Şeref Barut - Academia.edu (original) (raw)
Papers by Şeref Barut
PubMed, 1991
Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and... more Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and lesions were found in nine of them. Four of the lesions were located in the central nervous system; two cerebellar, one spinal, one cerebral. Eye lesions were present in eight of the nine patients and complications developed in seven; six unilateral and one bilateral blindness. Both mortality and morbidity were found to be higher than in other series. This is attributed to insufficient screening of the patients with familial VHL, the late diagnosis was established only after the onset of complications. The importance of screening tests in VHL risk patients is emphasized.
PubMed, 1995
A rare case of distal aneurysm of the posterior inferior cerebellar artery (d PICA) found in asso... more A rare case of distal aneurysm of the posterior inferior cerebellar artery (d PICA) found in association with distal anterior cerebral artery (d ACA) and middle cerebral artery (MCA) aneurysms is described. d PICA aneurysm causing subarachnoid hemorrhage was successfully clipped. The aneurysmal sac was excised and examined pathologically; no infectious etiology was found. Aneurysms at other locations were not operated. The association of vascular anomalies with d PICA aneurysms is discussed.
Neurosurgical Review, 1995
A surgically confirmed primary leptomeningeal malignant melanoma (PLMM) discovered at the parieta... more A surgically confirmed primary leptomeningeal malignant melanoma (PLMM) discovered at the parietal region is reported in a 72-year-old male. He developed progressive right hemiparesis and speech disorders caused by a parietal large mass that simulated a growing meningioma. A well-defined, dark-black tumor was removed completely and was histopathologically diagnosed as a malignant melanoma. No melanomas were detected by systemic clinical and radiological examination, including dermatological and ophthalmologic examinations. Follow-up examination 18 months postoperatively showed no evidence of recurrence of the tumor. The patient gradually became bedridden probably because of decreased general activity possibly due to brain atrophy and died of cardiac failure without any evidence of recurrence. Because of the absence of other systemic localizations, we consider this melanoma as primary. A favorable outcome was obtained by surgical treatment alone.
DergiPark (Istanbul University), Mar 1, 1988
Neurosurgery, Nov 1, 1990
The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly ... more The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly that may cause compression of either the median nerve, the brachial artery, or both. The authors present a case in which the supracondylar process and Struthers' ligament compressed both the median nerve and the brachial artery. This case is unusual, in that the symptoms of compression of the brachial artery increased—namely, the pulse intensity decreased and the pain increased with elbow flexion.
Neurosurgical Review, Mar 1, 1993
Damage which occurs following spinal traumas is often irreversible. During recent years free oxyg... more Damage which occurs following spinal traumas is often irreversible. During recent years free oxygen radicals formed due to the pathological changes following neural tissue ischemia have been identified as being responsible for the ethio-pathogenesis of such damage. In our experimental study, model lesions are formed in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid peroxidation product, was measured in the spinal tissues distal to the trauma in order to examine indirectly the time-quantity relationship of free oxygen radicals in the area. For this study 60 rats in six groups, including one control group, were used to determine the formation of MDA. Under a surgical microscope, the spines of all rats were exposed by CS-Th6 laminectomy, and pressure was applied to the spinal cords of animals, except the members of the control group, at the level of C7 by a Ya~argil aneurysm clip. MDA was measured in spinal cord tissues in order to determine free oxygen radicals at the first and fifteenth minutes and at the first, second, and fourth hours. The statistical evaluation of the findings revealed a significant increase in MDA, starting from the 15th minute after the compression, reaching a maximum at 1 hour, and then decreasing. This observation may provide an important guide for studies on prevention of neural destruction.
