Publications by authors named "Barış Özöner"

15 Publications

  • Page 1 of 1

Chondrosarcoma in the body of the C2 vertebral axis.

JAAPA 2020 Nov;33(11):29-31

Baris Ozoner practices in the Department of Neurosurgery at the medical faculty of Bahcesehir University in Istanbul, Turkey. Ahmet Kayhan practices in the Department of Neurosurgery at Istanbul University-Cerrahpasa, Cerrahpasa medical faculty in Istanbul, Turkey. Nil Comunoglu practices in the Department of Pathology at Istanbul University-Cerrahpasa. Seckin Aydin practices in the Department of Neurosurgery at the University of Health Sciences, Okmeydani Training and Research Hospital, in Istanbul, Turkey. Galip Zihni Sanus and Necmettin Tanriover practice in the Department of Neurosurgery at Istanbul University-Cerrahpasa. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Chondrosarcoma, a malignant bone tumor, is rarely encountered in the cervical spine. This article describes a patient whose neck pain and dysphagia were caused by an expansive, destructive lesion with calcification that was located in the body of the axis (C2 vertebra), the first time a chondrosarcoma has been reported in this location.
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http://dx.doi.org/10.1097/01.JAA.0000718280.57597.60DOI Listing
November 2020

A follow-up study on outcomes of endoscopic transsphenoidal approach for acromegaly.

Clin Neurol Neurosurg 2020 Nov 4;198:106201. Epub 2020 Sep 4.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey. Electronic address:

Objective: A thorough follow-up study in which the same clinic presents the change in the surgical outcomes of acromegaly over the years, is still lacking in the endoscopic era. In this study, we intended to evaluate the clinical characteristics, radiological features, surgical and late remission rates of newly diagnosed acromegaly patients treated in our clinic between 2014 and 2019 in order to delineate the surgical remission status according to radiological, microscopic, and hormonal features. As a follow-up to our initial report, we also aimed to display the change of surgical remission rates over time in a tertiary center.

Methods: A total of newly diagnosed 106 patients with acromegaly, who underwent endoscopic endonasal trans-sphenoidal approach (EETSA) in the last five years were retrospectively analyzed and presented in this study. Medical records were reviewed in clinical, biochemical, pathological, and radiological aspects to assess the relationship of preoperative patient characteristics with surgical remissions.

Results: The percentages of the giant pituitary adenomas (≥4 cm), adenomas with suprasellar extension and adenomas with surgically proven invasion of the cavernous sinus in the present series were 13%, 34%, and 20%, respectively. Gross total resection was achieved in 80% of the patients. Surgical remission and late remission rates were 66% and 86%, respectively. Nine (9.4%) patients in our current report had postoperative transient diabetes insipidus. The mean follow-up period in this series was 36.1 ± 18.1 (range 12-59) months.

Conclusion: The presented surgical results are considerably better than our published initial series of acromegaly patients operated in the same clinic between 2007 and 2014. The improvement in surgical remission rate support a positive surgical volume - remission rate relationship for acromegaly in the era of endoscopic endonasal skull base approaches. One possible factor for better results may be the increasing surgical experience in EETSA, which follows a trend toward gradual improvement of long-term late remissions via a multidisciplinary approach.
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http://dx.doi.org/10.1016/j.clineuro.2020.106201DOI Listing
November 2020

Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury.

Eur J Trauma Emerg Surg 2020 Aug 3;46(4):919-926. Epub 2020 Jun 3.

Department of Neurosurgery, Sisli Hamidiye Etfal Research and Education Hospital, University of Medical Sciences, Istanbul, Turkey.

Background: Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI.

Methods: A total of 126 patients, who met the inclusion criteria of the study, were divided into two groups: patients with PTH (n = 25) and patients without PTH (n = 101). Their demographic, clinical, radiological, operative, and postoperative factors, which may be associated with the development of PTH, were compared.

Results: Multivariate logistic regression analysis revealed that cranioplasty performed later than 2 months following DC was significantly associated with the requirement for ventriculoperitoneal shunting due to PTH (p < 0.001). Also, a significant unfavorable outcome rate was observed in patients with PTH at 1-year follow-up according to the Glasgow Outcome Scale-Extended (p = 0.047).

