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Öğe The Consideration of Diffusion MR Imaging, Dynamic Contrast-Enhanced MR and T2 Relaxation Time Measurements in Distinguishing of Cholesteatoma with Chronic Otitis Media(Aves, 2013) Ünal, Demet; Büyükkaya, Ramazan; Hakyemez, Bahattin; Kasapoğlu, Fikret; Parlak, MüfitPurpose: The aim of our study is to investigate the contribution of DWI, DCE-MRI, ADC measurements and T2 relaxometry in diagnosis of distinguishing cholesteatoma and COM Materials and Methods: Our study is created by retrospectively reviewing MR images of a digital archive of totally 41 patients that were clinically or surgically diagnosed as COM and cholesteatoma. DWI, ADC values, T2 relaxation time, and CEP of lesions between the two groups were compared statistically. CEP was qualitatively evaluated. ROC analysis and McNemar statistics test were performed. Level of significance was determined as p<0.05. Results: Cholesteatoma detection sensitivity in DWI is determined as 100%, and specificity was determined as 86%. ADC measurements revealed a statistically significant difference in differentiating COM and cholesteatoma (p<0.05). When T2 relaxometry were compared between two groups there was no statistically significant difference (p>0.05). When the groups were assessed according to the CEP, 13 of the COM cases showed type 1 (progressive heterogeneous enhancement), 2 cases did not show enhancement (type 3) and 6 cases showed type 4 (progressive homogeneous enhancement). Nineteen patients with cholesteatoma showed type 2 (rim-like enhancement), 1 case showed type 4. Statistical analysis of CEP revealed significant differences between types 1 and 2 (p<0.001), between types 2 and 3 (p=0.005) and between types 2 and 4 (p<0.001). Conclusion: DWI, ADC values and DCE-MRI may be beneficial in detecting cases of cholesteatoma of a high percentage.Öğe Effectiveness of percutaneous vertebroplasty in cases of vertebral metastases(Elsevier Masson, Corp Off, 2015) Nas, Ömer Fatih; İnecikli, Mehmet Fatih; Kaçar, Emre; Büyükkaya, Ramazan; Özkaya, Güven; Aydın, Ömer; Hakyemez, BahattinPurpose and objectives: To assess the effectiveness of percutaneous vertebroplasty (PV) in patients with vertebral collapse due to metastases. Materials and methods: PV procedures performed on 95 vertebras in 52 patients with primary malignancy were retrospectively evaluated. Vertebral metastases, primary malignancies of the patients, pain before and after PV on a visual analogue scale (VAS), amount of polymethylmethacrylate (PMMA) cement applied to the vertebral body during PV, PMMA cement leakage and vertebral approaches were evaluated. Results: VAS scores of 43 patients (in total 79 vertebras) were evaluated. Median VAS scores of patients declined from 8 (4-10) before PV to 3 (0-7) within one day after the procedure, to 2 (0-9) one week after the procedure and eventually to 2 (0-9) 3 months after the procedure (p < 0.001). PMMA amount applied to the vertebral body during PV varied between 1.5-9 mL (average +/- SD 4.91 +/- 1.61). There was no significant statistical correlation between PMMA amounts and VAS scores within one day after, 1 week after and 3 months after the PV procedure (p > 0.05). Conclusion: PV is a simple, effective, reliable, easy to perform and minimally invasive procedure in patients with painful vertebral metastases. (C) 2015 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.Öğe Effectiveness of percutaneous vertebroplasty in patients with multiple myeloma having vertebral pain(Aves, 2016) Nas, Ömer Fatih; İnecikli, Mehmet Fatih; Hacıkurt, Kadir; Büyükkaya, Ramazan; Özkaya, Güven; Özkalemkaş, Fahir; Hakyemez, BahattinPURPOSE We aimed to assess the effectiveness, benefits, and reliability of percutaneous vertebroplasty (PV) in patients with vertebral involvement of multiple myeloma. METHODS PV procedures performed on 166 vertebrae of 41 patients with multiple myeloma were retrospectively evaluated. Most of our patients were using level 3 (moderate to severe pain) analgesics. Magnetic resonance imaging was performed before the procedure to assess vertebral involvement of multiple myeloma. The following variables were evaluated: affected vertebral levels, loss of vertebral body height, polymethylmethacrylate (PMMA) cement amount applied to the vertebral body during PV, PMMA cement leakages, and pain before and after PV as assessed by a visual analogue scale (VAS). RESULTS Median VAS scores of patients decreased from 9 one day before PV, to 6 one day after the procedure, to 3 one week after the procedure, and eventually to 1 three months after the procedure (P < 0.001). During the PV procedure, cement leakage was observed at 68 vertebral levels (41%). The median value of PMMA applied to the vertebral body was 6 mL. CONCLUSION Being a minimally invasive and easily performed procedure with low complication rates, PV should be preferred for serious back pain of multiple myeloma patients.