Metin Kaplan - Academia.edu (original) (raw)

Papers by Metin Kaplan

Spinal dermoid cyst is a rare pathology among the intamedullary spinal cord tumors. An 11 year ol... more Spinal dermoid cyst is a rare pathology among the intamedullary spinal cord tumors. An 11 year old female patient applied with nausea, vomiting, and urine-bowel incontinence. The personal history of the patient revealed that she had been treated at the infectious diseases, pediatrics, and psychiatry departments of various centers for reccurent urinary tract infection and enuresis nocturna. Investigations revealed grade III hydronephrosis with dissynergic bladder and spinal intramedullary mass. The content of the mass was removed. The pathological diagnosis was dermoid cyst.The urinary incontinence of the patient improved to time to time night micturations. Hydronephrosis grade III had improved to grade II on the renal ultrasonography at the postoperative 1styear. In pediatric cases with frequent need for urination, continual drops after urination and relapsing urinary tract infections, the pathologies of neurogenic origin should be taken into consideration, and spinal imaging must b...

Iranian Journal of Child Neurology, 2017

Objective The morphology of anterior cerebral artery (ACA) in patients with hydrocephalus (HCP) w... more Objective The morphology of anterior cerebral artery (ACA) in patients with hydrocephalus (HCP) was analyzed, and its importance was discussed in maintaining cerebral perfusion. Materials & Methods A total of 84 cases in 2 groups between 0 and 3 months, followed-up at Firat Universitesi Hastanesi, Beyin Cerrahisi Klinigi, Elazig, Turkiye due to in 2010-2013, were enrolled. Two groups were created for the study. Group 1; patients with HCP and Group 2; as control group without HCP. In both groups, the length of the A2 segment of ACA was measured from its origin to the junction of the genu and body portions of the corpus callosum on T2 mid-sagittal magnetic resonance (MR) scans. For all cases, axial MR imaging scans were used to calculate Evans’ index (EI), and the cases were divided into three groups: Group A, EI ≥50%; Group B, EI of 40-50% and Group C, EI <40%. The two groups (Groups 1 and 2) were compared with respect to ACA length, and the correlation with the EI was quantified....

Turkish neurosurgery, Jan 19, 2018

We aimed to evaluate postoperative clinical cure and recurrence rates in cases with ventrally loc... more We aimed to evaluate postoperative clinical cure and recurrence rates in cases with ventrally localized spinal meningiomas that underwent Simpson grade 2 resection. We evaluated eight cases (six females and two males; age, 28-86 years; mean age, 60 years) with ventrally localized spinal meningioma that underwent surgical treatment at our clinic. The tumors were localized in the thoracic region in seven cases and in the cervical region in one case. All cases underwent surgery, which was performed using a traditional posterior midline approach. Laminectomy was unilaterally extended. The case with cervically localized tumor differed from the other cases in that a skull clamp was used and laminoplasty was performed. The tumor was completely resected in all cases. Furthermore, in all cases, the tumor nidus that caused the thickening of the dura was cauterized using bipolar cautery and peeled off (Simpson grade 2). The pathological examination of the tumor specimens revealed typical grade...

Turkish Neurosurgery, 2016

Pediatric Neurosurgery, 2016

Objective/Aim: The aim of this report was to investigate the effect of ventriculoperitoneal shunt... more Objective/Aim: The aim of this report was to investigate the effect of ventriculoperitoneal shunt insertion for the treatment of hydrocephalus on thyroid hormones in the first 3 months of life. Methods: Thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) levels were compared at 7 days (preoperatively) and at 30 and 90 days (postoperatively) after birth between 25 ventriculoperitoneal shunt-inserted hydrocephalic newborns and 20 healthy newborns. Results: The TSH level at 7 days was higher in the hydrocephalic patient group (6.33 µIU) compared to the control group (3.76 µIU). This value was significantly decreased at 90 days in the ventriculoperitoneal shunt-inserted newborns (2.35 µIU) compared to the control group (3.33 µIU; p < 0.05). There were no significant differences between time points for fT4 and fT3 values in the patient group or for TSH, fT4, and fT3 values in the control group. Conclusion: We propose that a ventriculoperitoneal shunt inserted in the ea...

Objective: The insertion time of the shunt used for hydrocephalus treatment is controversial for ... more Objective: The insertion time of the shunt used for hydrocephalus treatment is controversial for the risk of infection in patients with myelomeningocele. Many authors have reported the risk of ventriculo-peritoneal shunt infection in early myelomeningocele repaired patients (the first 3 days after birth). The aim of this study is to evaluate the VP shunt insertion time with risk of shunt infection in cases who repaired myelomeningocele sac in late stage. Materials and Methods: In this study, 50 patients who had undergone myelomeningocele repair after the 4 th day of life in our institution during the period between 2000 and 2009, were analyzed. 31 of 50 cases underwent a simultaneous shunt procedure (Group A) and the remaining 19 cases underwent a shunt operation following myelomeningocele sac repair at a different session (Group B). Results: For all cases, the shunt infection rate was 12% while infection ratio was 9.6% in Group A, and 15.7% in Group B. Shunt infection was 6,9% in c...

