Biomedical subjects
Publications and source records attributed to B Canbaz.
Neuromas arising from the distal branches of the trigeminal nerve with extracranial extension are unusual. Here, we present the clinical features, diagnosis and treatment of 28-year-old woman with trigeminal neuroma with extension to the infratemporal fossa.
Cerebral tuberculoma is a rare entity and is one of the causes of intracerebral mass lesions. A rapid diagnosis based on pathological findings improves its prognosis. We describe two cases where the tuberculoma was located in the cavernous sinus and prepontine cistern, respectively. The first case was a 36-year-old man who was admitted with progressive headache, left ptosis and diplopia. Computed tomography showed a solid enhancing mass in the left cavernous sinus. Diagnosis of meningioma was proposed and a left pterional craniotomy was performed. Histopathological examination revealed granulomatous inflammation with areas of caseation necrosis. The second case was a 20-year-old man who presented with headache, new-onset strabismus, diplopia, malaise, weight loss and low-grade fever. The lesion mimicked an aggressive meningioma on imaging. The patient was operated for primary diagnosis of cerebral tumour. The histopathological examination of the excised lesion revealed a tuberculoma. Although the incidence of tuberculosis is decreasing, a high index of suspicion must be maintained for the diagnosis of intracranial masses in the presence of risk factors for tuberculosis.
BACKGROUND: Clinical, radiological, postmortem and experimental studies are not enough for the definition of pathophysiological differences between rapid and slow-progressing cerebral venous system obstruction. AIMS: An experimental study was conducted to set some physiopathological differences between rapid and slow occlusion of the superior sagittal sinus. SETTINGS AND DESIGN: Eighteen dogs categorized into 3 groups were chosen as test subjects. The three groups were the rapid occlusion, slow occlusion and the control study groups and each group had six subjects. MATERIAL AND METHODS: Intracranial pressure values, histopathological findings, and the degree of cerebral edema formation, estimated by measuring the water content ratio of the brain and the angiographic results in the 2 different groups of subjects that underwent rapid and slow superior sagittal sinus obstruction were compared with that of the control subjects. STATISTICAL ANALYSIS: Statistical analysis was performed using GraphPad Prisma V.3 statistical software. Variables of the 3 groups were compared using non-parametric Kruskal Wallis ANOVA test and multiple comparisons were made using Dunn's multiple test. The comparison of initial and terminal intracranial pressure values obtained before and after the sinus occlusion, was made using the Wilcoxon test. A probability value of less than 0.05 was regarded as significant. RESULTS AND CONCLUSIONS: Comparison of the water content ratio of the brain in the 3 groups, the difference between the initial and terminal intracranial pressure values of the rapid occlusion study group, and the difference between the terminal intracranial pressure values of the 3 groups was statistically significant (P<0.05). Dunn's Multiple Comparison Test yielded significant differences in the water content ratio of the brain and in the intracranial pressure values between the rapid occlusion study group and the control group (P<0.05). Moreover, histopathological and radiological examination disclosed more prominent brain edema findings, and less apparent collateral venous flow in the rapid occlusion study group than in the slow occlusion one. To conclude, the clinical severity of sinus occlusion seems directly related to the quickness of the occlusion and the capacity of the collateral venous system.
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.
Iniencephaly is a rare congenital anomaly characterized by spina bifida of the cervical vertebrae, fixed retroflexion of the head on the cervical spine, and occipital bone defect. There are only five reports of surviving patients with iniencephaly. The authors report the case of a newborn who presented with iniencephaly and an encephalocele that were surgically treated in our service. Neurological examination of the patient yielded normal results except for a moderate psychomotor retardation. The neuroradiological and surgical findings of the case suggested that the trigger of the anomaly was the occipital bone defect and rachischisis of the posterior vertebral arches.
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.
Although hydatid disease is the most common human disease caused by helminths, cerebral and spinal involvement in hydatid disease is rare. Recurrence is common when cysts rupture during surgical removal. The authors present the results of combined treatment with surgery and mebendazole in four cerebral and five spinal cases of hydatid disease. The patients' ages ranged between 4 and 55 years with a mean of 26 years. In three of the four cranial patients who received mebendazole treatment, the cysts ruptured during surgical removal. Four of the five spinal cases had recurrent disease at the time of admission. Mebendazole was started immediately after surgery and continued over 12 months. All cases but one are stable clinically or radiologically at a mean 27 months follow-up period.
The case of a newborn who had ocular, cerebral and cerebellar dysgenesis with hydrocephalus, which represents very rarely occurring Warburg syndrome, is described. Clinical, radiographic, and histopathological features are detailed.