Conclusions: Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.
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http://dx.doi.org/10.1007/s00068-020-01409-xDOI Listing
August 2020

Neurosurgical Practice During Coronavirus Disease 2019 (COVID-19) Pandemic.

World Neurosurg 2020 08 28;140:198-207. Epub 2020 May 28.

Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly contagious life-threatening condition with unprecedented impacts for worldwide societies and health care systems. Since the first detection in China, it has spread rapidly worldwide. The increased burden has substantially affected neurosurgical practice and intensive modifications have been required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even in academic activities. In some systems, nonoverlapping teams have been created to minimize transmission among health care workers. In cases of a massive burden, neurosurgeons may need to be reassigned to COVID-19 wards, or teams from other regions may need to be sent to severely affected areas. Recommendations are as following. In outpatient practice, if possible, appointments should be undertaken via telemedicine. All staff assigned to the non-COVID treatment unit should be clothed in level 1 personal protective equipment. If possible, postponement is recommended for operations that do not require urgent or emergent intervention. All patients indicated for surgery must receive COVID-19 screening, including a nasopharyngeal swab and thorax computed tomography. Level 2 protection measures are appropriate during COVID-19-negative patients' operations. Operations of COVID-19-positive patients and emergency operations, in which screening cannot be obtained, should be performed after level 3 protective measures. During surgery, the use of high-speed drills and electrocautery should be reduced to minimize aerosol production. Screening is crucial in all patients because the surgical outcome is highly mortal in patients with COVID-19. All educational and academic conferences can be undertaken as virtual webinars.
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http://dx.doi.org/10.1016/j.wneu.2020.05.195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255756PMC
August 2020

Cranio-Orbital Tumors: Clinical Results and A Surgical Approach.

Sisli Etfal Hastan Tip Bul 2019 27;53(3):240-246. Epub 2019 Aug 27.

Department of Neurosurgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Objectives: In this study, we aimed to share the surgical approaches and clinical experiences of cranio-orbital tumors, which are surgically difficult anatomies.

Methods: A total of 22 orbital tumors with extraorbital-transcranial pathology between January 2004 and December 2017 were retrospectively reviewed. Information was obtained from hospital, operation and outpatient records for this study. Preoperative demographic data, ophthalmologic examination findings, clinical and radiological findings were recorded. All patients had cranial magnetic resonance and cranial computerised tomography examinations at this time. The location of the tumor, its size and its relation to neighboring structures were recorded in the light of these examinations.

Results: The lateral approach was performed in 12 cases. The lateral approach was performed with frontotemporal craniotomy. Because of the lateral inferior location of the tumor in three of 12 cases, zygoma osteotomy was added to classical osteotomy. In 10 cases, the anterior approach was applied and the frontal craniotomy was found sufficient in seven cases. In three cases subfrontal craniotomy was added to classical craniotomy.

Conclusion: The findings obtained in this study suggest that high resection rates can be achieved with appropriate surgical intervention in orbital tumors requiring a transcranial surgical approach. The most important factor in surgical planning is the location of the tumor. The size of the tumor and the expectation of the percentage of surgical removal are the other important factors. In our series, it has reached high excision ratio in most cases with low complication rate, good visual field and eye movements results.
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http://dx.doi.org/10.14744/SEMB.2018.82698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192274PMC
August 2019

Relationship between subarachnoid and central canal hemorrhage and spasticity: A first experimental study.

J Spinal Cord Med 2019 Oct 24:1-9. Epub 2019 Oct 24.

Department of Pathology, Medical Faculty of Ataturk University , Erzurum , Turkey.

