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Biomedical subjects

C Erzen

Publications and source records attributed to C Erzen.

At least 19 recordsLinked to original sources
PubMed1998

Cervical spondylotic myelopathy: surgical results and factors affecting prognosis.

OBJECTIVE: A variety of factors may affect surgical outcome in patients with cervical spondylotic myelopathy. The aim of this study is to determine these factors on the basis of preoperative radiological and clinical data. METHODS: To assess the factors affecting postoperative outcome after surgery for cervical spondylotic myelopathy, the clinical and radiological data of 27 patients with cervical spondylotic myelopathy were reviewed. Functional and neurological statuses were assessed using the Japanese Orthopaedic Association (JOA) scale modified by Benzel. In all patients, the effect of age, symptom duration, cervical curvature, presence or absence of preoperative high signal intensity within the spinal cord as revealed by T2-weighted magnetic resonance imaging, and diameters of the spinal canal and vertebral body on pre- and postoperative neurological statuses were investigated. Plain radiographs were obtained for all patients, magnetic resonance images for 21 patients (77.8%), computed tomographic scans for 13 patients (48.1%), myelograms for 6 patients (22.2%), and computed tomographic myelograms for 4 patients (14.8%). There were five patients with a JOA score of 10, six patients with a JOA score of 11, six patients with a JOA score of 12, four patients with a JOA score of 13, four patients with a JOA score of 14, one patient with a JOA score of 15, and one patient with a JOA score of 16. All patients underwent cervical laminectomies. The mean follow-up period was 54.1 months. The final neurological examinations revealed improvement in the JOA scores of 85.1 % of the patients. RESULTS: Statistical analysis of all patients revealed mean JOA scores of 12.185 +/- 1.618 and 14.370 +/- 2.15 before surgery and at final examination, respectively. The difference between the preoperative JOA score and the final JOA score was determined to be statistically significant (P < 0.0001). Statistical analyses also showed better neurological improvement in patients younger than 60 years and in patients with normal preoperative cervical lordosis. Although patients without preoperative high signal intensity of the spinal cord showed a better improvement rate than did patients with preoperative high signal intensity, the determined difference was statistically insignificant. CONCLUSION: It can be concluded that age and abnormal cervical curvature predict less postoperative neurological improvement. The presence of preoperative high signal intensity within the spinal cord may also reflect less neurological improvement.

Adult↗
PubMed1998

Grading and hemodynamic follow-up study of arteriovenous malformations with transcranial Doppler ultrasonography.

This study presents and tests the clinical validity of a hemodynamic grading system that depends on noninvasive transcranial Doppler ultrasonographic parameters. The suggested transcranial Doppler-based grading system was compared with the Spetzler-Martin anatomic grading for prognosticative validity and clinical dependability. We concluded the following: (1) The pulsatility index was shown to be a more dependable transcranial Doppler parameter in the clinical evaluation of an arteriovenous malformation because of two reasons: preoperative pulsatility index findings inversely correlated with arteriovenous malformation volume, and the pulsatility index returned to normal values before the mean blood flow velocity did. Therefore, hemodynamic arteriovenous malformation grading can be based on the pulsatility index. (2) A transcranial Doppler-based hemodynamic arteriovenous malformation grading system correlated highly with the Spetzler-Martin grading in predicting postoperative neurologic deficits and adverse radiologic findings. (3) The presented grading system may contribute to the standardization and quantification of the hemodynamic changes during multidisciplinary management of arteriovenous malformations.

Adolescent↗
PubMed1996

A new, more dependable methodology for the use of transcranial Doppler ultrasonography in the management of subarachnoid haemorrhage.

The role of transcranial Doppler ultrasound (TCD) in clinical decision making about vasospasm due to subarachnoid haemorrhage (SAH), shows a great variation according to neurosurgical clinics. In this prospective study, a total of 143 patients, admitted to Marmara University Department of Neurosurgery between January 1991 to March 1995 and treated surgically with the diagnosis of aneurysmal SAH, were examined by TCD. Eighty of these patients fulfilled the requirements for inclusion. In order to increase clinical dependability of TCD, a new grading system is proposed and tested in comparison with the one previously used, which takes absolute flow velocities as the main parameter in grading. The new, individually based TCD grading system is proposed to minimize the pitfalls caused by proximal stenosis, wide range of normal Vm values and proximally evolving vasospasm. We concluded that: 1) The new, individually based TCD grading system has a high degree of clinical dependability. 2) Daily TCD examinations supply reliable predictive information about developing delayed ischaemic deficit (DID). If a TCD Gr II patient shows an increase of 35 cm/sec (in 24 hours) in Vm value, his probability of developing DID was found to be 60% (p < 0.05); if a TCD Gr B III patient shows the same rate of increase in Vm, his probability of developing DID was 80% (< 0.05). 3) TCD has an important clinical role in decision making about the management of SAH patients. 4) Surgical manipulation causes a reversible increase of one or two TCD-grades in the early postoperative days.

Adolescent↗
PubMed1995

Multiple pineal cysts associated with an ependymal cyst presenting with infantile spasm.

We present a unique case of infantile spasm in a patient with multiple pineal cysts associated with an ependymal cyst. Such a morphological etiology, to our knowledge, has not been described for patients with infantile spasm. Although postoperative neuroradiological studies demonstrated satisfactory surgical results, the patient continued to have seizures.

Brain Diseases↗
PubMed1994

Intradural rupture of cervical vertebral disc.

