PubMed Health⌕ Search

Biomedical subjects

Nejmi Kiymaz

Publications and source records attributed to Nejmi Kiymaz.

At least 19 recordsLinked to original sources

Intracranial lipomas--a clinical study.

OBJECTIVE: This study aimed to investigate the localization of the lipoma, as well as associated intracranial and extracranial lesions in 14 patients immediately following hospital admission. The pathological findings from the neurological examinations of these patients are also investigated. METHODS: Fourteen patients who were admitted to our clinic with a variety of symptoms and diagnosed with intracranial lipoma were included in the study. Problems presented upon admission, neurological findings, and other existing system abnormalities were evaluated. Localization of the lipomas and accompanying pathologies were determined by using computerised tomography and magnetic resonance imaging. RESULTS: The most frequent reasons for admission of patients with intracranial lipomas were: headache 7 (50%), trauma 3 (21.5%), epilepsy 3 (21.5%) and one with symptoms due to the local mass effect of tumor (7%). Although the pericallosal region is accepted as the region where lipomas commonly occur, this study found the most frequent occurrence in the quadrigeminal cistern. Intracranial lipoma calcification was only evident in 1 of the 14 patients. In addition, contrary to the expectations, intracranial and extracranial lesions accompanying lipomas were rare. All patients received systematic treatment. CONCLUSION: This study showed that intracranial lipomas are more frequent in the quadrigeminal region of the brain; most are asymptomatic, generally caught incidentally; and accompanying intracranial and extracranial pathologies are less common than expected.

Adolescent↗

Lipid peroxidation in patients with brain tumor.

Molecular and genetic signatures may predict brain tumor behavior and may soon guide tumor classification, diagnosis, and tumor-specific treatment strategies. Free oxygen radicals (FOR) are thought to take part in oncogenesis and cellular differentiation. This article explored the state of FORs and antioxidant system in patients with cerebral tumor. The serum concentrations of malondialdehyde (MDA), catalase, and glutathione peroxidase (GSH-Px) enzyme activities were measured in the serum of 35 patients with cerebral tumors (21 glioma, 14 meningioma) and 11 controls. MDA measurement was done with fluorometric method and catalase and GSH-Px enzyme activities were done with photometric method. Mean serum MDA levels, catalase, and GSH-Px enzyme activities were significantly higher for both glial and meningiomal tumor cases when compared to controls (p < .05). There is no significant difference between glioma and meningioma groups in terms of the aforementioned parameters (p > .05). In conclusion, lipid peroxidation and antioxidant enzymes as assessed by MDA, catalase, and GSH-Px were increased in patients with brain tumors, for this respect there is no difference between gliomas and meningiomas.

Adolescent↗

Bilobed fasciocutaneous flap closure of large meningomyeloceles.

BACKGROUND: Closure of large meningomyelocele defects presents a challenging problem. In this paper, the procedure and outcome of bilobed fasciocutaneous flap closure of large meningomyeloceles have been discussed. MATERIALS AND METHODS: Bilobed fasciocutaneous flap was used in 20 patients with large meningomyelocele defects, the largest of which was 77 cm2. A fasciocutaneous dissection was performed and the defect area was covered by tension-free closure. RESULTS: In the follow-up period of 6 weeks, partial flap loss in a patient and cerebrospinal fluid leak inferior to the flap in another 2 were observed. These patients recovered by dressing without flap loss. CONCLUSIONS: Utilization of bilobed flaps for closure of large meningomyelocele defects seems to be an effective and reliable procedure, with advantages of decreased operative time, minimal bleeding, the suture lines for dura and flap not superimposed, and low morbidity.

Fascia↗

Spinal cord compression from spinal tuberculosis in a child.

Tuberculosis in children most frequently involves the pulmonary system. Spinal tuberculosis is very rare and insidious in children. We present a 1-year-old girl who was brought to our clinic with complaints of a bulge on her back and weakness in the feet. She was investigated with magnetic resonance imaging and at the thoracic level which revealed vertebral destruction and para- and perispinal abscess. Computed tomography of the lungs showed tuberculous lesions. The child's mother gave a post history of recovered lung tuberculosis. Due to appearance paraparesis secondary to vertebral destruction, we removed the abscess and infected bone and reconstruction was carried out with fibular allograft anteriorly. Tuberculosis bacilli were isolated from the postoperative biopsy culture. In this study, we evaluated the methods of diagnosis and treatment of spiral tuberculosis according to the studies and publications which have been done previously.

