Biomedical subjects

Ayhan Koçak

Publications and source records attributed to Ayhan Koçak.

8 recordsLinked to original sources

PubMed2005

Post-traumatic early epilepsy in pediatric age group with emphasis on influential factors.

OBJECTIVE: Posttraumatic epilepsy in the pediatric age group is mostly seen within the first week. An acute posttraumatic epileptic fit, which may induce secondary insults, should be hindered. The aim of the study is to define the risk factors for posttraumatic early epilepsy (PTEE) and the indications for prophylactic therapy. METHODS: In this survey, a total of 1,785 pediatric patients--under the age of 16--are studied. The majority of the patients (1,655) were treated in Haydarpaşa Numune Hospital within the years 1993-1999. The rest, which consists of 130 patients, were treated in Inönü University Turgut Ozal Medical Center between the years 2001 and 2003. The patients were categorized according to age, gender, neurological manifestations, type of trauma, cranial pathology, number and type of epileptic fits, the interval between trauma and convulsion, electroencephalogram findings, and antiepileptic therapy. All these factors were challenged due to their effect on the evolution of PTEE. RESULTS: Only 149 cases had PTEE (8.4%). There was no correlation between gender and the incidence of PTEE. The data showed that 11.7% of the patients at or under the age of 3 (p=0.00072), 30.8% of the patients with severe head injury (Glasgow Coma Scale=3-8; Children's Coma Scale = 3-8; p=0.00000), 19.3% of the patients with depressed skull fractures (p=0.00038), 13.7% of the patients with intraparenchymal hemorrhage (p=0.0000072), and 21.6% of the patients with cerebral edema (p=0.000008) had PTEE. Only 20% of the patients with PTEE had a Glasgow Outcome Scale (GOS) of 3 or less (p=0.0000075). CONCLUSION: Those patients at or under the age of 3, with severe head injury, cerebral edema, intraparenchymal hemorrhage, or depressed skull fracture, have a higher incidence of PTEE. Moreover, because the GOS of these patients are prone to be worse, antiepileptic therapy in acute stage may be effective in preventing the secondary brain damage.

Adolescent↗

PubMed2005

Mature spinal teratoma associated with thickened filum terminale.

A 30-year-old man presented with an intradural spinal teratoma with thickened filum terminale manifesting as urinary and sexual disturbances, and low back pain persisting for 4 years. Spinal magnetic resonance imaging revealed thickened filum terminale containing a heterogeneously enhanced intradural lesion extending from the L-3 to L-4 levels and in contact with the conus medullaris. The filum terminale was incised and the tumor was totally resected. The histological diagnosis was mature teratoma consisting of three germ cell layers. The patient's complaints had completely resolved 6 months later.

Adult↗

PubMed2005

Spinal epidural abscess caused by brucellosis. Two case reports.

Brucellosis is still an important public health problem in the Mediterranean countries, including Turkey, and is most probably underdiagnosed or underreported. Two rare cases of extradural brucellar granuloma causing spinal cord compression in the thoracic and cervical regions were identified by magnetic resonance imaging. The abscesses were totally excised surgically. Medical treatment was given immediately after diagnosis, but delayed neurosurgical intervention resulted in partial neurological recovery in one patient although the other showed complete neurological recovery. Abscess formation may cause myelopathy due to extradural compression of the spinal cord. Failure to correct this condition may cause irreversible impairment of motor functions. Magnetic resonance imaging should be performed periodically in patients with brucellosis and suspected vertebral involvement to monitor for epidural granuloma formation and prevent extradural cord compression.

Adult↗

PubMed2004

Intracranial migrating bullet.

Retained bullets and fragments following a civilian gunshot injury are quite frequent in practical neurosurgery. It is usually possible to extract the foreign body surgically, while rare cases are conservatively treated because of technical reasons. Conservative treatment may present complications, and a rare form of this presentation is migration of the bullet. A 20-year-old man presented with migrating bullet from a supratentorial to opposite infratentorial area. We consider that in the migrating bullet fragment cases, if there is no contraindication, the most reasonable treatment is its urgent surgical removal. This report reveals a supratentorial bullet migrating to the infratentorial contralateral area, and related literature considering the different mechanisms of migration is discussed.

Adult↗

PubMed2004

An unusual complication of septorhinoplasty: massive subarachnoid hemorrhage.

Septorhinoplasty is a very common operation in the practice of plastic surgery and otolaryngology. We report a case with massive subarachnoid hemorrhage originating from carotid artery injury, following corrective septorhinoplasty. The carotid rupture is a very rare but life-threatening, major complication of nasal surgery. Therefore, surgeons performing surgery in this area should be very careful and aware of this entity. According to our knowledge, this is the fourth case report of a carotid artery injury following septorhinoplasty, but it is the first bilateral and lethal one in the literature.

Adult↗

PubMed2004

Intraventricular solitary fibrous tumor: an unusual tumor with radiological, ultrastructural, and immunohistochemical evaluation: case report.

OBJECTIVE AND IMPORTANCE: Intracranial solitary fibrous tumors have been described previously, but intraventricular solitary fibrous tumors are extremely rare. We present what is, to our knowledge, the first reported case of solitary fibrous tumor in the third ventricle. CLINICAL PRESENTATION: A 63-year-old man presented with weakness of his lower extremities and headaches. Computed tomography and magnetic resonance imaging of the brain revealed an enhancing mass in the posterior part of the third ventricle. INTERVENTION: The tumor originated from the wall of the left internal cerebral vein and extended to the posterior part of the third ventricle. Nearly total excision was performed via an infratentorial-supracerebellar approach. CONCLUSION: The differential diagnosis of intracranial solitary fibrous tumors includes fibroblastic meningioma, meningeal hemangiopericytoma, neurofibroma, and schwannoma. The differential diagnosis in the present case was greatly helped by the immunohistochemical and ultrastructural findings, along with a disease-free 3.5-year follow-up. These findings are presented with reference to previous reports.

Cerebral Ventricle Neoplasms↗

PubMed2004

Middle cerebral artery aneurysm associated with Behçet's disease--case report.

A 37-year-old man with Behçet's disease suffered secondary subarachnoid hemorrhage and intracerebral hematoma in the right temporal lobe caused by a ruptured aneurysm of the right middle cerebral artery. The aneurysm was successfully clipped. Aneurysm formation is common in the visceral arteries in Behçet's disease, but extremely rare in the intracranial arteries. Vasculitis may be involved in the etiology of intracranial aneurysms in patients with Behçet's disease.

Adult↗

PubMedDate not supplied

Gliofibroma: an incompletely characterized tumor.

Although gliofibroma is a rare and incompletely characterized tumor, recent publications have revealed new aspects of this entity. The case of a 16-year-old boy who was diagnosed as having a gliofibroma is presented here, and the problems regarding nosology are discussed in the light of the recent literature.

Adolescent↗