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Öğe Giant subdural empyema in a child: a case report(Elsevier Science Inc, 2006) Hicdonmez, Tufan; Cakir, Bilge; Hamamcioglu, M. Kemal; Kilincer, Cumhur; Cobanoglu, SebahattinAn unusual case of a giant (8x6x6 cm) frontoparietal SDE of Streptococcus pneumoniae in a 17-month-old child is reported. The initial diagnosis was made with emergency CT. The purulent material was removed via a frontoparietal craniotomy. A series of postoperative MR imaging showed the gradual reduction in size of the lesion, although collapsed capsule, fibrous thickening of meningeal structures and associated displacement of the underlying brain persisted. The child was symptom-free in a follow-up period of 15 months. This case showed that SDE may reach a giant size and thus may mimic an intra-axial lesion; the coronal MR imaging is a more reliable diagnostic tool than the emergency axial CT in giant SDE of upper convexity localization, and the clinical improvement may be more impressive than the radiological changes. (c) 2006 Elsevier Inc. All rights reserved.Öğe Hydrocephalus in Sabuncuoglu's Textbook of Surgery(Springer, 2006) Hicdonmez, Tufan; Ozek, M. Memet[Abstract Not Available]Öğe Indications for Brain Computed Tomography and Hospital Admission in Pediatric Patients with Minor Head Injury: How Much Can We Rely upon Clinical Findings?(Karger, 2009) Guzel, Ahmet; Hicdonmez, Tufan; Temizoz, Osman; Aksu, Burhan; Aylanc, Hakan; Karasalihoglu, SerapObjectives: The aim of this study was to describe the characteristics of patients with a minor head injury (MHI) who were admitted to a pediatric emergency unit and to identify the clinical signs and symptoms that most reliably predict the need for cranial computed tomography (CCT) and hospital admission following MHI. Methods: All patients were retrospectively evaluated according to age, gender, details of injury, presenting symptoms, physical examination findings, radiological investigations ordered and results, length of stay, outcome of the injury and hospitalization rates. Results: The factors affecting indications for computed tomography and hospitalization were retrospectively analyzed in 916 patients - 585 males and 331 females, aged between 1 month and 15 years (mean: 5.01 +/- 3.58 years), with MHI. A multivariate analysis revealed significant correlations between CCT abnormalities and Glasgow Coma Scale scores of 13 or 14, headache, posttraumatic amnesia, blurred vision, cephalohematomas, periorbital ecchymoses, otorrhea and abnormal neurological findings. CCT abnormalities were identified in 67 (19.8%) of the 338 CCT scans. Twenty of the 67 patients (29.9%) with CCT scan abnormality had no clinical signs. Of all cases, 125 (13.6%) were hospitalized, 617 (67.4%) were treated as outpatients, and 174 (19.0%) left the emergency department based on a personal decision. Conclusion: Some clinical risk factors can be used as predictors of abnormalities in CCT scans following MHI, but the absence of such clinical findings does not exclude the possibility of intracranial injuries. Copyright (C) 2009 S. Karger AG, BaselÖğe Intrasacral extradural arachnoid cysts - Three case reports(Japan Neurosurgical Soc, 2008) Hamamcioglu, Mustafa Kemal; Hicdonmez, Tufan; Kilincer, Cumhur; Cobanoglu, SebahattinThree patients presented with rare intrasacral extradural arachnoid cysts manifesting as sensory deficiencies and pain in the lower extremities. Magnetic resonance imaging with various sequences identified the cysts. Two patients underwent surgery via laminectomy of the sacrum for cyst exploration and disconnection of the cyst with the dural theca. Postoperative outcome was favorable in these two patients. Intrasacral extradural arachnoid cyst should be considered in the differential diagnosis of low back pain.Öğe A laboratory training model in fresh cadaveric sheep brain for microneurosurgical dissection of cranial nerves in posterior fossa(Taylor & Francis Ltd, 2008) Hamamcioglu, Mustafa Kemal; Hicdonmez, Tufan; Tiryaki, Mehmet; Cobanoglu, SebahattinA neurosurgical laboratory training model is designed for residents of neurosurgery to handle surgical microscopes and microneurosurgical instruments. The material consists of a one-year-old fresh cadaveric sheep cranium. A four-step approach was designed to simulate microneurosurgical dissection along the posterior fossa cisterns, and to dissect cranial nerves emerging from the brain stem. We conclude that this laboratory training model is useful to allow trainees to gain experience with the general use of an operating microscope, and familiarity with handling cranial nerves.