Acta neurochirurgica, Aug 16, 2004
Background. The secondary injury process following spinal cord trauma has been shown to involve d... more Background. The secondary injury process following spinal cord trauma has been shown to involve different mechanisms such as excessive release of excitatory amino-acids, and induction of free radical induced lipid peroxidation. In this experimental study, the time-level relationship of the nitric oxide and the neuroprotective effects of aminoguanidine were investigated in a rat spinal cord trauma model. Methods. The experiments were performed on 63 Wistar albino rats divided into three groups; sham-operated control (Group 1), trauma created control (Group 2) and aminoguanidine group (Group 3). In groups 2 and 3, spinal cord trauma was produced at thoracic level by using weight the drop technique (at a severity of 50 gr-cm). After the trauma, the rats in Group 3, received an intraperitoneal injection of 100 mg=kg aminoquanidine twice a day for 3 days. The effects of the injury and the efficacy of aminoguanidine were determined based on biochemical parameters (lipid peroxidation and nitric oxide levels in tissue), and on light microscopy findings in cord tissue collected at different times post-injury. Biochemical parameters were performed one hour, three and five days after injury. Functional recovery was assessed at 3, and 5 days after cord trauma with the inclined-plane technique and Tarlov's motor grading scale. Findings. Although there was no statistically significant difference at the 1 st hour, the values of the tissue nitric oxide in trauma created controls were 42% higher on the 3 rd day and 40% higher on the 5 th day when compared with those in sham controls. The levels of the tissue lipid peroxidation in trauma created controls were 88% higher at the 1 st hour and 52.8% higher on the 5 th day when compared with shame controls, but there was no meaningful difference on the 3 rd day. In the trauma created control group, the mean motor function scores decreased to 1.16 AE 0.40 and to 1 AE 0 on the 3 rd and 5 th day, respectively. In this group the mean values of the inclined plane were 39.16 AE 2.04 on the 3 rd day and 37.91 AE 1.02 on the 5 th day. No statistically significant difference was observed in both tissue lipid peroxidation and nitric oxide levels for all time points between the aminoguanidine group and the sham-operated controls (p > 0.01). The motor function scores were observed as 2.16 AE 0.40 on the 3 rd day and as 3 AE 0 on the 5 th day in aminoguanidine group. These values were significantly higher than the trauma created controls (p < 0.01). Aminoguanidin treatment also improved the inclined plane performance of the rats; In this group, the mean values of the inclined plane scores were 44.58 AE 2.92 and 52.91 AE 1.88 on the 3 rd and 5 th days, respectively. These values were significantly higher than the trauma created controls (p < 0.01). Interpretation. This study shows that the nitric oxide level does not increase in the spinal cord tissue during the first hour after the spinal cord trauma. It increases significantly in the spinal cord tissue not only three days but also five days following the trauma. Aminoguanidine treatment, which is started just after the trauma, can prevent both the nitric oxide production and lipid peroxidation in spinal cord tissue and it can improve the functional status of the animals. In this respect, aminoguanidine may have a potential role in the treatment of acute spinal cord injury.
Neurosurgery, Nov 1, 1990
The presence of a supracondylar process and Struthers' ligament is a rare congenital anom... more The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly that may cause compression of either the median nerve, the brachial artery, or both. The authors present a case in which the supracondylar process and Struthers' ligament compressed both the median nerve and the brachial artery. This case is unusual, in that the symptoms of compression of the brachial artery increased--namely, the pulse intensity decreased and the pain increased with elbow flexion.
Journal of Clinical Neuroscience, Jun 1, 2008
We investigated the therapeutic efficacy of Ac-DMQD-CHO, a caspase-3 inhibitor, and functional re... more We investigated the therapeutic efficacy of Ac-DMQD-CHO, a caspase-3 inhibitor, and functional recovery in spinal cord injury in a rat model. Thirty rats were randomized into three groups of 10 each. In groups 2 and 3, spinal cord trauma was produced in the thoracic region. Group 3 rats were treated with Ac-DMQD-CHO. Treatment responses were evaluated based on histopathological and TUNEL staining findings at 24 h and 5 days post-injury. Neurologic performance was assessed during and following treatment. Twenty-four hours after injury, light microscopy examination revealed diffuse hemorrhagic necrosis, edema, vascular thrombi, and polymorphonuclear leukocyte infiltration in group 2 and 3 rats, but cavitation and demyelinization were less prominent in group 3. At this time point, treatment of the rats with Ac-DMQD-CHO significantly reduced the number of apoptotic cells. Traumatic injury to the spinal cord causes apoptosis and administration of Ac-DMQD-CHO decreases apoptosis and improves functional outcome.
