Browsing by Author "Ozgiray E."
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Item Endovascular treatment of intracranial infectious aneurysms(Springer Verlag, 2016) Esenkaya A.; Duzgun F.; Cinar C.; Bozkaya H.; Eraslan C.; Ozgiray E.; Oran I.Introduction: Intracranial infectious aneurysm (IIA) accounts for less than 5 % of all intracranial aneurysms. The aim of this study was to evaluate the role of endovascular treatment for IIA. Methods: During a 14-year period, 15 patients (age range, 2–68 years; mean, 42.8 years) with 17 aneurysms were diagnosed with IIA and treated via an endovascular route at our institution. The IIA diagnosis was based on clinical and laboratory findings of infection, echocardiography results, and digital subtraction angiography that were collected retrospectively. All patients were clinically and radiologically followed. The modified Rankin scale was used to evaluate clinical outcome. Results: Among 15 patients, 12 presented with ruptured aneurysms (7 intraparenchymal hematoma, 4 subarachnoid hemorrhage, 1 subdural hematoma), 2 with cerebral infarcts, and 1 with pansinusitis and epidural abscess. All but one aneurysm were distally located in intracranial circulation, 14 were in anterior, and the remaining 3 were in posterior circulation. The final diagnosis was based on aneurysm morphology, location, and clinical laboratory findings. Endovascular treatment was scheduled initially for all IIAs; 13 of 17 IIAs underwent endovascular parent vessel occlusion, 3 underwent spontaneous parent vessel occlusion while waiting for intervention, and the remaining patient was treated by intrasaccular coil occlusion. There were no instances of perioperative neurological complications. Late clinical and radiological outcomes included absence of endovascular treatment related to mortality and aneurysm recurrence. Conclusion: Endovascular treatment may be performed safely at the time of diagnosis for at least symptomatic IIAs under the protective effect of antibiotic treatment. © 2015, Springer-Verlag Berlin Heidelberg.Item Two challenging cases of pituicytoma(Springer Science and Business Media Deutschland GmbH, 2021) Ozisik H.; Yurekli B.S.; Simsir I.Y.; Ertan Y.; Eraslan C.; Ozdemir N.; Ozgiray E.; Saygili F.Introduction: Pituicytoma is a rare tumor of the pituitary gland derived from neurohypophyseal pituicytes. Case 1: A 58-year-old female presented with decreased vision; she was admitted to the neurosurgery department of Ege University after the detection of a pituitary macroadenoma. Magnetic resonance imaging (MRI) showed a 28 * 18 * 17-mm suprasellar mass, and laboratory tests revealed hypopituitarism. Hydrocortisone and L-thyroxine treatment were initiated, and the patient underwent resection through the endoscopic endonasal approach (EEA). The histopathological examination revealed a pituicytoma. The recurrence of tumor was detected during the 1-year follow-up, and the patient is awaiting surgery. Case 2: A 70-year-old woman presented with visual changes; she had a past medical history of hypophyseal macroadenoma and pituicytoma resected through an EEA in 2012 and 2017, respectively. During follow-up, 2 years after the second surgery, MRI showed progression of the pituicytoma then measuring 38 × 23 × 22 mm; it had invaded the cavernous sinus and was causing hydrocephaly and panhypopituitarism. The patient underwent the third resection through the transcranial approach in order to minimize bleeding. After this surgery, the patient developed diabetes insipidus and underwent treatment with desmopressin. Histopathological examination revealed a pituicytoma. At 6-month follow-up, imaging showed a sellar suprasellar mass 37 × 22 × 24 mm invading the cavernous sinus, indicative of recurrence. In the postoperative period, the patient applied to the department of radiation oncology to have fractionated radiotherapy. Discussion: Pituicytomas are known to be low-grade tumors; because of their rarity, they are a real challenge. These patients should be followed up closely. © 2021, Hellenic Endocrine Society.