MCBÜ Açıkerişim Sistemi :: Browsing by Author "Selçuki M."

Browsing by Author "Selçuki M."

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Patients with urinary incontinence often benefit from surgical detethering of tight filum terminale
(Springer Verlag, 2000) Selçuki M.; Ünlü A.; Uǧur H.C.; Soygür T.; Arikan N.; Selçuki D.
We retrospectively reviewed 77 patients with a tethered spinal cord syndrome to evaluate the results of neurosurgical treatment. The patients were divided into two groups: in group 1 there were 17 patients with primary tethered cord who had normal level conus medullaris (NLCM) and normal thickness ilium terminale (NTFT) with urinary incontinence, and group 2 was made up of 60 patients with secondary spinal cord tethering after a previous closure of a midline fusion defect who had a low-lying conus medullaris. Neurological examination, radiography, urodynamic tests and electrophysiological findings confirmed the diagnosis. Conventionally, tethered cord syndrome has been defined as a state in which the conus medullaris is located below the L1-2 disc space. However, in a patient with urinary incontinence and a hyperreflexive type of neurogenic bladder, in whom the conus medullaris is found to be at the normal level, there may still be cord tethering that is causing the incontinence. In this study the comparison was based on evaluation of the response to treatment and general characteristics of the syndrome in both groups of patients to draw attention to the general approach to this incapacitating maldevelopment.
Gigantic intracranial mass of hydatid cyst
(2001) Özkan Ü.; Kemaloğlu M.; Selçuki M.
A child (8 years old) with a gigantic mass of intracranial hydatid cysts (95×90×75 mm) is presented. The first manifestation was difficulty in walking, which was followed by symptoms of raised intracranial pressure. A craniotomy was performed, and more than 25 hydatid cysts were removed. The literature is reviewed and the incidence of gigantic mass of cerebral hydatid cyst is compared in the published reports.
The curly tail mouse model of human neural tube defects demonstrates normal spinal cord differentiation at the level of the meningomyelocele: Implications for fetal surgery
(2001) Selçuki M.; Manning S.; Bernfield M.
The paralysis associated with lumbosacral meningomyelocele has been attributed both to myelodysplasia and to degeneration of the exposed neural tissue. Surgically created dysraphism shows that exposure of an intact spinal cord in a genetically normal animal results in degeneration of the normal nervous tissue and subsequent paralysis. Our objective was to study neuronal differentiation in the curly tail mouse mutant model, which develops lumbosacral meningomyelocele naturally and is a phenocopy of nonsyndromic human neural tube defects. Prenatal repair of meningomyelocele assumes that the normal neuronal differentiation program occurs despite failure of neurulation. Here we demonstrate that this most suitable animal model has normal differentiation of neuronal structures at the level of the meningomyelocele. TuJ 1, an antibody to neuronal specific class III β-tubulin, an early marker of neuronal differentiation, was used to stain paraffin-embedded sections of curly tail mouse embryo meningomyelocele. Embryos were examined at embryonic day 13.5 (E13.5). The inbred mouse strain, C57BL6/J, which is genetically similar to the curly tail mouse, was used as a control in these studies. We show that early neuronal differentiation appears intact within the meningomyelocele. TuJ 1 stains structures within the open neural tube. Motor neurons are present in the ventral horn and ventral roots. Dorsal root ganglia are present and of similar size to controls. The staining pattern is similar to that seen in the C57BL/6J control mouse, although dorsal structures are laterally displaced in the curly tail meningomyelocele. Based on this model, fetal surgery to repair human meningomyelocele may preserve neurological function in those cases where there is not an inherent genetic defect of the neural tissue.
Widespread post-traumatic acute spinal subdural haematoma: Case report and review of the literature
(2002) ÜÖzkan Ü; Kemaloğlu M.S.; Aydin M.; Selçuki M.
Study design: A case report of acute post-traumatic spinal subdural haematoma (ASSH). Objective: To report a rare post-traumatic problem. Setting: Dicle University Hospital, Diyarbakir, Turkey. Method: A 3-year-old boy was admitted to our clinic with paraplegia 24 h after falling from a height of about 5 meters. Investigation revealed an acute spinal subdural haematoma. Results: Following surgery there was marked improvement. The rehabilitation of the patient continues. Conclusion: MRI is the most valuable diagnostic method. In each case diagnosed as ASSH, prompt evacuation should be performed before irreversible neurological damage occurs.
