Browsing by Author "Akyol, M.E."

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Colloid Cyst Presenting With Acute Hydrocephalus in an Adult Patient: Case Report and Review of Literature
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Aycan, A.; Gülşen, İ.; Arslan, M.; Kuyumcu, F.; Akyol, M.E.; Arslan, H.
Colloid cysts (CC) are rare cystic lesions with a wide clinical spectrum including the asymptomatic cysts that are coincidentally diagnosed and the cysts leading to sudden death. The symptoms in CC are usually caused by obstructive hydrocephalus. The most common symptom for CC is headache. CC rarely cause intracranial herniation and death. In this study, we aimed to present our experience in the diagnostic and treatment process of a 57-year-old male patient with CC who presented to the emergency service with sudden severe headache, vomiting and confusion. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Effect of Covid-19 Quarantine on Patients Admitted To Neurosurgery Outpatient Clinic Individuals With Copd
(Ondokuz Mayis Universitesi, 2022) Çetin, E.; Akyol, M.E.
Coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Throughout the pandemic period, numerous countries around the world have implemented nationwide isolation measures to control the spread and transmission of COVID-19. During this period, the prevalence of some physical and mental diseases have increased due to prolonged home isolation measures. In the present study, we aimed to examine the effect of the COVID-19 isolation measures imposed in Turkey on patients admitted to our neurosurgery outpatient clinic. © 2022 Ondokuz Mayis Universitesi. All rights reserved.
Evaluation of Patients Operatively Treated With a Diagnosis of Lumbar Disc Hernia: an Epidemiological Investigation
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Aycan, A.; Gülşen, İ.; Arslan, M.; Kuyumcu, F.; Akyol, M.E.
Lower back and leg pain is a common condition in the community which leads to loss of work and restricts daily life activities. About 2-3% of all painful lower back syndromes are caused by lumbar disc herniation (LDH). Surgery is performed in patients with sensory and motor deficits and the patients which are not responding to physical and medical treatment. In this study, we retrospectively evaluated the LDH patients that were operatively treated in our clinic through the review of the literature and the study was aimed to provide contribution to epidemiological studies. The retrospective study included 190 patients who were operatively treated between January 2013 and December 2015. Age, gender, level of herniation, neurological examination findings, presence of trauma, length of hospital stay, profession, recurrence, and surgical outcome were evaluated in all patients. The 190 patients included 108 (56.8%) males and 82 (43.2%) females with a mean age of 45 years. Mean length of hospital stay was 1.8 days. The level of herniation was L4-5 (51.6%), L5-S1 (32.1%) with a rate of 83.7%. Preoperative foot drop was found in 2.1% of the patients. Of these, 50% of them were improved and 50% of them sustained foot drop following the surgery. Lumbar disc herniation is one of the most common spine surgeries performed. Appropriate surgical procedure with an accurate diagnosis leads to good success rates and high patient satisfaction. Following the surgery, 122 patients were graded as “perfect”, 50 patients as “good”, 15 patients as “moderate”, and 3 patients as “poor”. These findings were consistent with the findings of the literature. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Hydrocephalus in Encephalocele
(Verduci Editore s.r.l, 2022) Akyol, M.E.; Çelegen, I.; Basar, I.; Arabaci, O.
OBJECTIVE: Encephalocele is a rare congenital neural tube defect (NTD) characterized by herniation of intracranial contents through a defect in the skull. In our study, encephalocele was diagnosed in our clinic and its association with hydrocephalus was evaluated. The effect of this association on the prognosis was discussed. PATIENTS AND METHODS: Patients who underwent surgery and follow-up with the diagnosis of encephalocele in the neurosurgery clinic of our hospital in an 8-year period from 2013 to 2021 were retrospectively examined. RESULTS: Patient records were obtained from the case notes of patients who underwent excision and repair for encephalocele. Of the 78 patients included in the study, 88.4% underwent surgery in the neonatal period. Moreover, 47% of the patients are male, and 31% are female. Encephalocele was present in 62.8% of patients and meningocele in 37.2%. Furthermore, 82.1% of encephalocele sacs were located in the occipital region. Chiari type 3 malformation was present in 57.6% of patients. Hydrocephalus developed in 56.4% of patients. There was an additional syndrome in 10.3% of the cases. The most common additional syndromes were corpus callosum dysgenesis with 39.7% and colpocephaly with 29.5%. The additional disease was present in 43.6% of patients. Preoperative and postoperative examination findings of more than half of patients were normal, but 33.3% were apathetic. Furthermore, 67.9% of patients, who underwent complete repair, survived, and 32.1% died. Hydrocephalus was present in 73.5% of patients with encephalocele (p<0.05). Hydrocephalus developed in 77.8% of patients with Chiari type 3 malformation (p<0.05). Hydrocephalus was found in 88.0% of patients with Ex (p<0.05). CONCLUSIONS: Encephalocele, which is a subgroup of NTD, differs clinically by its location and accompanying additional anomalies. In encephaloceles, the risk of morbidity and mortality can only be reduced with the multidisciplinary approach. Hydrocephalus and Chiari type 3 malformation are common in patients with encephalocele. These associations adversely affect the prognosis of the disease. Further research should be conducted on the evaluation of risk factors of NTD and methods of prevention from NTD. In this regard, we recommend that the training be repeated at certain intervals and that people’s awareness should be raised. © 2022 Verduci Editore s.r.l. All rights reserved.
