a number of factors have been examined in clinical and experimental studies, the agent(s) responsible for developing and diminishing vasospasm remain poorly understood. Here, the role of edaravone, an antioxidant agent, was evaluated for its ability to diminish vasospasm in an animal model of subarachnoid hemorrhage. Materials and Methods: A rat basilar artery subarachnoid hemorrhage model was used. Rats were divided into three groups: sham (n=7; Group 1), subarachnoid hemorrhage (n=7 Group 2), and subarachnoid hemorrhage plus edaravone (4 mg/kg intraperitoneally, n=7; Group 3). At the end of the seventh day, the rats were sacrificed, their brains were removed, and sections were taken from the basilar artery. These were examined using a light microscope, comparing the internal luminal circumference of the basilar artery of each group. Results: The circumference was largest in Group 1, followed by Group 3 and then Group 2. That of Group 3 was 2% higher than that of Group 2, but this difference was not statistically significant. Conclusion: This animal model for vasospasm suggests that edaravone helps enlarge internal luminal circumference following vasospasm caused by subarachnoid hemorrhage. It may do this by blocking lipid peroxidation and thereby reducing the effects of oxyhemoglobin and reactive oxygen species.Item Diffusion weighted MRI may be a life saving tool in cerebral fat embolism: Report of a case; [Difüzyon MRG serebral yaǧ embolisinde hayat kurtari{dotless}ci{dotless} araçti{dotless}r: Olgu sunumu](2012) Mete M.; Savran M.; Duransoy Y.K.; Selçuki M.Cerebral fat embolism syndrome is a rare, but potentially lethal, complication of long bone fractures. Neurological symptoms are variable, the clinical diagnosis is difficult and occurs in only 0.9-2.2% of these cases. A 19 year-old male with no head injury suffered 3 epileptic seizures 17 hours after left femoral shaft and left tibia fractures. He had hypoxia. Chest x-ray and thoracic computed tomography (CT) were normal. T2 and diffusion weighted magnetic resonance imaging (MRI) showed multiple hyperintesity within the bilateral basal ganglia. We thought that this indicated areas with multiple microemboli. He was intubated after clinical deteriotation. Heparin, acetylsalicylic acid, mannitol and corticosteroids were administered, he was operated on next morning for left femoral shaft and left tibia fractures and he showed neurological improvement after 24 hours. Diffusion weighted MRI of the brain should become the first step in the diagnostic algorithm of cerebral fat embolism and patients have neurological improvement with early diagnosis and appropriate management.Item [Cerebral cystic echinococcosis in the light of our experience].; [Klinik deneyimlerimiz işiǧinda serebral kistik ekinokokkoz.](2013) Duransoy Y.K.; Mete M.; Selçuki M.Cerebral cystic echinococcosis (CCE) is rare and constitutes 1-2% of all cystic echinococcosis. The cysts are usually solitary and most frequently located in the supratentorial region. CCE is classified as primary and secondary. The primary cysts developed from the embryos which escaped from the filter systems are more frequent and usually solitary and fertile. The secondary cysts result from spontaneous, traumatic or surgical rupture of the primary CCE by embolization of scolices. They are usually multiple and infertile and do not have brood capsule or scolices. Symptoms usually develop slowly and are usually due to increased intracranial pressure and depend on the location of the cyst. Diagnosis is made by evaluation of both clinical and laboratory findings. Computed tomography and magnetic resonance imaging is successful in the diagnosis. The cysts are observed as spherical, well defined, with thin regular margins by these methods. The most appropriate treatment method is total surgical removal of the cyst without rupture by using Dowling's method. However, when it is not possible to remove without rupture, the cyst should be removed totally after puncture and aspiration of contents of the cyst. After removal of large cysts, complications such as porencephalic cysts and subdural hemorrhage can occur postoperatively.Item A new guide tube for odontoid screw fixation for unstable odontoid fractures: Report of 6 case series(Turkish Neurosurgical Society, 2013) Duransoy Y.K.; Mete M.; Zileli M.; Selcuki