Vibrational spectroscopy and analytical electron microscopy studies of Fe-V-O and In-V-O thin films
(2002) ÜÖzkan Ü; Kemaloğlu M.S.; Aydin M.; Selçuki M.
Orthovanadate (M3+VO4; M = Fe, In) and vanadate (Fe2V4O13) thin films were prepared using sol-gel synthesis and dip coating deposition. Using analytical electron microscopy (AEM), the chemical composition and the degree of crystallization of the phases present in the thin Fe-V-O films were investigated. TEM samples were prepared in both orientations: parallel (plan view) and perpendicular (cross section) to the substrate. In the first stages of crystallization, when the particle sizes were in the nanometer range, the classical identification of phases using electron diffraction was not possible. Instead of measuring d values, experimentally selected area electron diffraction (SAED) patterns were compared to calculated (simulated) patterns in order to determine the phase composition. The problems of evaluating the ratio of amorphous and crystalline phases in thin films are reported. Results of TEM and XRD as well as IR and Raman spectroscopy showed that the films made at lower temperatures (300°C) consisted of nanograins embedded in the dominating amorphous phase. Characteristic vibrational spectra allowed to distinguish between the different crystalline phases, since the IR and Raman bands showed broadening due to the decreasing particle size of the films thermally treated at lower temperatures. Vibrational analysis also showed that the electrochemical cycling of crystalline films led to spectra that were in close agreement with the spectra of the nanocrystalline films prepared at lower temperatures. The formation of a nanocrystalline structure is therefore a prerequisite for obtaining a higher charging/discharging stability of Fe-V-O and In-V-O films.
B cell immunoblastic lymphoma of central nervous system: Case report
(Turkish Neurosurgical Society, 2003) Umur A.S.; Temiz C.; Selçuki M.; Mirzai H.; Okudur I.; Özkal B.; Işisaǧ A.
Primary central nervous system lymphoma (PCNSL) is defined as the lymphoma effecting only spinal axis and cranium without systemic symptoms. PCNSL is very rare. Hystologic type of lymphoma that arising in the CNS is most commonly B cell lymphoma. In our study we reported a 47 years old female patient with B cell non-hodgkin's lymphoma of CNS with no evidence of lymphoma outside the CNS. There was no evidence of systemic acquired immundeficiency syndrome.
Is a filum terminale with a normal appearance really normal?
(Springer Verlag, 2003) Selçuki M.; Vatansever S.; Inan S.; Erdemli E.; Baǧdatoǧlu C.; Polat A.
Introduction: Tethered spinal cord is defined as a condition in which the conus medullaris ends at a level below the L1-2 intervertebral space. The spinal cord is considered to be tethered when there is a thick filum terminale or low-lying conus medullaris. It has also been reported that a normal level of the conus medullaris and normal thickness of the filum terminale do not mean that there is no cord tethering. Materials and methods: In this investigation, we examined 21 fila terminalia; 5 of them were taken from cadavers, and these were used as a control group (group 1; n/n), 8 from patients with a normal appearance of the filum terminale but with clinical symptoms (incontinence) and pathologic results of a urodynamic study (group 2; n/ab), and 8 from patients with an abnormal appearance of the filum terminale and with clinical symptoms (group 3; ab/ab). Interestingly, we found that while fila terminalia in the control group were made up mainly of collagen fibers, more connective tissue with dense collagen fibers, some hyalinization and dilated capillaries were noticed in the fila from group 2. Results: Our results suggest that these histological features may reflect a decreased elasticity within the filum terminale, resulting in a tethering effect on the lower conus in otherwise normal physiological conditions. Conclusion: These findings lead us to reconsider sectioning of the filum terminale in incontinent patients with normal results in radiological studies, whose condition is called "nonneurogenic neurogenic bladder".
The Effects of Methotrexate on the Development of Neural Tube Defects in the Chick Embryo
(2003) Vatansever H.S.; Umur A.Ş.; Inan V.S.; Selçuki M.
