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Biomedical subjects

Yusuf Izci

Publications and source records attributed to Yusuf Izci.

At least 19 recordsLinked to original sources
PubMed2006

Transcavum septum pellucidum interforniceal approach for the colloid cyst of the third ventricle Operative nuance.

BACKGROUND: Despite their unfavorable locations, lesions of the third ventricle can be successfully removed via an interhemispheric, transcallosal approach. In cases with normal ventricular anatomy, this approach requires unilateral or bilateral identification of the foramen of Monro. TECHNIQUE: However, in the presence of abnormal ventricular configuration such as cavum septum pellucidum (CSP), this basic knowledge needs to be modified. After routine callosotomy, there may be a confusion while entering the CSP due to the invisualization of ventricular landmarks such as the foramen of Monro, thalamostriate vein, and choroid plexus. The floor of the CSP is formed by the fornices, and a direct approach to the interforniceal area is easier via the CSP. But the interforniceal approach is not a routine way to reach the third ventricle, which has higher risks than other modalities. CONCLUSION: This approach should be planned and used in selected cases of the CSP. Opening of the walls of CSP is recommended both to expose both the foramen of Monro and to gain safe access to the third ventricle before manipulating the interforniceal area.

Cerebral Veins↗
PubMed2006

A case of ventricular drainage infection with a rare pathogen in cerebrospinal fluid: vancomycin-resistant Enterococcus faecium.

The purpose of this study was to describe a patient, 7-month-old child with ventriculoperitoneal shunts for hydrocephalus with ventriculitis caused by vancomycin-resistant Enterococcus faecium. Two ventriculoperitoneal shunts were inserted just after birth and on the second month. On the sixth month, both shunts were removed because of dysfunction, and external drainage was inserted. The child developed fever, and lumbar puncture revealed a high leukocyte count and protein concentration after external drainage. Cerebrospinal fluid (CSF) cultures yielded E. faecium, which was resistant to ampicillin, erythromycin, gentamicin, penicillin G, vancomycin, and teicoplanin and was susceptible to chloramphenicol, ciprofloxacin, streptomycin, levofloxacin, and rifampin, as determined by the disk diffusion method. As a result of the antimicrobial susceptibility tests, multidrug antibiotic therapy was changed from vancomycin and ceftazidime to chloramphenicol, rifampin, and meropenem. In addition, a rifampin-clindamycin-impregnated shunt (The Codman Hakim Bactiseal, Raynham, MA) was inserted. The patient became afebrile, and CSF cultures were sterile after 15 days of yielding E. faecium. Implantation of the rifampin-clindamycin-impregnated shunt and timely use of appropriate antibiotics for 10 days according to antimicrobial susceptibility testing seem to be important in the resolution of vancomycin-resistant enterococci infections, especially in countries where linezolid and quinupristin-dalfopristin are not in use yet.

Cerebrospinal Fluid↗
PubMed2006

Neurenteric cyst of the upper cervical spine: excision via posterior approach.

Neurenteric cyst of the cervical spine is an uncommon congenital lesion and usually associated with many craniocervical anomalies. Solitary neurenteric cyst of the upper cervical spine is very rare. Surgery is the main treatment method. An 11-year-old female child presented with the symptoms of neck pain that radiated to both shoulders and arms. Magnetic resonance imaging of the patient showed a cystic mass lesion ventral to the spinal cord and lying at the level from C1 to C3. She underwent surgical resection via a posterior approach and complete cyst resection was performed. Although removal of a neurenteric cyst through a posterior approach may result in spinal cord injury, this method is easier and safer than the anterior approach, especially in children.

Cervical Vertebrae↗
PubMed2006

116 years (1889-2005) of neurosurgical practice and education at Gulhane Military Medical Academy.

Modern medical education in the Ottoman Empire began with the founding of the School of Medicine and Surgery in 1827. This was a military school established to provide military physicians for the army. The first neurosurgical interventions at this school were initiated by Cemil Pasha in 1889. This school has gradually expanded since its opening, and was reorganized and renamed "Gulhane Military Medical Academy" in 1898 as the result of efforts to establish modern medical education and practice in the Ottoman Empire. Neurosurgical operations have been continued by the different surgeons in the Department of Surgery at Gulhane Military Medical Academy. In 1957, the Department of Neurosurgery became an independent department through the work of Professor Zinnur Rollas. Today, neurosurgery is a dynamic and constantly changing department at Gulhane Military Medical Academy with work still in progress on technological, diagnostic, and surgical innovations that permit the treatment of highly complex cases.

History, 19th Century↗
PubMed2005

Desmoplastic fibroma of the cervical spine.

