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Gazanfer Ekinci

Publications and source records attributed to Gazanfer Ekinci.

18 recordsLinked to original sources
PubMed2006

Intracranial sewing needle in a man with seizure: a case of child abuse?

Physical abuse in infancy can cause persistent neurological deficits. Although intracranial foreign bodies are generally secondary to penetrating trauma or surgical procedures, rarely they also occur as a result of child abuse. A 32-year-old man presented with the complaint of generalized tonic clonic seizures to the Neurology Department of Marmara, University Hospital. Computerized tomography (CT) scan revealed a sewing needle located within the temporal lobe. The location and the position of the needle suggested that it must have been introduced in infancy through the lamdoid suture before the closure of it, as an unsuccessful deliberate homicide attempt or accidental injury.

Adult↗
PubMed2006

Corticospinal tract involvement in a patient with 3-HMG coenzyme A lyase deficiency.

3-Hydroxy-3-methylglutaryl coenzyme A lyase deficiency, an inborn error of ketone body synthesis and leucine degradation, is a rare disorder. There are few reports demonstrating clinical and neuroradiologic findings of this condition. This report describes a 3.5-year-old previously healthy male who was admitted with complex partial seizures and was diagnosed as having 3-hydroxy-3-methylglutaryl coenzyme A lyase deficiency. The patient's previous medical history was unremarkable. His development and neurologic examination were normal. Cranial magnetic resonance imaging indicated prominent corticospinal tract and pontine involvement with focal cerebral white matter changes which have not been described in the literature before.

Child, Preschool↗
PubMed2005

Arcuate foramen and its clinical significance.

OBJECTIVE: The present study determines the degree of ossification of the posterior atlanto-occipital membrane in dry bone, plane lateral cervical spine radiographs and computer tomography (CT). The average length, width and the area of the arcuate foramen were measured on dry bone and on cervical CT. Further, age, gender and complaints of the patients of shoulder and arm pain, neck pain, headache, vertigo, and lacrimation in relation to the presence of bony complete or incomplete arcuate foramen were evaluated. METHODS: From February 2004 to January 2005 60 dry atlases were obtained from the Anatomy Department, University of Marmara, Istanbul, Turkey and 416 lateral cervical spine radiographs were obtained from the Radiology department for neurological and orthopedic evaluations. Each complete arcuate foramen was calculated with the aid of Clemex Vision PE demo version computer program. RESULTS: Among the 60 dry atlases examined 7 (11.7%) had complete and 2 (3.3 %) had incomplete bony bridge formation. Of the 416 plane lateral cervical spine radiographs examined, 30 (7.2%) had complete and 26 (6.25%) had incomplete bony bridge formation. Of the 30 complete arcuate foramen 24 (80%) were females and 6 (20%) were males. The frequency of having a complete arcuate foramen in females was 8.45%, and in males it was 4.55%. Further, of the 26 incomplete arcuate foramen 20 (76.9%) were females and 6 (23.1%) were males. The frequency of having an incomplete arcuate foramen in females was 7%, and in males was 4.55%. The statistical evaluations showed that patients with complete arcuate foramen had significant complaints of shoulder-arm pain (p=0.0072), neck pain (p=0.0072) and vertigo (p=0.0598) compared to patients with incomplete arcuate foramen. The patients with complete arcuate foramen had a headache ratio of 12:30 and this ratio was 2:26 in patients with incomplete arcuate foramen and the difference between complete and incomplete arcuate foramen was statistically significant (p=0.0062). Further, no statistically significant relation was observed between both complete and incomplete arcuate foramen and lacrimation. No relationship between age and the presence of complete and incomplete arcuate foramen was observed. CONCLUSION: Presence of an arcuate foramen is always underestimated. Its presence should always be keep in mind in patients complaining of shoulder-arm and neck pain, headache and vertigo are examined.

Adult↗
PubMed2004

Temporal bone measurements on high-resolution computed tomography.

