Erol Tasdemiroglu - Academia.edu (original) (raw)
Papers by Erol Tasdemiroglu
The Journal of Turkish Spinal Surgery, Jun 2013
Backround data: CRS also referred to as caudal dysplasia and sacral agenesis syndrome is a rare c... more Backround data: CRS also referred to as caudal dysplasia and sacral agenesis syndrome is a rare congenital abnormality in which a segment of the spine and spinal cord fails to develop. The etiology is thought to be related to maternal diabetes, genetic predisposition, teratogens and vascular hypoperfusion, but not true causative factor has been determined. Since there is not a true cure, treatment is difficult, multidisciplinary, and largely supportive. Lower limb deformities with sensory or motor loss and neurogenic bladder call for intensive and long-term attention.
Objective: To evaluate using the Magnetic Resonance Imaging (MRI) results, radiological and clinical data of pediatric patients with spinal problems related to congenital or neuromuscular conditions using the MRI results.
Study design: We presented 10 cases of caudal regression syndrome (CRS) among the 65 consecutive pediatric cases that were diagnosed with congenital spinal column deformities that came to Department of Orthopedics and Traumatology, Baltalimani Bone Disease Hospital, İstanbul, Turkey between 2006 and 2009.
Material Methods: Clinical and radiological findings were reviewed to classify each patient to Renshaw’s and Guille’s classifications. The mean age was 81 (30-180) months. Clinical and radiological finding of these cases along with life time management were outlined and literature were reviewed.
Results: In this study 11.3 % of the patients were diagnosed with CRS in combination with congenital and spina bifida (SB) related spinal deformities. This indicates that the condition may not be as rare as most studies suggest. Our retrospective study allowed us to see the various concomitant conditions which often occur with CRS.
Conclussıon: The goal of this study was to show in which variations may CRS patients come into the picture and to provide insight into the CRS and management of this disorder.
Caudal Regression Syndrome remains associated with structural and systematic problems including genitourinary, gastrointestinal, orthopedic, neurological, respiratory and cardiac anomalies.First step of the early management of CRS should be an accurate prenatal diagnosis. We need larger studies to determine the utilities of the classifications and to improve them. It is possible that there are under- or misdiagnosed patients in many centers who are under treatment for accompanying disorders.
Spine Deformity 2 (2014) pp. 131-142, 2014
Study Design: A total of 126 scoliosis patients admitted to the hospital were screened for concom... more Study Design: A total of 126 scoliosis patients admitted to the hospital were screened for concomitant cervical pathologies.
Objectives: To investigate the prevalence of cervical spine pathologies and the clinical relevance of magnetic resonance imaging (MRI) in
the evaluation of patients with neuromuscular, congenital, syndromic, and idiopathic scoliosis.
Background Summary: With the development of MRI, upper neural axis abnormalities such as syringomyelia and Chiari malformation
are increasingly being found in patients with scoliosis, but no report in the literature describes other pathologies in the cervical area seen
concomitant with different scoliosis types.
Methods: A total of 126 consecutive patients who were classified as having neuromuscular, congenital, syndromic, and idiopathic scoliosis
were retrospectively evaluated. Data regarding cervical neural axis abnormalities obtained from the MRI studies were analyzed and
classified into each type of scoliosis group.
Results: A total of 126 patients with scoliosis were evaluated for hindbrain and cervical spine anomalies. Patients were divided into 4 groups regarding the type of scoliosis. The cervical spine of all patients was evaluated with MRI and other radiologic methods when needed. The most frequently seen pathology was syringomyelia. Other pathologies found included congenital vertebral anomalies, Chiari malformation, arachnoid cyst, atlanto-axial dissociation, split cord, posterior vertebral fusion, vertebral hypoplasia, neurenteric cyst,myelomalacia, dermoid cyst, and decrease in craniovertebral angle. Cervical pathologies were most frequently seen in neuromuscular scoliosis, followed by congenital and syndromic groups.
Conclusions: Cervical spinal pathologies vary according to the type of scoliosis. The number of cervical spinal pathologies diagnosed in
idiopathic scoliosis patients was least compared with neuromuscular and syndromic groups. The most common pathology was syringomyelia, followed by congenital vertebral anomalies and cerebral tonsillar hernia. Preoperative MRI scan provides vital information regarding cervical spinal pathologies encountered in scoliosis patients.
Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues exten... more Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues extends to early decades of the 20th century. Although several theories have been proposed for this entity, collection of secretory cells possessing the properties of amine precursor uptake and decarboxylation in some tissues and tumors have been the most justified proposal. As none of these theories completely provides a satisfactory explanation, roles played by more than 1 mechanism in the scenario are also probable. The ectopic production and secretion of corticotropin-releasing hormone, growth hormone–releasing hormone, gonadotropin-releasing hormone, adrenocortico-tropic hormone, prolactin, growth hormone, follicle-stimulating hormone, and luteinizing hormone have all been demonstrated in the tumors, as well as in the hyperplastic and chronic in-flammatory tissues outside the endocrine system. This review article focuses on the current available information on ectopic hypothalamic and pituitary hormone secreting syndromes, which may be beneficial for neurosurgeons.
Neuroblastic tumors (neuroblastoma [NB], ganglioneuroblastoma) are the most common extracranial s... more Neuroblastic tumors (neuroblastoma [NB], ganglioneuroblastoma) are the most common extracranial solid tumors in children during the first 2 years of life and account for 8% to 10% of all childhood cancers. NBs arising from a paravertebral ganglion have an unusual tendency to grow through the intervertebral foramen, forming a dumbbell-shaped or hourglass-shaped mass. The intraspinal component may cause neurologic symptoms of spinal cord compression with paralysis and/or incontinence. Most patients with dumbbell neuroblastoma (DNB) have an excellent chance for long-term survival. The frequency of spinal epidural extension with NB varies from 6% to 25% in different series and may occur by direct extension from a paraspinal primary tumor or from vertebral bone metastases. Congenital DNB accounts for about 10% of all DNB cases. DNB is the most common malignant cause of spinal cord or nerve root compression in children. Although chemotherapy is safe and effective, the treatment strategy remains controversial. Commonly asked questions that need to be answered when managing the DNB patients include 1) what studies are necessary for preoperative evaluation of a DNB; 2) what is the preferred treatment regimen, and how aggressive should treatment be; and 3) what is the long-term morbidity from treatment and disease? In this article, we review the clinical features of DNB and try to provide guidelines for the workup and treatment of the disorder.
Journal of Korean Neurosurgical Society, 2015
Journal of neurosurgery, 2004
The authors report the case of a 7-year-old girl who presented with persistent low-back and left ... more The authors report the case of a 7-year-old girl who presented with persistent low-back and left leg pain and was diagnosed with expanding occult intrasacral meningocele (OIM), diastematomyelia, tethered cord, and multiple vertebral anomalies. She was followed for 27 months. Removal of a bone spur and sectioning of the tight terminal filum did not relieve her left leg and back pain. Serial magnetic resonance (MR) imaging after initial detection of the OIM revealed gradual but significant enlargement of the lesion. Fifteen months after terminal filum release and bone spur resection, the OIM was excised. After this surgery, the back and leg pain resolved. No case of OIM reported to date contains documented serial MR imaging confirmation of enlargement of OIM. Furthermore, this is the first report of OIM associated with diastematomyelia. Because most OIMs expand, the authors recommend that, in addition to surgery for associated congenital anomalies, the OIM be totally excised to resolv...
Neurosurgery Quarterly, 2004
... Inappropriate (Ectopic) Hypothalamic and Pituitary Hormone-Secreting Syndromes. Tasdemiroglu,... more ... Inappropriate (Ectopic) Hypothalamic and Pituitary Hormone-Secreting Syndromes. Tasdemiroglu, Erol MD; Kaya, Ahmet Hilmi MD. ... This is particularly true when a small and sometimes relatively benign tumor results in acromegaly, Cushing syndrome, and/or hyperprolactinemia. ...
Turkish neurosurgery, 2015
The objective of this study was to investigate the antifibrotic effect of parenteral administrati... more The objective of this study was to investigate the antifibrotic effect of parenteral administration of alpha-lipoic acid (ALA), which has been reported to reduce fibrosis in the liver, oral mucosa, and peritoneum, in laminectomized rabbits as a potential candidate for the prevention of peridural fibrosis. Twelve adult New Zealand white male rabbits were divided into control (n=6) and ALA treatment groups (n=6). Laminectomy of the lumbar spine was performed in all animals, and ALA was administered intramuscularly in six rabbits composing the treatment group. Total RNA obtained from the paraffin-embedded tissues was analyzed for transforming growth factor-β1 (TGF-β1), plateletderived growth factor (PDGF), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). mRNA investigations showed that TGF-β1, PDGF, PAI-1 and IL-6 gene expressions, which constitute strong evidence for the development of fibrosis, were significantly lower in the treatment group compared with the resul...
