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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 Epidural extension of a lumbar vertebral haemangioma(Elsevier Sci Ltd, 2006) İş, Merih; Gezen, Ferruh; Alper, Murat; Yıldız, H.K.; Akyüz, FevzullahVertebral haemangiomas are relatively common, but those extending into the epidural space are rare. A 59-year-old man with severe lower back and right leg pain that did not resolve with conservative treatment was seen in an outpatient clinic. Magnetic resonance imaging of the lumbar spine identified an L3 vertebral corpus lesion with epidural extension. The diagnosis was unclear, so the patient underwent surgery. The pathologic diagnosis was capillary haemangioma, so angiography-guided embolization was performed postoperatively. Vertebral haemangioma must be considered when there is evidence of a vertebral corpus lesion with epidural extension on magnetic resonance imaging. (c) 2006 Published by Elsevier Ltd.Öğe Esthesioneuroblastoma located in the thoracic extradural space: Case report(Elsevier Sci Ltd, 2016) Akgül, Mehmet Hüseyin; Gezen, Ferruh; Uzunlar, Ali KemalOBJECTIVE: Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB's are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. CASE HISTORY: A 52-year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intrana sal biopsy with local anesthesia was performed. Hi stopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery. CONCLUSION: It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment. (C) 2016 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.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 The importance of evaluating all seven cervical vertebrae in the trauma patient: A case report(Turkish Neurosurgical Soc, 2007) İş, Merih; Karataş, Ayşe; Akyüz, Fevzullah; Gezen, FerruhThe cervical spine is injured in approximately 3% of major trauma patients and 10% of patients with serious head injury We present a patient in whom an unstable cervical spine, without neurological deficit, resulting from a traffic accident was misdiagnosed as normal in the emergency room. Although cervical spine pain or tenderness and neurological deficit have a sensitivity of 93% for cervical spine injury, asymptomatic patients or patients with mild symptoms can have spine injury. All trauma patients with a complaint of mild neck pain require a standard three-view radiological evaluation of the cervical spine demonstrating all seven vertebrae and the top of first thoracic vertebra even if their neurologic examination is normal.Öğe Intracranial epidural abscess secondary to isolated sphenoid sinusitis(Taylor & Francis Ltd, 2007) Karataş, Anıl; İş, Merih; Güçlü, Ender; Döşoğlu, Murat; Gezen, FerruhIsolated sphenoid sinus infection, although an uncommon entity, can cause severe cranial complications when left untreated. A case of temporal epidural abscess secondary to isolated sphenoid sinusitis in a 13-year-old boy is presented. Early diagnosis and treatment are critical because the disease can progress rapidly.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 Lomber disk herniasyonuna bağlı inkomplet kauda ekuina sendromu(2006) Karataş, Ayşe; İş, Merih; Yıldız, Hakan; Gezen, FerruhLomber disk herniasyonu nadiren kauda ekuina sendromu ile ortaya çıkar. Bu yazıda lomber disk herniasyonuna bağlı inkomplet kauda ekuina sendromu ile ortaya çıkan bir olgu sunulmuştur. Olgu, kuvvet kaybı ve siyatalji olmadan perianal duyu kaybı ve sifinkter kusuru ile kliniğimize başvurmuştur. L5-S1 düzeyinde santral yerleşimli disk hernisi tesbit edilmiş ve öpere edilmiştir. Kauda equina sendromu hızlı tanı konulması ve tedavi edilmesi gereken bir tablodur. Hastalar kauda ekuina sendromunun sadece bazı klinik belirtileri ile başvurabilirler.