STUDY DESIGN: The authors discuss their experience with a patient who had cervical intradural disc herniation and relate the case to the relevant literature. OBJECTIVES: The patient was evaluated with direct radiographies, myelography, electromyography, and computerized tomography, as well as with neurologic examination. The follow-up period was 10 months post-operative. SUMMARY OF BACKGROUND DATA: Intradural disc herniation is a rare pathology nearly always confined to the lumbar region. In 1989, Katooka et al reviewed the existing literature and discovered 70 cases. Cervical intradural disc herniation, on the other hand, is much rarer, and there are only five cases in the literature. METHODS: The patient's neurologic, neuroradiologic, and operative findings were evaluated and compared with the cases reported in the literature. CONCLUSIONS: The five patients in the literature had signs of cord compression, but the present patient is the first with root compression.

Adult↗
PubMed1993

Pleomorphic xanthoastrocytoma associated with von Recklinghausen neurofibromatosis.

The authors present a case of pleomorphic xanthoastrocytoma that occurred in a 14-year-old boy with von Recklinghausen's neurofibromatosis. The circumscribed tumor with a cystic component was located in the medial right temporal lobe. The designation of pleomorphic xanthoastrocytoma has been suggested for this neoplasm on the basis of its unique histological features. These include positive glial fibrillary acidic protein staining.

Adolescent↗
PubMed1993

Magnetic resonance imaging in the diagnosis of idiopathic giant-cell granulomatous hypophysitis: a rare cause of hyperprolactinaemia.

Idiopathic giant cell granulomatous hypophysitis is a rare disorder of pituitary gland characterised by a chronic inflammatory process. It can also be an extremely rare cause of hyperprolactinaemia. In this paper, we present our experience with two cases of idiopathic giant cell granulomatous hypophysitis manifested by hyperprolactinaemia, and their neuroradiological evaluation including preoperative MRI studies in one of them, and discuss our findings in the light of the literature.

Adult↗
PubMed1993

Computed tomography and magnetic resonance imaging in three patients with Tolosa-Hunt syndrome.

Three patients with Tolosa-Hunt syndrome were examined by computed tomography (CT) and magnetic resonance imaging (MRI). CT of the brain did not reveal any definite abnormality in any of the patients. MRI demonstrated an abnormal soft tissue area in the cavernous sinus in only 1 patient. There was clinical improvement after corticosteroid therapy. MRI is mandatory for demonstrating lesions in the cavernous sinus or in the superior orbital fissure in patients with THS.

Adrenal Cortex Hormones↗
PubMed1993

A pontine tuberculoma mimicking an exophytic brain stem tumor.

A 21 year old man with a five month history of facial paresis, diplopia, and gait disturbance diagnosed with a brain stem tumor at another institution was evaluated. Computed tomography, magnetic resonance imaging, clinical and laboratory evaluations suggested a pontine astrocytoma, and the mass was excised. Pathological diagnosis was a tuberculoma confirmed by postoperative positive Mantoux testing. CT and MRI appearances of tuberculomas have been described, but can not differentiate them completely from other tumors such as astrocytomas. Because the incidence of tuberculomas has increased in recent years and they may mimic exophytic tumors of pons, it is important to include pontine tuberculoma in the differential diagnosis of pontine tumors.

Adult↗
PubMed1992

The aid of computerized tomography in hemifacial spasm.

Although the physiopathological mechanisms causing hemifacial spasm are not clearly understood, it is generally accepted that the causative factor is compression of the facial nerve at its root exit zone. In this paper we present seven cases of hemifacial spasm which were studied by dynamic CT scanning in the preoperative period, and treated with microvascular decompression. We suggest that CT scanning has considerable diagnostic value in disclosing the asymmetrical vascular formation causing root exit zone compression and that microvascular decompression should be the treatment of choice in this condition.

Adult↗
PubMed1991

Low density in the posterior aspect of the intervertebral disk in the patient with herniated nucleus pulposus. A prospective study of 50 cases.

It was previously reported that a low density are in the posterior aspect of the intervertebral disk is an additional computed tomography (CT) finding suggesting a herniated nucleuos pulposus. In this report the incidence of this finding, its correlation with the duration of symptoms and severity of herniation, were studied on 59 herniated intervertebral disks of 50 cases.

Adult↗
PubMed1990

CT cisternography in evaluation of cerebrospinal fluid rhinorrhea.

The clinical, radiological and surgical features of 14 patients who presented with cerebrospinal fluid rhinorrhea and had undergone surgical treatment during a three-year period are given with special reference to preoperative evaluation by CT cisternography. The merits and demerits of this technique are discussed.

Adolescent↗
PubMed1989

Patchy cerebral white matter edema in chronic renal failure.

Bilateral patchy cerebral white matter edema was observed in two children with chronic renal failure. Uremia in one case and hypertension or hyponatremia in the other appeared to be the cause of the neurological and radiological findings.

Adolescent↗
PubMed1989

Leukoaraiosis and intracerebral hematoma.

We studied 33 consecutive patients with computed tomographic findings of decreased density in the periventricular white matter (leukoaraiosis). Computed tomograms in five (aged 56-75 years) of the 33 demonstrated intracerebral hematoma. The hemorrhages were situated in the thalamic area in four and in the parietotemporal area in one patient. These five patients were hypertensive and had signs characteristic of parenchymal hemorrhage. Three of the five patients had progressive dementia prior to the ictus, and two of the three also had a history of single or multiple strokes. There was no significant difference in the clinical findings of hematoma patients with or without leukoaraiosis.

Aged↗