Publications by authors named "Hadi Sasani"

18 Publications

  • Page 1 of 1

Quantitative evaluation of computed tomography findings in patients with pulmonary embolism: the link between D-Dimer level and thrombus volume.

Rev Assoc Med Bras (1992) 2021 Feb;67(2):218-223

Tekirdag Namik Kemal University, Faculty of Medicine, Department of Chest Diseases - Tekirdag, Turkey.

Objective: To investigate the correlation of D-dimer levels and computed tomography properties of pulmonary embolism.

Methods: A total of 58 treated patients with diagnosis of properties of pulmonary embolism were retrospectively studied. All patients underwent a D-dimer blood test. In computed tomography images, septal angle, interventricular septal thickness, and the diameters of all cardiac chambers and pulmonary arteries were measured. The thrombus volume (load) and density at all pulmonary arteries (main, right, left pulmonary arteries, and segmental arteries) were calculated.

Results: A significant correlation was found between D-dimer and total thrombus volume (p=0.009, r=0.342). Total thrombus volume and total thrombus density were calculated with mean value of 23.40±60.63 ml and 66.16±38.48 hounsfield unit (HU), respectively. Right ventricle/left ventricle ratio showed positive correlation with the D-dimer level (p=0.02).

Conclusion: Increased D-dimer levels with RV/LV ratio and their correlation with total thrombus volume suggest that it may be a prognostic factor.
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http://dx.doi.org/10.1590/1806-9282.67.02.20200539DOI Listing
February 2021

Evaluation of epicardial adipose tissue and carotid intima-media thickness as a marker of atherosclerosis in patients with inflammatory bowel disease.

Rev Esp Enferm Dig 2021 Sep;113(9):643-648

Radiology, Faculty of Medicine. Tekirdağ Namik Kemal University, Turkey.

Background And Aim: this study aimed to compare carotid intima media (CIMT) and epicardial adipose tissue (EAT) measurements, which are considered as markers for the detection of early atherosclerosis in healthy controls and inflammatory bowel disease (IBD) cases.

Methods: a total of 60 IBD patients (25 Crohn's disease and 35 ulcerative colitis) and 60 healthy patients (as a control group) were included in the study. The measurements of CIMT and EAT were performed using echocardiography and ultrasonography, respectively. Statistical analysis was used to determine the relationship between the parameters.

Results: the thickness of bilateral (right and left) CIMT and EAT were significantly higher in IBD than in the control group (p < 0.05). There was a positive correlation between EAT and bilateral (right and left) CIMT in IBD patients (p < 0.05).

Conclusion: IBD is associated with an increased thickness of EAT and CIMT. Chronic inflammation in IBD may increase the risk of atherosclerotic heart disease. Thus, only measuring the thickness of EAT and CIMT can be used as an objective, easy, simple, affordable, non-invasive and accessible assessment method in order to screen for this risk.
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http://dx.doi.org/10.17235/reed.2020.7394/2020DOI Listing
September 2021

Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure.

J Orthop Surg (Hong Kong) 2020 Sep-Dec;28(3):2309499020964602

Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey.

Purpose: In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures.

Methods: Computed tomography images of 120 patients (mean age: 41.18 ± 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques.

Results: There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results ( > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size ( > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness ( < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders ( < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders.

Conclusion: Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques.
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http://dx.doi.org/10.1177/2309499020964602DOI Listing
July 2021

Relationship between pruritus and autotaxin in intrahepatic cholestasis of pregnancy.

Gastroenterol Hepatol 2021 Feb 1;44(2):96-102. Epub 2020 Oct 1.

Tekirdag Namık Kemal University, Faculty of Medicine, Department of Radiology, Tekirdag, Turkey.

Objective: Intrahepatic cholestasis of pregnancy is a temporary, pregnancy-specific disease that resolves with delivery, characterized by itching (pruritus), as well as high transaminase and serum bile acid levels in the third trimester of pregnancy. Due to the effects of Autotaxin on the physiology of pregnancy, we aimed to investigate Autotaxin activity in patients with intrahepatic cholestasis of pregnancy.

Patients And Methods: Sixty-nine patients diagnosed with intrahepatic cholestasis of pregnancy and 20 healthy pregnant women were enrolled in the study. Fasting serum bile acid, pruritus intensity, serum parameters, gestational week of the patients at the time of diagnosis were recorded, and birth week and birth weight were monitored. Autotaxin serum level was measured enzymatically.

