Keramettin Aydin

Hippocampal cell loss after an anterior and posterior anastomotic vein occlusion model in rats

Estimation of the cell number after cortical venous ischemia/infarction induced by anterior and posterior anastomotic veins occlusion in a rat model is very important. Twenty male Sprague‐Dawley rats were used in this experiment. Small burr‐holes were made over the anterior (the crossing point of the line drawn from the posterior border of the orbital rim and the line drawn along the para‐midline to the superior sagittal suture) and posterior (just inferior point of the posterior ending of the zygomatic arch) anastomotic veins. Bipolar coagulation technique and micro‐scissor were used to sacrifice the venous vessels after final inspection and description. Specimens were evaluated by histopathological and unbiased stereological methods for microscopic evaluation and volumetric analysis, respectively. Significant cell loss was seen in the pyramidal and granule cells of the cornu ammonis and dentate gyrus of the hippocampus after venous ischemia. Cell loss was also pronounced when seen in the histological examination. The present results suggest that the sacrifice of anterior and posterior anastomotic veins can be used as an experimental rat model in the evaluation of pyramidal and granule cell loss in the hippocampus that often assesses the neural damage inflicted by this intervention.

Cortical anastomotic veins occlusion in the rat including the assessment of cerebral swelling.

A rat model composed of the sacrifice of the anterior and posterior cortical anastomotic veins by microsurgical techniques was used for the assessment of brain swelling. Twenty male, 15-week-old Sprague-Dawley rats were used in this animal experiment. Small burr-holes were made over the anterior (the intersection of the line drawn from the posterior border of the orbital rim and the line drawn along the para-midline to the superior sagittal suture) and posterior (inferior point of the posterior end of the zygomatic arch) anastomotic veins. After performing a final inspection and describing the venous vessels, they were sacrificed using bipolar coagulation technique and micro-scissors. Specimens were evaluated using histopathological approach, albumin immunostaining technique and a stereological method. Hemispheric swelling, midline shift, brain oedema, subcortical petechial haemorrhagia, ischemia and necrosis were histopathological findings observed in this experimental study. The albumin immunostaining study demonstrated disrupted areas of the blood-brain barrier in the operated hemisphere. Stereological volumetric analysis revealed an 8% brain swelling in the operated hemispheres compared with unoperated ones. Our results suggest that the sacrifice of the anterior and posterior anastomotic veins may be used as an experimental rat model in the evaluation of brain damage and swelling caused by the occlusion of the venous anastomotic outflow.

Use of topical landmarks for percutaneous projection of intracranial tumors for neurosurgical oncology.

AIM The objective of this study was to introduce a surgical navigation method which provides a safe, quick and effective access to cortical and subcortical tumors, along with a review of other methods in use for this purpose. MATERIAL AND METHODS 53 patients have been operated using this technique. The area overlying the tumor is shaved and one half of a smoothly cut hazelnut is taped on the skin. The precise localization of the hazelnut is confirmed with MRI and then stained. After general anesthesia, the stained impression is projected firstly to the bone, dura and then cortex respectively by the Midas Rex cutting tip. Cortical landmarks surrounding the tumors cortical projection are further confirmed with ultrasonography. RESULTS After removal, cortical and subcortical tumors were separately graded for efficiency. Grade 1 and 2 were accepted as precise access. Our method accordingly yielded 95.2% and 90.6% success rates for cortical and subcortical tumors respectively. CONCLUSION Considering the methods success rate along with its inexpensiveness and modest technical requirements, it is believed that this method can be of widespread use.

Spontaneous thrombosis of a giant cerebral varix in a pediatric patient

IntroductionCerebral cortical venous aneurysm also known as cerebral varix is a rare entity that usually occurs in relation to high-flow draining veins of arteriovenous fistulas, arteriovenous malformations, and venous angioma. Isolated cerebral varix is an extremely rare entity.Case reportWe present a 1-year-old male with isolated cerebral varix. During follow-up, the varix thrombosed spontaneously without causing any neurological deficits.ConclusionTo the best of our knowledge, spontaneous asymptomatic thrombosis of an isolated cerebral varix without any clinical finding was reported for the first time in the literature.

Pediyatrik Travma Hastasına Yaklaşım: Güncellenmiş Gözden Geçirme

Eriskin yas grubunda oldugu gibi 1 yas ve uzeri cocuklarda da olumlerin en sik nedeni travmadir (Ipekci F., 2005). Pediyatrik travma hastasinin yonetiminden sorumlu acil servis doktoru iki temel sorun ile karsi karsiya kalmaktadir. Birinci temel sorun pediyatrik yas grubundakiler ile eriskinler arasindaki anatomik ve fizyolojik farkliliklarin tani, tedavi ve takipte yarattigi guclukler, ikinci ise pediyatrik travmali hastaya yaklasim konusunda klinik tecrube eksikliginden dogan standart yaklasimdaki sorundur. Bu sorunlar kalici sakatliklara ve hatta hayatin sonlanmasina neden olabilmektedir. Travma geciren cocuklarin ilk degerlendirmelerinin yapildigi acil servislerde, standart travma protokollerinin kabul edilmesi ve bu protokoller cercevesinde acil ekibinin travmali cocugu degerlendirmesi onem arz eder. Zira, travma organizasyonunun olmadigi acil servislere basvuran cocuk travma olgularindaki olum oranlarinin travma organizasyonunun bulundugu acil servislere gore daha yuksek oldugu rapor edilmistir (Osler et al., 2001). Biz bu yazimizda pediyatrik yas grubundaki travma hastalarina guncel yaklasimi yeni bilgiler isiginda tartisarak acil hekimlerinin yararlanabilecegi bir sistematik yaklasim gelistirmeyi amacladik. Trauma is the leading cause of death in children older than 1 year. Difficulties that clinicians are experiencing are the anatomical and physiological differences of pediatric patients and lack of a standardized approach to these patients. Disorganized approaches cause increase in mortality in this group of age. The best method is to set up centers specialized for pediatric trauma. If this is not possible, education and experience levels of emergency physicians must be increased and standards must be determined in relation with other departments. Besides vital importance of establishing and performing certain algorhytms for patients with trauma, it is also important for decreasing the workload and loss of time of emergency physicians. In this study, we aimed to contribute to systematic approach to the pediatric trauma in the light of current literature.