Minimally Invasive Neurosurgery, Nov 1, 1992
In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangiob... more In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangioblastomas in two members, one from each, in our clinic. In the first family we saw 17 lesions in 9 members. Although in the first family carcinoma of the kidney was often observed, in the second family retinal haemangioma was found to be predominant, namely, in eight out of nine patients. In both families there were 11 patients with retinal haemangioma; of these, 9 patients were blind (82%). In 6 patients with retinal haemangioblastoma blindness was unilateral and bilateral only in one. All the patients with renal carcinoma were male and died young. In one of our patients with renal carcinoma we found metastatic lesions in the distal and proximal parts of the femur, vertebral arch, cranium and the thoracic wall. In these two families 23 members had 32 lesions, from which eleven were retinal haemangiomas (3 + 8), nine haemangioblastomas of CNS (5 + 4), one a renal cyst (0 + 1), eight renal carcinomas (7 + 1), two pancreatic cysts (1 + 1) and one liver cyst (0 + 1).
International Journal of Radiation Oncology*Biology*Physics, 1980
Acta Neurochirurgica, 2005
Background. Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare,... more Background. Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare, and their underlying clinical features and surgical management are poorly understood. We report our series of 16 patients with 18 distal PICA aneurysms. Method. All patients with distal PICA aneurysms were treated between March 1996 and August 2004. We excluded all PICA aneurysms that involved the vertebral artery. Patients were analysed in the light of their clinical profiles, radiological studies, intraoperative findings and outcomes. All patients underwent non-enhanced and contrast enhanced CT scans followed by 4-vessel cerebral angiography on admission. The hemorrhagic patterns on initial CT scans were assessed using the Fisher Grading Score. The outcomes were documented using the Glasgow Outcome Scale at time of discharge and at three or twelve months follow-up. Findings. The series included 6 men and 10 women. Massive intraventricular haemorrhage was found in 13 patients with proven CT subarachnoid haemorrhage, one patient revealed SAH without intraventricular components, one presented with only intraventricular blood in the occipital horns and 3 aneurysms were found incidentally without presence of blood. Fourteen aneurysms were saccular and four were fusiform. Nine cases were associated with another cerebrovascular lesion. A lateral transcondylar or a median suboccipital approach was used to secure the aneurysms in 15 patients, either by direct clipping (14 lesions) or vessel sacrifice (3 lesions). One aneurysm was treated by an endovascular approach. At long-term follow up, an excellent or good outcome was achieved in 75% of cases. One patient died due to preexisting cardiopulmonary complications. Conclusions. Most of our cases of ruptured distal PICA aneurysms presented with haematocephalus. These were frequently associated with another vascular abnormality and 22% were fusiform or multilobulated. These specific features require special management strategies entailing an appropriate surgical approach to the aneurysm, clipping method, haematoma removal, ventricular drainage and when suitable choice of endovascular interventions.
Acta neurologica Belgica, 1991
Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined... more Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and lesions were found in nine of them. Four of the lesions were located in the central nervous system; two cerebellar, one spinal, one cerebral. Eye lesions were present in eight of the nine patients and complications developed in seven; six unilateral and one bilateral blindness. Both mortality and morbidity were found to be higher than in other series. This is attributed to insufficient screening of the patients with familial VHL, the late diagnosis was established only after the onset of complications. The importance of screening tests in VHL risk patients is emphasized.