Öğe Efficacy of ultrasonography in lymphatic malformations: diagnosis, treatment and follow-up: a case report(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2013) Aslan, Ahmet; Büyükkaya, Ramazan; Tan, Sinan; Erdoğan, Cüneyt; Hakyemez, BahattinLymphatic malformation (LM) is a localized and rare benign anomaly of the lymphatic system. Surgery is the primary form of treatment, but total resection is difficult and generally not possible. The least invasive and most effective form of treatment is injection sclerotherapy with sclerosing agents. Here, we report a case of LM in a baby, detected at prenatal ultrasound. The aim of this report is to assess the importance of ultrasonography in the prenatal diagnosis, therapy and follow-up of LM's.Öğe Evaluation of recurrent vertebral hydatid cyst with computed tomography myelography in a case with spinal instrumentation(Elsevier Science Inc, 2015) Sanal, Bekir; Nas, Ömer Fatih; Büyükkaya, Ramazan; Hacıkurt, Kadir; Hakyemez, Bahattin…Öğe Isolated meningeal inflammatory myofibroblastic tumor: an enigmatic tumor(Springer Heidelberg, 2016) Büyükkaya, Ramazan; Aydın, Ömer; Sayar, Ayşe; Yılmazlar, Selçuk; Hakyemez, Bahattin…Öğe Kummel disease and successful percutaneous vertebroplasty treatment(Elsevier Science Inc, 2015) Sanal, Bekir; Nas, Ömer Fatih; Büyükkaya, Ramazan; Hacıkurt, Kadir; Hakyemez, Bahattin…Öğe Massive cerebrovascular air embolism during posttraumatic cardiopulmonary resuscitation(W B Saunders Co-Elsevier Inc, 2014) Büyükkaya, Ramazan; Aydın, Ömer; Hakyemez, Bahattin; Parlak, MüfitAir embolism is known to be a complicating factor in several clinical settings, including thoracic, cardiovascular, and neurosurgical operations; central line placement; and penetrating thoracic and cranial trauma. There are, however, only few case descriptions for cardiopulmonary resuscitation massive cerebral air embolism, and the frequency of this supposedly rare complication is unknown. Computed tomography is useful for showing cerebral air embolism. In this report, we present a 16-year-old adolescent girl with cerebrovascular air embolism on computed tomographic examination after a posttraumatic cardiopulmonary resuscitation and discuss the reasonable mechanisms of cerebrovascular air embolism.Öğe Rapid spontaneous recovery after development of a spinal epidural hematoma: a case report(W B Saunders Co-Elsevier Inc, 2014) Büyükkaya, Ramazan; Aydın, Ömer; Hakyemez, Bahattin; Şeref, DoğanSpontaneous spinal epidural hematoma is a very rare clinical emergency. A permanent neurological deficit or even death may result if diagnosis and treatment are delayed. Many cases can be diagnosed upon detailed neurological examination and magnetic resonance (MR) imaging. Usually surgery is required but rarely the condition may improve spontaneously. A 46-year-old male patient was admitted to our emergency department because of rapidly evolving severe paraplegia following development of sudden-onset neck pain. Spinal MR imaging detected an epidural hematoma compressing the spinal cord at the C5-T1 level. Clinical and radiological follow-up showed that the patient recovered spontaneously in 48 hours without any need for surgical treatment.Öğe Rapid spontaneous recovery after development of a spinal epidural hematoma: a case report.(2014) Büyükkaya, Ramazan; Aydın, Ömer; Hakyemez, Bahattin; Şeref, DoğanSpontaneous spinal epidural hematoma is a very rare clinical emergency. A permanent neurological deficit or even death may result if diagnosis and treatment are delayed. Many cases can be diagnosed upon detailed neurological examination and magnetic resonance (MR) imaging. Usually, surgery is required, but rarely, the condition may improve spontaneously. A 46-year-old male patient was admitted to our emergency department because of rapidly evolving severe paraplegia following development of sudden-onset neck pain. Spinal MR imaging detected an epidural hematoma compressing the spinal cord at the C5-T1 level. Clinical and radiological follow-up showed that the patient recovered spontaneously in 48 hours without any need for surgical treatment.Öğe The relationship between perimesencephalic subarachnoid hemorrhage and deep venous system drainage pattern and calibrations(Elsevier Science Inc, 2014) Büyükkaya, Ramazan; Yıldırım, Nalan; Cebeci, Hakan; Kocaeli, Hasan; Dusak, Abdurrahim; Ocakoğlu, Gökhan; Hakyemez, BahattinBackground and purpose: The purpose of this study is to investigate the relationship between Rosenthal basal vein (BVR) type and diameter and perimesencephalic nonaneurysmal subarachnoid hemorrhage (P-SAH). Materials and methods: Aneurysmal subarachnoid hemorrhage (A-SAH), P-SAH, and control groups were evaluated, and BVRs were classified by type. BVR diameters in patients were measured. Results: There was a statistically significant difference of BVR drainage types between groups (P=.002). BVR diameters of patients with normal drainage pattern in P-SAH group were significantly smaller than those in both other groups (P<.001). Conclusion: There is a relationship between P-SAH and BVR primitive drainage type. P-SAH risk increases in parallel with decreasing caliber of BVR in patients with normal drainage pattern.