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Öğe An 11-year-old girl with Pott's puffy tumour(2007) İş, Merih; Karataş, Ayşe; Aytekin, Hikmet; Döşoğlu, Murat; Gezen, FerruhObjective: Pott's puffy tumour (PPT) is a rare entity that is characterised by a subperiosteal abscess associated with frontal bone osteomyelitis. Case: We report a case where a frontal periosteal abscess was successfully treated with simple surgical abscess drainage, followed by prolonged broad-spectrum antibiotic therapy. Conclusion: The treatment goal is early diagnosis and aggressive therapy to prevent severe complications like meningitis, subdural empyema, and brain abscess. © 2007 Elsevier Ireland Ltd. All rights reserved.Öğe A 13-year-old girl with a cystic cerebellar lesion: Consider the hydatid cyst(Elsevier Sci Ltd, 2009) İş, Merih; Gezen, Ferruh; Akyüz, Fevzullah; Aytekin, Hikmet; Döşoğlu, MuratWe report a 13-year-old girl with a hydatid cyst located in the posterior fossa. The pre-operative diagnosis was a cerebellar turnout; the cyst was operated on using puncture, aspiration, irrigation and resection. Sixteen months post-operatively, the patient is in a good health. A hydatid cyst must always be considered in the differential diagnosis of cystic lesions of the cranium, especially for those children living in rural areas. (C) 2008 Elsevier Ltd. All rights reserved.Öğe Deneysel kafa travmasında Pregabalin'in akut dönemdeki antienflamatuar, antiödem ve koruyucu etkisi(Düzce Üniversitesi, 2011) Aytekin, Hikmet; Gezen, FerruhAmaç: Travmatik beyin hasarı, primer ve sekonder hasar mekanizmalarını içerir. Sekonder hasar, saatler veya günler sonra ortaya çıkmakta ve birçok karmaşık fizyopatolojik mekanizmaya bağlı olarak oluşmaktadır. Yapılan çalışmalarda, Pregabalin ?2-? alt ünitesi ile kalsiyum kanallarına kuvvetli bağlanır, sonuçta glutamat, noradrenalin, serotonin, dopamin ve substans P gibi çeşitli eksitatör nörotransmitterlerin salınımında bir azalmaya neden olur. Çalışmamızda, ağır kapalı diffüz beyin travması oluşturulan ratlara, travma oluşturulduktan sonra akut dönemde pregabalin tedavisi verilerek antiödem, antienflamatuar ve nöroprotektif etkisinin araştırılması amaçlandı.Metod: Bu deneysel hayvan çalışmasında ağırlıkları 300- 350 g arasında değişen 32 adet erkek erişkin Spraque- Dawley sıçanı kullanıldı. Denekler her grupta sekiz sıçan olacak şekilde Kontrol (K); Travma (T); Travma sonrası pregabalin (T + P); Sadece Pregabalin P) gruplarına ayrıldı. Çalışmada pregabalin izotonik ile sulandırılarak intraperitoneal olarak verildi. Travma + medikasyon sonrası 84. saatte sıçanlar dekapite edilerek örnekler histopatolojik olarak incelendi.Bulgular: Travma grubu ile travma sonrası pregabalin verilen grup arasında kanama açısından bir fark olmadığı (p: 0.368), enflamasyon açısından ise anlamlı fark (p: 0.003) olduğu görülmüştür. Yine bu gruplar arasında ödem açısından istatistiksel olarak anlamlı bir farklılık yoktur (p=0,131). Travma grubunda 8 denekte, travma sonrası pregabalin verilen grupta 6 denekte ödem görülmüştür. 2 denekte ödem görülmemiştir.Sonuç: Çalışmamızın sonuçları akut travmatik beyin hasarında, pregabalinintedavisinin enflamasyonu azaltarak sekonder travmatik beyin hasarına karşı koruyucu olabileceğini göstermiştir. Sonuç olarak pregabalinin insanlarda akuttravmatik beyin hasarının tedavisinde yararlı bir seçenek olabileceği düşünüldü. Pregabalin farklı dozlar ve sürelerde uygulanarak antiödem etkinliği açısından daha geniş çalışmalar yapılabileceği düşünüldü.Anahtar sözcükler: Travmatik beyin hasarı, nöroprotektif etki, beyin ödemi, pregabalin.Öğe EFFECT OF L-CARNITINE IN PREVENTING SECONDARY DAMAGE IN TRAUMATIC BRAIN INJURY: AN EXPERIMENTAL STUDY(Carbone Editore, 2015) Çalıkoğlu, Çağatay; Akgül, Osman; Akgül, Mehmet Hüseyin; Gezen, Ahmet Ferruh; Aytekin, Hikmet; Döşoğlu, Murat Servan; Erdem, HavvaIntroduction: Prevention of secondary damage occurring after traumatic brain injury (TBI) reduces morbidity and mortality. The present study aimed to evaluate efficacy of L-carnitine, the benefit of which has been proven in many fields such as liver, kidney and neurological diseases, in the treatment of TBI. Matherials and method: Forty adult male Sprague-Dawley rats were included and divided into 4 groups, each containing 10 rats. The control group comprised subjects without induced head trauma and treatment. The trauma group comprised subjects with induced head trauma and no treatment. The carnitine group comprised subjects without induced head trauma and with L-carnitine treatment (100 mg/kg via intraperitoneal