Spastic disorders are considered as important cerebral complications of subarachnoid hemorrhage (SAH). However, there has been no research concerning the pathophysiological mechanism of its link with the spinal cord. The present study aimed to assess the relationship between the development of spasticity and neuronal degeneration after SAH and increase in spinal cord pressure after central canal hemorrhage (CCH). Twenty-three rabbits were included. Of all rabbits, 5, 5, and 13 were allocated in the control, SHAM and study groups, respectively. Moreover, 1 cc of saline and 1 cc of autologous arterial blood were injected into the cisterna magna of the SHAM and study groups, respectively. The Muscle spasticity tension values (MSTVs) were determined according to the modified Ashworth scale. Degenerated neuron densities (DND) in the gray matter (GM) of each animal's spinal cord were stereologically calculated. The average MSTV of each group was as follows: control group (n = 5) 2; SHAM group (n = 5) 3-5; and study group (n = 13) 8-10. The DND values of the spinal cord of each group were as follows: control group, 2 ± 1/mm; SHAM group, 12 ± 3/mm; and study group, 34 ± 9/mm. Results showed an important linear relationship between the MSTVs and the DND of the spinal cord (P < 0.001). Spasticity may be attributed to other causes such as ischemic neurodegenerative process that develops after spinal SAH and the de-synchronization of the flexor-extensor muscles due to the spontaneous discharge of interneuronal structures, which are crossed within the spinal cord owing to the build-up of pressure after CCH.
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http://dx.doi.org/10.1080/10790268.2019.1669956DOI Listing
October 2019

Comparative Volumetric Analysis of the Brain and Cerebrospinal Fluid in Chiari Type I Malformation Patients: A Morphological Study.

Brain Sci 2019 Sep 29;9(10). Epub 2019 Sep 29.

Department of Neurosurgery, School of Medicine, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.

Background: Chiari Type I malformation (CM-I) is defined as the migration of cerebellar tonsils from the foramen magnum in the caudal direction and is characterized by the disproportion of the neural structures. The aim of this study was to investigate the brain volume differences between CM-I patients and normal population using a comparative volumetric analysis.

Methods: 140 patients with CM-I and 140 age- and sex-matched healthy controls were included in this study. The magnetic resonance imaging (MRI) data of both groups were analyzed with an automated MRI brain morphometry system. Total intracranial, cerebrum, cerebellum, brainstem, cerebrospinal fluid (CSF), and lateral ventricle volumes as well as cerebrum and cerebellum gray/white matter (GM/WM) volumes were measured. Statistical analysis was performed.

Results: Both total CSF and lateral ventricle volumes and volume percentages (Pct) were found significantly higher in CM-I patients compared to the control group. However, there were significant decreases in cerebrum and cerebellum volume Pct in CM-I patients. Although there were no significant differences in cerebrum WM volumes and volume Pct, cerebrum GM volume Pct were found to be significantly lower in CM-I patients.

Conclusions: Revealing the increased CSF and lateral ventricle volume, and volume Pct supported concomitant ventricular enlargement and hydrocephalus in some CM-I patients. Decreased cerebrum GM volume Pct compared to the control group might be the underlying factor of some cortical dysfunctions in CM-I patients.
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http://dx.doi.org/10.3390/brainsci9100260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826836PMC
September 2019

Effect of Vasa Vasorum on Basilar Artery Vasospasm Following Subarachnoid Hemorrhage.

World Neurosurg 2019 Nov 23;131:e218-e225. Epub 2019 Jul 23.

Department of Pathology, School of Medicine, Firat University, Elazig, Turkey.

Background: A well-documented association exists between the vasa vasorum and vasopathologies, including atherosclerosis. However, information on the role of the vasa vasorum during vascular degenerative changes of vasospasm after subarachnoid hemorrhage (SAH) is insufficient.

Methods: In this study, 34 rabbits were divided into 3 groups: basal group (N = 8), sham group (N = 8), and SAH group (N = 18). Experimental SAH was formed using a double-injection model. During follow-up, the neurologic status of the rabbits was observed. All rabbits were euthanized after 2 weeks, and the vasopathologic degeneration was categorized as normal, mild, moderate, and severe according to the changes in the basilar arteries. The numbers, locations, and spasms of the vasa vasorum and their relation to the vasodegenerative changes of the basilar artery were investigated.

Results: The basilar arteries were graded as normal in the basal and sham groups. In the SAH group, 6 rabbits had mild, 7 had moderate, and 5 had severe degeneration. Neurologic deficits were prominent in the SAH group, and deficit grades correlated with vascular degeneration. The number of the vasa vasorum were significantly higher in the SAH group, and an enhanced formation of the vasa vasorum was noted in which severe degenerative changes were present. Moreover, the vasospasm index of the vasa vasorum, which increased with the aggravation of vascular degenerative changes, was significantly higher in the SAH group.