Turkish neurosurgery, 2007

In the present study, the clinical effectiveness of a surgical procedure in which no draining tub... more In the present study, the clinical effectiveness of a surgical procedure in which no draining tubes are installed following simple burr hole drainage and saline irrigation is investigated. 10 patients, having undergone operative intervention for unilateral chronic subdural hemorrhage, having a clinical grade of 2 and a hemorrhage thickness of 2 cm, were included in the study. The cerebral blood flow rates of middle cerebral artery were evaluated bilaterally with Doppler before and after the surgery. All the cases underwent the operation using the simple burr hole drainage technique without the drain and consequent saline irrigation. Statistical analysis was performed by Wilcoxon signed rank test (p<0.05). There was a pronounced decrease in the preoperative MCA blood flow in the hemisphere the hemorrhage had occurred (p=0.008). An increased PI value on the side of the hemorrhage drew our attention (p=0.005). Postoperative MCA blood flow measurements showed a statistically signific...

Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové, 2012

An eight-month-old male child was admitted with weakness and swelling in the feet. Paraparesis an... more An eight-month-old male child was admitted with weakness and swelling in the feet. Paraparesis and bilateral lower extremity edema were present in the neurological examination. Thoracic MRI showed an intradural intramedullary mass 61 x 11 mm in size in the T5-T10 levels. Laminotomy between the T5-T10 vertebrae was performed. A mass with smooth borders was separated from most of the neural tissue. In the postoperative MRI, we observed a contrast enhancing area, considered a residual fragment, only 5 x 4 mm in size. Histopathological properties were compatible with the intermixed subtype of ganglioneuroblastoma. Only a limited number of thoracic cord Ganglioneuroblastoma reports have been previously published. Although very rare in children and young adults, ganglioneuroblastoma should be included in the differential diagnosis of thoracic cord tumors. It is difficult to obtain a preoperative diagnosis with clinical features and radiological investigations. Diagnosis depends on histopa...

Turkish Neurosurgery, 2012

Neurologia medico-chirurgica, 2002

Turkish Journal of Trauma and Emergency Surgery, 2012

Journal of Neurosurgery, 2004

Object.This is an investigation into the effects of two barrier membranes in the prevention of pe... more Object.This is an investigation into the effects of two barrier membranes in the prevention of peridural fibrosis in an animal model.Methods.Seprafilm or Gore-Tex was applied to a laminectomy defect overlying the dura mater in rats separated into treatment groups. A third group of rats underwent laminectomy only and served as controls. Two months postoperatively a histological study was performed to compare the amount of scar tissue in each group.The gross dissection demonstrated that both membranes created a controlled dissection plane, facilitated access to the epidural space, and provided a reduction in the amount of tissue adhering to the dura mater. Statistically, Seprafilm was superior to Gore-Tex in preventing peridural fibrosis (p < 0.05).Conclusions.Seprafilm can prevent peridural fibrosis better than Gore-Tex and can be used in humans in spinal surgery.

Journal of Clinical Neuroscience, 2007

European Spine Journal, 2013

Turkish neurosurgery, 2008

Ossified chronic subdural hematoma is a very rarely seen entity. We present here a 22-year-old ma... more Ossified chronic subdural hematoma is a very rarely seen entity. We present here a 22-year-old male who had presented with severe headache consequent to brain compression caused by bifronto-parieto-temporal ossified subdural hematoma. We evaluated our method and surgical intervention in the light of the literature. The question whether the ossified membrane should be excised or not excised in these cases is a matter of controversy. We think that an ossified membrane causing an armored brain appearance should be excised in symptomatic, young patients with prominent cerebral compression. During this dissection, the relatively thickened arachnoid mater provides a safe border.

Egyptian Journal of Neurosurgery, 2019

Background: Although neurofibromatosis type 1 (NF1) is a common genetical disorder, symptoms due ... more Background: Although neurofibromatosis type 1 (NF1) is a common genetical disorder, symptoms due to neural involvement are rare among infants and children. Ganglioneuromas are slow-growing tumors and can be seen in patients with NF1. However, bilateral symmetrical involvement is very rarely reported in the literature. We present a rare pediatric case with NF1 who presented with upper cervical bilateral symmetrical ganglioneuroma. Case presentation: A 7-year-old male presented with progressive gait disturbance, falls, and bilateral limb and trunk numbness that started several weeks ago. Physical examination revealed generalized café au lait spots, neurofibromas, and axillary and inguinal freckling. Family history for NF1 was positive. Neurological examination showed slight paraparesis and hypoesthesia of the upper extremities with C4-C5 dermatomas being more distinct. Cervical magnetic resonance imaging (MRI) revealed contrast enhancing dumbbell-shaped symmetrical lesions originating from both C3 nerve roots extending to C2-C5 vertebral body levels. There was a significant spinal cord compression causing myelopathy as well as dystrophic changes and kyphotic deformity at those levels. The patient was operated and the lesions were totally excised via C2-3-4 laminoplasty. Histopathological evaluation reported the lesion as ganglioneuroma. Following the surgery for excision of the lesions, the patient presented with rapidly progressing kyphotic deformity and underwent rigid craniocervical fusion. Conclusion: Ganglioneuromas are seen among children, tend to occur in the mediastinum, abdomen, and retroperitoneal area, and may accompany NF1. Cervical spinal ganglioneuroma, however, is a very rare entity. Coexistence of NF1 and bilateral symmetrical cervical ganglioneuroma is highly unusual. Like neurofibromas, ganglioneuromas are slow-growing tumors and therefore they are not expected to cause myelopathy and related symptoms during childhood. Symmetrical nature of the lesions results in myelopathy and early onset of symptoms. Due to the risk of postoperative increase of kyphotic angulation, laminoplasty should be considered. Although laminoplasty alone does not prevent the progression of kyphotic changes, the procedure may allow the use of sublaminar wires and laminar hooks for future surgeries to correct the deformity.