route for 6 times). The trauma+carnitine group comprised subjects with induced head trauma and L-carnitine treatment. Edema, inflammation, and neuronal damage were histopathologically examined. Results: In the trauma group, all subjects had edema, inflammation, and neuronal damage. In the control, carnitine, and trauma+carnitine groups, edema was detected in 5, 6, and 4 subjects, respectively; inflammation was detected in 2, 4, and 3 subjects, respectively; and neuronal damage was detected in 1, 3, and 7 subjects, respectively. Edema and neuronal damage scores were significantly higher in the trauma group than in the other groups. Inflammation rate was significantly higher in the trauma group than in the control and trauma+carnitine groups. Conclusion: Antiedema, anti-inflammatory, and neuroprotective effects of L-carnitine were histopathologically demonstrated in the rats with experimentally induced head trauma. L-carnitine could be a beneficial treatment option for edema and inflammation secondary to acute TBI in humans.Öğe Effects of anti-edema drugs on diffuse cerebral edema in rats: Experimental study(Turkish Assoc Trauma Emergency Surgery, 2013) Akyüz, Fevzullah; İş, Merih; Aytekin, Hikmet; Anlar, Murat; Akgül, OsmanBACKGROUND Traumatic brain edema is one of the most common problems encountered in neurosurgical practice and it leads to morbidity and mortality via increased intracranial pressure. The aim of this study was to examine the effect of hypertonic saline on traumatic brain edema in comparison to mannitol. METHODS Eighty adult male Sprauge-Dawley rats weighting 300-350 g were used in this experimental study. Rats were randomly divided into control (C); trauma (T); mannitol only trauma+mannitol; NaCl 3% only; Trauma+NaCl 3%; NaCl 7.5% only; trauma+NaCl 7.5%; NaCl 23.4% only and trauma+NaCl 23.4% groups. All medications were given intraperitoneally. Rats were sacrificed and decapitated 24 hours after trauma with or without medications and the brains were examined histopatologically. RESULTS Although no difference was observed with regard to hemorrhage between trauma only and trauma+NaCl 23.4% groups, there was a statistically significant difference in brain edema within these two groups (p=0.003). There were no statistically significant differences within groups with respect to plasma osmolarity and serum sodium levels. CONCLUSION This study demonstrates that 23.4% NaCl is more effective than other concentrations of hypertonic saline or mannitol in the prevention of posttraumatic brain edema. Further clinical studies with different dosages and concentrations of hypertonic saline are required.Öğe Evaluation of Different Surgical Techniques to Repair Iatrogenic Esophageal Injury; an Experimental Study(Journal Neurological Sciences, 2015) İş, Merih; Pehlivan, Mevlüt; Akyüz, Fevzullah; Çelikoğlu, Erhan; Gökçe, Aysun; Aytekin, Hikmet; Altay, TamerObjective: Esophageal perforation during anterior spine surgery is a rare but serious complication that may lead to death, if not managed properly. Optimal management of these injuries is still debated, which varies from conservative approach to different types of surgical repair. The purpose of this study was to evaluate and compare the healing process following various surgical techniques to repair experimentally induced esophageal injury in rodents. We hypothesized that repair techniques that involve flap rotation along with primary suture was superior to primary suture alone. Material and Methods: Fifty male Sprague-Dawley rats were used for this study. Esophageal injury was induced by a vertical incision through all layers of its wall. Groups were determined according to the repair techniques used, i.e., Group-1 (sham, no injury), Group-2 (primary suture), Group 3 (primary suture plus muscle flap), Group 4 (primary suture omental flap) and Group 5 (untreated). Esophageal segments repaired were obtained fourteen days after the injury/repair surgery for histopathological evaluation. Results: Total histopathological damage scores were highest in Group 5. Lower total scores were obtained in Group 3 than in Group 2 and 5, whereas total scores between Groups 2 and 4, 2 and 5, and 3 and 4 were similar. Infiltration and submucosal/muscular healing scores were higher in Group 2 than in 3. There was no difference in any of the parameters between groups 2 and 4, 2 and 5, and 3 and 4. Conclusions: Primary suture closure reinforced by a muscle flap provides better healing in a rat model of iatrogenic esophageal injury. Primary suture reinforced by omentum, or primary suture alone may be considered as second options for repair.