The distances between the important neural and vascular structures in normal temporal bones were measured by using high-resolution computed tomography (HRCT). We examined 100 normal ears in 50 subjects ranging in age from 15 to 72 years (mean age 39 years). We measured the distances from the medial lip of the posterior wall of the internal auditory canal to the medial wall of the vestibule (mean 9.7 mm), from the cochlea to the tympanic segment of the facial canal (mean 1.76 mm), from the medial wall of the vestibule to the lateral aspect of the lateral semicircular canal (mean 8.03 mm), and from the external auditory canal to the lateral sinus (mean 13.2 mm). HRCT examination is the best method for defining the morphology of temporal bone.

Adolescent↗
PubMed2004

[Evaluation of autologous fat volume with magnetic resonance imaging following vocal cord injection].

OBJECTIVES: The aim of this study was to measure the change in the volume of the autologous fat used for the treatment of glottic insufficiency caused by recurrent laryngeal nerve palsy. PATIENTS AND METHODS: Six patients who were treated by autologous fat injection for the treatment of glottic closure deficiency were included in the study. MRI was performed one week, and 1, 3, 6, and 12 months after the injection. After MRI, the images were transferred to GE Advantage Windows 2.0 workstation. By three-dimensional multiplanar volume rendering technique (MPVR), a threshold between +1500 and +150 was applied and bone and soft tissue signals except fat tissue were erased from images. The volume of the fat graft was calculated by SAVS/paintbrush common window. RESULTS: The mean volume of the fat graft in vocal cord was estimated to be 0.9 ml (100%) after one week of the injection. Measurements after one month and three months of the injection revealed that fat volume reduced to 66% (0.6 ml) and 44% (0.4 ml), respectively. The volume reduced to 33% (0.3 ml) of the baseline volume after six months. Finally, three patients had 33% (0.3 ml) of fat volume after 12 months. CONCLUSION: Approximately two-thirds of the fat graft injected to the vocal cord is resorbed within the first six months. For this reason, techniques with stable long-term results should be performed in patients who are not expected to recover glottic functions.

Adipose Tissue↗
PubMed2003

Venous variations in the region of the third ventricle: the role of MR venography.

In this study, we examined the anatomical variations of the subependymal veins in the region of the foramen of Monro and the third ventricle by MR time of flight (TOF) venography. Fifty healthy subjects, ten patients with third-ventricle tumors, and four patients with lateral-ventricle tumors were included in the study. The courses of the anterior septal vein (ASV), thalamostriate vein (TSV), and internal cerebral vein (ICV) were studied. The proximity of the venous angle, the false venous angle, and the ASV-ICV junction to the posterior margin of the foramen of Monro was measured. In 69 (53.9%) sides, the ASV-ICV junction was located at the venous angle and at the posterior margin of the foramen of Monro. In 59 (46.1%) sides, the ASV-ICV junction was located beyond the foramen of Monro. Our study shows the high incidence of posteriorly located ASV-ICV junctions, which can be crucial in the planning of a better surgical approach. We strongly recommend that MR venography, which is a short radiological examination, be used before one operates on third-ventricle and lateral-ventricle tumors.

Cerebral Veins↗
PubMed2003

Early-postoperative magnetic resonance imaging in glial tumors: prediction of tumor regrowth and recurrence.

