Yusuf Kurtulus Duransoy

Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA

Geniculate neuralgia is a rare cause of craniofacial pains. The anterior inferior cerebellar artery is the offending vessel which compress nervus intermedius in the patients with typical geniculate neuralgia. We report a patient whose pain was atypical for either geniculate neuralgia and trigeminal neuralgia. At operation the anterior inferior cerebellar artery was coursing with the nerves and was separated. After the decompression the pain resolved immediately.

Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature review

Hydatid disease is a parasitic infection affecting the brain in about 2% of the cases. Brain involvement is most commonly observed in children. Here, we report a 13-year-old male patient who presented with headache, nausea, and vomiting. Before cranial computed tomography (CT) was performed, the patient had generalized epileptic seizures. He was disoriented, and had anisocoria with dilatation of the right pupilla. CT showed a cystic lesion of 10-cm diameter in the right temporoparietal region that had caused a shift of the midline structures to the contralateral side; an urgent operation was performed as there were signs of midbrain herniation.

Congenital dermal sinus tract of the spine: experience of 16 patients.

Congenital dermal sinus tract is a rare entity which lined by epithelial cells and can end anywhere between subcutaneous planes to thecal sac. These tracts may be accompanied with other pathologies such as lipomyelomeningocele, myelomeningocele, split cord malformation, tethered cord, filum abnormality and inclusion tumors and treatment includes resection of tract with intradural exploration. The authors review their experience with 16 cases. Clinical, radiological appearance and treatment of these lesions discussed with literature review.

Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications.

Tethered Cord Syndrome in Adults: Experience of 56 Patients.

AIM The aim of this study was to describe the results of surgery performed in a group of adult patients with tethered cord syndrome with their outcomes. MATERIAL AND METHODS This retrospective study included 56 patients. There were 38 females and 18 males. All patients were older than 18 years. RESULTS The mean age at referral was 36 years and 1 month. The mean follow-up period was 10 months 27 days. 95% of all patients with back and leg pains improved and 5% remained the same. Three patients with motor deficits remained the same in the postoperative period. Of the 16 patients with urological complaints, 10 improved, 5 unchanged and 1 patient died in the postoperative first day due to pulmonary embolism. CONCLUSION The syndrome of tethered cord may be a situation to be treated even in the elderly in case of normal level conus medullaris and filum terminale with a normal appearance as well as a low-lying conus and thick filum. To prevent overlooking the diagnosis of tethered cord and/or unnecessary spinal surgeries, the tethered cord syndrome should be remembered in the differential diagnosis list in the presence of back and leg pains, neurological deficits or urological complaints.

Differences in individual susceptibility affect the development of trigeminal neuralgia.

Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention. The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.

Neuroprotective effects of oleocanthal, a compound in virgin olive oil, in a rat model of traumatic brain injury

AIM To evaluate the neuroprotective effects of deocanthal OC in a rat model of traumatic brain injury (TBI). MATERIAL AND METHODS Twenty-six adult male, Wistar albino rats were used. The rats were divided into 4 groups. Group 1 was the sham group (n=5). Group 2 was the trauma group (n=5) where rats were treated with 10 mg/kg saline intraperitoneally (IP) twice a day. Groups 3 and 4, rats were treated with 10 (group 3, n=8) or 30 (group 4, n=8) mg/kg OC IP twice a day. For each group, brain samples were collected 72 hours after injury. Brain samples and blood were evaluated with histopathological and biochemical methods. RESULTS Histopathological evaluation revealed a significant difference between Group 2 and Group 4. Biochemical findings demonstrated that the oxidative stress index was highest in Group 2 and lowest in Group 4. CONCLUSION OC has a protective effect on neural cells after TBI. This effect is achieved by reducing oxidative stress and apoptosis.

Dermoid Cyst Rupture Presenting as Subarachnoid Hemorrhage: Report of a Rare Case

Dermoid cysts are usually asymptomatic tumors and consist <0.5% of all primary intracranial tumors. Rupture of the cyst can occur spontaneously, due to head trauma or during the intraoperative or postoperative period. Although patients have been reported to be asymptomatic after cyst rupture, its etiology is not fully understood. Here, we present a 53-year-old male patient who was admitted to the emergency department with loss of consciousness following sudden onset of headache. He had a stiff neck on physical examination. Although complaints and findings suggested spontaneous subarachnoid hemorrhage, cranial computed tomography and magnetic resonance imaging demonstrated rupture of a dermoid cyst.

A new guide tube for odontoid screw fixation for unstable odontoid fractures: report of 6 case series.

AIM We describe a modified form of traditional open surgery with a new guide tube. This guide tube permits anterior screwing of odontoid in a shorter time with a more simple technique as compared to traditional open surgery, endoscopic and percutaneous surgeries. MATERIAL AND METHODS Our series includes 6 patients who were operated for unstable odontoid fracture. We used a new guide tube for anterior odontoid screw fixation. This guide tube was designed by the first author to facilitate the insertion of the K-wire for placement of a cannulated lag screw. RESULTS Successful placement of the odontoid screws and immediate spinal stabilization were achieved in all patients. Solid fusion was observed during follow-up time in all patients. CONCLUSION This screw insertion technique for odontoid screw fixation provides a minimally invasive, safe and easy surgery in contrast to other surgical approaches.

Report of an unusual upper cervical spine injury: traumatic atlantoaxial rotatory subluxation with vertical odontoid fracture in a child.

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