Öğe Microneurosurgical training model in fresh cadaveric cow brain: a laboratory study simulating the approach to the circle of Willis(Elsevier Science Inc, 2006) Hicdonmez, Tufan; Hamamcioglu, M. Kemal; Tiryaki, Mehmet; Cukur, Ziya; Cobanoglu, SebahattinBackgrounds: Residents of neurosurgery need many years to develop microneurosurgical skills, and laboratory training models are essential for developing and refining surgical skills before clinical application of microneurosurgery. A simple simulation model is needed for young residents to learn how to handle microneurosurgical instruments, and to perform safe dissection of intracranial vessels and nerves. Methods: The material consists of a 2-year-old fresh cadaveric cow cranium. A 4-step approach was designed to dissect the internal carotid artery and its proximal branches, the optic nerve, the optic chiasm, and the pituitary stalk. Results: The model simulates standard microneurosurgery using a variety of approaches to vessels and neural structures in and around the circle of Willis of the human brain. Conclusion: The cadaveric cow brain, besides being cost-effective, represents a fairly useful method to accustom residents of neurosurgery, especially junior residents, to dissecting intracranial vessels and nerves, and it simulates intracranial microneurosurgical procedures performed in the human brain. (c) 2006 Elsevier Inc. All rights reserved.Öğe 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, SebahattinBackground: 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.Öğe Neuroprotective effects of N-acetylcysteine on experimental closed head trauma in rats(Springer/Plenum Publishers, 2006) Hicdonmez, Tufan; Kanter, Mehmet; Tiryaki, Mehmet; Parsak, Turgay; Cobanoglu, SebahattinN-acetylcysteine (NAC) is a precursor of glutathione, a potent antioxidant, and a free radical scavenger. The beneficial effect of NAC on nervous system ischemia and ischemia/reperfusion models has been well documented. However, the effect of NAC on nervous system trauma remains less understood. Therefore, we aimed to investigate the therapeutic efficacy of NAC with an experimental closed head trauma model in rats. Thirty-six adult male Sprague-Dawley rats were randomly divided into three groups of 12 rats each: Group I (control), Group II (trauma-alone), and Group III (trauma+NAC treatment). In Groups II and III, a cranial impact was delivered to the skull from a height of 7 cm at a point just in front of the coronal suture and over the right hemisphere. Rats were sacrificed at 2 h (Subgroups I-A, II-A, and III-A) and 12 h (Subgroups I-B, II-B, and III-B) after the onset of injury. Brain tissues were removed for biochemical and histopathological investigation. The closed head trauma significantly increased tissue malondialdehyde (MDA) levels (P < 0.05), and significantly decreased tissue superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities (P < 0.05), but not tissue catalase (CAT) activity, when compared with controls. The administration of a single dose of NAC (150 mg/kg) 15 min after the trauma has shown protective effect via decreasing significantly the elevated MDA levels (P < 0.05) and also significantly (P < 0.05) increasing the reduced antioxidant enzyme (SOD and GPx) activities, except CAT activity. In the trauma-alone group, the neurons became extensively dark and degenerated into picnotic nuclei. The morphology of neurons in the NAC treatment group was well protected. The number of neurons in the trauma-alone group was significantly less than that of both the control and trauma+NAC treatment groups. In conclusion, the NAC treatment might be beneficial in preventing trauma-induced oxidative brain tissue damage, thus showing potential for clinical implications.Öğe Nocardial brain abscess: Review of clinical management(Elsevier Sci Ltd, 2006) Kilincer, Cumhur; Hamamcioglu, M. Kemal; Simsek, Osman; Hicdonmez, Tufan; Aydoslu, Bayram; Tansel, Ozlem; Tiryaki, MehmetNocardiosis has become a significant opportunistic infection over the last two decades as the number of immunocompromised individuals has grown worldwide. We present two patients with nocardial brain abscess. The first patient was a 39-year-old woman with systemic lupus erythematosus. A left temporoparietal abscess was detected and aspirated through a burr-hole. Nocardia farcinica infection was diagnosed. The patient had an accompanying pulmonary infection and was thus treated with imipenem and amikacine for 3 weeks. She received oral minocycline for 1 year. The second patient was a 43-year-old man who was being treated with corticosteroids for glomerulonephritis. He was diagnosed with a ring-enhancing multiloculated abscess in the left cerebellar hemisphere, with an additional two small supratentorial lesions and triventricular hydrocephalus. Gross total excision of the cerebellar abscess was performed via a left suboccipital craniectomy. Culture revealed Nocardia asteroides, and the patient was successfully treated with intravenous ceftriaxone, then oral trimethoprime-sulfamethoxazole for 1 year. The clinical course, radiological findings, and management of nocardial brain abscess are discussed in light of the relevant literature, and current clinical management is reviewed through examination of the cases presented here. (C) 2006 Elsevier Ltd. All rights reserved.