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    Hereditary neuropathy with liability to pressure palsies in a Turkish patient (HNPP)
    (Turkish Neurosurgical Soc, 2008) Celik, Yahya; Kilincer, Cumhur; Hamamcioglu, M. Kemal; Balci, Kemal; Birgili, Baris; Cobanoglu, Sebahattin; Utku, Ufuk
    Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant nerve disease usually caused by 1,5 Mb deletion on chromosome 17p11.2.2-p12, the region where the PMP-22 gene is located. The patients with HNPP usually have relapsing and remitting entrapment neuropathies due to compression. We present a 14-year-old male who had acute onset, right-sided ulnar nerve entrapment at the elbow. He had electrophysiological findings of bilateral ulnar nerve entrapments (more severe at the right side) at the elbow and bilateral median nerve entrapment at the wrist. Genetic tests of the patient demonstrated deletions in the 17p11.2 region. The patient underwent decompressive surgery for ulnar nerve entrapment at the elbow and completely recovered two months after the event. Although HNPP is extremely rare, it should be taken into consideration in young adults with entrapment neuropathies.
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    Infection in patients with isolated head injury: risk factors and the impact on treatment cost
    (Turkish Assoc Trauma Emergency Surgery, 2012) Arslan, Alp; Birgili, Baris; Akinci, Ahmet Tolgay; Simsek, Osman; Kilincer, Cumhur
    BACKGROUND We aimed to determine risk factors and the impact on treatment cost of infection in patients with isolated head injury. METHODS Data acquired from 299 patients (239 males, 60 females; mean age 35,1 +/- 23,2 years) with isolated head trauma who were hospitalized for more than 72 hours at Trakya University Training and Research Hospital between 2001-2007 Were evaluated retrospectively. Data including age, gender, initial neurological examination, radiological findings, duration of hospitalization, need for surgery, cost of infection treatment, total cost of care, and outcome scores were determined. Two groups divided according to the development of infection were compared for risk factors and the impact of infection on the cost of treatment. RESULTS In the group of patients with infection, the mean Glasgow Coma Scale score at delivery was lower; anisocoria, light reflex loss, lateralized deficit, skull base fracture, subdural hematoma, and cerebral edema findings were more frequent. A four-times longer hospital stay, 10-times higher total cost and a significantly increased mortality rate were determined in this group. For the patients with light head injury, in the group of patients with infection, the mean age was found to be higher. CONCLUSION For patients with isolated head injury, there are some risk factors for the development of infection that increase the hospitalization duration, total cost of care and mortality rates.
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    Microsurgical training model for residents to approach to the orbit and the optic nerve in fresh cadaveric sheep cranium
    (Wolters Kluwer Medknow Publications, 2014) Altunrende, M. Emre; Hamamcioglu, Mustafa Kemal; Hicdonmez, Tufan; Akcakaya, Mehmet Osman; Birgili, Baris; Cobanoglu, Sebahattin
    Background: Neurosurgery and ophthalmology residents need many years to improve microsurgical skills. Laboratory training models are very important for developing surgical skills before clinical application of microsurgery. A simple simulation model is needed for residents to learn how to handle microsurgical instruments and to perform safe dissection of intracranial or intraorbital nerves, vessels, and other structures. Materials and Methods: The simulation material consists of a one-year-old fresh cadaveric sheep cranium. Two parts (Part 1 and Part 2) were designed to approach structures of the orbit. Part 1 consisted of a 2-step approach to dissect intraorbital structures, and Part 2 consisted of a 3-step approach to dissect the optic nerve intracranially. Results: The model simulates standard microsurgical techniques using a variety of approaches to structures in and around the orbit and the optic nerve. Conclusions: This laboratory training model enables trainees to gain experience with an operating microscope, microsurgical instruments and orbital structures.
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    Postoperative Spinal Epidural Haematoma Causing Cauda Equina Syndrome: Case Report
    (Derman Medical Publ, 2013) Delen, Emre; Birgili, Baris; Akinci, Ahmet Tolgay; Yavuz, Selcuk
    Cauda equina syndrome is a neurological disorder defined by urinary and/or anal sphincter dysfunction, bilateral sciatica and bilateral motor and sensory deficits. Regarding the etiology, lumbar disc disease, spinal stenosis, tumors, haematomas, fractures, infectious diseases and ankylosing spondylitis are pathologies causing this syndrome. Spinal epidural haematomas are common amongst complications after spinal surgery. However the majority of these cases are asymptomatic, thus having little clinical importance. Symptomatic postoperative spinal epidural haematomas is a serious complication, and in order to prevent permanent neurologic deficit it requires urgent surgical intervention. This article aims to present the case of a patient with a spinal epidural haematoma after spinal stenosis surgery, causing cauda equina syndrome.