Spinal Cord, 1995
Eosinophilic granuloma of bone is the localised and most benign form of Langerhans-cell histiocyt... more Eosinophilic granuloma of bone is the localised and most benign form of Langerhans-cell histiocytosis, previously known as histiocytosis X and is characterised by lytic lesions of one or more bones. It is a disease of children and adolescents, and very rarely affects adults. We report a 34-year-old patient with a solitary eosinophilic granuloma involving the fifth lumbar vertebra which produced sciatica. Operative treatment performed by a single extended posterior approach consisted of total resection of the tumour with hemicorpo recto my , L4-5 and L5-S1 discectomy, interbody fusion with an iliac bone graft, and interpedicular fixation, Postoperatively, the symptoms resolved and the patient continues to do well at 2� years follow-up,
Neurosurgical Review, 1993
Damage which occurs following spinal traumas is often irreversible. During recent years free oxyg... more Damage which occurs following spinal traumas is often irreversible. During recent years free oxygen radicals formed due to the pathological changes following neural tissue ischemia have been identified as being responsible for the ethio-pathogenesis of such damage. In our experimental study, model lesions are formed in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid peroxidation product, was measured in the spinal tissues distal to the trauma in order to examine indirectly the time-quantity relationship of free oxygen radicals in the area. For this study 60 rats in six groups, including one control group, were used to determine the formation of MDA. Under a surgical microscope, the spines of all rats were exposed by CS-Th6 laminectomy, and pressure was applied to the spinal cords of animals, except the members of the control group, at the level of C7 by a Ya~argil aneurysm clip. MDA was measured in spinal cord tissues in order to determine free oxygen radicals at the first and fifteenth minutes and at the first, second, and fourth hours. The statistical evaluation of the findings revealed a significant increase in MDA, starting from the 15th minute after the compression, reaching a maximum at 1 hour, and then decreasing. This observation may provide an important guide for studies on prevention of neural destruction.
Acta Orthop Traumatol Turc, 2004
Metastatic Iesions involving the spine may cause vertebral body collapse, resulting in either spi... more Metastatic Iesions involving the spine may cause vertebral body collapse, resulting in either spinal instabiIity or neural compression or both. Pathological fracture and instability involving the Iower thoracic and Iumber Ievels may be adequately reduced and stabilized ...
min - Minimally Invasive Neurosurgery, 1992
In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangiob... more In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangioblastomas in two members, one from each, in our clinic. In the first family we saw 17 lesions in 9 members. Although in the first family carcinoma of the kidney was often observed, in the second family retinal haemangioma was found to be predominant, namely, in eight out of nine patients. In both families there were 11 patients with retinal haemangioma; of these, 9 patients were blind (82%). In 6 patients with retinal haemangioblastoma blindness was unilateral and bilateral only in one. All the patients with renal carcinoma were male and died young. In one of our patients with renal carcinoma we found metastatic lesions in the distal and proximal parts of the femur, vertebral arch, cranium and the thoracic wall. In these two families 23 members had 32 lesions, from which eleven were retinal haemangiomas (3 + 8), nine haemangioblastomas of CNS (5 + 4), one a renal cyst (0 + 1), eight renal carcinomas (7 + 1), two pancreatic cysts (1 + 1) and one liver cyst (0 + 1).
Neurologia medico-chirurgica, 2004
This study evaluated the combination of the classical interlaminar approach and the intertransver... more This study evaluated the combination of the classical interlaminar approach and the intertransverse route through a midline approach for the treatment of 18 patients with far-lateral lumbar disc herniations, as identified by magnetic resonance imaging. The patients presented with acute severe sciatica, antalgic posture, positive Las àegue sign and femoral stretch test, motor and sensory deficits, and reflex loss findings. Discectomy of all 18 patients was performed by the combined approach. Neurological outcome of all patients was excellent in the follow-up period, ranging from 5 to 8 years. This combined midline approach permits complete evacuation of the involved disc level and treatment of additional bone resection procedures. Therefore, we advocate this approach in far-lateral lumbar disc herniation cases.