Neurosurgery Quarterly, 2004
Spine, 2012
A case report. To describe the presentation of pyogenic spondylodiscitis as an iatrogenic spinal ... more A case report. To describe the presentation of pyogenic spondylodiscitis as an iatrogenic spinal complication of a transrectal ultrasound-guided needle biopsy of the prostate (TUGNBP), despite prophylactic use of antibiotics, and discuss possible route of infection. Pyogenic spondylodiscitis is a rare complication of TUGNBP. Several similar case reports, have been previously published, including 1 by the authors of this case report; however, in the present case, spondylodiscitis occurred despite prophylactic antibiotic use. A 59-year-old man was admitted to the neurosurgery department, experiencing severe back and bilateral leg pain for 6 weeks. His neurological examination was normal. His medical and surgical histories were unremarkable, except for a TUGNBP performed 2 months ago because of the high serum levels of prostate-specific antigen levels. At the time of the biopsy, he had been given prophylactic oral antibiotic (ciprofloxacin, 500 mg twice a day) for 2 weeks. The day after biopsy, the patient experienced intermittent high fever and fatigue, and a week after biopsy, he complained of progressive back pain. After 2 weeks, whole-body bone scan with Tc99m-MDP revealed hyperactivity at the level of L4 and L5 vertebral bodies. His contrast-enhanced magnetic resonance image of the lumbar spine showed diffuse contrast enhancement vertebral bodies and intervertebral disc of L4 and L5 along with contrast-enhanced circumferential epidural mass extending from S2 to L3 levels. L4 hemilaminectomy and epidural and intradiscal abscess drainage at the L4-L5 levels were performed. The diagnosis was consistent with acute discitis with Gram (-) bacilli, and microbiological culture was positive for Escherichia coli. He received intravenous and oral antibiotics for 6 weeks. Acute pyogenic spondylodiscitis should be considered among the major complications of TUGNBP and may occur despite prophylactic antibiotic use.
Spine, 1995
This retrospective study examined the hospital records of 60 patients with thoracolumbar fracture... more This retrospective study examined the hospital records of 60 patients with thoracolumbar fractures treated with posterior fusion and spinal instrumentation. The mean follow-up period was 66 months. The goal of this study was to evaluate and analyze the long-term outcome and socioeconomic conditions of patients who had sustained a thoracolumbar fracture. In four patients, additional spinal injuries were detected. Three of the patients evaluated with magnetic resonance imaging showed cord contusion and edema. In six patients, ruptured disc fragments were detected by preoperative magnetic resonance imaging or during surgery. Long-term follow-up results in 60 patients with unstable thoracolumbar fractures treated with posterior fusion and spinal instrumentation were analyzed. Neurologic outcomes and independence in function and daily living activities were reviewed. Age, sex, mechanism of injury, associated injuries to the spinal cord, and associated injuries to the spinal cord and other systems were analyzed. Fractures were classified according to the system of Ferguson and Allen. The patients with incomplete spinal cord injury showed significant functional improvement. During the follow-up period, 28 patients showed neurologic improvement. Postoperative complications occurred in 11 patients. Five patients required late rod removal because of rod dislocation. Regardless of neurologic recovery, most patients reported some disability, usually caused by pain. Inability to return to alternative jobs resulted from insufficient educational background rather than neurologic dysfunction. Advanced academic achievement was the single most important predictive factor of ability to return to work.
Neurosurgical FOCUS, 2004
Neurosurgery Quarterly, 2004
Neurosurgery Quarterly, 2013
Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues exten... more Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues extends to early decades of the 20th century. Although several theories have been proposed for this entity, collection of secretory cells possessing the properties of amine precursor uptake and decarboxylation in some tissues and tumors have been the most justified proposal. As none of these theories completely provides a satisfactory explanation, roles played by more than 1 mechanism in the scenario are also probable. The ectopic production and secretion of corticotropin-releasing hormone, growth hormone-releasing hormone, gonadotropin-releasing hormone, adrenocorticotropic hormone, prolactin, growth hormone, follicle-stimulating hormone, and luteinizing hormone have all been demonstrated in the tumors, as well as in the hyperplastic and chronic inflammatory tissues outside the endocrine system. This review article focuses on the current available information on ectopic hypothalamic and pituitary hormone secreting syndromes, which may be beneficial for neurosurgeons.