Öğe Paraplegia due to spinal subdural hematoma as a complication of posterior fossa surgery: Case report and review of the literature(Elsevier Science Bv, 2006) Hicdonmez, Tufan; Kilincer, Cumhur; Hamamcioglu, A. Kemal; Cobanoglu, SebahattinAlthough blood contamination of cerebrospinal fluid (CSF) after an intracranial operation is possible, development of a symptomatic spinal hematoma after a posterior fossa surgery has never been reported. A 43-year-old woman underwent a posterior fossa tumor removal in the prone position with no intraoperative difficulty. On the second postoperative day, she complained of severe epigastric pain and developed a rapid onset of paraplegia with anesthesia below the thoracic 5 spinal level. The emergency cranial and spinal MRIs revealed a spinal extramedullary hemorrhage spreading to the whole spinal regions, just sparing the cauda equina area. There was a prominent localized hematoma formation surrounding and compressing the spinal cord at the upper thoracic levels, which was evacuated via an urgent laminectomy. The patient showed partial neurological recovery after the decompression. Development of the spinal hematoma was explained by the movement of blood from the tumor bed into the spinal canal under the effect of gravity, during or after the operation. A 30 degrees head elevation might facilitate the accumulation of blood. Localization of the hematoma formation may be caused by the fact that the upper thoracic levels constitute the apex of the kyphosis. We conclusively suggest that a spinal hematoma should be taken into consideration as a rare but potentially severe complication of a posterior fossa surgery. Meticulous hemostasis and isolation of the surgical area from the spinal spaces are essential. Overdrainage of CSF should be abandoned. Postoperatively, patients should be monitored for spinal findings as well as cranial signs. (c) 2005 Elsevier B.V. All rights reserved.Öğe Simulation of surgery for craniosynostosis: a training model in a fresh cadaveric sheep cranium - Technical note(Amer Assoc Neurological Surgeons, 2006) Hicdonmez, Tufan; Parsak, Turgay; Cobanoglu, SebahattinThe authors present a training model in sheep crania that allows residents in neurosurgery and plastic surgery to prac practice the frontoorbital remodeling procedure used in the surgical correction of simple craniosynostoses such as plagiocephaly, trigonocephaly, and brachiocephaly. The model comprises a three-step approach: subperiosteal and subperiorbital dissection; elevation of the bifrontal bone flap and the supraorbital bar; and finally, frontoorbital remodeling. The authors conclude that this training model, based on the use of cadaveric sheep crania, represents a fairly useful method to accustom trainees to the required surgical techniques and simulates well the steps of standard pediatric and adult craniofacial surgery for simple craniosynostosis.Öğe Treatment of a large and symptomatic septum pellicidum cyst with endoscopic fenestration in a child-Case report and review of the literature(Elsevier Science Bv, 2012) Hicdonmez, Tufan; Suslu, Hikmet Turan; Butuc, Radu; Bilal, Serkan; Akinci, Ahmet Tolgay[Abstract Not Available]Öğe Validity of serum tau protein levels in pediatric patients with minor head trauma(W B Saunders Co-Elsevier Inc, 2010) Guzel, Ahmet; Karasalihoglu, Serap; Aylanc, Hakan; Temizoz, Osman; Hicdonmez, TufanBackground: The aim of this study was to investigate the relationship between intracranial injury and serum tau protein levels in pediatric patients with minor head trauma (NI HT). Methods: We included 60 pediatric patients with MELT (Glasgow Coma Scale [GCS], 14-15) and 28 control patients. The patients were divided into 3 groups as follows: those without (group 1) and with (group 2) intracranial lesions shown on cranial computed tomography (CCT) and the control group (group 3). Results: The mean serum tau protein level was 96.06 +/- 70.36 pg/mL in group I. whereas it was 112.04 +/- 52.66 pg/mL in group 2, with no statistically significant difference between the groups (p = .160). The mean serum tau protein levels between the study groups (group I and group 2) and control (38.52 +/- 29.01) were statistically significant (P < .001 and P < .001, respectively). The GCS score and pathologic condition in CCT were only influential variables on tau protein levels. Conclusions: We found that serum tau protein increased after M HT but did not distinguish between those with and those without intracranial lesions demonstrable on CCT. (C) 2010 Elsevier Inc. 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