PubMed, 1991
Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and... more Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and lesions were found in nine of them. Four of the lesions were located in the central nervous system; two cerebellar, one spinal, one cerebral. Eye lesions were present in eight of the nine patients and complications developed in seven; six unilateral and one bilateral blindness. Both mortality and morbidity were found to be higher than in other series. This is attributed to insufficient screening of the patients with familial VHL, the late diagnosis was established only after the onset of complications. The importance of screening tests in VHL risk patients is emphasized.
PubMed, 1995
A rare case of distal aneurysm of the posterior inferior cerebellar artery (d PICA) found in asso... more A rare case of distal aneurysm of the posterior inferior cerebellar artery (d PICA) found in association with distal anterior cerebral artery (d ACA) and middle cerebral artery (MCA) aneurysms is described. d PICA aneurysm causing subarachnoid hemorrhage was successfully clipped. The aneurysmal sac was excised and examined pathologically; no infectious etiology was found. Aneurysms at other locations were not operated. The association of vascular anomalies with d PICA aneurysms is discussed.
Neurosurgical Review, 1995
A surgically confirmed primary leptomeningeal malignant melanoma (PLMM) discovered at the parieta... more A surgically confirmed primary leptomeningeal malignant melanoma (PLMM) discovered at the parietal region is reported in a 72-year-old male. He developed progressive right hemiparesis and speech disorders caused by a parietal large mass that simulated a growing meningioma. A well-defined, dark-black tumor was removed completely and was histopathologically diagnosed as a malignant melanoma. No melanomas were detected by systemic clinical and radiological examination, including dermatological and ophthalmologic examinations. Follow-up examination 18 months postoperatively showed no evidence of recurrence of the tumor. The patient gradually became bedridden probably because of decreased general activity possibly due to brain atrophy and died of cardiac failure without any evidence of recurrence. Because of the absence of other systemic localizations, we consider this melanoma as primary. A favorable outcome was obtained by surgical treatment alone.
DergiPark (Istanbul University), Mar 1, 1988
Neurosurgery, Nov 1, 1990
The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly ... more The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly that may cause compression of either the median nerve, the brachial artery, or both. The authors present a case in which the supracondylar process and Struthers' ligament compressed both the median nerve and the brachial artery. This case is unusual, in that the symptoms of compression of the brachial artery increased—namely, the pulse intensity decreased and the pain increased with elbow flexion.
Neurosurgical Review, Mar 1, 1993
Damage which occurs following spinal traumas is often irreversible. During recent years free oxyg... more Damage which occurs following spinal traumas is often irreversible. During recent years free oxygen radicals formed due to the pathological changes following neural tissue ischemia have been identified as being responsible for the ethio-pathogenesis of such damage. In our experimental study, model lesions are formed in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid peroxidation product, was measured in the spinal tissues distal to the trauma in order to examine indirectly the time-quantity relationship of free oxygen radicals in the area. For this study 60 rats in six groups, including one control group, were used to determine the formation of MDA. Under a surgical microscope, the spines of all rats were exposed by CS-Th6 laminectomy, and pressure was applied to the spinal cords of animals, except the members of the control group, at the level of C7 by a Ya~argil aneurysm clip. MDA was measured in spinal cord tissues in order to determine free oxygen radicals at the first and fifteenth minutes and at the first, second, and fourth hours. The statistical evaluation of the findings revealed a significant increase in MDA, starting from the 15th minute after the compression, reaching a maximum at 1 hour, and then decreasing. This observation may provide an important guide for studies on prevention of neural destruction.