During chick development, one of the earliest differentiated tissues is the neural tube. After 24 h of incubation, a chick egg starts to differentiate and 30-48 h after incubation the neural plate is closed from head to tail to form the neural tube. If factors controlling the neural tube's closing are disrupted, this consequently causes neural tube closure defects during this time. In this study, the effect of methotrexate on the developing neural tube was investigated during early chick development. For this research, 40 specific pathogen free (SPF) white Leghorn type chick embryos were used. They were incubated for 30 h at 37.8 ± 2°C. Methotrexate, which inhibits the dihydrofolate reductase enzyme by a competitive mechanism, was injected within therapeutic dosage limits (10 mg/m2, 20 mg/m2, 40 mg/m2) in ovo. Ten eggs were injected with 0.9% NaCl and used as a control group. All groups, after the injection, were incubated for 48 and 72 h. They were then dissected and the embryos were fixed in 10% (v/v) formalin for 2 h. The embryos were embedded in paraffin wax and 5 μ serial sections were taken. Sections were stained with haematoxylin and then observed under light microscopy. While 20 mg/m2 or 40 mg/m2 methotrexate embryos were not alive when they were opened at 48 h incubation, 10 mg/m 2 methotrexate embryos maintained normal development after 48 and 72 h incubation. However, there was developmental retardation in the methotrexate injected group when compared with the control group with development of the brain being retarded; the volume of brain vesicles was lower than in the control group. Our results suggested that methotrexate, an antimetabolite of folic acid, caused neural tube closure defects when injected at therapeutic dosage levels. Folic acid is essential for normal development of the nervous system; therefore, folate antagonists might be more harmful to the central nervous system than to other parts of the developing body.
Neural tissue continues its maturation at the site of neural tube closure defects: Implications for prenatal intervention in human samples
(2004) Selçuki M.; Vatansever S.; Inan S.; Sanci M.; Sayhan S.; Baǧdatoǧlu C.
Objective: Our objective was to investigate the relation between the embryological development and neural tissue maturation at the site where the neural plate failed to form a neural tube. Material and methods: Samples from 15 aborted human fetuses with neural tube defects (NTD). All of the fetuses were between 20 and 25 gestational weeks old. Indicators of neural tissue maturation, formation of basal lamina, expression of integrins and neuron specific class III beta tubulin (tuj1) were investigated. To detect the adverse effects of the environment, if any, p53 and bcl-2 activity at both sites of the open and closed neural plate were investigated as well. Results: No difference was found in the expression of maturation-related molecules at the site of the neural plate that remained open compared with the site where the neural tube is normally formed. While high p53 activity was noted in neural tissue at the site of the neural tube defect, no such activity was detected in the neural tissue where the neural tube is normally formed. Conclusion: Our results suggested that maturation and differentiation of neural tissue continued regardless of the failure of neural tube closure. Therefore, the neurological deficits that are encountered in NTD patients should be related to secondary damage such as amnion fluid toxicity, uterus contractions, labor, etc. It seems valuable to save the neural plate before the negative effects of the environment renders the neural tissue functionless. © Springer-Verlag 2004.
A case of posttraumatic intracranial meningioma; [Bir olguda travma sonrasinda intrakranyal meningiom oluşumu.]
(2004) Mirzai H.; Akbaşak A.; Işisag A.; Selçuki M.
Several etiologic factors have been proposed in the development of meningiomas, including trauma, radiation, oncogenic viruses, chromosomal abnormalities, and hormonal factors. We presented a 71-year-old female patient who had undergone an operation for a head trauma 27 years ago. Brain computed tomography scans showed a contrast-enhancing intracranial mass lesion, 5 x 4 x 4 cm in size, leading to diffuse edema in the left frontal region. At surgery, a tumoral mass was detected below the former craniotomy flap, with dural invasion, and a total excision was performed. Two silver clips were also noted in the previous surgical site. Histopathologic diagnosis was made as a transitional meningioma. No recurrences were detected within a year follow-up period.
Penetrating injury of cranium: A case report
(Turkish Association of Trauma and Emergency Surgery, 2005) Temiz C.; Umur A.Ş.; Baǧdatoǧlu C.; Tosun C.; Selçuki M.