OBJECTIVE: This study investigated the value of early-postoperative magnetic resonance (EPMR) imaging in the detection of residual glial tumor and investigated the role of EPMR for the prediction of tumor regrowth and recurrence. METHODS AND MATERIALS: We retrospectively analyzed pre- and post-operative magnetic resonance imaging results from 50 adult patients who underwent surgical treatment for supratentorial glial tumor. There were glioblastoma multiforme in 25 patients, astrocytoma (grades II and III) in 11 patients, oligodendroglioma (grades II and III) in 9 patients, and oligoastrocytoma (grades II and III) in 5 patients. EPMR imaging was performed within 24 h after surgery. EPMR findings were compared with the neurosurgeon's intraoperative estimation of gross tumor removal. Patterns of contrast enhancement at the resection site, in residual and developing tumor tissue and blood at the resection site were evaluated on EPMR and in follow-up studies. 'Residual tumor' was defined as contrast enhancing mass at the operative site on EPMR. 'Regrowth' was defined as contrast enhancing mass detected on follow-up in the same location as the primary tumor. 'Recurrence' was defined as appearance of a mass lesion in the brain parenchyma distant from the resection bed during follow-up. RESULTS: Nineteen patients showed no evidence of residual tumor, regrowth, or recurrence on EPMR or any of the later follow-up radiological examinations. EPMR identified 20 cases of residual tumor. Follow-up showed tumor regrowth in 10 patients, and tumor recurrence in 1 case. EPMR showed contrast enhancement of the resection bed in 45 of the 50 patients. Four of the 20 residual tumors showed a thick linear enhancement pattern, and the other 16 cases exhibited thick linear-nodular enhancement. No thin linear enhancement was observed in the residual tumor group. Nine of the 10-regrowth tumors showed a thick linear-nodular enhancement pattern, and one exhibited thin linear enhancement in EPMR. For predicting regrowth tumor EPMR sensitivity was 91%, specificity was 100%, positive predictive value 1; negative predictive value was 0.9375. CONCLUSION: EPMR, depending on the surgical site enhancement pattern, is a valuable means of demonstrating residual tumors, and can be used to predict possible regrowth after surgery.

Adult↗
PubMed2003

Totally thrombosed giant P2 aneurysm: a case report and review of literature.

The diagnosis and treatment of intracranial saccular giant aneurysms is still difficult despite developments in neuroradiology, neuroanesthesiology and micro-neurosurgery. These aneurysms are usually located on major intracranial arteries and are rarely on distal branches of these arteries. An extra-axial 4 x 5 cm mass lesion in the left mediobasal temporal region was detected on the CT and MRI examinations of a 37 year old male patient who was admitted to our institution with headache and slight right-sided hemiparesis lasting for 2 months. The lesion was avascular on angiography. Surgery proved that the lesion was a totally thrombosed giant aneurysm of the P2 segment of posterior cerebral artery (PCA). The P2 segment was clipped proximal to the aneurysm with pterional-transsylvian approach and the aneurysm was totally excised. Giant aneurysms of the P2 segment are rare and 15 cases have been reported in the literature. This report presents a rarely seen totally thrombosed giant P2 aneurysms and discusses the difficulties in diagnosis and treatment.

Adult↗
PubMed2003

Evaluation of the mastoid air cell system by high resolution computed tomography: three-dimensional multiplanar volume rendering technique.

The mastoid air cell system is an important contributor to the pathophysiology of middle-ear inflammatory disease. The mastoid cavity is not only an air reservoir, but also an active space for gas exchange. Various methods of temporal bone imaging have been designed to investigate mastoid pneumatization. In this study, we examined 100 normal temporal bones for the evaluation of mastoid pneumatization. Mastoid air cell systems were measured by reconstructed axial and coronal high resolution computed tomography (HRCT) images. The reconstructions were made by a three-dimensional multiplanar volume rendering (3D MPVR) technique. The mean volume of the mastoid air cell pneumatization was 7.9 cm(3) (4.0-14.0 cm(3), SD = 2.3 cm(3)). The ears were allocated to the groups with respect to measured mastoid air cell pneumatization. Twenty-eight per cent of the ears have small pneumatization with an air cell system not exceeding 6 cm(3). Fifty-two per cent had an air cell system between six and 10 cm(3), and 20 per cent had an air cell system exceeding 10 cm(3). With its excellent imaging quality and the ability to eliminate bone and soft tissue, HRCT is the best method for evaluating the mastoid air cell system. The 3D MPVR technique must be used to measure the temporal bone/mastoid pneumatization for the best results.

Adolescent↗
PubMed2003

[Intraarterial thrombolysis in the treatment of acute ischemic stroke: Technical and clinical results].