Results: The mean serum bile acid level (n=69; 38.74±35.92μmol/L) in patients with intrahepatic cholestasis of pregnancy (n=69) was detected to be higher than healthy pregnant women (n=20; 5.05±1.88μmol/L) (p<0.001). Weak correlation was detected between serum bile acid level and itch intensity (p=0.014, r=0.295), while no relation was detected between Autotaxin and itch intensity (p=0.446, r=0.09). Although mean Autotaxin (intrahepatic cholestasis of pregnancy: 678.10±424.42pg/mL, control: 535.16±256.47pg/mL) levels were high in patients with intrahepatic cholestasis of pregnancy, it was not statistically significant (p=0.157).

Conclusion: In our study, we observed that the serum Autotaxin level did not make a significant difference in patients with intrahepatic cholestasis of pregnancy compared to healthy pregnant women. These findings suggest that larger clinical studies are required to reveal the physio-pathological effects of Autotaxin on pregnancy.
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http://dx.doi.org/10.1016/j.gastrohep.2020.08.001DOI Listing
February 2021

The Results of Abdominopelvic Computed Tomography Interpreted via Remote Access for the Diagnosis of Acute Appendicitis.

Cureus 2020 Aug 16;12(8):e9773. Epub 2020 Aug 16.

Gastroenterology, Gazi University Faculty of Medicine, Ankara, TUR.

Introduction: Abdominal computed tomography (CT) is one of the imaging modalities for the diagnosis of acute appendicitis (AA). Today, CT scans can be interpreted via remote access called tele-radiology, besides conventional methods. The objective of this study was to evaluate the CT interpreted via tele-radiology for diagnosing AA.

Methods: In this retrospective study, a total of 679 patients, who were interpreted via tele-radiology of CT due to suspicion of AA, were evaluated. Age, gender, CT findings, pathology results and intra-operative diagnosis of those with normal CT results were analysed. A sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of CT in the diagnosis of AA were calculated.

Results: 520 patients who were operated with pre-diagnosed AA were found. Of those, 441 patients (84.8%) were diagnosed with AA according to CT reports, out of which 368 (83.4%) were positive (true-positive) and 73 (16.6%) were negative (false-positive) in terms of pathology results. In the remaining operated 79 patients with normal CT results, 58 (73.4%) were positive for AA and 21 (26.6%) (negative laparotomy) were negative for AA in terms of pathological examination. The sensitivity, specificity, accuracy, PPV and NPV of CT in the diagnosis of AA were determined as 81.2%, 67.7%, 76.7%, 83.4% and 64.2%, respectively.

Conclusion: The sensitivity and PPV rates were found similar in both conventional and tele-radiological methods. However, specificity, accuracy and NPV rates were determined lower than in literature. Additionally, the negative laparotomy rate was higher than the conventional method.
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http://dx.doi.org/10.7759/cureus.9773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491699PMC
August 2020

Comparison of Two Minimally Invasive Techniques with Endoscopy and Microscopy for Extraforaminal Disc Herniations.

World Neurosurg 2020 12 8;144:e612-e621. Epub 2020 Sep 8.

Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey; Department of Neurosurgery, American Hospital, Istanbul, Turkey.

Objective: Extraforaminal disc herniations are extraordinary herniations because they are located outside the foraminal bony borders and compress the root exiting at the corresponding level, whereas in median or paramedian herniations, the root 1 level below is compressed. Percutaneous endoscopic discectomy (PED) and microscopic extraforaminal discectomy (MEFD) are 2 popular contemporary techniques that have been performed extensively for these herniations since the 1970s.

Methods: In this study, we retrospectively analyzed 118 patients who underwent either PED (66 patients) or MEFD (52 patients). All the patients were clinically evaluated for neurologic examination findings, visual analog scale (VAS) scores for leg pain and Oswestry Disability Index (ODI) preoperatively and on the seventh postoperative day as well as 6 and 12 months after surgery. The complication rates and types of both techniques were discussed.

Results: The preoperative VAS score and ODI were all comparable. Improvements in VAS scores 6 months postoperatively and improvements in ODI at all follow-up periods were statistically significant in favor of PED. However, there was great discrepancy regarding the postsurgical complications in favor of MEFD.