Epidural Abscess↗

Surgical treatment outcome of subdural empyema: A clinical study.

A retrospective study of 28 patients identified with subdural empyema (SE) at the Department of Neurosurgery between the years 1995 and 2005 was carried out. SE occurred in all patients following bacterial meningitis. The six most frequently encountered clinical features included: (1) fever in 22 (79%) patients; (2) disturbed consciousness in 16 (57%) patients; (3) papilledema in 11 (39%) patients; (4) hemiparesis in 4 (14%) patients; (5) meningismus or meningeal signs in 4 (14%) patients, and (6) seizures in 3 (11%) patients. In the majority of cases, the most frequent causative pathogen of SE was Staphylococcus aureus. Surgery was performed on all patients, which included craniotomy in a group of 20 patients and burr hole drainage in a group of 8 patients. In conclusion, we believe that infants and young children should be carefully monitored following meningitis, in case of SE development, and that surgical intervention in patients presenting with meningitis may facilitate the development of SE. Furthermore, from a surgical point of view, our experience has led us to believe that craniotomy in comparison with burr hole surgery is the best surgical modality for management of SE as the recurrence rate of SE associated with burr hole surgery is high.

Anti-Bacterial Agents↗

Primary hydatid cyst of the brain during pregnancy.

A 26-year-old woman in the 28th week of pregnancy presented with a primary cerebral hydatid cyst manifesting as deteriorating consciousness and weakness in the left arm and leg. Cranial computed tomography revealed an intracranial hydatid cyst. The cyst was surgically removed and albendazole was administered. The patient had a spontaneous vaginal term delivery and no problem was observed in the mother or child. No primary focus was found in the lungs, liver, and other organs. Hydatid cyst is still an important disease. Intracranial hydatid cyst without primary foci in organs such as the liver and lungs is very rare. Primary cerebral hydatid cyst during pregnancy can be successfully treated by surgical and medical intervention.

Adult↗

Effects of dexamethasone on trace elements and serum protein patterns following brain trauma in rats.

The effect of dexamethasone (Dxm) on trace elements and serum protein patterns was investigated in male Sprague-Dawley rats subjected to brain trauma. After 6- or 24 h of the traumatic incident, the level of serum copper was significantly higher in the Dxm-treated rats, compared to controls (p < 0.05). The corresponding levels of zinc and iron did not show significant differences. The zinc level returned to normal 24 h after trauma. After 6 and 24 h of trauma, the sodium dodecyl sulfate (SDS)-polyacrylamide gel patterns of serum proteins showed that a 41.6-kDa protein was significantly increased in the Dxm-treated animals. Two proteins weighing 26.6 kDa and 55.1 kDa did not show Dxm-induced changes. These results suggest that increases in the copper-zinc ratio and the changes of the 26.6- kDa, 41.6-kDa, and 55.1-kDa proteins might be a useful prognostic indicator for severe traumatic brain injury.

Animals↗

Spontaneous cervical paraspinal and epidural giant abscess in a child--case report--.

A 10-year-old girl presented with a very rare paraspinal and spinal epidural abscess manifesting as fever, and neck pain and stiffness. Initially, she was treated under a diagnosis of meningitis for 3 weeks. However, she developed monoparesis of the right upper extremity, and was referred for neurosurgery. Magnetic resonance imaging revealed an epidural and paraspinal lesion intensely enhanced by gadolinium. The patient underwent urgent surgery for C2-3 laminectomy and abscess drainage, followed by broad spectrum antibiotic therapy. She was discharged and followed up in the outpatient clinic. Two months later, the paraspinal abscess recurred with great increase in size. A second operation was performed and 150 ml pus was drained. Streptococcus anginosus was grown in the culture. The patient fully recovered after long-term targeted antibiotic therapy. Such abscesses are very rare in children, especially in the cervical region. The correct diagnosis can be difficult to establish but early treatment is essential for a good prognosis.