Journal of Neurosurgery, 1991
Cerebral hyperperfusion, a state in which blood flow exceeds the metabolic needs of brain, may co... more Cerebral hyperperfusion, a state in which blood flow exceeds the metabolic needs of brain, may complicate a number of neurological and neurosurgical conditions. It may account for the propensity with which hemorrhage, cerebral edema, or seizures follow embolic stroke, carotid endarterectomy, or the excision of large arteriovenous malformations, and for some of the morbidity that accompanies acute severe head injury, prolonged seizures, and acute severe hypertension. Hyperperfusion syndromes have in common acute increases in blood pressure, vasodilatation, breakdown of the blood-brain barrier, and the development of cerebral edema. These common features suggest the possibility that they share the same pathogenic mechanisms. It was believed until recently that reactive hyperemia was caused primarily by the generation of vasoactive metabolites, which induced vasodilatation through relaxation of vascular smooth muscle. However, the authors have recently established that the release of vasoactive neuropeptides from perivascular sensory nerves via axon reflex-like mechanisms has a significant bearing upon a number of hyperperfusion syndromes. In this article, the authors summarize their data and discuss possible therapeutic implications for blockade of these nerves or their constituent neuropeptides.
Child's Nervous System, 2011
I read the article "An Inside View of Autism&amp... more I read the article "An Inside View of Autism" written by a 44-year-old autistic woman who had a successful international career designing livestock equipment. In this article, she wrote about her life, disease, and experiences as an autistic individual. She stated that "It is interesting that my speech resembled the stressed speech in young children who have had tumors removed from the cerebellum". In this article, we intend to review and extensively document both postoperative cerebellar mutism and autistic spectrum disorder. We reviewed the clinical and neurological findings, etio-pathogenesis, neuroanatomy, mechanisms of development, and similarities between the etio-pathogenesis of both diseases. Cerebellar lesions can produce mutism and dysarthria, symptoms sometimes seen in autistic spectrum disorder. In mammals, cerebellar lesions disturb motivated behavior and reduce social interactions, functions that are disturbed in autistic spectrum disorder and cerebellar mutism. The cerebellum and two regions within the frontal lobes are active in certain language tasks. Language is abnormal in autistic spectrum disorder and cerebellar mutism.
Child's Nervous System, 2011
Dear Editor, Response: We appreciate Dr. Gudrunardottir and colleagues' interests and comments to... more Dear Editor, Response: We appreciate Dr. Gudrunardottir and colleagues' interests and comments to our recent review.
Medical Journal of …
The aim of this study is to assess the contribution of magnetic resonance imaging (MRI) in the di... more The aim of this study is to assess the contribution of magnetic resonance imaging (MRI) in the diagnosis and evaluation of split spinal cord malformations (SSCM) and associated spinal anomalies. Material and Methods: According to pang's classification, we have reviewed ...
Acta Neurochirurgica, 1996
Five cases of primary spinal column sarcomas are presented. Sarcomas primarily originating from p... more Five cases of primary spinal column sarcomas are presented. Sarcomas primarily originating from paravertebral soft tissues were excluded. Patients' age ranged from 1 to 14 years (mean 8.4 years). The male : female ratio was 2 : 3. Two patients had Ewing's sarcoma (ES) originating from L5-S1 and L4-5 pedicles, respectively; two patients had mesenchymal chondrosarcoma (MCS) originating from L 1-2 pedicles and L5 body, respectively; and one patient had osteogenic sarcoma (OS) of C4 body. All patients clinically presented with pain and progressive weakness of the extremities. The time that elapsed between the onset of symptoms and diagnoses ranged from one to five months. All cases were treated with chemotherapy, radiotherapy and subtotal tumour resection with spinal canal decompression. Two cases received posterior spinal fusion operations. Three patients were alive 10 to 98 months following diagnosis. Only the case with ES of L5-S1 pedicles was in complete remission and off therapy at the 98th postoperative month. The two MCS cases were in partial remission, and were receiving chemoterapy at the time of analysis. These tumours caused similar clinical findings and prognoses, and required combined treatment, which consisted of surgery, radiotherapy and chemotherapy; histologically three different types of malignant tumours are presented in the same category. We preferred surgical decompression and stabilization procedures especially for neurologically symptomatic patients, even if they had extensive tumours with high grades. By spinal canal decompression and stabilisation, we did not intend to cure the disease; however, we intended to provide neurological improvement, spinal stabilisation, improved quality of life, early mobilisation of the patient, and cytoreduction by means of surgical tumour ablation, which could render the chemotherapy more effective.
