Özdemir Gürçay

Multiple meningiomas of the central nervous system without the stigmata of neurofibromatosis. Clinical and therapeutic study

Multiple meningiomas are relatively rare tumors without known neurofibromatosis. In this paper, such eight cases of multiple meningiomas as described byCushing andEisenhardt are presented. Certain aspects of diagnosis and surgical management of this rare condition are discussed with particular emphasis on the importance of the distinction among multiple meningioma, meningiomatosis, or recurrences of these tumors. Fortunately, many of these patients tolerate multiple surgical interventions well, although the removal of these tumors in critical areas is a difficult problem. Thus, we think that it is important to examine and supervise all patients who have had a meningioma for a possible occurence of a second meningioma.

Combined Posterior and Posterolateral One-Stage Removal of a Giant Cervical Dumbbell Schwannoma

Objective: Huge dumbbell schwannomas in the cervical region are not a rare clinical entity in neurosurgical practice. Despite the benign nature, the adhesions between tumor capsule and spinal cord, vertebral artery, cervical plexus, and carotid sheath can complicate surgery, leading to a fatal outcome. We performed one-stage combined surgery through the posterior midline and an unusual posterolateral cervical route in the same position and describe its advantages. Method: We removed the intraspinal component totally through a posterior midline approach and freed spinal cord and vertebral artery. After removal of the posterolateral extraspinal component using the same incision, a posterolateral cervical approach along the posterior margin of sternocleidomastoid muscle was performed, and the anterolateral extraspinal tumor was excised totally through the dissection plane between anterior and middle scalene muscles. Results and Conclusions: The operative time was less than 3 h, and the patient was discharged on the 3rd postoperative day without any neurological sequel. The combination of posterior midline and posterolateral approach in large dumbbell schwannomas is easier to perform and a more safe technique than the combination with anterolateral accesses in the cervical region and also less invasive than the transuncodiscal technique in selected cases. This approach reduces the risk of neurovascular injury, since it does not require retraction and repositioning of the patient and, therefore, facilitates total excision and reduces the operative time.

Congenital nasal encephalocele: a review of 35 cases

Congenital encephaloceles are rare lesions which are usually seen in the occipital region, in the West. They may rarely be seen in the frontal region and they have distinct diagnostic features, together with several other pathological conditions occurring in this region. In order to emphasize these points, a retrospective analysis of 35 cases which have been operated on in our clinic, is made in this study. The findings are compared with the data obtained from the literature.

Civilian penetrating spinal firearm injuries of the spine

In this study, the cases of 17 civilians with penetrating firearm injuries of the spinal cord treated between 1968 and 1990 at the Department of Neurosurgery, Hacettepe University Faculty of Medicine, were analyzed. Relevant literature was reviewed and compared with our study. The results of treatment and other factors determining mortality rate and prognosis were evaluated. Our study and the literature both appear to indicate that operative intervention is the mainstay of treatment.

Liquid extradural hematoma with congenital fibrinogen deficiency: Case report

A case of extradural hematoma in a child with congenital fibrinogen deficiency is reported. Although the hematoma was 3 days old, it was purely liquid.

Foreign Body in the Right Atrium: a Complication of Pudenz Ventriculo-Atrial Shunt: A Case Report

A dislodged Pudenz ventriculo-atrial shunting catheter in a 1.5 year old girl, removed from the right heart by right atriotomy, is presented. The diagnosis, complications and treatment of this unusual complication of the Pudenz shunt are discussed.