Nejat Çıplak

Posterior fossa arachnoid cysts

Arachnoid cysts of the posterior fossa are rare lesions that are considered to be mostly congenital in origin. In this article, we retrospectively review 12 patients who underwent surgical treatment for their symptomatic posterior fossa arachnoid cysts. The most common presenting symptoms were gait disturbances and headache. The diagnosis was established on computed tomography or magnetic resonance imaging. Surgery consisted of cyst wall excision with fenestration in nine cases and shunting procedures in three cases. In all cases except one who-died, the postsurgical follow-up neuroradiological investigations showed that the cysts had decreased in size, the cerebellum had re-expanded, and if there was preoperative hydrocephalus, the ventricular size was decreased. The follow-up period ranged from 1 to 11 years. All surviving cases are free of symptoms and no arachnoid cysts recurred. The classification, pathophysiology, differential diagnosis and surgical treatment of infratentorial arachnoid cysts are discussed and the relevant literature is reviewed.

Hydrocephalus and chronically increased intracranial pressure in achondroplasia

Abstract Two achondroplastic children with ventriculomegaly are reported. The patients had no signs of increased intracranial pressure, but in one blindness had previously been detected by the parents. Neuroradiological examinations showed ventriculomegaly in both. Intracranial pressure remained at high levels (20–55 mmHg) preoperatively; ventriculo-peritoneal shunting was performed in both cases, and postoperatively levels fell to normal (5–16 mmHg). The need for the treatment of ventriculomegaly seen in achondroplastic children is analyzed on the basis of these two patients, with a brief review of literature.

The effect of duration of compression on lipid peroxidation after experimental spinal cord injury

The present study was performed to evaluate the effect of duration of acute spinal cord compression on tissue lipid peroxidation in rats. A clip compression method (1) was used to produce acute spinal cord injury. Rats were divided into 3 groups, each consisting of 10. At 1 hour after trauma all rats were sacrificed, and MDA content of the injured spinal cord segment was measured. The tissue MDA contents were 3.922 μmolMDA/gww in group 1 (control), 10.192 μmol MDA/gww in group 2 (30 seconds compression), and 12.147 μmolMDA/gww in group 3 (60 seconds compression). These results demonstrate that the length of duration of compression significantly enhances lipid peroxidation. Our study supported the view that persisting compression may cause progression of secondary mechanisms which may irreversibly eliminate any potential for recovery.

Effect of nimodipine and N-acetylcysteine on lipid peroxidation after experimental spinal cord injury.

The effectiveness of nimodipine and N-acetylcysteine in experimental spinal cord injury was evaluated by measuring tissue lipid peroxidation levels of the damaged spinal cords 1 hour after the injury. We used the clip compression method to produce acute spinal cord injury in 40 female Sprague-Dawley rats were used. The rats were divided into four groups of 10 each. Lipid peroxidation was assessed by measuring the tissue content of malonil dialdehyde (MDA). In group 3, nimodipine, and in group 4,n-acetylcysteine, was administered i.p. as a single dose immediately after the injury. The rats were sacrificed 1 hour after clip application. The tissue mean MDA content was 3,992 μmol MDA/gww in group 1 (sham operated), 10,192 μmol MDA/gww in group 2 (trauma), 10,449 μmol MDA/gww in group 3 (nimodipine treatment) and 9,009 μmol MDA/gww in group 4 (n-acetylcysteine treatment). These results demonstrated that a single dose of nimodipine andn-acetylcysteine had no effect on peroxidation of lipid membranes in the early period of experimental spinal cord injury.

Two different surgical techniques for reduction cranioplasty

Abstract Reduction cranioplasty is required in selected patients when macrocephaly interferes with head control, seating, locomotion, and social acceptance. Two different surgical techniques for reduction cranioplasty in two cases of older hydrocephalic patients are described. Emphasis is placed on the basic stages of the procedure.

Influence of aging on blood-brain barrier permeability and free radical formation following experimental brain cold injury.

Summary. The aim of this study is to investigate the effects of experimental cold brain injury on blood-brain barrier integrity, on brain oedema formation, and on lipid peroxidation and to compare the results between the aged and young rats. Cold brain injury was used to create a standard model of brain trauma in old and young rats. Disruption of the blood-brain barrier was analyzed by Evans blue method. The values of cerebral water content were calculated by using the fresh and dry weights of the cerebral hemispheres. Lipid peroxidation was assessed by measuring the tissue content of malonyl dialdehyde. Blood-brain barrier was destroyed significantly in young and old rats, but it was more severe in old rats. Accordingly, cerebral water content was increased in both groups, however this increase was significantly more prominent in old rats. No significant difference was found on malonyl dialdehyde levels between young and old rats. The blood-brain barrier was more easily disrupted in old rats, and this was supposed to be the basic event causing more secondary damage.

Terminal syringomyelia mimicking an intramedullary tumor: case report.

In this report, the authors present a 14-year-old male patient admitted with progressive paraparesis and urinary incontinence that developed in a 3-month period. Thoracolumbar MRI revealed an intramedullary lesion starting from the level of the T10 vertebra and extending to fill the sacral spinal canal. Based on the radiological findings an intramedullary tumor was suspected. Exploratory operation with right L5 hemilaminectomy was done and the intraoperative finding was syringomyelia which was punctured with releasing of the tethered cord. The patient was followed for 3 years with clinical and radiological regression of the pathology and no symptoms and sings have remained. Syringomyelia can mimic intramedullary tumors clinically and radiologically. That is why it is useful to consider exploratory hemilaminectomy to confirm diagnosis.

0 1 Yaş Hidrosefalik Bebeklerin Ventrikülo Peritoneal Şant Operasyonlarında Sefalosporin Grubu Antibiyotiklerle Profilaksi

In this study 75 hydrocephalic patients who underwent ventriculo peritoneal shunt operation and were put on cephalosporine prophylaxis during their first year of life in the Department of Neurosurgery of Cerrahpasa Medical Faculty University of Istanbul between 1992 1997 were evaluated Postoperative infection rate the responsible bacteria and the time of infection were evaluated to compare the effectiveness of prophylactic antibiotherapy In surgical prophylaxis we have observed that the effectiveness of both first and third generation cephalosporines were equal The source of pathogenic bacteria is generally the patients dermal flora Key words: Hydrocephalus Ventriculo Peritoneal Shunt Cephalosporine