Acta neurochirurgica, Aug 16, 2004
Background. The secondary injury process following spinal cord trauma has been shown to involve d... more Background. The secondary injury process following spinal cord trauma has been shown to involve different mechanisms such as excessive release of excitatory amino-acids, and induction of free radical induced lipid peroxidation. In this experimental study, the time-level relationship of the nitric oxide and the neuroprotective effects of aminoguanidine were investigated in a rat spinal cord trauma model. Methods. The experiments were performed on 63 Wistar albino rats divided into three groups; sham-operated control (Group 1), trauma created control (Group 2) and aminoguanidine group (Group 3). In groups 2 and 3, spinal cord trauma was produced at thoracic level by using weight the drop technique (at a severity of 50 gr-cm). After the trauma, the rats in Group 3, received an intraperitoneal injection of 100 mg=kg aminoquanidine twice a day for 3 days. The effects of the injury and the efficacy of aminoguanidine were determined based on biochemical parameters (lipid peroxidation and nitric oxide levels in tissue), and on light microscopy findings in cord tissue collected at different times post-injury. Biochemical parameters were performed one hour, three and five days after injury. Functional recovery was assessed at 3, and 5 days after cord trauma with the inclined-plane technique and Tarlov's motor grading scale. Findings. Although there was no statistically significant difference at the 1 st hour, the values of the tissue nitric oxide in trauma created controls were 42% higher on the 3 rd day and 40% higher on the 5 th day when compared with those in sham controls. The levels of the tissue lipid peroxidation in trauma created controls were 88% higher at the 1 st hour and 52.8% higher on the 5 th day when compared with shame controls, but there was no meaningful difference on the 3 rd day. In the trauma created control group, the mean motor function scores decreased to 1.16 AE 0.40 and to 1 AE 0 on the 3 rd and 5 th day, respectively. In this group the mean values of the inclined plane were 39.16 AE 2.04 on the 3 rd day and 37.91 AE 1.02 on the 5 th day. No statistically significant difference was observed in both tissue lipid peroxidation and nitric oxide levels for all time points between the aminoguanidine group and the sham-operated controls (p > 0.01). The motor function scores were observed as 2.16 AE 0.40 on the 3 rd day and as 3 AE 0 on the 5 th day in aminoguanidine group. These values were significantly higher than the trauma created controls (p < 0.01). Aminoguanidin treatment also improved the inclined plane performance of the rats; In this group, the mean values of the inclined plane scores were 44.58 AE 2.92 and 52.91 AE 1.88 on the 3 rd and 5 th days, respectively. These values were significantly higher than the trauma created controls (p < 0.01). Interpretation. This study shows that the nitric oxide level does not increase in the spinal cord tissue during the first hour after the spinal cord trauma. It increases significantly in the spinal cord tissue not only three days but also five days following the trauma. Aminoguanidine treatment, which is started just after the trauma, can prevent both the nitric oxide production and lipid peroxidation in spinal cord tissue and it can improve the functional status of the animals. In this respect, aminoguanidine may have a potential role in the treatment of acute spinal cord injury.
Neurosurgery, Nov 1, 1990
The presence of a supracondylar process and Struthers' ligament is a rare congenital anom... more The presence of a supracondylar process and Struthers' ligament is a rare congenital anomaly that may cause compression of either the median nerve, the brachial artery, or both. The authors present a case in which the supracondylar process and Struthers' ligament compressed both the median nerve and the brachial artery. This case is unusual, in that the symptoms of compression of the brachial artery increased--namely, the pulse intensity decreased and the pain increased with elbow flexion.
Journal of Clinical Neuroscience, Jun 1, 2008
We investigated the therapeutic efficacy of Ac-DMQD-CHO, a caspase-3 inhibitor, and functional re... more We investigated the therapeutic efficacy of Ac-DMQD-CHO, a caspase-3 inhibitor, and functional recovery in spinal cord injury in a rat model. Thirty rats were randomized into three groups of 10 each. In groups 2 and 3, spinal cord trauma was produced in the thoracic region. Group 3 rats were treated with Ac-DMQD-CHO. Treatment responses were evaluated based on histopathological and TUNEL staining findings at 24 h and 5 days post-injury. Neurologic performance was assessed during and following treatment. Twenty-four hours after injury, light microscopy examination revealed diffuse hemorrhagic necrosis, edema, vascular thrombi, and polymorphonuclear leukocyte infiltration in group 2 and 3 rats, but cavitation and demyelinization were less prominent in group 3. At this time point, treatment of the rats with Ac-DMQD-CHO significantly reduced the number of apoptotic cells. Traumatic injury to the spinal cord causes apoptosis and administration of Ac-DMQD-CHO decreases apoptosis and improves functional outcome.