Öğe Management of spontaneous intraparenchymatous hemorrhage: Retrospective analysis of 19 cases treated conservatively or surgery(Düzce Üniversitesi, 2005) İş, Merih; Can, Aytaç; Öztürk, Ayhan; Atakay, Selçuk; Gezen, FerruhObjective: The aim of this study was to assess the treatment modalities of spontaneous intraparenchymatous hematomas. Material and Method: The retrospective analysis of nineteen patients, who attended the neurology or neurosurgery department with spontaneous intraparenchymatous hematoma, was carried out. Results: Of the 9 patients in neurology department, 6 were male and 3 were female. Mean age was 64.5 . The Glasgow Coma Score (GCS) at presentation was 14-15 in four patients and ? 7 in 5 patients. Mean hematoma volume was 16.1cc ( 2.5-45.5cc). While 4 patients with GCS 14-15, were discharged with Glasgow Outcome Scale (GOS) 4 or 5, GOS was 1 in all of the patients with GCS ? 7. Of the ten patients in neurosurgery department, 6 were male and 4 were female. Mean age was 60.3 . Initial GCS was 9-12 in 4 patients and 3-7 in 6 patients. The hematoma volume varied from 56 cc to 248 cc (mean 96.5 cc). The GOS values at the time of hospital discharge were 5 in 3 patients and 4 in 1 patient in the subgroup of patients with GCS 9-12; while GOS values were 3 or 2 in 3 patients and 1 in 2 patients in group with initial GCS ? 7. However, the remaining 1 patient died because of pulmonary embolus at postoperative 7th month. Conclusion: The aim of the conservative treatment in intraparenchymatous hematoma should be the control of blood pressure, maintenance of normal intracranial pressure and cerebral perfusion, and prophylaxis of convulsions. The purpose of surgery is to lessen the mass effect of hematoma and minimize the potential brain damage. The patients can be treated better if collaborative evaluation of neurosurgery and neurology departments can be carried outÖğe Mitomycin C, 5-fluorouracil, and cyclosporin A prevent epidural fibrosis in an experimental laminectomy model(Springer, 2007) Yıldız, Kartal Hakan; Gezen, Ferruh; İş, Merih; Çukur, Selma; Döşoğlu, MuratThis study examined the preventive effects of the local application of mitomycin C (MMC), 5-fluorouracil (5-FU), and cyclosporine A (CsA) in minimizing spinal epidural fibrosis in a rat laminectomy model. Thirty-two 2-year-old male Wistar albino rats, each weighing 400 +/- 50 g, were divided into four equal groups: sham, MMC, 5-FU, and CsA. Each rat underwent laminectomy at the L5-L6 lumbar level. Cotton pads (4 x 4 mm(2)) soaked with MMC (0.5 mg/ml), 5-FU (5 ml/mg), or CsA (5 mg/ml) were placed on the exposed dura for 5 min. Thirty days after surgery, the rats were killed and the epidural fibrosis, fibroblast density, inflammatory cell density, and arachnoid fibrosis were quantified. The epidural and arachnoid fibroses were reduced significantly in the treatment groups compared to the sham group. Fibroblast cell density and inflammatory cell density were decreased significantly in the MMC and 5-FU groups, but were similar in the sham and CsA groups. The decreased rate of epidural fibrosis was promising. Further studies in humans are needed to determine the short- and long-term complications of the agents used here.Öğe Multiple brain abscesses and mastoiditis due to Morganella morgonii after chronic otitis media - Case report and literature review(Lippincott Williams & Wilkins, 2007) Küçükbayrak, Abdülkadir; Özdemir, Davut; Yıldırım, Mustafa; Güçlü, Ertuğrul; Erdoğmuş, Beşir; Akgül, Mehmet; Gezen, FerruhMorganella morganii is a Gram-negative facultative anaerobic rod. It frequently causes urinary-tract and wound infections. We identify 4 M. morganii brain abscess cases previously reported in adults in the literature. This is the first case of multiple brain abscesses after mastoiditis secondary to chronic otitis media. The patient presented to an emergency service with fever, nausea, vomiting, headache, otalgia, and a tendency to sleep. Computerized tomography of the brain and temporal bone tomography scan demonstrated subdural abscesses in the frontal and parietal areas, parenchymal abscess in the temporal lobe, and mastoiditis. The abscesses were evacuated immediately with surgery and M. morganii was grown from the aspirate. The patient was treated with intravenous meropenem (3 x 2 g/d) and improved without neurologic sequelae.