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Biomedical subjects

N Yücemen

Publications and source records attributed to N Yücemen.

7 recordsLinked to original sources

Multiple spinal intramedullary cavernous angioma: case report.

Spinal cavernous angiomas frequently accompany to cranial cavernous angiomas. Multiple spinal cord cavernous angiomas are very rare and to authors knowledge, only one case has been described having multiple intramedullary cavernous angiomas without cranial involvement until now. In this report, we present a case with acute paraplegia who had thoracic and cervical intramedullary cavernous angiomas and normal cranial magnetic resonance imaging.

Acute Disease↗

A case of atypical idiopathic orbital myositis mimicking neurological disease.

A 24 year old patient with acute double vision and headache was admitted to our clinic. A diagnosis of orbital myositis was confirmed after magnetic resonance imaging and orbital echogram. No other clinical manifestations were observed on general examination. Since orbital myositis cases with only neurological symptoms and without typical visual impairment are not frequent, we decided to present this case.

Adult↗

Bilateral sixth-nerve palsy associated with dural arteriovenous malformation.

A fifty-two year old postmenopausal woman was admitted to the hospital with complaints of diplopia, headache, humming over the head, and pain over the left eye. Neurological examination showed right abducens nerve palsy. In a few days, she also developed left abducens nerve palsy and chemosis, exophthalmos, and proptosis of both eyes. There was pulsation over the left eye. Intraocular pressure was found to be elevated bilaterally. Selective carotid angiograms showed the presence of bilateral dural arteriovenous malformations (AVM) supplied by the external carotid arteries. Two months after the embolisation of the AVMs, eye movements improved. Repeat angiograms showed the absence of flow into the previously embolised AVMs.

Abducens Nerve Diseases↗

In-111 platelets used in evaluation of emboli and thrombi in patients with cerebrovascular accident.

Studies with In-111 platelets were conducted to evaluate pulmonary embolus, deep vein thrombus and cardiac thrombus. This study aimed to evaluate active thrombi and possible new emboli in patients with cerebrovascular accident (CVA) in the first 24 hours by using autologous In-111 platelets. Twenty-five patients were included in the study. Carotid artery thrombi observed in 10 patients with this technique were confirmed by Doppler ultrasonography. Intracranial thrombi appearing in 3 cases were verified by X-ray computed tomography (CT). Scintigraphy of 8 patients who showed findings suggesting CVA in CT revealed no abnormal accumulation. This was attributed to the possibility that they were small in size, deep in location and/or were also quite aged. Abnormal accumulations observed in the lungs of 3 patients and in the mediastinum and pelvis in one patient were verified by other radiological methods. In-111 platelet study was found to be useful in patients with CVA to evaluate the active thrombi and possible emboli in the early period before clinical symptoms appeared.

Aged↗

Hemidystonia secondary to cervical demyelinating lesions.

Hemidystonia is usually associated with a structural lesion in the contralateral basal ganglia. We report a patient with definite multiple sclerosis, according to Poser's criteria, presenting with an acute-onset sustained left hemidystonia. Cranial T2-weighted magnetic resonance imaging (MRI) showed several hyperintense lesions in the centri semiovali and in the periventricular area without basal ganglia involvement. Moreover cervical spinal cord T2-weighted MRI showed two hyperintense lesions in the left posterolateral spine at C2 and C3, and one lesion in the right posterolateral spine at C4 levels. The hemidystonia improved completely after daily treatment with 1000 mg of methylprednisolone, and cervical MRI was performed after the improvement which showed that the lesions had become smaller and less intense. Finally we consider that the hemidystonia may be caused by the cervical spinal cord lesions of multiple sclerosis.

Adult↗

Isolated nuclear oculomotor nerve syndrome due to mesencephalic hematoma.

Unilateral third nerve palsy with bilateral superior rectus paresis and bilateral ptosis is a typical condition for nuclear oculomotor nerve syndrome. We report a case of nuclear oculomotor nerve syndrome due to midbrain hemorrhage, as a rare cause. A 73-year-old man presented with an abrupt onset of double vision and difficulty opening his eyes. He had uncontrolled hypertension in his history. Neurological examination revealed right oculomotor palsy with impairment of bilateral upward gaze and bilateral ptosis. MRI showed a mesencephalic area of increased T1 signal and decreased T2 signal consistent with a subacute hematoma. It is emphasized that isolated mesencephalic hemorrhage may be the cause of the nuclear oculomotor nerve syndrome without associated neurological signs.

Aged↗

Medically treated intraspinal "Brucella" granuloma.

BACKGROUND: Although there have been reports of Brucella granuloma or abscess in the literature, they were all localized extradurally except one, and most patients underwent surgery. CASE REPORT: A 40-year-old female presented with urinary and fecal incontinence and a two-month history of progressive weakness of the right leg and numbness of the left leg. Four months previously, she had been diagnosed with systemic brucellosis with a period of radiculomeningoencephalitis; she was treated successfully with rifampicin, doxycycline, trimethoprim/sulfamethoxazole (TMP/SMZ), and streptomycin, and was discharged symptom-free on rifampicin and doxycycline. Neurological examination revealed spastic paraparesis, globally hyperactive deep tendon reflexes (DTRs) and sensory level at T6. Magnetic resonance imaging (MRI) of the spinal cord revealed a 10 x 30 mm intradural-intramedullary mass lesion at the T5 level with surrounding edema that enhanced with contrast. The cerebrospinal fluid (CSF) was xanthochromic with lymphocytic pleocytosis and elevated levels of albumin, immunoglobulins, and antibody titers for Brucella. The medications were modified to rifampicin 1200 mg, doxycycline 400 mg, and TMP/SMZ 480/2400 mg daily, and methylprednisolone 100 mg in decremental doses (for 6 weeks). After 2 months, the patient was almost symptom-free and her medication doses were decreased. After 5 months, the mass lesion resolved almost completely. The treatment was discontinued after 2 years. CONCLUSIONS: The case is presented because of its uniqueness. In cases of Brucella granuloma, the authors recommend a trial of medical treatment with adequate dosages for a reasonable length of time before considering surgical intervention.

Adult↗