A 38 year-old male patient treated for paranoid schizophrenia for five years was found on a chain saw table at his workplace with a great parasagittal, linear active bleeding wound from left occiput to medial portion of left orbita. He was unconscious with a Glascow coma score of 5 points as 1-3-1. Cranial radiographies revealed a bone defect from left occipital region to left medial border of orbita. CT scan showed also a great linear tissue damage involving left lateral ventricle, and an intracerebral hematoma located mainly at left frontoparietal region. An emergent left frontoparietal craniotomy was performed. Four centimetres laterally midline, there was a linear, vertical tissue wound. Hemostasis was achieved at first and intracerebral haematoma evacuated. At one week postoperatively his eyes started to react to verbal commands. At 7 months postoperatively he was attempting to cooperate with eye movements and writing. He was right hemiplegic, aphasic and on the right side deep tendon reflexes were hyperactive. His Karnofsky score was almost 40 points. Cranial injuries due to chain saw accidents are very rare. Early surgical procedures (incl. decompression) combined with aggressive antibiotherapy seem to have a great survival benefits. However best long- term results show that this type of injuries have a great rate of mortality and morbidity despite all surgical and medical treatment procedures.
Apoptosis seems to be the major process while surface and neural ectodermal layers detach during neurulation
(2008) Selçuki M.; Vatansever S.; Umur A.S.; Temiz C.; Sayin M.
Objective: The aim of this study is to demonstrate the process of detaching neural and surface ectodermal layers soon after the neurulation completes. Materials and methods: Specific pathogen-free chicken egg embryos were used to investigate the neurulation procedure. Ten eggs were saved as controls. The other ten eggs were opened at the 30th hour of embryo development and cultured with Z-VAD-FMK (peptide caspase inhibitor) to investigate the results of the apoptosis inhibition. Embryos were placed and developed up to 48 h in the culture medium. To detect apoptotic cells between neural and surface dermal layers, immunoreactivity of p53 and terminal uridine deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay were used. Results: While the control group shows positive immunoreactivity of p53 and TUNEL-positive apoptotic cells at the site where the neural folds detach from the surface ectoderm, no TUNEL activity and no detachment were detected in the apoptosis-inhibited group. Conclusion: As inhibition of apoptosis prevented the detachment of the neural and surface ectodermal layers from each other at the end of the neurulation, inhibition of apoptosis seemed to cause a considerable embryological error accounted for congenital dermal sinus tractus maldevelopment. © Springer-Verlag 2007.
Genetical and histological investigation of Turkish siblings with spina bifida occulta who had neurosurgical intervention
(2009) Altintas N.; Umur Ş.; Vatansever S.; Temiz C.; Selçuki M.; Selçuki D.; Örenay S.; Arslan E.
Spina bifida is the one of the most frequently occurring birth defects. More children have spina bifida than muscular dystrophy, multiple sclerosis, and cystic fibrosis combined. Occulta present type is a mild very common form of spina bifida. The reported frequency of occurrence of spina bifida occulta (SBO) varies widely, depending largely on the age groups included in a particular study. The most accurate estimate of occurrence rate is 17% of examined spines. In present study we have examined and compared two Turkish siblings with spina bifida occulta who had neurosurgical intervention. Clinical, histopathological and cytogenetical analyses had been performed on mother and both siblings (brother and sister) diagnosed with spina bifida occulta. Hypertrichosis on their low-backs was diagnosed in both siblings. Magnetic resonance imaging (MRI) studies revealed low conus medullaris and thick filum terminale in brother and sister. The brother somatosensory evoked potential (SEP) results showed lumbar conduction blockade which was not found in sister. Despite the brothers's thick and fatty filum terminale sisters's seemed to be normal. Filum terminale sections from both siblings had normal appearance but atypical structure with increased amount of connective tissue and hyalinization areas. Sections from 9 years old boy were also prominent in glial cells. Genetical analysis revealed normal caryotype in 13 years old sister (46,XX) , however deletions on chromosome 17 have been detected in 9 year-old brother [46,XY/46,XY,del(17)(q25) /47,+mar] and their mother [46,XX/46,XX,del(17)(q25)]. Our results show on strong correlation between the deletion of chromosome 17(q25) with genetical and histological results in both siblings with SBO. This is the first report of chromosome 17 (q25) deletion related to the SBO and its genetic connection with neural tube defects.
Analysis of the effects of inhibitor and activator systems (smad's proteins) of TGF-βs on chick neural tube closure; [Tavuk Nöral Tüp Kapanmasinda TGF-βs Inhibitör ve Aktivatör Sisteminin (Smad's Proteinleri) Etkilerinin Araştirilmasi]
(2010) Umur N.; Vatansever S.; Umur A.Ş.; Özbilgin K.; Selçuki M.