The Journal of Turkish Spinal Surgery, Jun 2013
Backround data: CRS also referred to as caudal dysplasia and sacral agenesis syndrome is a rare c... more Backround data: CRS also referred to as caudal dysplasia and sacral agenesis syndrome is a rare congenital abnormality in which a segment of the spine and spinal cord fails to develop. The etiology is thought to be related to maternal diabetes, genetic predisposition, teratogens and vascular hypoperfusion, but not true causative factor has been determined. Since there is not a true cure, treatment is difficult, multidisciplinary, and largely supportive. Lower limb deformities with sensory or motor loss and neurogenic bladder call for intensive and long-term attention.
Objective: To evaluate using the Magnetic Resonance Imaging (MRI) results, radiological and clinical data of pediatric patients with spinal problems related to congenital or neuromuscular conditions using the MRI results.
Study design: We presented 10 cases of caudal regression syndrome (CRS) among the 65 consecutive pediatric cases that were diagnosed with congenital spinal column deformities that came to Department of Orthopedics and Traumatology, Baltalimani Bone Disease Hospital, İstanbul, Turkey between 2006 and 2009.
Material Methods: Clinical and radiological findings were reviewed to classify each patient to Renshaw’s and Guille’s classifications. The mean age was 81 (30-180) months. Clinical and radiological finding of these cases along with life time management were outlined and literature were reviewed.
Results: In this study 11.3 % of the patients were diagnosed with CRS in combination with congenital and spina bifida (SB) related spinal deformities. This indicates that the condition may not be as rare as most studies suggest. Our retrospective study allowed us to see the various concomitant conditions which often occur with CRS.
Conclussıon: The goal of this study was to show in which variations may CRS patients come into the picture and to provide insight into the CRS and management of this disorder.
Caudal Regression Syndrome remains associated with structural and systematic problems including genitourinary, gastrointestinal, orthopedic, neurological, respiratory and cardiac anomalies.First step of the early management of CRS should be an accurate prenatal diagnosis. We need larger studies to determine the utilities of the classifications and to improve them. It is possible that there are under- or misdiagnosed patients in many centers who are under treatment for accompanying disorders.
Spine Deformity 2 (2014) pp. 131-142, 2014
Study Design: A total of 126 scoliosis patients admitted to the hospital were screened for concom... more Study Design: A total of 126 scoliosis patients admitted to the hospital were screened for concomitant cervical pathologies.
Objectives: To investigate the prevalence of cervical spine pathologies and the clinical relevance of magnetic resonance imaging (MRI) in
the evaluation of patients with neuromuscular, congenital, syndromic, and idiopathic scoliosis.
Background Summary: With the development of MRI, upper neural axis abnormalities such as syringomyelia and Chiari malformation
are increasingly being found in patients with scoliosis, but no report in the literature describes other pathologies in the cervical area seen
concomitant with different scoliosis types.
Methods: A total of 126 consecutive patients who were classified as having neuromuscular, congenital, syndromic, and idiopathic scoliosis
were retrospectively evaluated. Data regarding cervical neural axis abnormalities obtained from the MRI studies were analyzed and
classified into each type of scoliosis group.
Results: A total of 126 patients with scoliosis were evaluated for hindbrain and cervical spine anomalies. Patients were divided into 4 groups regarding the type of scoliosis. The cervical spine of all patients was evaluated with MRI and other radiologic methods when needed. The most frequently seen pathology was syringomyelia. Other pathologies found included congenital vertebral anomalies, Chiari malformation, arachnoid cyst, atlanto-axial dissociation, split cord, posterior vertebral fusion, vertebral hypoplasia, neurenteric cyst,myelomalacia, dermoid cyst, and decrease in craniovertebral angle. Cervical pathologies were most frequently seen in neuromuscular scoliosis, followed by congenital and syndromic groups.
Conclusions: Cervical spinal pathologies vary according to the type of scoliosis. The number of cervical spinal pathologies diagnosed in
idiopathic scoliosis patients was least compared with neuromuscular and syndromic groups. The most common pathology was syringomyelia, followed by congenital vertebral anomalies and cerebral tonsillar hernia. Preoperative MRI scan provides vital information regarding cervical spinal pathologies encountered in scoliosis patients.
Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues exten... more Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues extends to early decades of the 20th century. Although several theories have been proposed for this entity, collection of secretory cells possessing the properties of amine precursor uptake and decarboxylation in some tissues and tumors have been the most justified proposal. As none of these theories completely provides a satisfactory explanation, roles played by more than 1 mechanism in the scenario are also probable. The ectopic production and secretion of corticotropin-releasing hormone, growth hormone–releasing hormone, gonadotropin-releasing hormone, adrenocortico-tropic hormone, prolactin, growth hormone, follicle-stimulating hormone, and luteinizing hormone have all been demonstrated in the tumors, as well as in the hyperplastic and chronic in-flammatory tissues outside the endocrine system. This review article focuses on the current available information on ectopic hypothalamic and pituitary hormone secreting syndromes, which may be beneficial for neurosurgeons.
Neuroblastic tumors (neuroblastoma [NB], ganglioneuroblastoma) are the most common extracranial s... more Neuroblastic tumors (neuroblastoma [NB], ganglioneuroblastoma) are the most common extracranial solid tumors in children during the first 2 years of life and account for 8% to 10% of all childhood cancers. NBs arising from a paravertebral ganglion have an unusual tendency to grow through the intervertebral foramen, forming a dumbbell-shaped or hourglass-shaped mass. The intraspinal component may cause neurologic symptoms of spinal cord compression with paralysis and/or incontinence. Most patients with dumbbell neuroblastoma (DNB) have an excellent chance for long-term survival. The frequency of spinal epidural extension with NB varies from 6% to 25% in different series and may occur by direct extension from a paraspinal primary tumor or from vertebral bone metastases. Congenital DNB accounts for about 10% of all DNB cases. DNB is the most common malignant cause of spinal cord or nerve root compression in children. Although chemotherapy is safe and effective, the treatment strategy remains controversial. Commonly asked questions that need to be answered when managing the DNB patients include 1) what studies are necessary for preoperative evaluation of a DNB; 2) what is the preferred treatment regimen, and how aggressive should treatment be; and 3) what is the long-term morbidity from treatment and disease? In this article, we review the clinical features of DNB and try to provide guidelines for the workup and treatment of the disorder.
Journal of Korean Neurosurgical Society, 2015
Journal of neurosurgery, 2004
The authors report the case of a 7-year-old girl who presented with persistent low-back and left ... more The authors report the case of a 7-year-old girl who presented with persistent low-back and left leg pain and was diagnosed with expanding occult intrasacral meningocele (OIM), diastematomyelia, tethered cord, and multiple vertebral anomalies. She was followed for 27 months. Removal of a bone spur and sectioning of the tight terminal filum did not relieve her left leg and back pain. Serial magnetic resonance (MR) imaging after initial detection of the OIM revealed gradual but significant enlargement of the lesion. Fifteen months after terminal filum release and bone spur resection, the OIM was excised. After this surgery, the back and leg pain resolved. No case of OIM reported to date contains documented serial MR imaging confirmation of enlargement of OIM. Furthermore, this is the first report of OIM associated with diastematomyelia. Because most OIMs expand, the authors recommend that, in addition to surgery for associated congenital anomalies, the OIM be totally excised to resolv...
Neurosurgery Quarterly, 2004
... Inappropriate (Ectopic) Hypothalamic and Pituitary Hormone-Secreting Syndromes. Tasdemiroglu,... more ... Inappropriate (Ectopic) Hypothalamic and Pituitary Hormone-Secreting Syndromes. Tasdemiroglu, Erol MD; Kaya, Ahmet Hilmi MD. ... This is particularly true when a small and sometimes relatively benign tumor results in acromegaly, Cushing syndrome, and/or hyperprolactinemia. ...
Turkish neurosurgery, 2015
The objective of this study was to investigate the antifibrotic effect of parenteral administrati... more The objective of this study was to investigate the antifibrotic effect of parenteral administration of alpha-lipoic acid (ALA), which has been reported to reduce fibrosis in the liver, oral mucosa, and peritoneum, in laminectomized rabbits as a potential candidate for the prevention of peridural fibrosis. Twelve adult New Zealand white male rabbits were divided into control (n=6) and ALA treatment groups (n=6). Laminectomy of the lumbar spine was performed in all animals, and ALA was administered intramuscularly in six rabbits composing the treatment group. Total RNA obtained from the paraffin-embedded tissues was analyzed for transforming growth factor-β1 (TGF-β1), plateletderived growth factor (PDGF), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). mRNA investigations showed that TGF-β1, PDGF, PAI-1 and IL-6 gene expressions, which constitute strong evidence for the development of fibrosis, were significantly lower in the treatment group compared with the resul...