There have been only a few cases of desmoplastic fibroma of the spine in the literature and only one of them was purely located on the cervical spine. We report a new patient with the diagnosis of desmoplastic fibroma of the fourth cervical spine. The patient had the complaints of left arm and neck pain. After his radiological evaluation, a mass lesion was found on the left lamina of the fourth cervical spine. Surgical treatment was performed, and the histopathological examination revealed the diagnosis of desmoplastic fibroma. Patients with desmoplastic fibroma of the cervical spine may present with the arm and neck pain mimicking cervical disc disease. Higher index of suspicion by the clinicians must be practiced to make the appropriate diagnosis. Successful surgical outcome may be achieved in these patients.

Adult↗
PubMed2005

Clinical significance of congenital lumbosacral malformations in young male population with prolonged low back pain.

STUDY DESIGN: A prospective clinical investigation. OBJECTIVE: To determine the clinical significance of congenital lumbosacral malformations in young male patients with subacute or chronic low back pain and to investigate a possible worsening of the clinical picture with the concurrence of transitional vertebra (TV) or spina bifida occulta (SBO). SUMMARY OF BACKGROUND DATA: Although the causative roles of congenital malformations in low back pain and lumbar disc herniation have been investigated, there is no study that compares the incidence of congenital malformations in prolonged low back pain between radicular and nonradicular groups; nor is there a study that compares the pain intensity between the groups with and without congenital malformations. METHODS: Lumbosacral plain radiographs of 881 young male patients with low back pain lasting for >4 weeks were evaluated. For all patients, we recorded the clinical signs and their pain intensities based on a 10-cm visual analog scale (VAS). RESULTS: Congenital lumbosacral malformations were determined in 88 of 881 patients. Of these, 48 were TV, 38 were SBO, and 2 were a combined lesion of TV and SBO. The difference in positive clinical sign and VAS was statistically significant (P < 0.05) between the groups with and without congenital lumbosacral malformations. In contrast to SBO, there was a statistically significant difference of TV incidence between the sign positive and the sign negative groups (P < 0.05). The difference in VAS values was statistically significant for both TV and SBO (P < 0.001). CONCLUSIONS: The results of this study show that SBO and TV increase the severity of the clinical picture whether or not they have a causal relationship. Additionally, transitional vertebrae seem to increase nerve-root symptoms whereas spina bifida occulta does not.

Abnormalities, Multiple↗
PubMed2005

Prognostic factors for the surgical management of peripheral nerve lesions.

Although the evaluation and treatment of patients with peripheral nerve injuries has evolved and improved over the years, there are still some arguments on the methods and results of surgery. We reviewed retrospectively the clinical, electrophysiological and surgical characteristics of peripheral nerve lesions for 1,636 nerves in 1,565 patients who had been managed in our department in a 10-year period. The most common cause of injuries was gunshot wound in 56.3% of all patients, followed by sharp lacerations (20.6%), fractures (10.6%) and tractions (5.1%). Among 1,636 cases of nerve injuries, the most frequently wounded nerve was median nerve (32.3%), followed by ulnar (24.1%), radial (12.1%), sciatic (10.7%) and peroneal nerves (7.7%), and brachial plexus (7.7%). Simple decompression was the most preferred technique for nerve repair in 27.8%. The electrophysiological improvement was observed in 66.8%, as assessed by electromyography. Clinical improvement was found in 58.4%, as judged by muscle strength grading. If the nerve is compressed or contused, but remains intact, the improvement is satisfactory after surgery. The type of injury, its time of occurrence, initial deficit, and degree of recovery expected are important issues in establishing the treatment plan, which may range from skilled observation to extensive surgical intervention.

Adolescent↗
PubMed2005

Composite type of split cord malformation: two different types at three different levels: case report.

The authors report on a child with a composite type of split cord malformation (SCM). The patient presented with symptoms of a common cold. The diagnosis of SCM was made based on computerized tomography and magnetic resonance (MR) imaging of whole spinal axis. The SCM was Type I at T-4 and T-5 and Type II at T-12, according to the classification developed by Pang. The child underwent resection of the splitting lesions and terminal filum release. No case of composite-type SCM reported to date contains documentation of such a malformation. Because of the possible neurological and urological problems, the authors recommend MR imaging of the whole spine be performed during/an evaluation for SCM.

Female↗
PubMed2004

The clinical and surgical aspects of spinal tumors in children.

A series of 20 pediatric patients underwent surgery for spinal tumor at the Department of Neurosurgery, Gulhane Military Medical Academy between 1995 and 2003. Motor weakness and reflex changes were the main initial signs in these patients. Epidural tumors and intradural-extramedullary tumors were in equal number, and total tumor removal was achieved in most of the patients without adjuvant treatment. Laminotomy was the main surgical method in 60% of the patients with spinal tumor, especially in children younger than 3 years of age.

Adolescent↗
PubMed2004

Management of lower back pain in young Turkish recruits.

