Biomedical subjects

K M Akay

Publications and source records attributed to K M Akay.

7 recordsLinked to original sources

PubMed2003

End-to-side anastomoses in small arteries with partial lateral clipping. An experimental study.

The problem of total therapeutic occlusion of the cranial arteries remains a relatively important area of concern for neurosurgery, neurology, neuroradiology and neuroanesthesia as well as for the patients. Cerebral revascularization procedures require total occlusion of the cranial arteries for a while. End-to-side anastomoses with partial lateral clipping were done in 20 cadaver arteries and then, in one rat common carotid artery. The results of the study were compared with the current cerebrovascular bypass procedures on a theoretical basis and possible clinical implications of the method were suggested. All the anastomoses were found to be open. As conclusions; 1) End-to-side anastomosis with partial lateral clipping and along with this technique the maintenance of blood flow in the target vessel during the anastomosis procedure are experimentally possible. 2) Although the available aneurysm clips may be used in the bigger vessels (> 2.5 mm), currently, the exclusive clips for the technique are not available commercially. 3) Further clinical implications of the technique may be investigated.

Anastomosis, Surgical↗

PubMed2002

Continuous neural monitoring in lumbar spine surgery: experience with 101 patients.

The first report about lumbar spinal surgery under epidural anesthesia has been published in 1958. The aim of this study was assess to epidural anesthesia as a regional operative anesthesia in lower lumbar spine surgery and to use the opportunity of verbal interaction with the patient who is able to move her/his lower extremities voluntarily during surgery. We called this simultaneous clinical assessment process as continuous neural monitoring. Established pathologies in the patients were as follows; lumbar herniated intervertebral disc disease (n = 95), lumbar spondylolisthesis (n = 4), lumbar lamina fracture (n = 1) and lumbar dumbbell Ewing's sarcoma (n = 1). Preoperative findings, operative findings, operative complications, postoperative complications and short-term results were assessed by the surgeon-anesthesiologist team. The patients, 99 out of 101, were followed-up for more than 15 months (mean 21.2 months). Fair and failure results were assessed in 7.0 % of the patients. Even though epidural anesthesia is almost equal to general anesthesia in terms of anesthetic complications, surgical complications and surgical results in uncomplicated lumbar spinal surgery cases, it has the advantage of being able to simultaneously evaluate motor results of surgical maneuvers and/or manipulations on the neural structures. This advantage, which is not available at the same accuracy with other neurophysiologic monitoring modalities, would be valuable in complex lumbar spine surgery cases.

Adult↗

PubMed2002

Cervical spondyloptosis: a case report.

A 5-year-old male child who had undergone orthopedic surgery for foot deformities three years prior presented to the outpatient clinic with a complaint of flexion restriction in both hands. The radiological evaluation of the patient showed C3-4 spondyloptosis. Halo traction was placed and posterior and anterior spinal fusions were performed respectively to achieve realignment of the spine. The postoperative period was uneventful and the patient has been followed for 24 months. The etiology, diagnostic features and treatment options of childhood cervical spondyloptosis have been briefly reviewed and the pertinent literature discussed.

Cervical Vertebrae↗

PubMed2000

Tethered cord syndrome in adults.

BACKGROUND: The tethered cord syndrome (TCS) consists of an abnormally low conus medullaris tethered by a thickened filum terminale or various forms of spinal dysraphism. The adult variant of the syndrome seems not to be as rare as once thought. METHOD: This study includes 11 patients with a TCS. Clinical, radiological findings and outcome were reviewed in these adult patients with TCS. FINDINGS: The patients ranged in age from 18 to 34 years (mean 24.09 years). There were 7 men and 4 women. The presenting symptoms in order of frequency were as follows: low back pain radiating to legs, urinary complaints, weakness in legs and impotence. All patients had magnetic resonance imaging scans. Physical exercise in 8, birth delivery in 1 and carrying heavy objects in 1 patient were determined as the precipitating factors. No precipitating factor could be defined in one of the patients. All patients were operated on, except for one. None of the patients worsened after surgery. INTERPRETATION: The patients presenting with low back pain and sciatica responded to surgery better than those with sphincter problems.

Adolescent↗

PubMed1998

Dumbbell lymphoma of the cervical spine in a child. Case report.

Primary or secondary spinal involvement of lymphoma is a rarely reported entity. An eleven-year-old girl with primary cervical dumbbell non-Hodgkin's lymphoma (NHL) was presented. We could not found any such growth pattern of primary or secondary NHL'S in the literature. For this reason, we reviewed shortly pertinent literature and discussed the pathophysiologic, diagnostic and prognostic features of the lesion with treatment modalities.

Child↗

PubMed1996

Spinal pigmented villonodular synovitis: a case report.

STUDY DESIGN: This case report illustrates a young male patient with thoracal spinal pigmented villonodular synovitis who presented with difficulty in walking. OBJECTIVES: The treatment of this lesion with posterior approach for preventing neurological deterioration and follow-up with magnetic resonance imaging studies. SUMMARY OF BACKGROUND DATA: Spinal involvement of pigmented villonodular synovitis rare. It is treated by radical surgical excision. But in some cases, as in our case, surgical total excision of the lesion with a one-stage operation is not possible. For this reason, in such cases, follow-up studies with magnetic resonance images are sufficient. This report represents the 14th case of spinal involvement of pigmented villonodular synovitis. METHODS: The patient presented with difficulty walking and received surgery including posterior decompression and subtotal tumor excision. All neurologic signs and symptoms disappeared in a short period. Postoperatively, follow-up studies with magnetic resonance imaging were performed and regrowth of residual lesion was not detected. RESULTS: The patient was discharged home without neurologic deficit. Follow-up studies with magnetic resonance images showed no regrowth of residual lesion. CONCLUSIONS: The principle of surgical management of spinal lesions causing neurologic deficit is early surgical decompression. Although pigmented villonodular synovitis requires total excision, in the presented case total excision of lesion was impossible, because vertebral body involvement needs an anterior or posterolateral approach. During the 16-month follow up, regrowth of the lesion has not occurred. These observations indicate that surgical decompression and follow-up of a patient with magnetic resonance imaging constitute a satisfactory treatment of pigmented villonodular synovitis.

Adult↗

PubMed1995

Hydatid cysts of the brain.

Intracranial hydatid cysts, although still rare, are being seen with increasing frequency. We report 12 cases of intracerebral hydatid cysts diagnosed with the use of computed tomography. We also review the methods recently available for diagnosis and therapy of this disease. Excellent therapeutic results can be achieved through surgical removal of the hydatid cyst; however, it is important to avoid rupturing the cyst.

Adult↗