Neurosurgery Quarterly, 2004
Spine, 2012
A case report. To describe the presentation of pyogenic spondylodiscitis as an iatrogenic spinal ... more A case report. To describe the presentation of pyogenic spondylodiscitis as an iatrogenic spinal complication of a transrectal ultrasound-guided needle biopsy of the prostate (TUGNBP), despite prophylactic use of antibiotics, and discuss possible route of infection. Pyogenic spondylodiscitis is a rare complication of TUGNBP. Several similar case reports, have been previously published, including 1 by the authors of this case report; however, in the present case, spondylodiscitis occurred despite prophylactic antibiotic use. A 59-year-old man was admitted to the neurosurgery department, experiencing severe back and bilateral leg pain for 6 weeks. His neurological examination was normal. His medical and surgical histories were unremarkable, except for a TUGNBP performed 2 months ago because of the high serum levels of prostate-specific antigen levels. At the time of the biopsy, he had been given prophylactic oral antibiotic (ciprofloxacin, 500 mg twice a day) for 2 weeks. The day after biopsy, the patient experienced intermittent high fever and fatigue, and a week after biopsy, he complained of progressive back pain. After 2 weeks, whole-body bone scan with Tc99m-MDP revealed hyperactivity at the level of L4 and L5 vertebral bodies. His contrast-enhanced magnetic resonance image of the lumbar spine showed diffuse contrast enhancement vertebral bodies and intervertebral disc of L4 and L5 along with contrast-enhanced circumferential epidural mass extending from S2 to L3 levels. L4 hemilaminectomy and epidural and intradiscal abscess drainage at the L4-L5 levels were performed. The diagnosis was consistent with acute discitis with Gram (-) bacilli, and microbiological culture was positive for Escherichia coli. He received intravenous and oral antibiotics for 6 weeks. Acute pyogenic spondylodiscitis should be considered among the major complications of TUGNBP and may occur despite prophylactic antibiotic use.
Spine, 1995
This retrospective study examined the hospital records of 60 patients with thoracolumbar fracture... more This retrospective study examined the hospital records of 60 patients with thoracolumbar fractures treated with posterior fusion and spinal instrumentation. The mean follow-up period was 66 months. The goal of this study was to evaluate and analyze the long-term outcome and socioeconomic conditions of patients who had sustained a thoracolumbar fracture. In four patients, additional spinal injuries were detected. Three of the patients evaluated with magnetic resonance imaging showed cord contusion and edema. In six patients, ruptured disc fragments were detected by preoperative magnetic resonance imaging or during surgery. Long-term follow-up results in 60 patients with unstable thoracolumbar fractures treated with posterior fusion and spinal instrumentation were analyzed. Neurologic outcomes and independence in function and daily living activities were reviewed. Age, sex, mechanism of injury, associated injuries to the spinal cord, and associated injuries to the spinal cord and other systems were analyzed. Fractures were classified according to the system of Ferguson and Allen. The patients with incomplete spinal cord injury showed significant functional improvement. During the follow-up period, 28 patients showed neurologic improvement. Postoperative complications occurred in 11 patients. Five patients required late rod removal because of rod dislocation. Regardless of neurologic recovery, most patients reported some disability, usually caused by pain. Inability to return to alternative jobs resulted from insufficient educational background rather than neurologic dysfunction. Advanced academic achievement was the single most important predictive factor of ability to return to work.
Neurosurgical FOCUS, 2004
Neurosurgery Quarterly, 2004
Neurosurgery Quarterly, 2013
Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues exten... more Recognition of the ectopic hormone secretion outside the primary hormone glands and tissues extends to early decades of the 20th century. Although several theories have been proposed for this entity, collection of secretory cells possessing the properties of amine precursor uptake and decarboxylation in some tissues and tumors have been the most justified proposal. As none of these theories completely provides a satisfactory explanation, roles played by more than 1 mechanism in the scenario are also probable. The ectopic production and secretion of corticotropin-releasing hormone, growth hormone-releasing hormone, gonadotropin-releasing hormone, adrenocorticotropic hormone, prolactin, growth hormone, follicle-stimulating hormone, and luteinizing hormone have all been demonstrated in the tumors, as well as in the hyperplastic and chronic inflammatory tissues outside the endocrine system. This review article focuses on the current available information on ectopic hypothalamic and pituitary hormone secreting syndromes, which may be beneficial for neurosurgeons.