PURPOSE: To evaluate the safety and recanalization efficacy of local IA rt-PA delivery in patients with acute ischemic stroke. MATERIALS AND METHODS: Fifteen patients with acute ischemic stroke were treated; of these, 10 were carotid artery stroke, 5 were vertebrobasilar territory stroke cases. The neurological status of the patients were graded according to the Glascow Coma Scale and National Institutes of Heart Stroke Scale. All patients underwent a CT examination on admission. In addition, 4 patients had diffusion-weighted and one patient had a perfusion MR examination. Patients of carotid territory stroke were treated within 6 hours from the stroke onset. There was no time limitation for the basilar artery territory. The Rankin Scale (RS) was used as outcome measures. RESULTS: Two of the 10 patients with carotid artery stroke had carotid territory occlusions, 8 had middle cerebral artery main trunk occlusions. Four patients had symptomatic hemorrhage; of these, 3 died within 24 hours. At the third month 4 patients had a good outcome. Of 5 patients with basilar artery stroke, 4 had basilar artery occlusions. In one patient, the basilar artery was open but the flow of the contrast material was very slow. Two patients with unsuccessful recanalization due to underlying high grade atherosclerotic stenosis and one patient with successful recanalization died. At the third month, the other patient with succesful recanalization had a poor outcome (RS 4). The patient with slow basilar artery flow developed from RS 5 to RS 1 and was discharged without any neurological deficit. CONCLUSION: In acute ischemic stroke, local IA thrombolysis is a safe and feasible treatment when the right patient is selected. Hemorrhage does not exceed that which occurs in the natural history of the disease and with other treatment methods.

Adult↗
PubMed2003

[Endovascular treatment of renal artery stenosis: Technical and clinical results].

PURPOSE: To determine the primary success rate and follow-up results of renal artery stenting in controlling renovascular hypertension and renal failure in patients with renal artery stenosis. MATERIALS AND METHODS: Balloon expandable stents were placed in 40 renal arteries of 35 patients (16 men, 19 women; mean age 60, 1). Indications for treatment were hypertension alone in 11 patients, disturbed renal functions alone in 12 patients and hypertension associated with renal failure in eight patients. Four of the patients were diagnosed during angiography due to peripheral arterial diseases. Blood pressures and serum creatinine levels were measured before the operation and after stenting. RESULTS: The primary technical success rate was 100%. Mean percent stenosis was 81%. The lesions were ostial in 28 patients, proximal in 10 patients and distal in 2 patients. In those patients having at least one year of follow up, the primary patency at one year was 93% (14/15). Hypertension was cured in 7 (20%) patients, improved in 17 (48.5%) patients and did not respond in 11 (31.5%) patients. Of 21 patients with disturbed renal function, 12 (57.2%) patients improved, 3 (14.3%) patients deteriorated and 6 (28.5%) patients were stabilized. CONCLUSION: Revascularization of renal artery stenosis is a simple, efficient and safe procedure with high primary technical results, low restenosis rates and acceptable complication rates. It has a beneficial effect on blood pressure control and a non-deleterious effect on renal function.

Adult↗
PubMed2002

Thalamic involvement in a patient with kernicterus.

We report the MR imaging findings of a 16-month-old boy with dyskinetic cerebral palsy resulting from kernicterus. T2-weighted images showed symmetric bilateral hyperintensity in the thalamus in addition to the globus pallidus.

Globus Pallidus↗
PubMed2002

Metastatic papillary craniopharyngioma: case study and study of tumor angiogenesis.

We report a case of suprasellar papillary craniopharyngioma metastatic to the temporoparietal region 2 years after its initial resection. The literature documents examples of craniopharyngioma recurrences along the surgical tract, as well as remote ipsi- and contralateral metastases via cerebrospinal fluid seeding. Ours is the second report of a craniopharyngioma of papillary type to exhibit metastatic behavior. The tumor spread opposite the side of craniotomy. Although a rare occurrence, it confirms the limited capacity of histologically benign craniopharyngiomas to undergo meningeal seeding, likely the result of surgical manipulation. Immunohistochemical demonstration of increased microvascular density and vascular endothelial growth factor expression, as well as a high vascular endothelial growth receptor (VEGFR2) signal by in situ hybridization, suggests that tumor vascularity facilitated angiogenesis and may have been involved in the establishment and growth of the metastatic deposit.