The families of TGF-βs and Smads proteins that controls its intracellular signaling pathways are known to play a role in early neurulation. The aim of this study is to demonstrate distribution of TGF-βs (1, 2, 3) and Smads (1/2/3, 6, 7) proteins as a system in different hours of neural tube development of chick embryos. The SPF eggs were incubated at 37.8±2°C for 24th, 30th, 48th, 72nd h. After that, embryos were examined using immunohistochemistry and western blotting techniques. To the results, TGF-βs immunoreactivities (particularly TGF-β3) at the 24th, 30th and 48th h of chick development (during neural tube closure) were determined and decreased at the 72nd h (after neural tube closure), but expressions of TGF-βs were detected in all stage of embryos in western blotting. While Smad 1/2/3 immunoreactivitiy and expression was less than that of the Smad 6 and 7 at the 24th, it was increased at the 30th h. Smads proteins immunoreactivities were decresead at the 72nd h. In conclusion, the members of TGF-βs are play a role in chick neural tube closure, the secretions of TGF-βs are controlled different Smad proteins. In addition, immunoblotting results showed that TGF-βs and Smads proteins were effective in the development of all tissues and organs of the embryos.
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.
Large primary intraorbital hydatid cyst
(2011) Yurt A.; Seçer M.; Selçuki M.
The authors report a rare case of a large primary intraorbital hydatid cyst diagnosed in 3-year-old children who had presented with unilateral progressive nonpulsatile proptosis of the left eye, explored by computed tomography and magnetic resonance imaging. © 2011 Springer-Verlag.
Prognostic factors in metastatic brain tumors: Study of 62 patients; [Metastatik beyin tümörlerinde prognostik faktörler: 62 hastalık çalışma]
(Ege University Press, 2012) Duransoy Y.K.; Selçuki M.; Gökçe T.; Duransoy A.
Background: Brain metastases are the major cause of morbidity and mortality in patients with cancer. Variety of clinical and autopsy studies showed that brain metastases develop at 15%-45% of all cancer patients during the course of the disease and 1/2-2/3 of them were symptomatic. Average life expectancy of cancer patients with untreated metastatic brain tumors are approximately 1-2 months. Methods: We investigated the prognostic factors of removal of metastatic brain tumors in patients who admitted to neurosurgery department. Eighteen of 80 patients in the program excluded for various reasons and this study was completed with the remaining 62 cases. Results: Our study showed that neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Conclusion: In the planning of treatment of patients with metastatic brain tumors, colleagues have to keep in mind level of neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Surgical resection is beneficial for improving neurological status and survival of patients in brain metastases. Local control is essential and can be achieved with one of the adjunct therapies following the surgery.
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.
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.
Inappropriate surgical interventions for midline fusion defects cause secondary tethered cord symptoms: Implications for natural history report of four cases
(Springer Verlag, 2012) Selçuki M.; Umur A.Ş.; Duransoy Y.K.; Ozdemir S.; Selcuki D.
Introduction The causes of tethered spinal cord are various. In order to release the tethering effect of these malformations, the surgical interventions must include removal of all tethering components, reconstruction of the neural tube and sectioning of tight filum terminale as well. Cases The cases reported in this paper have had an operation many years before for various developmental defects. After a certain period of time (5-10 years) of the first operation, the patients reapplied to the hospital with various symptoms of spinal cord tethering, either vertical or horizontal. Discussion At surgical intervention, it was noted that inappropriate surgical procedures caused retethering of the spinal cord in all patients. Postoperative period of all patients were uneventful. All patients declared relief in their symptoms. We would like to draw attention that untreated (or inappropriately treated) midline developmental defects will invariably cause syndrome of tethered cord. Consequently, prophylactic surgical untethering must be applied to all patients with developmental midline defects as soon as possible. Conclusion It looks that tethered cord symptoms invariably appear as enough negative influence accumulates as the time passes. Elapsed time may vary but unpleasant end result invariably arrives. While these cases with tethered spinal cord develop progressive neurological symptoms, prophylactic and appropriate surgical intervention should be considered as early as possible. There is no acceptable rationale to wait for the appearance of tethered cord syndrome symptoms to perform surgical untethering of the spinal cord because of the probability of irreversibility of the symptoms (incontinence of urine in particular) of tethered spinal cord syndrome. ©Springer-Verlag 2012.

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