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Engin Uluç

Publications and source records attributed to Engin Uluç.

3 recordsLinked to original sources

Traumatic posterior fossa hematomas.

PURPOSE: Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4% to 7%. Seven cases of posttraumatic posterior fossa epidural hematomas diagnosed by computed tomography (CT) are reported with radiological and clinical findings. MATERIALS AND METHODS: This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospitalized in an 18-month period. The patients were evaluated regarding age, gender, type of trauma, cranial CT and Glasgow coma score in admittance, treatment and follow-up. RESULTS: Average age was 24.2 years and 85.7% of the cases were male. All cases had occipital fracture. Fifty-seven percent of the cases had only occipital fracture and posterior fossa epidural hematoma. All of the cases in this group were neurologically intact except for one who had a Glasgow coma score of 9 in admission. Two cases of this group were conservatively treated. In the others posterior fossa epidural hematomas got larger and they were treated surgically; these two cases recovered after surgery. Three of the 7 cases had the supratentorial region lesions; one of these cases died before operation. Two of them were treated surgically, one of them died and the other showed recovery after surgery. CONCLUSION: Acute posterior fossa epidural hematomas are usually symptom-free initially. After this silent period, clinical deterioration is quick to become fatal in most of patients. Surgery can be life-saving when performed in a timely manner. Therefore, CT should always be performed when an occipital trauma is diagnosed.

Adolescent↗

Cranial MR imaging with clinical correlation in preeclampsia and eclampsia.

PURPOSE: Our aim was to determine the distribution and nature of cranial MRI findings in preeclampsia/eclampsia, and also to correlate them with clinical and laboratory data. MATERIALS AND METHODS: MR imaging was performed in 39 patients with preeclampsia (n=30) and eclampsia (n=9), and the distribution and signal patterns of the lesions were documented. Clinical findings, blood pressures, and laboratory data were compared statistically in patients with and without MR imaging findings. RESULTS: MR imaging was normal in 21 of the patients. In 18 patients, cortical-subcortical lesions, which appeared iso-/hypointense on T1W and hyperintense on T2W images, were detected. The occipital lobe was involved in all patients, followed by the parietal, frontal, and temporal lobes, and basal ganglia and pons. The lesions showed watershed distribution in 13 patients. When the patients with and without MR imaging findings were compared, there was a statistically significant difference regarding visual disturbances, depression of consciousness, and seizures (p=0.042, p=0.006, p=0.000, respectively). Although patients with MR imaging findings showed higher blood pressures as compared to those without MR imaging findings, there was no statistically significant difference (p=0.074). In patients with MR imaging findings, lactate dehydrogenase (LDH), uric acid, and creatinine levels were significantly higher than those without MR imaging findings (p=0.006, p=0.010, p=0.005, respectively). CONCLUSION: Increased permeability of the blood-brain-barrier related to endothelial injury plays a major role in the pathogenesis of preeclampsia/eclampsia. Relatively minor increases in blood pressure may cause cerebral lesions. However, when the cerebral autoregulation mechanism is considered, the distribution of cerebral lesions in the posterior circulation and watershed zones, which are relatively sparsely innervated by sympathetic nerves, provides evidence that the main determinant of pathogenesis is acute fluctuations in blood pressure.

Adolescent↗