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Biomedical subjects

G Bademci

Publications and source records attributed to G Bademci.

11 recordsLinked to original sources
PubMed2006

First illustrations of female "Neurosurgeons" in the fifteenth century by Serefeddin Sabuncuoglu.

Males have dominated medicine for many centuries. Females could not appear in the medical history equally till the end of the 18th century; although they always have been in medicine as healers. It is worth mentioning that first illustrations indicating female surgeons were found in the book written in Turkish by Serefeddin Sabuncuoglu in the 15th century; while Europe was newly waking up from its dark ages and Middle East was under the influence of strict rules of Arabic and Islamic culture. Serefeddin Sabuncuoglu (1385-1470) was the author of the first illustrated surgical textbook Cerrahiyyetu'l-Haniyye (Imperial surgery) in Turkish Literature. Inside miniatures drawn by Serefeddin Sabuncuoglu indicated that the female surgeons, acknowledged "Tabibe", had been allowed to practice alone in Anatolia. Tabibes are illustrated in the miniatures practicing on the management of dead foetus with foetal hydrocephalus and macrocephalus which were the first clues by means of Turkish women in Neurosurgery.

Books, Illustrated↗
PubMed2006

"Triple cross" of the hypoglossal nerve and its microsurgical impact to entrapment disorders.

OBJECTIVE: Cadaveric dissections were performed to review the intracranial and extracranial course of the hypoglossal nerve. The neurological significance of a newly defined "triple cross" of the hypoglossal nerve is discussed. MATERIALS AND METHODS: 10 cadaveric heads (left and right; 20 sides) were dissected using microsurgical techniques. RESULTS: In the cisternal segment of hypoglossal nerve, the diameter of the rostral trunk amounted to 155-680 microm (mean 435 microm), and the caudal trunk to 210-820 microm (mean 482 microm). The roots formed three trunks in 20% of the hypoglossal nerves and two trunks in the rest. As a first cross, the anterior medullary segment of the vertebral artery crossed the hypoglossal nerve roots in 14 of 20 sides (70%). As a rare variation, the vertebral artery extended medial to the nerve (25%) or between its roots (5%). The second cross was found between the descendens hypoglossus and the occipital artery (75%), sternocleidomastoid artery and vein complex (15%) and external carotid artery (10%). The third cross was shown in the submandibular triangle between the lingual hypoglossus and its drainage vein; vena committans nervus hypoglossus. CONCLUSION: Throughout its way, the hypoglossal nerve passes over vascular structures in three crossing points which may serve as a probable cause of hypoglossal nerve entrapment disorders.

Adult↗
PubMed2005

Pott's puffy tumor of the vertex years after trauma in a diabetic patient: case report.

Pott's puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma. This is the unique report of a Pott's puffy tumor located over the vertex of a type 1 diabetic patient with an unusual latency of 14 years following injury. A 27-year old man presented with pain and a soft swelling on his vertex. Magnetic resonance imaging demonstrated subperiosteal abscess in the vertex region associated with dural thickening and perisinusal irregularities of epidural space. Further history revealed that he had a trauma to the same location when he was 13 years old. Considering possible complications due to proximity of the lesion to the sagittal sinus, we retrained from aggressive surgical interventions. We treated our patient with a simple surgical abscess drainage followed by prolonged use of antibiotics and achieved complete therapy. The cellular and humoral elements of the immune system may be disrupted in diabetic patients resulting in such atypical courses and complications of infections. We want to emphasize both importance of the prompt diagnosis of Pott's puffy tumor as intracranial invasion may cause severe neurologic problems, and importance of a surgical intervention tailored for the individual lesion.

Abscess↗
PubMed2005

Non-traumatic elevation techniques of the hypoglossal nerve during carotid endarterectomy: a cadaveric study.

OBJECTIVE: Ligation and dissection techniques of sternocleidomastoid artery, vein, ansa cervicalis and posterior belly of digastric muscle were developed in a cadaveric study for achieving minimally invasive elevation of the hypoglossal nerve during carotid endarterectomy and were subsequently used in patient treatment. METHODS: Carotid bifurcations, the extracranial part of the hypoglossal nerve, the sternocleidomastoid artery and vein and neighboring neurovascular structures were studied on 10 formalin-fixed adult cadaver heads (20 sides) under the surgical microscope. Landmarks and measurements for identification of the sternocleidomastoid artery and vein are described. RESULTS: The distance between the hypoglossal loop and the carotid bifurcation was measured as 14.5 - 25.2 mm (mean: 19.24 mm). 30 % of 20 sides were determined to have a Zone II-type carotid bifurcation. In 33 % of the Zone-II-type bifurcations, a low-lying hypoglossal loop was demonstrated. The sternocleidomastoid artery begins 2.2 - 3.5 mm (mean: 2.94 mm) supero-posterior from the occipital artery after the crossing point between the occipital artery and the hypoglossal nerve. The sternocleidomastoid artery and vein complex was 17.1 - 21.5 mm (mean 18.47 mm) away from the carotid bifurcation and forms a right angle with the descending hypoglossal nerve. The contribution of the sternocleidomastoid branch of the occipital artery always reaches the middle parts of the sternocleidomastoid muscle. CONCLUSION: Carotid endarterectomy through having knowledge of the normal and variable trajectories of the structures can almost always be accomplished as a safe procedure when appropriate maneuvers are applied. Dissection and ligation of the sternocleidomastoid artery, vein, ansa cervicalis and posterior belly of digastric muscle are very simple but effective techniques to obtain adequate exposure either for safe arterial reconstruction or to diminish the necessity for more complicated technical procedures.

Accessory Nerve↗
PubMed2005

Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation.