Conclusions: PED is more prone to complications because this technique is strictly dependent on the tubular system and the ideal anatomy of the Kambin triangle. Variations in or degeneration of the Kambin triangle can lead to devastating complications in the PED technique, but normal anatomic conditions are feasible in only approximately 20% of patients. The most important feature of this study was that both techniques were performed by the same experienced team, who developed their own concept.
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http://dx.doi.org/10.1016/j.wneu.2020.09.022DOI Listing
December 2020

The role of multislice computerized tomography angiography in assessing postoperative vascular complications in liver transplant patients

Turk J Med Sci 2019 Aug 8;49(4):1212-1220. Epub 2019 Aug 8.

Department of Radiology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey

Background/aim: Vascular complications can be detected in liver transplant patients. Digital subtraction angiography has served as the gold standard to make this diagnosis; however, due to its invasive nature, ultrasonography is used for the preliminary evaluation. The purpose of this study was to evaluate the role of multislice computerized tomography angiography (MSCTA) in the detection of vascular complications of symptomatic and asymptomatic liver transplant patients and to compare the results with Doppler ultrasound (Doppler US) findings.

Materials And Methods: Fifty-three liver transplant patients (6 symptomatic, 47 asymptomatic) underwent Doppler US examination followed by an MSCTA. The findings in each modality were interpreted in a blinded fashion and then compared.

Results: MSCTA detected 15 abnormalities, none of which were detected by Doppler US. There were hepatic and splenic artery aneu-rysms (n = 4) and various stenoses (n = 4), infrarenal aortic anastomosis (n = 4), vena cava inferior thrombosis (n = 1), arteriovenous malformation (n = 1), and esophageal varices (n = 1).

Conclusion: MSCTA detected more lesions and we believe that it should be considered as a road map for Doppler US follow-ups as well as a routine screening modality for early detection of vascular complications in symptomatic and asymptomatic liver transplantation patients that may be missed by Doppler US.
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http://dx.doi.org/10.3906/sag-1902-145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018385PMC
August 2019

The role of multislice computerized tomography angiography in assessing postoperative vascular complications in liver transplant patients

Turk J Med Sci 2019 Aug 6;49(4). Epub 2019 Aug 6.

Background/aim: Vascular complications can be detected in liver transplant patients. Digital subtraction angiography has served as the gold standard to make this diagnosis; however, due to its invasive nature, ultrasonography is used for the preliminary evaluation. The purpose of this study was to evaluate the role of multislice computerized tomography angiography (MSCTA) in the detection of vascular complications of symptomatic and asymptomatic liver transplant patients and to compare the results with Doppler ultrasound (Doppler US) findings.

Materials And Methods: Fifty-three liver transplant patients (6 symptomatic, 47 asymptomatic) underwent Doppler US examination followed by an MSCTA. The findings in each modality were interpreted in a blinded fashion and then compared.

Results: MSCTA detected 15 abnormalities, none of which were detected by Doppler US. There were hepatic and splenic artery aneurysms (n = 4) and various stenoses (n = 4), infrarenal aortic anastomosis (n = 4), vena cava inferior thrombosis (n = 1), arteriovenous malformation (n = 1), and esophageal varices (n = 1).

Conclusion: MSCTA detected more lesions and we believe that it should be considered as a road map for Doppler US follow-ups as well as a routine screening modality for early detection of vascular complications in symptomatic and asymptomatic liver transplantation patients that may be missed by Doppler US.
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August 2019

Diagnostic Importance of Axial Loaded Magnetic Resonance Imaging in Patients with Suspected Lumbar Spinal Canal Stenosis.

World Neurosurg 2019 Jul 9;127:e69-e75. Epub 2019 Mar 9.

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

Objective And Background: To study the efficacy of lumbar (AL) magnetic resonance imaging (MRI) in patients with suspected lumbar spinal stenosis (LSS), with and without AL compression. Supine MRI is used in the assessment of patients with LSS. However, MRI findings may poorly correlate with neurologic findings because of the morphologic changes of the lumbar spinal canal between upright standing and supine positions. In patients without significant stenosis in routine lumbar MRI, by applying AL, MRI can show significant LSS.

Methods: This study included 103 consecutive patients (188 disc levels) who presented with neurogenic claudication with and without low back pain. AL was performed using a nonmagnetic compression device for 5 minutes. T1- and T2-weighted axial and sagittal sequences were obtained during AL applied to the spine. The dural sac cross-sectional area (DSCA) appeared to be narrow at each disc level of L4-5 to L5-S1 in all patients and was measured using T2-weighted images in routine supine and AL images.