The aims of this study were to determine the appropriate management strategy for lower back pain in the young male population of the Turkish Army and to analyze the results of surgical treatment of such a common health problem versus medical treatment. Participants in the study included 865 recruits who underwent basic military training between June 2001 and June 2002. All were admitted to our department with the complaint of lower back pain and were evaluated by neurological and radiological examinations. We operated on 23 of them and followed-up by 3 months. We compared the data of surgically and nonsurgically treated patients. In our opinion, the indications for surgery for lower back pain must be strict, and careful selection of patients is needed for a satisfactory outcome.

Adult↗
PubMed2004

Ventricular injury following cranial gunshot wounds: clinical study.

Gunshot wounds to the head are usually fatal injuries, despite all medical and surgical interventions. Ventricular injury is a poor prognostic factor-for penetrating cranial gunshot wounds. Intraventricular hemorrhage and ventricular lacerations are the main components of such injuries. The incidence, management, and outcomes of cases of ventricular injury secondary to cranial gunshot wounds that were treated during a 9-year period at Gülhane Military Medical Academy were examined. The study group consisted of 67 consecutive patients who were admitted to the Department of Neurosurgery with the diagnosis of ventricular injury, with different penetration sites. The patients had been injured by either bullets or shrapnel. Surgical treatment was performed for all patients with ventricular injuries and 22 (32.8%) died. Ventricular injury in cranial gunshot wounds is a complex severe type of trauma that requires serious treatment. Early radiological diagnosis and accurate treatment frequently had lifesaving roles for these patients.

Adult↗
PubMed2003

Split cord malformation in adults.

Although split cord malformations have been well documented in children, there is no consensus about their surgical indications and clinical course in adults because of their rarity. Medical records of nine young adult patients with split cord malformations were reviewed retrospectively. The most common complaint was radicular low back pain persisting more than 1 year, and the most common finding was hypertrichosis. Adult split cord malformation patients in our series had neither scoliosis nor foot deformities. Radiologically, all had low-situated conus medullaris. Eight of them underwent surgery. The radicular low back pain decreased in all the surgically treated patients at short-term follow-up but had not disappeared. Although pain originating from split cord malformations seems to be the most common surgical indication in adult patients and shows good short-term results, in our opinion long-term pain improvement is necessary for confirmation. According to our results, it seems that symptomatic young adults with split cord malformations are good candidates for complaint and deficit stabilization surgery.

Adult↗
PubMed2003

The bony malformations of lumbosacral junction and sacrum: case reports and literature review.

The lumbosacral region, with its manifold variations and anomalies, is one of the most important section of the entire spine. From the fusion defects to the segmentation anomalies, a wide variety of malformation exists in this region. Individuals with such anomalies usually have no physical complaints until their spines undergo pathological conditions. Two patients with a variety of lumbosacral vertebra anomalies are described. Each of them had a different malformation, but low back pain was the common complaint of these patients. According to our knowledge, these cases have never been reported before. We analysed their clinical and radiological features and discussed with the literature.

Adult↗
PubMed2003

The clinical, radiological and surgical characteristics of supratentorial penetrating craniocerebral injuries: a retrospective clinical study.

Penetrating craniocerebral injuries (PCIs) are the most fatal injuries of the head that usually have a poor outcome. From the parenchymal destructions to ventricular lacerations, a wide variety of damages occurs during the injury. Surgical treatment is still the mainstay of the management in these patients. Twenty-two consecutive patients with supratentorial PCIs were retrospectively evaluated. Conflicts were the main causes of such injuries followed by suicide attempts and accidental gunfires. Shrapnel and bullet were the most wounding agents. All of the patients underwent surgical treatment following clinical and radiological evaluations. Nine of them were died and 7 were rehabilitated because of severe neurological deficits.

Accidents↗
PubMed2003

Medulloblastoma of the cerebellopontine angle--case report.

A 21-year-old male patient presented with a rare cerebellopontine angle medulloblastoma manifesting as cerebellar and long tract involvement signs and symptoms. The clinical and radiological characteristics of the lesion were similar to extraaxial lesions of cerebellopontine angle. The histological diagnosis of the lesion was medulloblastoma. Surgery achieved partial removal and was followed by radiotherapy and chemotherapy. The patient remained well after 18 months. Medulloblastoma of the cerebellopontine angle is a relatively rare clinical entity and may occur as a dural-based extraaxial mass.

Adult↗
PubMed2003

[Traumatic dissection of bilateral vertebral arteries].

58-year-old male comatose patient following a motor vehicle accident with a history of coronary bypass surgery 5 years ago has been presented. The patient was awake after the accident and he became comatose 30 minutes after the accident. The early diagnostic investigations showed no responsible cranial or spinal lesion. At the 2nd day of the accident, diffusion weighted magnetic resonance scans, magnetic resonance arteriography and digital subtraction arteriography revealed bilateral vertebral artery dissection at the second part of the vertebral arteries. Clinical, radiological features and treatment options of the vertebral artery dissection has been discussed with the ertinent literature.

Accidents, Traffic↗