Öğe Giant cavernous haemangioma in an infant(Taylor & Francis Ltd, 2008) Gezen, Ferruh; Karataş, Anıl; İş, Merih; Yıldırım, Ümran; Aytekin, HikmetCavernous haemangiomas are benign vascular lesions of the central nervous system. Their size varies from a few millimetres to several centimetres. Giant and paediatric cases are rare. This report presents a 10-month-old baby with a giant multilobular cavernous haemangioma in the left parietal lobe who presented with seizures.Öğe Kranial bilgisayarlı tomografi incelemesinde izlenemeyen ve direkt grafide saptanan kranial fraktür olgusu(2007) Aytekin, Hikmet; İş, Merih; Döşoğlu, Murat; Gezen, FerruhGünümüzde kafa travmalarında artık direkt grafinin yeri olmadığına dair görüşler vardır. Fakat transvers kalvaryal fraktürleri BT’de tespit etmek zordur. Düşme sonrası kafa travmasıyla bir merkeze başvuran, çekilen kranial BT’de kırık hattı izlenmeyen olgu sunulmuştur. Baş ağrısı, bulantı-kusma, şikayetiyle acil servisimize başvuran hastanın muayenesi normaldi. Direkt kraniografik incelemede sağ frontal lineer fraktür hattı izlenen hasta takip amacıyla yatırıldı. Hukuki nedenlerle ve transvers kırıkların BT’de saptanmama olasılığı nedeniyle kliniğimizde rutin olarak hafif kafa travması dahi olsa, kafa travmasıyla başvuran tüm olgulara kraniografi çekilmektedir.Öğe Sıçanlarda, antiödem olarak kullanılan ilaçların diffüz beyin ödemine etkileri: Deneysel çalışma(2013) Akyüz, Fevzullah; İş, Merih; Aytekin, Hikmet; Anlar, Murat; Akgül, OsmanAMAÇ Travmatik beyin ödemi, nöroşirürji pratiğinde sık karşıla- şılan önemli sorunlardan biridir. Beyin ödemi, kafaiçi ba- sıncını yükseltmekte, morbidite ve mortalite artışına yol açmaktadır. Bu çalışmanın amacı travmatik beyin ödemi tedavisinde hiperozmolar tuzların tedavi etkinliğinin sap- tanması ve mannitole göre karşılaştırılmasıdır. GEREÇ VE YÖNTEM Bu deneysel çalışmada ağırlıkları 300-350 g arasında deği- şen 80 adet erkek erişkin Spraque-Dawley sıçanı kullanıldı. Sıçanlar kontrol; travma; sadece mannitol; travma sonrası mannitol; sadece %3 NaCl; travma sonrası %3 NaCl; sade- ce %7,5 NaCl; travma sonrası %7,5 NaCl; sadece %23,4 NaCl; travma sonrası %23.4 NaCl gruplarına ayrıldı. Tüm ilaçlar periton içine verildi. Travma ve ilaç uygulaması son- rası 24. saatte sıçanlar dekapite edildi, örnekler histopatolo- jik olarak incelendi. BULGULAR Travma grubu ile travma sonrası %23,4 NaCl verilen grup arasında kanama açısından bir fark olmadığı (p0,473), ödem açısından ise anlamlı fark (p0,003) olduğu saptan- dı. Gruplar plazma osmolaritesi ve serum sodyum değerleri açısından karşılaştırıldığında kontrollerle diğer tüm gruplar arasında anlamlı fark bulunmadı. SONUÇ Travma sonrası beyin ödemi önlemek amacıyla verilen %23,4 NaCl’nin diğer hipertonik salinlerden ve mannitol- den daha etkili olduğu görülmüştür. Bu bulgunun hipertonik salinlerin farklı doz, konsantrasyon ve sürelerde verildiği daha geniş klinik çalışmalarla desteklenmesi gerekmektedir.Öğe Unexpected Perioperative Complication of Aneurysm Surgery: Armored Arachnoiditis Case Report(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2011) Döşoğlu, Murat; İş, Merih; Aytekin, Hikmet; Gezen, Ferruh; Karataş, AyşeNumerous problems have been described during the aneurysm surgery. In this report, severe arachnoidal scarring (that is named as armored arachnoiditis) that made clipping of anterior communicating (ACom) aneurysm impossible in our case of study is presented. A case with recurrent hemorrhage is hospitalized in our institution. Initial diagnosis was meningitis in a local hospital. The patient was operated after recurrent intraventricular hemorrhage in late phase due to unavailability of endovascular options at our institution. At surgery, surprisingly all of the cisterns were obliterated and no cleavage plane was found. Every effort for taking CSF was unsuccessful. The corticectomy of gyrus rectus did not solve the problem. Neither aneurysm nor proximal and distal controls could be exposed in spite of any dissection techniques used. We felt that any further attempts to dissect aneurysm and ACom complex would result in a catastrophic injury and rupture. Since, the armored arachnoiditis could not be detected before the surgery, patients should be treated by endovascular techniques following the surgery in the presence of this type of arachnoiditis. In this report, the pertinent literature related to perioperative complications of aneurysm surgery is shortly reviewed. (Archives of Neuropsychiatry 2011; 48: 207-10)