M.Aim: We describe a modified form of traditional open surgery with a new guide tube. This guide tube permits anterior screwing of odontoid in a shorter time with a more simple technique as compared to traditional open surgery, endoscopic and percutaneous surgeries. MATERIAL and METHODS: Our series includes 6 patients who were operated for unstable odontoid fracture. We used a new guide tube for anterior odontoid screw fixation. This guide tube was designed by the first author to facilitate the insertion of the K-wire for placement of a cannulated lag screw. RESULTS: Successful placement of the odontoid screws and immediate spinal stabilization were achieved in all patients. Solid fusion was observed during follow-up time in all patients. CONCLUSION: This screw insertion technique for odontoid screw fixation provides a minimally invasive, safe and easy surgery in contrast to other surgical approaches.Item Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature review(2013) Duransoy Y.K.; Mete M.; Barutçuoǧlu M.; Ünsal Ü.Ü.; Selçuki M.Hydatid disease is a parasitic infection affecting the brain in about 2% of the cases. Brain involvement is most commonly observed in children. Here, we report a 13-year-old male patient who presented with headache, nausea, and vomiting. Before cranial computed tomography (CT) was performed, the patient had generalized epileptic seizures. He was disoriented, and had anisocoria with dilatation of the right pupilla. CT showed a cystic lesion of 10-cm diameter in the right temporoparietal region that had caused a shift of the midline structures to the contralateral side; an urgent operation was performed as there were signs of midbrain herniation.Item Comparison of the histopathologic outcome of three different allograft used for the repair of spinal dural defect in rats; [Ratlarda spinal dura defekt tamirinde kullanılan üç farklı allogreftin histopatolojik sonuçlarının karşılaştırılması](Ege University Press, 2013) Atci I.B.; Demirçivi Özer F.; Mete M.; Çamlar M.; Kocaman Ü.; Akçay E.; Erşahin y.; Öner Ö.; Küpelioǧlu A.Purpose: Repairing of the duramater is one of the major factor that effects the mortality and morbidity of patients after neurosurgical approaches. The gold standard for repairing of duramater is watertight suture or duraplasty with autografts such as pericranium and/or temporal fascia. Sometimes edges of the dura mater generally are shrunken and the watertight suture of the dura becomes impossible especially in emergency conditions. In the present study, we aimed to determine the most effective artificial dural graft in experimental dural defect in rats. Materials and Methods: Twenty eights wistar albino rats weight ranging from 280-320 grams and equal numbers of male and female were used. The animals were divided into four groups. Control (n=7 Group-1), collagen matrix graft (n=7 Group-2), cellulose graft (n=7 Group-3) and teflon graft (n=7 Group-4). Rats were sacrificed after 30 days and their damaged dura were removed and sections were taken. All histological preparations examined using light microscope. Histological analysis focused on fibroblastic activation, new capillary formation, inflammatory reaction, foreign body reaction and capsule formation and results were compared. Results: While fibroblastic activation was observed most frequently in teflon graft group, new capillary formation, inflammatory reactions and capsule formation were most frequently seen in cellulose grafts group. Conclusion: This animal model for artificial dural grafts suggest that cellulose was the most effective dural substitute for repairing of defective dura.Item Differences in individual susceptibility affect the development of trigeminal neuralgia(Editorial Board of Neural Regeneration Research, 2013) Duransoy Y.K.; Mete M.; Akçay E.; Selçuki M.Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention. The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.Item Report of an unusual upper cervical spine injury: Traumatic atlantoaxial rotatory subluxation with vertical odontoid fracture in a child(2013) Mete M.; Ünsal U.Ü.; Duransoy Y.K.; Barutçuog̃lu M.; Selçuki M.