Journal of Neurosurgery, 1991
Cerebral hyperperfusion, a state in which blood flow exceeds the metabolic needs of brain, may co... more Cerebral hyperperfusion, a state in which blood flow exceeds the metabolic needs of brain, may complicate a number of neurological and neurosurgical conditions. It may account for the propensity with which hemorrhage, cerebral edema, or seizures follow embolic stroke, carotid endarterectomy, or the excision of large arteriovenous malformations, and for some of the morbidity that accompanies acute severe head injury, prolonged seizures, and acute severe hypertension. Hyperperfusion syndromes have in common acute increases in blood pressure, vasodilatation, breakdown of the blood-brain barrier, and the development of cerebral edema. These common features suggest the possibility that they share the same pathogenic mechanisms. It was believed until recently that reactive hyperemia was caused primarily by the generation of vasoactive metabolites, which induced vasodilatation through relaxation of vascular smooth muscle. However, the authors have recently established that the release of vasoactive neuropeptides from perivascular sensory nerves via axon reflex-like mechanisms has a significant bearing upon a number of hyperperfusion syndromes. In this article, the authors summarize their data and discuss possible therapeutic implications for blockade of these nerves or their constituent neuropeptides.
Child's Nervous System, 2011
I read the article "An Inside View of Autism&amp... more I read the article "An Inside View of Autism" written by a 44-year-old autistic woman who had a successful international career designing livestock equipment. In this article, she wrote about her life, disease, and experiences as an autistic individual. She stated that "It is interesting that my speech resembled the stressed speech in young children who have had tumors removed from the cerebellum". In this article, we intend to review and extensively document both postoperative cerebellar mutism and autistic spectrum disorder. We reviewed the clinical and neurological findings, etio-pathogenesis, neuroanatomy, mechanisms of development, and similarities between the etio-pathogenesis of both diseases. Cerebellar lesions can produce mutism and dysarthria, symptoms sometimes seen in autistic spectrum disorder. In mammals, cerebellar lesions disturb motivated behavior and reduce social interactions, functions that are disturbed in autistic spectrum disorder and cerebellar mutism. The cerebellum and two regions within the frontal lobes are active in certain language tasks. Language is abnormal in autistic spectrum disorder and cerebellar mutism.
Child's Nervous System, 2011
Dear Editor, Response: We appreciate Dr. Gudrunardottir and colleagues' interests and comments to... more Dear Editor, Response: We appreciate Dr. Gudrunardottir and colleagues' interests and comments to our recent review.
Medical Journal of …
The aim of this study is to assess the contribution of magnetic resonance imaging (MRI) in the di... more The aim of this study is to assess the contribution of magnetic resonance imaging (MRI) in the diagnosis and evaluation of split spinal cord malformations (SSCM) and associated spinal anomalies. Material and Methods: According to pang's classification, we have reviewed ...
Acta Neurochirurgica, 1996
Five cases of primary spinal column sarcomas are presented. Sarcomas primarily originating from p... more Five cases of primary spinal column sarcomas are presented. Sarcomas primarily originating from paravertebral soft tissues were excluded. Patients' age ranged from 1 to 14 years (mean 8.4 years). The male : female ratio was 2 : 3. Two patients had Ewing's sarcoma (ES) originating from L5-S1 and L4-5 pedicles, respectively; two patients had mesenchymal chondrosarcoma (MCS) originating from L 1-2 pedicles and L5 body, respectively; and one patient had osteogenic sarcoma (OS) of C4 body. All patients clinically presented with pain and progressive weakness of the extremities. The time that elapsed between the onset of symptoms and diagnoses ranged from one to five months. All cases were treated with chemotherapy, radiotherapy and subtotal tumour resection with spinal canal decompression. Two cases received posterior spinal fusion operations. Three patients were alive 10 to 98 months following diagnosis. Only the case with ES of L5-S1 pedicles was in complete remission and off therapy at the 98th postoperative month. The two MCS cases were in partial remission, and were receiving chemoterapy at the time of analysis. These tumours caused similar clinical findings and prognoses, and required combined treatment, which consisted of surgery, radiotherapy and chemotherapy; histologically three different types of malignant tumours are presented in the same category. We preferred surgical decompression and stabilization procedures especially for neurologically symptomatic patients, even if they had extensive tumours with high grades. By spinal canal decompression and stabilisation, we did not intend to cure the disease; however, we intended to provide neurological improvement, spinal stabilisation, improved quality of life, early mobilisation of the patient, and cytoreduction by means of surgical tumour ablation, which could render the chemotherapy more effective.