Biopsy↗
PubMed2002

Tenascin in meningioma: expression is correlated with anaplasia, vascular endothelial growth factor expression, and peritumoral edema but not with tumor border shape.

OBJECTIVE: Tenascin is an extracellular matrix glycoprotein that is expressed during embryogenesis, inflammation, angiogenesis, and carcinogenesis. The aim of this study was to investigate how tenascin expression relates to histological grade, angiogenesis, and radiological findings in meningiomas. METHODS: Twenty typical, 20 atypical, and 5 malignant meningiomas were studied retrospectively. Tenascin expression and vascular endothelial growth factor (VEGF) expression in the tumor tissue were investigated by immunohistochemistry. Tenascin messenger ribonucleic acid expression was also studied by comparative reverse transcriptase-polymerase chain reaction. Magnetic resonance images from each case were assessed for peritumoral edema and tumor border shape. RESULTS: The atypical and malignant meningiomas showed higher levels of tenascin expression than the typical meningiomas. The more sensitive messenger ribonucleic acid-based methods confirmed this finding. Tenascin expression was correlated with peritumoral edema and VEGF expression but not with tumor border shape. In the 13 tumors with marked tenascin expression, peritumoral edema was Grade 0 in one, Grade 1 in three, and Grade 2 in nine specimens. In the same 13 tumors, VEGF expression was Grade 1 in five and Grade 2 in eight specimens, and the findings for tumor border shape were Grade 0 in seven, Grade 1 in four, and Grade 2 in two specimens. CONCLUSION: In meningiomas, tenascin expression is correlated with anaplasia, tumor-associated edema, and VEGF expression but not with tumor border shape. This protein may play a role in the neoplastic and/or angiogenic processes in atypical and malignant meningiomas and may thus be a potential target for meningioma therapy.

Anaplasia↗
PubMedDate not supplied

Sonographic measurement of kidney size in geriatric patients.

PURPOSE: The aim of this study was to compare the value of absolute and relative renal length (ARL and RRL, respectively) measurements in determining variations in normal kidney size related to sex, body height, and increasing age among patients older than 60 years. METHODS: Kidney sizes were prospectively measured sonographically in patients older than age 60 years. Longitudinal renal lengths (ARLs) were measured, and the RRLs were calculated by dividing the ARL by the body height. ARL and RRL measurements were analyzed according to sex, age, and body height. RESULTS: The ARLs and RRLs of the left kidney in 236 patients were significantly greater than those of the right kidney (p < 0.05) in both sexes. The ARLs for both kidneys were also significantly greater in men than they were in women (p < 0.05). In contrast, the RRLs for both kidneys were significantly lower in men than they were in women (p < 0.05). Both left and right ARLs decreased significantly with increasing age regardless of sex (p < 0.01 and p < 0.05, respectively). The same was true for left and right RRLs (p < 0.01 and p < 0.05, respectively). CONCLUSIONS: Renal size decreases with increasing age among patients older than 60 years. In our series of geriatric patients, the use of RRLs could not completely eliminate variations related to a subject's height, sex, and age. Therefore, we recommend that the ARL be used for renal measurements in geriatric patients.

Aged↗
PubMedDate not supplied

An anencephalic monocephalus diprosopus "headed twin": postmortem and CT findings with emphasis on the cranial bones.

Monocephalus diprosopus is a form of conjoined twinning characterized by a single body, one unusual head and two faces or a spectrum of duplication of the craniofacial structures. Such cases have been mainly described according to postmortem pathologic examination. This presented case is a 26-week-stillborn female fetus, with unusual facial appearance with four eyes, two mouths, two noses, two ears and a defective cranial vault. To our knowledge, a detailed computerized tomography (CT) examination of the aberrant facial and cranial bones of such a case has not been reported to date. In this reported case, we present an anencephalic monocephalus diprosopus "headed twin", and describe the CT findings with emphasis on the cranial bones.

Anencephaly↗