Conclusions: The vasa vasorum and their vasospasm play a crucial role in the pathogenesis of basilar artery degeneration in the vasospasm following SAH.
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http://dx.doi.org/10.1016/j.wneu.2019.07.124DOI Listing
November 2019

Predictive Factors for Rathke's Cleft Cyst Consistency.

World Neurosurg 2019 Aug 30;128:e522-e530. Epub 2019 Apr 30.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University -Cerrahpasa, Istanbul, Turkey. Electronic address:

Objective: Rathke's cleft cysts (RCCs) may have various anatomic, clinical, and radiologic characteristics, which may be related to their differences in texture or consistency. The purpose of the study was to investigate RCCs based on consistency.

Methods: We retrospectively reviewed 25 cases of patients with RCCs who underwent endoscopic endonasal transsphenoidal surgery between 2008 and 2018. Cases were divided into 3 types based on cyst consistency: fluid (serous) or type A (n = 4); semi-fluid (mucoid) or type B (n = 17); and non-fluid (caseous) or type C (n = 4). Demographic, clinical, radiologic, and surgical characteristics for each group were analyzed.

Results: All type A RCCs (100%) had visual impairment. The mean age (42.8 ± 13 years) and cyst volume (2442.5 ± 533.6 mm) were higher in these patients. T1-weighted images were hypointense and T2-weighted images were hyperintense on magnetic resonance imaging. Type B RCCs were more frequently encountered (68%). Although headache was the most common (82.3%) symptom, endocrine disorders were also prevalent (52.9%). T1-weighted images were typically isointense or hyperintense on magnetic resonance imaging. Type C RCCs had the youngest patient population (30.3 ± 10.2 years) and T2-weighted images were predominantly hypointense in this group.

Conclusions: The proposed novel consistency classification of RCCs will provide a practical tool for more accurately estimating the nature of the pathology, because each type has its own specific characteristics. Furthermore, the new classification of RCCs may aid in planning a consistency-specific surgery.
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http://dx.doi.org/10.1016/j.wneu.2019.04.188DOI Listing
August 2019

Effects of pycnogenol on ischemia/reperfusion-induced inflammatory and oxidative brain injury in rats.

Neurosci Lett 2019 06 6;704:169-175. Epub 2019 Apr 6.

Department of Pharmacology, Erzincan Binali Yildirim University School of Medicine, Erzincan, Turkey. Electronic address:

Background: Ischemia/reperfusion (I/R) injury results from the onset of re-circulation following a perfusion deterioration period in the tissues, resulting in more damage than that caused by perfusion deterioration. This study aimed to determine the effects of pycnogenol on I/R injury in rat brain tissues.

Methods: Eighteen albino Wistar rats were divided into three groups: I/R injury (IR, n = 6) group; I/R injury + pycnogenol (IR + P, n = 6) group; and sham group (SG, n = 6). After 30 min of transient ischemia, 24 h of reperfusion was achieved in the IR and IR + P groups. Surgical dissection, except for transient ischemia, was performed in SG. Next, histopathological and biochemical investigations were performed on brain tissues. Malondialdehyde (MDA), reduced glutathione (GSH), and glutathione peroxidase (GPO) were analyzed as oxidative stress markers; IL-1β and TNF-α were analyzed as inflammatory stress markers in biochemical tests.

Results: Histopathological examination revealed normal morphology in SG and diffuse cortex damage with edema, vasopathology, and inflammatory cell infiltration in the IR group. The IR + P group showed less cortex damage, edema, and vasopathology than the IR group. The MDA, IL-1β, and TNF-α levels were significantly higher in the IR group than those in the SG group. The values of same markers for the IR + P group were significantly lower than the IR group. The GSH and GPO levels were significantly decreased with IR damage, but PYC treatment showed significant improvement in the levels.

Conclusion: This study showed that the administration of pycnogenol ameliorated brain damage after I/R injury by reducing oxidative and inflammatory damage in the rat brain.
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http://dx.doi.org/10.1016/j.neulet.2019.04.010DOI Listing
June 2019

A New Neuropathologic Mechanism of Blood pH Irregularities After Neck Trauma: Importance of Carotid Body-Glossopharyngeal Nerve Network Degeneration.

World Neurosurg 2019 05 11;125:e972-e977. Epub 2019 Feb 11.