Anti-Bacterial Agents↗

Traumatic lumbar fracture-dislocation related to spina bifida occulta: case report.

Traumatic lumbar fracture-dislocation is a rare condition. Congenital spinal deformities may facilitate the occurrence of this case. We diagnosed spina bifida occulta accompanied at the same level by a L2 anterior dislocation which resulted from a vehicle in-site traffic accident in a 35-year-old female patient. Posterior intervention was carried out during therapy, and reduction and stabilization were performed by means of a T12-L1 and L2-L3 trans-pedicular screw. In patients with a congenital spinal anomaly the effect of spinal traumas may be greater than normal. Therefore, spinal traumas in patients with a congenital spinal anomaly should be assessed more carefully.

Adult↗

Metastatic germ cell testicular tumor of the eye and brain: case report.

The aim of this report is to contribute to the clinical understanding of this rare combined pathology. Intraocular metastatic tumors are rarely encountered pathologies. Mostly encountered primary sites are breast, prostate, kidney, lung and skin. Testis as a primary site for orbital metastases is rather rare. Metastasis to orbit usually occurs to periorbital structures, but to vitreus is relatively rare. Here we describe a case of intraocular metastatic tumor to the vitreus originating from testicular embryonal cell carcinoma. Patient with intraocular tumor had also intracranial metastasis. He was operated on for intracranial lesion, after an uneventfull postoperative period he was discharged. 2 months later when he died, postmortem examination of the intraocular lesion reported as metastatic embryonal cell carcinoma. As a conclusion testicular embryonal cell carcinoma, eventhough rare, must be considered to metastasize to the eye.

Adult↗

Surgical treatment of craniocervical decompression without Chiari malformation in syringomyelia.

We aimed to describe a patient without Chiari malformation who was treated via craniocervical decompression and by creating cisterna manga with an autologous fascia graft, and who displayed a clinical and radiological improvement in the post-operative period. Syringomyelia is a chronic and progressive disease with cavitation and gliosis in the spinal cord. It is more common in adulthood and often involves the cervical region. Due to the fact that craniocervical decompression therapy is successful in syringomyelia with Chiari malformation, this surgical treatment is currently controversial in syringomyelia without Chiari malformation. A 33-year-old male applied to our clinic with numbness and weakness in his left hand that had lasted for 2 years, but his condition had worsened in recent months, with neck pain before over previous the 8 months and a walking disturbance that had appeared 7 months before. Syringomyelia was found between the C2 and T8 vertebrae levels on magnetic resonance imaging (MRI) scans. The patient was diagnosed with syringomyelia and underwent suboccipital decompression. Cisterna magna was created by duraplasty with a fascia lata graft. Consequently, craniocervical decompression might be accepted as a treatment method of choice in patients with syringomyelia without Chiari malformation.

Adult↗

The effects of endothelin antagonist BQ-610 on cerebral vascular wall following experimental subarachnoid hemorrhage and cerebral vasospasm.

Endothelin, a potent vasoconstrictor, has been found to increase in the cerebrospinal fluid and serum of patients following subarachnoid hemorrhage (SAH) and to play a major role in the development of cerebral vasospasm. The aim of this study is to investigate the role of endothelin-A antagonist BQ-610 in the experimentally performed cerebral vasospasm following SAH. Thirty New Zealand rabbits were divided into three groups (each n = 10): group A, control group; Group B, SAH group; Group C, treatment (endothelin antagonist BQ-610 treated) group. In the study, the rabbits developed vasospasm after injection of intracisternal autolog blood into the cisterna magna. After cerebral vasospasm development, in group C, endothelin antagonist BQ-610 was injected intracisternally. Morphometrically, basilar artery lumen was constricted 25% and 62% compared to the control group (group A) in the endothelin treated group (group C) and the endothelin untreated group (group B), respectively. Histopathological findings of the basilar artery wall confirmed the therapeutic effect of endothelin antagonist in vasospasm development. Endothelin-A receptor antagonist BQ-610 has a therapeutic effect in the cerebral vasospasm following experimentally performed subarachnoid hemorrhage when used intracisternally.