(C) 2014 Elsevier Inc. All rights reserved.Öğe Retrievable Stent Technique and Coil Embolization of High-Flow Iatrogenic Cervical Vertebral Arteriovenous Fistula: Technical Note(Sage Publications Inc, 2013) Büyükkaya, Ramazan; Hakyemez, Bahattin; Erdogan, CüneytCervical vertebral arteriovenous fistulas (VAFs) are rare clinical entities between the vertebral artery and veins of the neighborhood. We report the first approach in the literature experience in the treatment of high-flow VAF caused by percutaneous catheterization of the internal jugular vein, which was successfully occluded with coils and Solitaire AB neurovascular remodeling device system that can be fully retrieved even when fully deployed for procedural control. Complete angiographic and clinical cure was achieved, and no complications related to the new embolization procedure occurred.Öğe Spinal Type II arteriovenous malformation and endovascular treatment(Elsevier Science Inc, 2015) Nas, Ömer Fatih; Büyükkaya, Ramazan; Erdoğan, Cüneyt; Hakyemez, Bahattin…Öğe Spontaneous cervicothoracic epidural hematoma(Elsevier Science Inc, 2015) Nas, Ömer Fatih; Sanal, Bekir; Büyükkaya, Ramazan; Hacıkurt, Kadir; Hakyemez, Bahattin…Öğe Susceptibility Imaging in Glial Tumor Grading; Using 3 Tesla Magnetic Resonance (MR) System and 32 Channel Head Coil(Int Scientific Information Inc, 2017) Aydın, Ömer; Büyükkaya, Ramazan; Hakyemez, BahattinBackground: Susceptibility weighted imaging (SWI) is a velocity compensated, high-resolution three-dimensional (3D) spoiled gradient-echo sequence that uses magnitude and filtered-phase data. SWI seems to be a valuable tool for non-invasive evaluation of central nervous system gliomas. Relative cerebral blood volume (rCBV) ratio is one of the best noninvasive methods for glioma grading. Degree of intratumoral susceptibility signal (ITSS) on SWI correlates with rCBV ratio and histopathological grade. This study investigated the effectiveness of ITSS grading and rCBV ratio in preoperative assessment. Material/Methods: Thirty-one patients (17 males and 14 females) with histopathogical diagnosis of glial tumor undergoing routine cranial MRI, SWI, and perfusion MRI examinations between October 2011 and July 2013 were retrospectively enrolled. All examinations were performed using 3T apparatus with 32-channel head coil. We used ITSS number for SWI grading. Correlations between SWI grade, rCBV ratio, and pathological grading were evaluated. ROC analysis was performed to determine the optimal rCBV ratio to distinguish between high-grade and low-grade glial tumors. Results: There was a strong positive correlation between both pathological and SWI grading. We determined the optimal rCBV ratio to discriminate between high-grade and low-grade tumors to be 2.21 Conslusions: In conclusion, perfusion MRI and SWI using 3T MR and 32-channel head coil may provide useful information for preoperative glial tumor grading. SWI can be used as an accessory to perfusion MR technique in preoperative tumor grading.Öğe Thoracolumbar Glomus-type Intramedullary Arteriovenous Malformations Presenting with Nonperimesencephalic Subarachnoid Hemorrhage: A Case Report(Lippincott Williams and Wilkins, 2015) Büyükkaya, Ramazan; Cebeci, Hakan; Aydın, Ömer; Erdoğan, Cüneyt; Hakyemez, BahattinA 22-year-old man presented with severe head and neck pain, nausea, and vomitting at the emergency department. Computed tomography revealed nonperimesencephalic subarachnoid hemorrhage. Subarachnoid hemorrhage is caused by a spinal glomus type (type 2) intramedullar arteriovenous malformation (AVM) at Th10-12 level. Venous hypertension is considered as the underlying factor of subarachnoid hemorrhage associated with spinal AVM. We aimed to present a spinal glomus type (type 2) intramedullary AVM that presented with nonperimesencephalic subarachnoid hemorrhage accompanied by the literature. © 2014 Wolters Kluwer Health, Inc. All rights reserved.Öğe Treatment of Complex Intracranial Aneurysms Using Flow-Diverting Silk (R) Stents An Analysis of 32 Consecutive Patients(Sage Publications Inc, 2014) Büyükkaya, Ramazan; Kocaeli, Hasan; Yıldırım, Nalan; Cebeci, Hakan; Erdoğan, Cüneyt; Hakyemez, BahattinThis study describes the pen-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient-bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Mis-deployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.Öğe Treatment of sacral aneurysmal bone cyst with percutaneous sacroplasty(Elsevier Science Inc, 2016) Nas, Ömer Fatih; Kaçar, Emre; Büyükkaya, Ramazan; Sanal, Bekir; Erdoğan, Cüneyt; Hakyemez, Bahattin…Öğe Use of Solitaire (TM) retrievable stent-assisted coiling technique for endovascular treatment of post-traumatic direct carotid cavernous fistula(Elsevier Masson, 2016) Nas, Ömer Fatih; Büyükkaya, Ramazan; Kaçar, Emre; Erdoğan, Cüneyt; Hakyemez, Bahattin…