Minimally Invasive Neurosurgery, Nov 1, 1992
In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangiob... more In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangioblastomas in two members, one from each, in our clinic. In the first family we saw 17 lesions in 9 members. Although in the first family carcinoma of the kidney was often observed, in the second family retinal haemangioma was found to be predominant, namely, in eight out of nine patients. In both families there were 11 patients with retinal haemangioma; of these, 9 patients were blind (82%). In 6 patients with retinal haemangioblastoma blindness was unilateral and bilateral only in one. All the patients with renal carcinoma were male and died young. In one of our patients with renal carcinoma we found metastatic lesions in the distal and proximal parts of the femur, vertebral arch, cranium and the thoracic wall. In these two families 23 members had 32 lesions, from which eleven were retinal haemangiomas (3 + 8), nine haemangioblastomas of CNS (5 + 4), one a renal cyst (0 + 1), eight renal carcinomas (7 + 1), two pancreatic cysts (1 + 1) and one liver cyst (0 + 1).
International Journal of Radiation Oncology*Biology*Physics, 1980
Acta Neurochirurgica, 2005
Background. Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare,... more Background. Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare, and their underlying clinical features and surgical management are poorly understood. We report our series of 16 patients with 18 distal PICA aneurysms. Method. All patients with distal PICA aneurysms were treated between March 1996 and August 2004. We excluded all PICA aneurysms that involved the vertebral artery. Patients were analysed in the light of their clinical profiles, radiological studies, intraoperative findings and outcomes. All patients underwent non-enhanced and contrast enhanced CT scans followed by 4-vessel cerebral angiography on admission. The hemorrhagic patterns on initial CT scans were assessed using the Fisher Grading Score. The outcomes were documented using the Glasgow Outcome Scale at time of discharge and at three or twelve months follow-up. Findings. The series included 6 men and 10 women. Massive intraventricular haemorrhage was found in 13 patients with proven CT subarachnoid haemorrhage, one patient revealed SAH without intraventricular components, one presented with only intraventricular blood in the occipital horns and 3 aneurysms were found incidentally without presence of blood. Fourteen aneurysms were saccular and four were fusiform. Nine cases were associated with another cerebrovascular lesion. A lateral transcondylar or a median suboccipital approach was used to secure the aneurysms in 15 patients, either by direct clipping (14 lesions) or vessel sacrifice (3 lesions). One aneurysm was treated by an endovascular approach. At long-term follow up, an excellent or good outcome was achieved in 75% of cases. One patient died due to preexisting cardiopulmonary complications. Conclusions. Most of our cases of ruptured distal PICA aneurysms presented with haematocephalus. These were frequently associated with another vascular abnormality and 22% were fusiform or multilobulated. These specific features require special management strategies entailing an appropriate surgical approach to the aneurysm, clipping method, haematoma removal, ventricular drainage and when suitable choice of endovascular interventions.
Acta neurologica Belgica, 1991
Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined... more Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL) were examined and lesions were found in nine of them. Four of the lesions were located in the central nervous system; two cerebellar, one spinal, one cerebral. Eye lesions were present in eight of the nine patients and complications developed in seven; six unilateral and one bilateral blindness. Both mortality and morbidity were found to be higher than in other series. This is attributed to insufficient screening of the patients with familial VHL, the late diagnosis was established only after the onset of complications. The importance of screening tests in VHL risk patients is emphasized.