Öğe Posterior epidural migration of a lumbar disc fragment causing cauda equina syndrome: Case report and review of the relevant literature(Springer-Verlag, 2001) Döşoğlu, Murat; İş, Merih; Gezen, Ferruh; Ziyal, M.Posterior epidural migration (PEM) of free disc fragments is rare, and reported PEM patients usually presented with radicular signs. An uncommon case involving a patient with cauda equina syndrome due to PEM of a lumbar disc fragment is reported with a review of the literature. The patient described in this report presented with an acute cauda equina syndrome resulting from disc fragment migration at the L3-L4 level that occurred after traction therapy for his lower back pain. The radiological characteristics of the disc fragment were the posterior epidural location and the ring enhancement. A fenestration was performed and histologically confirmed sequestered disc material was removed. An early postoperative examination revealed that motor, sensory, urological, and sexual functions had been recovered. At late followup, the patient was doing well after 18 months. Sequestered disc fragments may occasionally migrate to the posterior epidural space of the dural sac. Definite diagnosis of posteriorly located disc fragments is difficult because the radiological images of disc fragments may mimic those of other more common posterior epidural lesions.Öğe Radiation Necrosis that is Diagnosed by Magnetic Resonance Spektroscopy in an Anaplastic Ependymoma Case: Case Report(Düzce Üniversitesi, 2005) İş, Merih; Gezen, Ferruh; Yıldız, K Hakan; Akyüz, Fevzullah; Can, AytaçEpendymoma is an uncommon intracerebral tumor and most ependymomas occur in the supratentorial compartment in adults. A mass was diagnosed during the control computerized tomography of a patient whose cranial computerized tomography, obtained for persistent headache, was normal previous year. Anaplastic ependymoma was diagnosed with post operative histopathological examination. After total tumor excision and radiotheraphy, tumor recurrence was diagnosed in Magnetic Resonance Imaging (MRI) at post operative 8th month and the patient was reoperated; pathological examination revealed radionecrosis. Magnetic Resonance Spectroscopy (MRS) confirmed that the lesion was radionecrosis. In this article, the role of MRS in the differential diagnosis of tumor recurrence and radionecrosis was discussedÖğe Regional anatomic structures of the elbow that may potentially compress the ulnar nerve(Mosby-Elsevier, 2009) Karataş, Ayşe; Apaydın, Nihal; Uz, Aysun; Tubbs, Shane R.; Loukas, Marios; Gezen, FerruhHypothesis: Traumatic injuries to the ulnar nerve at the elbow are a frequent problem as it is vulnerable to stretching and compression with motion of the upper limb. The aim of the present study was to explore the course of the ulnar nerve at the elbow and forearm and to determine possible anatomical structures that may cause compression of this structure. Materials and methods: We examined 12 upper limbs from cadavers. The length of any fibrous bands, and if present, their distance to the medial epicondyle was recorded. Results: On 5 sides a fibrous band originating from the medial intermuscular septum was observed to cross over the ulnar nerve. The average length of the fibrous band was 5.7 cm, and it attached to the medial epicondyle. The mean length of the ulnar nerve as it coursed in the cubital tunnel was 3.8 cm. In 4 of the cases, the ulnar nerve was covered by muscle fibers originating from the flexor digitorum superficialis and extending to the flexor carpi ulnaris. On 5 sides we observed fibrous thickenings, and on 8 sides vascular structures were found crossing over the ulnar nerve. Discussion: The cubital tunnel is the most common site of compression of the ulnar nerve. Numerous surgical procedures are recommended for cubital tunnel syndrome. Simple decompression is used most commonly. Although surgical procedures are reported to provide efficient pain relief and functional recovery, residual or recurrent symptoms have been reported. Reasons for such recurrences may be more proximal or distal compression of the ulnar nerve as seen in our study. Conclusion: Knowledge of possible compression sites of the ulnar nerve is important to the surgeon so that complications are avoided and postoperative recurrence is decreased. Level of evidence: Basic science study. (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.