Department of Biochemistry, Erzurum Research-Training Hospital, Erzurum, Turkey.

Objective: We created a neck trauma model by injecting blood into the sheath of rabbits' carotid bodies (CBs). Then we determined the relationship between neuronal degeneration of the CB due to hemorrhage of this organ and its clinical effects such as blood pH and heart rhythm.

Methods: The present study included 24 adult male New Zealand rabbits. The animals were divided into 3 groups: control (n = 5); sham (0.5 mL saline injected into CBs; n = 5); and study (CB trauma model; n = 14). pH values and heart rhythms were recorded before the experiment to determine the values under normal conditions, and measurements were repeated thrice in the days following the experiment. The number of normal and degenerated neuron density of CBs was counted. The relationship between the blood pH values, heart rhythms, and degenerated neuron densities was analyzed.

Results: Heart rhythms were 218 ± 20 in the control group, 197 ± 16 in the sham group (P = 0.09), and 167 ± 13 in the study group (P < 0.0005). pH values were 7.40 ± 0.041 in the control group, 7.321 ± 0.062 in the sham group (P = 0.203), and 7.23 ± 0.02 in study group (P < 0.0005). Degenerated neuron densities were 12 ± 4/mm in the control group, 430 ± 74/mm in the sham group (P < 0.005), and 7434 ± 810/mm in the study group (P < 0.0001).

Conclusions: A high degenerate neuron density in the CB can decrease blood pH and hearth rhythm after neck trauma, and there might be a close relationship between the number of degenerated neurons and clinical findings (such as heart rhythm and blood pH). This relationship suggests that injury to the glossopharyngeal nerve-CB network can cause acidosis by disturbing the breathing-circulating reflex and results in respiratory acidosis.
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http://dx.doi.org/10.1016/j.wneu.2019.01.218DOI Listing
May 2019

Solitary Extramedullary Plasmacytoma Mimicking Acute Subdural Hematoma.

World Neurosurg 2018 Dec 27;120:521-524. Epub 2018 Sep 27.

Department of Neurosurgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Background: Solitary extramedullary plasmacytoma (SEP) is a plasma cell neoplasm located outside the bone. It is rarely observed in the intracranial area. It is very difficult to diagnose this condition radiologically before surgery. In addition, dural SEP is usually misdiagnosed.

Case Description: We report a case of plasmacytoma that presented as altered mental status after head trauma, located in the subdural area. We also describe its differential diagnosis and treatment by total removal and adjuvant radiotherapy. The 66-month follow-up findings showed distant plasmacytoma development, which was treated with radiotherapy alone.

Conclusions: Some pathological entities should be considered in the differential diagnosis of acute subdural hematomas. Furthermore, to the best of our knowledge, we report the first case of dural SEP mimicking acute subdural hematoma.
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http://dx.doi.org/10.1016/j.wneu.2018.09.151DOI Listing
December 2018

Surgical Management of Sphenoid Sinus Lateral Recess Cerebrospinal Fluid Leaks: A Single Neurosurgical Center Analysis of Endoscopic Endonasal Minimal Transpterygoid Approach.

World Neurosurg 2018 Oct 6;118:e473-e482. Epub 2018 Jul 6.

Department of Neurosurgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. Electronic address:

Objective: To review the results of sphenoid sinus lateral recess (SSLR) cerebrospinal fluid (CSF) leaks treated with the endoscopic endonasal minimal transpterygoid approach (EEMTPA) and to discuss the surgical technique and outcomes.

Methods: We performed a retrospective analysis of 13 cases who underwent SSLR CSF leak repair through the EEMTPA in our clinic between September 2008 and December 2017. Demographic and etiological features with reconstruction and surgical outcomes were examined. Mean follow-up time was 6.1 years.

Results: In regard to etiology, the SSLR CSF leaks included 9 patients with spontaneous, 2 patients with traumatic, and 2 with iatrogenic causes. CSF leak was at the left lateral recess in 8 cases and at right lateral recess in 5 cases. Nine patients had empty sella syndrome, and 11 patients had meningoencephaloceles in addition to SSLR CSF leaks. All patients underwent surgery through the EEMTPA, and a multilayer closure with tissue overlay grafts were used for reconstruction. A pedicled nasoseptal flap and/or pedicled middle turbinate flap were applied to the area of the leak in all cases. One patient had a persistent CSF leak and another had recurrence, both of which required revision surgery. Our overall success rate was 100%.