Spinal Cord, 1995
Eosinophilic granuloma of bone is the localised and most benign form of Langerhans-cell histiocyt... more Eosinophilic granuloma of bone is the localised and most benign form of Langerhans-cell histiocytosis, previously known as histiocytosis X and is characterised by lytic lesions of one or more bones. It is a disease of children and adolescents, and very rarely affects adults. We report a 34-year-old patient with a solitary eosinophilic granuloma involving the fifth lumbar vertebra which produced sciatica. Operative treatment performed by a single extended posterior approach consisted of total resection of the tumour with hemicorpo recto my , L4-5 and L5-S1 discectomy, interbody fusion with an iliac bone graft, and interpedicular fixation, Postoperatively, the symptoms resolved and the patient continues to do well at 2� years follow-up,
Neurosurgical Review, 1993
Damage which occurs following spinal traumas is often irreversible. During recent years free oxyg... more Damage which occurs following spinal traumas is often irreversible. During recent years free oxygen radicals formed due to the pathological changes following neural tissue ischemia have been identified as being responsible for the ethio-pathogenesis of such damage. In our experimental study, model lesions are formed in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid peroxidation product, was measured in the spinal tissues distal to the trauma in order to examine indirectly the time-quantity relationship of free oxygen radicals in the area. For this study 60 rats in six groups, including one control group, were used to determine the formation of MDA. Under a surgical microscope, the spines of all rats were exposed by CS-Th6 laminectomy, and pressure was applied to the spinal cords of animals, except the members of the control group, at the level of C7 by a Ya~argil aneurysm clip. MDA was measured in spinal cord tissues in order to determine free oxygen radicals at the first and fifteenth minutes and at the first, second, and fourth hours. The statistical evaluation of the findings revealed a significant increase in MDA, starting from the 15th minute after the compression, reaching a maximum at 1 hour, and then decreasing. This observation may provide an important guide for studies on prevention of neural destruction.
Acta Orthop Traumatol Turc, 2004
Metastatic Iesions involving the spine may cause vertebral body collapse, resulting in either spi... more Metastatic Iesions involving the spine may cause vertebral body collapse, resulting in either spinal instabiIity or neural compression or both. Pathological fracture and instability involving the Iower thoracic and Iumber Ievels may be adequately reduced and stabilized ...
min - Minimally Invasive Neurosurgery, 1992
In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangiob... more In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangioblastomas in two members, one from each, in our clinic. In the first family we saw 17 lesions in 9 members. Although in the first family carcinoma of the kidney was often observed, in the second family retinal haemangioma was found to be predominant, namely, in eight out of nine patients. In both families there were 11 patients with retinal haemangioma; of these, 9 patients were blind (82%). In 6 patients with retinal haemangioblastoma blindness was unilateral and bilateral only in one. All the patients with renal carcinoma were male and died young. In one of our patients with renal carcinoma we found metastatic lesions in the distal and proximal parts of the femur, vertebral arch, cranium and the thoracic wall. In these two families 23 members had 32 lesions, from which eleven were retinal haemangiomas (3 + 8), nine haemangioblastomas of CNS (5 + 4), one a renal cyst (0 + 1), eight renal carcinomas (7 + 1), two pancreatic cysts (1 + 1) and one liver cyst (0 + 1).
Neurologia medico-chirurgica, 2004
This study evaluated the combination of the classical interlaminar approach and the intertransver... more This study evaluated the combination of the classical interlaminar approach and the intertransverse route through a midline approach for the treatment of 18 patients with far-lateral lumbar disc herniations, as identified by magnetic resonance imaging. The patients presented with acute severe sciatica, antalgic posture, positive Las àegue sign and femoral stretch test, motor and sensory deficits, and reflex loss findings. Discectomy of all 18 patients was performed by the combined approach. Neurological outcome of all patients was excellent in the follow-up period, ranging from 5 to 8 years. This combined midline approach permits complete evacuation of the involved disc level and treatment of additional bone resection procedures. Therefore, we advocate this approach in far-lateral lumbar disc herniation cases.