[No abstract available]Item Congenital dermal sinus tract of the spine: Experience of 16 patients(SAGE Publications Inc., 2014) Mete M.; Umur A.S.; Duransoy Y.K.; Barutçuoʇlu M.; Umur N.; Gurgen S.G.; Selçuki M.Congenital dermal sinus tract is a rare entity which lined by epithelial cells and can end anywhere between subcutaneous planes to thecal sac. These tracts may be accompanied with other pathologies such as lipomyelomeningocele, myelomeningocele, split cord malformation, tethered cord, filum abnormality and inclusion tumors and treatment includes resection of tract with intradural exploration. The authors review their experience with 16 cases. Clinical, radiological appearance and treatment of these lesions discussed with literature review. © The Author(s) 2014.Item Double dorsal lipoma; Fibrous septum; lipomyelomeningocele; split cord malformation; [Aynı seviyede ayrık omurilik anomalisi tip ii ve çift lipom birlikteliği: Nadir bir olgunun sunumu](Ege University Press, 2014) Mete M.; Gursoy G.; Umur A.Ş.; Selçukİ M.Split cord malformations are classified as type I and type II and can be associated with lipomyelomeningocele. Although multiple lipoma in different levels at the same patient has been described, combination of SCM with double lipoma at the same level in literature is only once described previously. Herein, authors presented a 12 years old girl who had SCM type II associated with double lipoma at the same level. © 2014, Ege University Press. All rights reserved.Item The effects of fibroblast growth factor-2 blocking on development of chick cervical vertebra and relationship with oxidative stress and apoptosis; [Fibroblast growth faktör-2 bloklamasi{dotless}ni{dotless}n tavuk servikal omurlari{dotless} üzerindeki etkisi ve oksidatif stres ve apoptozis ile i̇lişkisi](Ege University Press, 2014) Duransoy Y.K.; Şimşek T.; Öztürk F.; Mete M.; Tuǧlu M.I.; Selçuki M.Fibroblast growth factor (FGF) plays a role in the development of bone and cartilage. FGF-2 is a member of this family and blocking of FGF-2 affects the bone development. In this study, effects of FGF-2 blocking on the formation of vertebrae in chick embryos before ossifications and orientation of cervical vertebrae were investigated with histological examinations. In this study, anti-FGF-2 was performed to chick embryos at E4th and E10th days. Samples were taken in E15th days and changes in the cervical spine were evaluated as histochemically (with hematoxylin-eosin, Alizarin red, Masson's trichrome staining) and immunohistochemically (with iNOS, eNOS and TUNEL). Also changings were evaluated by morphometric analysis. In macroscopic examination of the cervical vertebrae significant difference was not detected. But in histochemical staining, defects were observed in cartilage and ossification process. Increasing in oxidative stress was demonstrated by iNOS and eNOS. Also apoptosis which was represented by tunnel was found to be increased. FGF-2 blocking affects the ossification process in the cervical spine by inducing oxidative stress and apoptosis which results with cell death.Item Extremely rare cause of ventriculo-peritoneal (V-P) shunt dysfunction: Spontaneous peritoneal catheter knotting; [Ventrikülo-peritoneal(V-P) şant disfonksiyonun nadir sebebi: Spontan peritoneal katater düǧümlenmesi](Ege University Press, 2014) Yaldiz C.; Kurtuluş Duransoy Y.; Mete M.; Ünlü Ünsal U.; Selçuki M.Shunt application is one of the most common treatment method for hydrocephalus. Many complications have been reported in literature for ventricular and peritoneal catheters and shunt valve. Spontaneous knotting of peritoneal catheter is an extremely rare condition. Mechanism of knotting is still unclear and peristaltism, elasticity of shunt materials, intraabdominal density, length of the peritoneal catheter and surgical technique may be responsible factors. In this paper, we presented a peritoneal catheter knotting resulted in shunt dysfunction in an 8-year-old girl. During surgery, we removed the peritoneal catheter, untied the knot and placed in the peritoneum again.Item Neurotoxic effects of local anesthetics on the mouse neuroblastoma NB2a cell line(Informa Healthcare, 2015) Mete M.; Aydemir I.; Tuglu I.M.; Selcuki M.Local anesthetics are used clinically for peripheral nerve blocks, epidural anesthesia, spinal anesthesia and pain management; large concentrations, continuous application and long exposure time can cause neurotoxicity. The mechanism of neurotoxicity caused by local anesthetics is unclear. Neurite outgrowth