Results: The groups included patients with a reduction in the DSCA (>15 mm) according to patient age and DSCA in routine spine MRI. The mean DSCA of the disc levels without and with AL were 138 mm and 123 mm, with a mean difference of 15 mm at L4-5, 134 mm and 125 mm and a mean difference of 9 mm at L5-S1, respectively.

Conclusions: The use of AL MRI in patients with clinically suspected LSS could reduce the risk of misdiagnosis of stenosis, leading to inappropriate treatment.
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http://dx.doi.org/10.1016/j.wneu.2019.02.091DOI Listing
July 2019

Investigation of Brain Impairment Using Diffusion-Weighted and Diffusion Tensor Magnetic Resonance Imaging in Experienced Healthy Divers.

Med Sci Monit 2018 Nov 17;24:8279-8289. Epub 2018 Nov 17.

Department of Radiology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.

BACKGROUND The aim of this study was to understand the changes of decompression illness in healthy divers by comparing diffusion-weighted (DWI) and diffusion tensor MRI findings among healthy professional divers and healthy non-divers with no history of diving. MATERIAL AND METHODS A total of 26 people were recruited in this prospective study: 11 experienced divers with no history of neurological decompression disease (cohort) and 15 healthy non-divers (control). In all study subjects, we evaluated apparent diffusion coefficient (ADC) and type of diffusion tensor metric fractional anisotropy (FA) values of different brain locations (e.g., frontal and parieto-occipital white matter, hippocampus, globus pallidus, putamen, internal capsule, thalamus, cerebral peduncle, pons, cerebellum, and corpus callosum). RESULTS ADC values of hippocampus were high in divers but low in the control group; FA values of globus pallidus and putamen were lower in divers compared to the control group. DWI depicted possible changes due to hypoxia in different regions of the brain. Statistically significant differences in ADC values were found in hypoxia, particularly in the hippocampus (p=0.0002), while FA values in the globus pallidus and putamen were statistically significant (p=0.015 and p=0.031, respectively). We detected forgetfulness in 6 divers and deterioration in fine-motor skills in 2 divers (p=0.002 and p=0.17, respectively). All of them were examined using neuro-psychometric tests. CONCLUSIONS Repeated hyperbaric exposure increases the risk of white matter damage in experienced healthy divers without neurological decompression illness. The hippocampus, globus pallidus, and putamen are the brain areas responsible for memory, learning, navigation, and fine-motor skills and are sensitive to repeated hyperbaric exposure.
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http://dx.doi.org/10.12659/MSM.911475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252049PMC
November 2018

A Case of Anomalous Origin and Course of Vertebral Artery in a Patient with Klippel Feil Syndrome.

Korean J Radiol 2016 Jul-Aug;17(4):554-7. Epub 2016 Jun 27.

Department of Anatomy, Trakya University, Faculty of Medicine, Edirne 22030, Turkey.

Patients with Klippel-Feil syndrome (KFS) have an increased incidence of vascular anomalies as well as vertebral artery (VA) anomalies. In this article, we presented imaging findings of a 15-year-old female patient with KFS with a rare association of extraforaminal cranially ascending right VA that originated from the ipsilateral carotid bulb. Trifurcation of the carotid bulb with VA is a very unusual variation and to the best of our knowledge, right-sided one has not been reported in the literature.
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http://dx.doi.org/10.3348/kjr.2016.17.4.554DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936178PMC
August 2017

Leptin as an important link between obesity and cardiovascular risk factors in men with acute myocardial infarction.

Indian Heart J 2016 Mar-Apr;68(2):132-7. Epub 2016 Jan 14.

Medical Doctor, Okmeydani Training and Research Hospital, Clinical Biochemistry Laboratory, Istanbul, Turkey.

Objective: The levels of leptin, a major regulator of lipid metabolism, may increase in obesity, and contribute to the development of metabolic syndrome. Leptin is produced by adipose tissue and is a peptide hormone, which has strong association with obesity, elevated cardiovascular risk, and morbidity. The present study was designed to evaluate the relationships between leptin levels, obesity, and cardiovascular risk factors in men with acute myocardial infarction.

Methods And Results: Twenty-four obese and twenty-three nonobese male patients, who had experienced their first myocardial infarction, were included in the study. Their leptin levels, biochemical parameters, and anthropometric measures were obtained. Mean leptin levels were significantly higher in the obese group compared to the nonobese group (2.53ng/mL versus 1.23ng/mL; p<0.01). Leptin levels correlated positively with anthropometric measurements, triglyceride, fasting glucose, C-reactive protein, and uric acid levels, and negatively with high-density lipoprotein cholesterol levels.