Conclusions: EEMTPA is a safe and effective method that can be used to treat challenging pathologies at the SSLR, including CSF leaks accompanying meningoencephaloceles. Furthermore, the success rate of EEMTPA for SSLR CSF leaks can be increased by applying endoscopic skull base reconstruction techniques such as the pedicled nasoseptal flap and pedicled middle turbinate flap.
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http://dx.doi.org/10.1016/j.wneu.2018.06.219DOI Listing
October 2018

Chronic subdural hematoma associated with arachnoid cyst of the middle fossa : Surgical treatment and mid-term results in fifteen patients.

Turk Neurosurg 2017 Oct 18. Epub 2017 Oct 18.

University of Health Sciences, Hamidiye Sisli Etfal SUAM, Department of Neurosurgery, Istanbul, Turkey.

Aim: We report the neurological and radiological features, surgical management and Mid-term outcome in a series of patients with chronic subdural hematoma (CSDH) and associated ipsilateral arachnoid cyst (AC) of the middle fossa.

Material And Methods: Between August 2004 and August 2012, 453 patients were treated with diagnosis of CSDH in our clinic. Of those, 15 patients had ipsilateral arachnoid cyst in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma and the AC left intact at first in 14 patients, one patient had no surgical intervention. Follow-up period ranged from 13 months to 88 months (mean 43.07 ± 23.23 months).

Results: The patients having CSDH with AC were found to be younger than the patients with CSDH alone, the mean age was 13.93 ±12.37 years Eleven patients had head trauma 21 to 50 days before admission. Hematoma evacuation through a single burr hole and closed system subdural drainage 2 to 4 days after surgery improved the symptoms in all patients. Two patients developed subdural fluid collection which is treated by subduroperitoneal shunt placement.

Conclusion: Greater prevalence of ACs in patients with CSDHs has been reported in the literature. We recommend the drainage of the hematoma via a single craniostomy and to leave the AC intact as the first choice of treatment if the associated AC is a Galassi type I or II. Additional subduroperitoneal shunting may be performed in patients with Galassi type III cyst.
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http://dx.doi.org/10.5137/1019-5149.JTN.21513-17.3DOI Listing
October 2017

Computerized Tomography-Guided Stereotactic Biopsy of Intracranial Lesions: Report of 500 Consecutive Cases.

Turk Neurosurg 2017 ;27(3):395-400

Sisli Hamidiye Etfal Research and Training Hospital, Clinic of Neurosurgery, Istanbul, Turkey.

Aim: Computed tomography (CT)-guided stereotactic brain biopsy has been performed in our clinic since March 1998. In this prospective study, we examined the patient data undergoing stereotactic biopsy and the results of biopsies in 500 consecutive patients.

Material And Methods: Between the dates of March 1998 and January 2015, CT-guided stereotactic biopsies were performed by using the Leksell stereotactic frame system (Elekta Instruments EU, Sweden) in 500 patients. A total of 512 procedures were performed in patients consisting of 184 females (36.8%) and 316 males (63.2%), ages ranging from 3 to 81 years (mean 50.40±16.67).

Results: Conclusive histopathological diagnosis was not achieved in 17(3.3%) of 512 procedures. Of the others, 173 (33.8%) were high-grade gliomas, 103 (20.1%) were low-grade gliomas, 36 (7%) were malignant lymphomas, 34 (6.6%) were other types of brain tumors, 82 (16%) were metastasis and 67 (13.1%) were non-tumoral lesions. Complications were occurred in ten cases: 3 tumoral bleedings, 2 hypertensive cerebral hematomas, 2 peroperative convulsions, 1 epidural hematoma, 1 myocardial infarction and 1 brain edema. The patients who developed myocardial infarction and hypertensive thalamic hematoma died. The mortality was 0.4% and morbidity was 1.6% in 512 procedures.

Conclusion: CT-guided stereotactic biopsy is a reliable and a safe procedure in cases with intracranial lesions when histopathological diagnosis is required for the appropriate treatment.
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http://dx.doi.org/10.5137/1019-5149.JTN.16280-15.1DOI Listing
December 2017