Animals↗

Trigeminal neuralgia caused by intracranial epidermoid tumor: report of a case and review of the different therapeutic modalities.

Trigeminal neuralgia (TGN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. Paroxysms typically last for 1 to 2 seconds. Etiology includes compression of the trigeminal nerve by vascular structures, tumors and multiple sclerosis plaques in the medulla spinalis. TGN is rather rare as a presenting symptom with intracranial tumors. Epidermoid tumors comprise 1% of all intracranial tumors. The majority of epidermoid tumors are located at the pontocerebellar angle, the third ventricle, and the suprasellar region. Symptomatology is not different from other tumors located at the same sites. Trigeminal neuralgia may be caused by tumor compressing the nerve itself, an inflammatory response to the epidermoid tumor or vascular compression of the nerve. We describe the case of a 30-year old female presenting with right-sided facial pain. Her past history revealed multiple teeth extractions done to relieve facial pain. Radiological evaluation, including magnetic resonance imaging (MRI), showed a pontocerebellar angle (PCA) epidermoid tumor. TGN resolved completely after total tumor resection. A temporary facial paralysis consequent to surgical removal of the tumor improved 6 months postoperatively, and she remained painfree, without medications.

Journal Article↗

Central nervous system lipomas.

The lipomas of the central nervous system are rare lesions of congenital origin and are located in the medial line and especially in corpus callosum. Intramedullary spinal lipomas can be seen in the life span of 30 years of age and most frequently coincide with initial puberty period. Magnetic resonance imaging and computerized tomography together with clinical trials are of crucial importance for diagnosis. The first case: A two-year-aged girl who had lipoma in quadrigeminal cistern and who suffered from encephalocraniocutaneous lipomatosis has been clinically studied. The fascial lipoma of the patient has been excised subtotally by the Plastic Surgeons; then the patient has underwent supracerebellar infratentorial operation where the intracranial lipoma has been excised by our team. The histopathology has been reported to be consisting of peripheric nerve tissue and calcification. The second case: A twenty-year-aged man with intramedullary lipoma localized between T1-T4 has been given our clinical trials. T1-T5 total laminectomy and subtotal excision were made for this patient. Due to the fact that the lipomas of central nervous system are rarely seen and are involved in nervous and calcific tissues except for fatty tissues they can be mistaken for hamartomatous masses. The total excision of the lipomas of central nervous system and especially the spinal intramedullary lipomas are quite difficult to be excised since they are tightly entangled with the neural tissue. So any attempt for total excision would be dangerous. Operation for decompression and biopsy is of primary concern.

Adult↗

Is external ventricular drainage useful in primary intraventricular hemorrhages?

Nontraumatic primary intraventricular hemorrhage (PIVH) is characterized by direct bleeding into the neuroventricular system. A very rare condition, PIVH accounts for 3% of all spontaneous intracerebral hemorrhages. Hypertension is a major cause of PIVH. Reports about PIVH in the literature are infrequent and it appears to be a relatively benign condition. Between 1998 and 2001, 15 patients with PIVH were evaluated in the Departments of Neurosurgery of Yüzüncü Yil and Pamukkale Universities; their prognosis and results of treatment with external ventricular drainage (EVD) were recorded. The diagnosis was established easily and rapidly with computed tomography. Prognoses of the patients were made by the Glasgow Coma Score (GCS). Hypertension was the most common etiology (n = 9, 60%); the prognosis for survivors (73.3%) was good (mortality, 26.6%). Elderly patients, who scored low on the GCS, and patients with coagulopathy had poor prognoses. All patients with PIVH underwent surgery with EVD within 24 hours of their hospital admission. Applying EVD had positive results and influenced the prognosis and early and late complications of PIVH accordingly.

Adult↗

Penetrating intracranial stone.

Traumatic intracranial foreign objects may cause cranial hemorrhage and contusion at an early stage and epileptic seizures and infections at a later stage, leading to morbidity and mortality in children. In the present study we report a case of a traumatic intracranial stone, which is a rarely encountered foreign object in intracranial traumatic injuries.

Accidents, Traffic↗