Conclusion: Findings indicate high leptin levels to be positively correlated with obesity and diastolic blood pressure in male patients with myocardial infarction.
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http://dx.doi.org/10.1016/j.ihj.2015.07.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867951PMC
May 2017

Differentiation of true anophthalmia from clinical anophthalmia using neuroradiological imaging.

World J Radiol 2014 Jul;6(7):515-8

Ali Riza Cenk Celebi, Ophthalmology Clinic, Republic of Turkey Ministry of Health, Nigde State Hospital, Nigde 51000, Turkey.

Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit. It is associated with many known syndromes. Clinical findings, as well as imaging modalities and genetic analysis, are important in making the diagnosis. Imaging modalities are crucial scanning methods. Cryptophthalmos, cyclopia, synophthalmia and congenital cystic eye should be considered in differential diagnoses. We report two clinical anophthalmic siblings, emphasizing the importance of neuroradiological and orbital imaging findings in distinguishing true congenital anophthalmia from clinical anophthalmia.
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http://dx.doi.org/10.4329/wjr.v6.i7.515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4109105PMC
July 2014

Idiopathic spinal cord herniation at two separate zones of the thoracic spine: the first reported case and literature review.

Spine J 2011 Aug 8;11(8):e9-e14. Epub 2011 Sep 8.

Neurosurgery Department, Istanbul Physical Therapy and Rehabilitation Training Hospital, Istanbul, Turkey.

Background Context: Idiopathic spinal cord herniation (ISCH) is a rare cause of progressive myelopathy. Preoperative diagnosis can be made with magnetic resonance imaging (MRI). Many surgical techniques have been applied by various authors, and ISCH is usually reversible by surgical treatment.

Purpose: To present a case of ISCH in two separate zones at two thoracic levels. To our knowledge, this is the first such case to be published in English literature. We also discuss the clinical findings, surgical procedures, and surgical outcomes for other previously reported cases of ISCH in the literature.

Study Design: Case report.

Methods: A 52-year-old woman with bilateral lower extremity weakness underwent thoracic MRI, which revealed transdural spinal cord herniation at two separate zones, namely, the T4-T5 and T5-T6 intervertebral disc levels.

Results: During surgery, the spinal cord was reduced, the two separate dural defects were connected, and the new single defect was restored then reinforced with a thin layer of fascial graft. The posterior dural defect was then closed with interrupted stitches. The patient's neurologic status was characterized by no changing of the preoperative motor status. Follow-up MRI scans showed that the cord was replaced in the dural sac and showed cord hyperintensity in the herniation levels. The patient could move with a cane at the sixth month postoperatively.

Conclusions: Idiopathic spinal cord herniation is a rare clinical condition that should be considered in the differential diagnosis of paraplegia. Although progression of neurologic deficits can be very slow, reduction of the spinal cord and repair of the defect are crucial to stop or reverse the deterioration. The outcome for patients who initially have Brown-Séquard syndrome is significantly better than for patients who presented with spastic paralysis. To our knowledge, this case study represents the first reported instance in which two separate anterior dural defects caused two levels of anterior spinal cord herniation.
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http://dx.doi.org/10.1016/j.spinee.2011.07.003DOI Listing
August 2011

Primary central nervous system lymphoma presenting as a pure third ventricular lesion: a case report.

J Med Case Rep 2011 May 28;5:213. Epub 2011 May 28.

American Hospital Neurosurgery Department, Nisantasi, Istanbul, Turkey.

Introduction: Primary central nervous system lymphomas are infrequently occurring lymphomas that account for only 0.3-1.5% of all intra-cranial neoplasms in patients without acquired immune deficiency syndrome. However, a pure third ventricle lymphoma is extremely rare. Here, we discuss the similar radiological appearances of lesions localized in the third ventricle and the importance of accurately diagnosing primary central nervous system lymphomas for favorable treatment outcomes.

Case Presentation: A 38-year-old Caucasian man from Turkey presented with a severe headache lasting for three months that failed to respond to any medication. Both severity and duration of the symptoms increased gradually, resulting in vomiting, nausea and gait disturbance that accompanied the headache for three weeks. Neuro-imaging studies showed a lesion located solely in the third ventricle, resulting in partial obstruction of the foramen of Monro. The pre-operative diagnosis was a colloid cyst. Following the surgical procedure, the results of pathological and immunochemical assays revealed that the pre-operative diagnosis was incorrect and that the lesion was a primary central system lymphoma.