and apoptosis can be used to evaluate neurotoxic effects. Mouse neuroblastoma cells were induced to differentiate and generate neurites in the presence of local anesthetics. The culture medium was removed and replaced with serum-free medium plus 20 μl combinations of epidermal growth factor and fibroblast growth factor containing tetracaine, prilocaine, lidocaine or procaine at concentrations of 1, 10, 25, or 100 μl prior to neurite measurement. Cell viability, iNOS, eNOS and apoptosis were evaluated. Local anesthetics produced toxic effects by neurite inhibition at low concentrations and by apoptosis at high concentrations. There was an inverse relation between local anesthetic concentrations and cell viability. Comparison of different local anesthetics showed toxicity, as assessed by cell viability and apoptotic potency, in the following order: tetracaine > prilocaine > lidocaine > procaine. Procaine was the least neurotoxic local anesthetic and because it is short-acting, may be preferred for pain prevention during short procedures. © 2015 The Biological Stain Commission.Item Unusual presentation of congenital dermal sinus: Tethered cord with paramedian cutaneous ostia(Lippincott Williams and Wilkins, 2015) Mete M.; Simsek T.; Umur A.S.; Selçuki M.; Umur N.; Gurgen S.G.Congenital dermal sinus tract is a rare dysraphism with an incidence of 1/2500-3000 ratio. The sinus ostium located in the midline of the posterior of the body from the occiput to the lumbosacral region. Paramedian congenital dermal sinus tract with paramedian ostium are rare. Here, we describe a 2-year-old boy who presented with paramedian pigmented lesion with an ostium on the left lumbosacral region. During surgery we noted that sinus tract attached to thick lipomatous filum terminale. © 2013 Wolters Kluwer Health, Inc.Item Tethered cord syndrome in adults: Experience of 56 patients(Turkish Neurosurgical Society, 2015) Selcuki M.; Mete M.; Barutcuoglu M.; Duransoy Y.K.; Umur A.S.; Selcuki D.Aim: The aim of this study was to describe the results of surgery performed in a group of adult patients with tethered cord syndrome with their outcomes. Material and Methods: This retrospective study included 56 patients. There were 38 females and 18 males. All patients were older than 18 years. Results: The mean age at referral was 36 years and 1 month. The mean follow-up period was 10 months 27 days. 95% of all patients with back and leg pains improved and 5% remained the same. Three patients with motor deficits remained the same in the postoperative period. Of the 16 patients with urological complaints, 10 improved, 5 unchanged and 1 patient died in the postoperative first day due to pulmonary embolism. Conclusion: The syndrome of tethered cord may be a situation to be treated even in the elderly in case of normal level conus medullaris and filum terminale with a normal appearance as well as a low-lying conus and thick filum. To prevent overlooking the diagnosis of tethered cord and/or unnecessary spinal surgeries, the tethered cord syndrome should be remembered in the differential diagnosis list in the presence of back and leg pains, neurological deficits or urological complaints.Item Double split cord malformations in a child: Types I and II at 2 different levels in the same route: Report of a rare case(Lippincott Williams and Wilkins, 2015) Barutçuoʇlu M.; Umur A.S.; Özdemir S.; Mete M.; Selçuki M.Spinal split cord malformations (SSCMs) are thought to be originated from an error that causes splitting of the notochord during gastrulation period, in which the formation of an accessory neurenteric canal between the yolk sac and amnion cavity takes place. Herein, we reported a 1-month-old boy who had both type II SSCM with meningocele at Th2-4 level and type I SSCM at Th10-12 level. Between those 2 malformations there was a normally developed spinal cord. Lesions were surgically corrected with good cosmetic and neurological outcome. There have been divergent suggestions on these pathologies. Although the multisite closure model of the neural tube may be used for explanation of these multiple neural tube defects, this theory alone cannot explain the nature and mechanism of development of such developmental defects of the neural tube. The aim of this study is to understand the embryological changes that cause the formation of a composite split spinal cord malformation. The idea of temporally different unexpected events that may cause developmental defects at different levels while other segments continue to neurulate normally seems appropriate to explain the multiple midline closure defects. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.Item Cutting filum terminale is very important in split cord malformation cases to achieve total release(Springer Verlag, 2015) Barutcuoglu M.; Selcuki M.; Selcuki D.; Umur S.; Mete M.; Gurgen S.G.; UmurAim: Split cord malformations (SCMs) are rare congenital anomalies of the vertebrae and the spinal cord. Tethered cord syndrome (TCS) is a clinical condition of various origins that arises from tension on the spinal cord. Radiographic findings may include and/or associate split cord malformations and the other neural tube defects. However, the spinal cord can even be tethered by a filum terminale with normal appearance and normal level conus medullaris in magnetic resonance imaging (MRI). The aim of our study is to show whether SMC patients with normal or abnormal MRI findings had all histological abnormal filum terminale and also to show that the standard SCM repairing operation without cutting filum will not achieve total release.; Material and methods: We have reviewed 33 SCM patients between July 2005 and December 2013. They were operated by adding untethering procedure of filum terminale following standard surgical intervention, and a part of the filum was taken for histopathological examination even though MRI did not show the presence of abnormality of filum terminale.; Results: We found that abnormal filum terminale with a normal appearance may had dense collagen fibers, wide and numerous capillaries, and hyaline formation, while normal filum terminale is a mixture of collagen fibers and blood vessels. We did not obtain positive Verhoeff elastic fiber staining. The elastic fibers had disappeared in all fila terminalia, except control cadaver group.; Conclusion: Our results showed that all fila of SCM patients had loss of elastic fibers and increased of hyalinization, which means loss of elasticity of filum terminale. Less severe traction may remain asymptomatic in childhood and present with neurological dysfunction later in life. For this reason, surgical procedure of SCM patients including releasing of filum terminale seems more beneficial for the patients and be better for long term. © 2014, Springer-Verlag Berlin Heidelberg.Item Dermoid cyst rupture presenting as subarachnoid hemorrhage: Report of a rare case(Lippincott Williams and Wilkins, 2015) Yaldiz C.; Duransoy Y.K.; Mete M.; Şimsek T.; Işisaʇ A.; Selçuki M.Dermoid cysts are usually asymptomatic tumors and consist <0.5% of all primary intracranial tumors. Rupture of the cyst can occur spontaneously, due to head trauma or during the intraoperative or postoperative period. Although patients have been reported to be asymptomatic after cyst rupture, its etiology is not fully understood. Here, we present a 53-year-old male patient who was admitted to the emergency department with loss of consciousness following sudden onset of headache. He had a stiff neck on physical examination. Although complaints and findings suggested spontaneous subarachnoid hemorrhage, cranial computed tomography and magnetic resonance imaging demonstrated rupture of a dermoid cyst. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.Item A giant hypertrophy of C5 spinous process in Klippel-Feil syndrome; [Klippel-Feil sendromunda C5 spinöz proçesinin dev hipertrofisi](Ege University Press, 2015) Mete M.; Ünsal Ü.Ü.; Duransoy Y.K.; Umur A.Ş.; Selçukİ M.Congenital cervical spinal anomalies are relatively common and can be seen in upper and lower cervical regions. However, hypertrophy of the lamina and spinous process of cervical vertebra is extremely rare. Here we reported an 11-year-old girl with unilateral hypertrophy of the lamina and spinous process of C5 vertebra coexistence with Klippel-Feil syndrome, occipitalization of atlas and atlantoaxial congenital fusion. Because of cosmetic anomaly patient underwent surgery and spinous process excised. To the best of our knowledge, this coexistence of congenital cervical bony anomalies in a child has not been reported previously in English literature. © 2015, Ege University Press. All rights reserved.