In neurosurgery, ceftriaxone is a widely used, third generation cephalosporin for the treatment of CNS infections and perioperational prophylaxis. Recent studies have demonstrated that ceftriaxone induces reversible precipitates in the gallbladder. This complication is referred to as "biliary pseudolithiasis", and it has symptoms similar to the raised intracranial pressure (ICP) symptoms of the perioperative period. Symptomatic biliary pseudolithiasis should be kept in mind in all pediatric neurosurgery cases under ceftriaxone therapy in order to prevent unnecessary postoperative investigations and surgery.

Adolescent↗
PubMed2005

Posterior communicating artery: from microsurgical, endoscopic and radiological perspective.

OBJECTIVE: The main objective of this study was to display the morphological characteristics of the posterior communicating artery and its perforating branches in various configurations of the circle of Willis and their relationship with neighbouring anatomic structures by microscopic examination of the brain hemispheres and endoscopic examination of cadaver specimens. A secondary aim was to investigate the possibility of detecting the posterior communicating artery and its variations in cerebral MR angiographies performed for various reasons. METHODS: The posterior communicating artery was examined under the microscope in 24 cerebral hemisphere specimens, by endoscopy in 5 cadavers and by 3D TOF MRI in 62 patients. RESULTS: The posterior communicating artery had a hypoplastic configuration in 28 %, whereas it was transitional in 14 %, fetal in 28 % and adult in 30 % of cerebral hemisphere specimens. While no posterior communicating artery and transitional configuration could be detected in 11 % of the MR angiography examinations, 34 % had a hypoplastic configuration, 10 % a fetal configuration and 45 % an adult configuration. The percentage of infundibular dilatation was 22 % and the pre-mamillary artery was the thickest perforating branch. The diameter of the posterior communicating artery varied between 0.5 and 3.03 mm. DISCUSSION: A detailed knowledge on the variations of the posterior communicating artery and the morphological characteristics of the perforators arising from this artery in various configurations of the circle of Willis is an important factor affecting the results of surgical interventions.

Angiography, Digital Subtraction↗
PubMed2005

Microsurgical landmarks for safe removal of anterior clinoid process.

OBJECTIVE: The microsurgical and radiological anatomy of the clinoid process were studied to give surgeons more details about the anterior clinoid process and its relations to the vascular and nervous neighbourhood during intradural and extradural clinoidectomy, thus making the operative procedures safer. METHODS: Seven formalin-fixed (14 sides) and two fresh cadavers (four sides) were studied to reveal the surgical anatomy of the anterior clinoid process and related landmarks during intradural and extradural drilling techniques of clinoid process. Furthermore, aeration of the anterior clinoid process was investigated in 100 paranasal tomography (200 sides) scans. RESULTS: Careful drilling of the anterior clinoid process is mandatory to avoid damage to the extremely important adjacent structures. The anterior clinoid process must not be removed in one piece. Clinoid folds and the frontotemporal fold should be exposed adequately. The falciform ligament must be cut to visualize the optic nerve and ophthalmic artery clearly. Preoperative radiological assessment of clinoid process variations should be done. In computerized tomography scans, pneumatization of the right anterior clinoid process was found in 12%, of the left anterior clinoid process in 7% and bilaterally pneumatization was present in 9%. CONCLUSIONS: Removal of the ACP is one of the most critical procedures to the successful and safe management of ophthalmic segment aneurysms and tumors located in the paraclinoid region and cavernous sinus. Special attention should be paid to the anatomic landmarks indicating the relationship between the anterior clinoid process and adjacent structures. Beside that, pneumatization of the anterior clinoid process should be evaluated preoperatively with computed tomography to avoid complications such as rhinorrhea and pneumocephalus.

Cadaver↗
PubMed2004

Selective microsurgical vestibular neurectomy: an option in the treatment of intractable vertigo and related microsurgical landmarks.

Selective microsurgical vestibular neurectomy (SMVN) is an accepted and effective means of treating patients with intractable vertigo, a resistant component of Meniere's syndrome. Meniere's syndrome is a condition characterized by fluctuating hearing loss, tinnitus and serious vertigo attacks. Vertigo is the most disabling symptom of the disease. There may be permanent hearing loss in untreated cases and vertigo may continue after deafness. Selective microsurgical vestibular neurectomy is an elite surgical procedure providing exact relief from vertigo while protecting the preoperative hearing level. In this report, clinical results of nine patients with intractable vertigo operated in the University of Ankara Medical Faculty, Department of Neurosurgery between 1999 and 2001 are discussed. Accordingly, we aimed to represent the landmarks often required for microsurgical exposure. From this study we conclude that SMVN is an effective neurosurgical procedure for those patients who are resistant for medical treatment and require hearing preservation.

Aged↗
PubMed2004

[The effect of aging on the apparent diffusion coefficient of normal appearing white and gray matter].

PURPOSE: To test if the apparent diffusion coefficient (ADC) values reflect the ultrastructural changes of normal appearing white and gray matter with advancing age. MATERIALS AND METHODS: We selected 45 patients with normal MRI and DW imaging findings. DW and MRI imaging was performed and for each patient the average ADC on trace images of the frontal and occipital white matter and the thalamus were compared with increasing patient age. RESULTS: The average ADC value was 0.753+/-0.054 x 10-3 mm2/sec in frontal white matter, 0.673+/-0.085 x 10-3 mm2/sec in occipital white matter, and 0.763+/-0.063 x 10-3 mm2/sec in the thalamus. For white matter, ADC values increased with advancing age. Although ADC tended to increase with age, comparison of individual thalamic ADC and patient ages did not reach statistical significance. CONCLUSION: Advancing age is associated with a small but statistically significant increase of water diffusibility in human white matter. This increase may reflect mild structural changes with normal aging.

Adolescent↗