Conclusion: Pure third ventricle lymphomas are extremely rare and are exceptionally localized. It is important to be aware of, and to differentiate between, other possible third ventricular lesions that may mimic the same radiological appearance. Accurate diagnosis is necessary for selecting appropriate treatment modalities.
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http://dx.doi.org/10.1186/1752-1947-5-213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121681PMC
May 2011

Bilateral late remote cerebellar hemorrhage as a complication of a lumbo-peritoneal shunt applied after spinal arteriovenous malformation surgery.

J Spinal Cord Med 2010 ;33(1):77-9

Neurosurgery Department, VKF: American Hospital, Istanbul, Turkey.

Background/objective: Cerebellar hemorrhage is a very infrequent and unpredictable complication of spinal surgery. To the best of our knowledge, cerebellar hemorrhage resulting from the insertion of a lumbo-peritoneal shunt through which cerebrospinal fluid (CSF) is slowly drained has not been documented to date.

Methods: Case report.

Results: A 47-year-old woman presented with lower extremity weakness. Spinal arteriovenous malformation was diagnosed, and she underwent surgery. Her neurologic status improved; however, CSF collected subcutaneously as a cyst and leaked 21 days after surgery. The patient underwent urgent surgery during which the dural defect was repaired and a lumbo-peritoneal catheter was put in place to treat the CSF leakage. The lumbo-peritoneal drainage system was removed when bilateral cerebellar hemorrhage was seen 12 days later. Physical therapy was stopped, and conservative treatment was initiated consisting of bed rest, analgesics, sedatives, and careful monitoring of blood pressure. The patient's headache gradually resolved; physical therapy was restarted to rehabilitate this patient with paraparesis.

Conclusions: Remote cerebellar hemorrhage seems to be life threatening and entails significant morbidity. Cerebellar symptoms, and even a late sudden headache after spinal surgery, may be signs of remote cerebellar hemorrhage, which is a rare complication.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853334PMC
http://dx.doi.org/10.1080/10790268.2010.11689678DOI Listing
May 2010

Remote cerebellar hemorrhage following resection of a supratentorial tumor: a case report.

Cases J 2009 Jun 12;2:7299. Epub 2009 Jun 12.

Neurosurgery Department, American Hospital, Guzelbahce Sk. No: 20, 34365 Nisantasi - Istanbul, Turkey.

Remote cerebellar hemorrhage after supratentorial surgery is rare, ranging between 0.08% and 0.29% in adults and children. However, it is extremely rare in children. This phenomenon underlying mechanisms remain obscure. A 14-year-old male child patient had a history of right focal seizures and underwent craniotomy for a left frontal mass (Dysembryoplastic Neuroepithelial Tumor). First hours post recovery period, the patient was somnolent and had right hemiparesis. Postoperative Computer Tomography and magnetic resonance imaging findings revealed that the patient had developed remote cerebellar hemorrhage. He was treated conservatively, and was free of neurological deficits.Although dehydration and the displacement of the cerebellum are associated with this phenomenon after supratentorial surgery, the identification of the exact etiological factors remains elusive. It is advisable for case givers to be aware of the high potential risk of morbidity and mortality of this entity. Preoperative attention to prevent cerebrospinal fluid overflow leakage and exaggerated dehydration of the patient may prevent remote cerebellar hemorrhages.
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http://dx.doi.org/10.4076/1757-1626-2-7299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740260PMC
June 2009

A large choroid plexus cyst diagnosed with magnetic resonance imaging in utero: a case report.

Cases J 2009 Jul 10;2:7098. Epub 2009 Jul 10.

Neurosurgery Department, American Hospital, Guzelbahce Sk. No: 20, 34365 Nisantasi – Istanbul, Turkey.

The incidence of choroid plexus cysts represents approximately 1% of fetal anomalies. We describe a case in which fetal ultrasonography and fetal magnetic resonance scans were used to identify a large choroid cyst in a fetus without the use of a diagnostic amniocentesis to detect aneuploidy. After birth, the child underwent surgery. In conclusion, the nature of prenatal intracranial cysts should be fully evaluated and differentiated between choroid plexus cysts and other types of cysts. We believe that a detailed evaluation of detected cysts and other structural brain abnormalities are essential. Prenatal magnetic resonance scans clearly can decrease the need for risky procedures, such as an amniocentesis, in the evaluation of antenatal choroid plexus cysts.
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http://dx.doi.org/10.4076/1757-1626-2-7098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740256PMC
July 2009
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