Öğe A retained surgical sponge (gossypiboma) mimicking a paraspinal abscess(Taylor & Francis Ltd, 2007) İş, Merih; Karataş, Anıl; Akgül, Mehmet; Yıldırım, Ümran; Gezen, FerruhGossypiboma (textiloma, gauzoma, muslinoma) is a rare iatrogenic mass caused by the retention of gauze fibres during surgery. This intraoperative complication has rarely been reported for an intraspinal or paraspinal location. Here, we present a patient in whom a retained surgical sponge between the paraspinal muscles was encountered 3 years after lumbar surgery, and discuss the radiological and pathological appearance and differential diagnosis.Öğe Subdural Hematoma that Underwent Early Spontaneous Resolution: Case Report(Düzce Üniversitesi, 2012) Çalıkoğlu, Çağatay; Akgül, M Hüseyin; Gezen, Ferruh; Aykanat, ÖmerA 29-year-old man with right temporoparietal acute subdural hematoma (ASDH) after traumain whom cranial computed tomographic scan demonstrated spontaneous resolution of thehematoma with clinical improvement in 3 hours is presented. Our case is one of the ASDH casesthat become early (in 3 hours 15 minutes) spontaneous resolution in the literatureÖğe Subdural hematoma that underwent early spontaneous resolution: Case report [Erken spontan rezolüsyona u?rayan subdural hematom: Olgu sunumu](2012) Çalıkoğlu, Çağatay; Aykanat, Ömer; Akgül, Mehmet Hüseyin; Gezen, FerruhA 29-year-old man with right temporoparietal acute subdural hematoma (ASDH) after trauma in whom cranial computed tomographic scan demonstrated spontaneous resolution of the hematoma with clinical improvement in 3 hours is presented. Our case is one of the ASDH cases that become early (in 3 hours 15 minutes) spontaneous resolution in the literature. © 2012 Düzce Medical Journal.Öğe Thoracic intradural cystic schwannoma: A case report(Turkish Neurosurgical Soc, 2007) Karataş, Ayşe; İş, Merih; Yıldırım, Ümran; Akyüz, Feyzullah; Gezen, FerruhSpinal schwannomas are benign tumors arising from spinal nerve root sheaths. These are the most common intradural exramedullary spinal tumous. Schwannomas are mostly solid or heterogenous solid tumors. Cystic schwannomas are rare lesions. We present a 27-year-old woman with an intradural extramedullary cystic tumor in the lower thoracic region who complained of back pain and walking difficulty. The patient was operated and the tumor was totally removed. The postoperative course was uneventful. The histopathological diagnosis was cystic schwannoma. Differentiation of cystic schwannomas from other cystic mass lesions can be difficult. Magnetic resonance imaging and histopathological findings are important for evaluating these tumors.Öğe Traumatic Intraventricular Hemorrhage with a Good Prognosis(Turkish Neurosurgical Soc, 2011) İş, Merih; Gezen, Ferruh; Akgül, Mehmet; Döşoğlu, MuratWe report a 10-year-old girl with an isolated traumatic intraventricular hemorrhage following a traffic accident, who had a good prognosis. Her neurological examination upon arrival was normal and she had no complaint other than headache and vomiting. Computed tomography on admission showed a hemorrhage in the lateral and fourth ventricles. She had a Glasgow Coma Score of 15, and she was thus given only antiepileptic drugs for prophylaxis and followed. Computed tomography that was repeated 5 days after admission showed no blood and all ventricles were of normal size. There was no vascular pathology on magnetic resonance imaging and magnetic resonance angiography. The patient remains well 5 months after her accident. Intraventricular hemorrhage does not always have a poor prognosis.