Investigation of Mortality and Additional Morbidity Factors in Stroke Patients Who Have Undergone Decompressive Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Görken, G.; Sari, A.; Milanlioğlu, A.; Akyol, M.E.
We aimed to investigate the factors that may determine the effects of decompressive craniectomy by analyzing the data of patients who experienced ischemic and hemorrhagic stroke following the decompressive surgical procedure performed at our stroke center. Thus, we sought to establish a consensus on decompressive surgery practices. Within the scope of this research, we conducted a retrospective analysis of the files of all stroke patients who underwent decompressive craniectomy and were followed between 2015 and 2020. The contributing factors influencing prognosis were examined. A total of 27 patients were included in the study. We recorded and statistically compared the sociodemographic characteristics of these patients, along with their NIH score at admission, GCS, an d mRS after 3-6 months. Out of the 27 patients, 16 (59.3%) had ischemic stroke and 11 (40.7%) had hemorrhagic stroke. The average age of the patients was 56±13.2 years. The mean NIHSS score was 16±7.2. After decompressive surgery, 70% of patients were deceased prior to discharge. The average craniectomy dimensions for all patients were calculated as 9.4±1.5 cm x 7.7±1.5 cm. We observed that factors such as the timing of decompressive surgery, Glasgow coma score, length of hospital stay, stroke hemisphere, glucose, and hemoglobin values did not affect prognosis post-surgery. Patients who underwent decompressive surgery due to hemorrhagic stroke demonstrated better outcomes after the procedure. The selection of patients for surgery and the timing of the procedure should be guided by each clinic's own experience. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A New Alternative Flap in the Closure of Meningomyelocele Defects: Modified S Flaps
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Koçak, Ö.F.; Demir, C.Y.; Ersöz, M.E.; Özsular, Y.; Sultanoğlu, Y.; Aycan, A.; Akyol, M.E.
Back defects may occur after several factors such as cancer, trauma and pressure sores. These conditions are more frequent in adult group, whereas the etiological factor in newborn infants is usually meningomyelocele defects. The aim of this study is to define more reliable and easily applicable surgical technique for the closure of meningomy elocele defects. This study included a total of 15 infants who underwent operation with the diagnosis of meningomyelocele and were treated with a modified S flap at our clinic between January 2016 and January 2017. During surgery, two flaps with a random pattern planned from the healthy skin on the right and left side of the meningomyelocele defect were transposed to close the defect. The flap donor sites were primarily sutured by elevating the surrounding skin. The left-sided flap was designed with superior pedicle and the right one with inferior pedicle. Of the participants, 13 were females and two were males with a mean age of 3.2 (min-max: 1 to 16) days. The mean follow-up was 11.5 (min-max: 5 to 17) months. The mean defect size was 6.5×5 (min-max: 5×4 to 7×6) cm. The mean flap size was 6.5×2.9 cm for the flap planned from the left side and right side of the defect. Complication was observed only in one patients including partial necrosis. Our study results suggest that modified S flap is an easily applicable flap. The greatest advantage of this flap is the shortening of the operation time. However, the major disadvantage of this flap is the random pattern flap (absence of a known blood vessel). © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Povidone-Iodine Antisepsis in Lumbar Disc Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Taş, A.; Aycan, N.; Aycan, A.; Zengin, İ.; Akyol, M.E.
Postoperative surgical sit e infection still constitutes a major concern in spinal surgery and related with poor outcome. We aimed to investigate the effect of povidone-iodine (PVP-I) on skin colonization in lumbar disc herniation (LDH) surgery. Adult patients scheduled for LDH surgery were included in the study. Three skin swab cultures were taken when lying on the operating table (culture 1), after PVP-I application (culture 2), and at the end of the operation (culture 3). The effect of PVP-I and other independent predictors on ski n culture was analyzed. A total of 62 [28 (45%) female, mean age 47±13 years] patients were included. Only male sex and taking shower before the surgery have been found to be independent factors for affecting culture 1 growth while adjusted to age, body ma ss index, smoking, preoperative hospital stay, and surgery site shaving [OR (95% CI): 7.8 (1.4-41.9), p=0.016; OR (95% CI): 0.34 (0.003-0.35), p=0.005]. After PVP-I, the growth frequency of culture 2 decreased significantly compared to culture 1 [8 (13%) vs. 43 (70%), p<0.001]. However, culture 3 positivity rate was similar to culture 2 (p=0.219). In preoperative sterilization of lumbar disc surgery, PVP-I significantly reduces skin colonization both immediately after application and at the end of the operation. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A Randomized Trial of the Effects of Platelet- Rich Plasma on Postoperative Complications After Meningomyelocele Sac Repair
(NLM (Medline), 2023) Arabacı, Ö.; Akyol, M.E.; Çelikkaleli, E.; Sönmez, B.; Çetin, E.; Beger, B.
OBJECTIVE: Meningomyelocele is a common congenital neural tube defect. To reduce complications, we need early surgery and a multidisciplinary approach. In this study, we administered platelet-rich plasma (PRP) to babies with meningomyelocele following corrective surgery to minimize cerebrospinal fluid (CSF) leakage and accelerate the healing of the immature pouch tissue. We compared these with a control group that did not receive PRP. PATIENTS AND METHODS: Of the 40 babies who had surgery with the diagnosis of meningomyelocele, 20 patients received PRP after surgical repair, and 20 were followed up without PRP. In the PRP group, 10 of the 20 patients underwent primary defect repair, the other 10 underwent flap repair. In the group that did not receive PRP, primary closure was performed in 14 patients and flap closure in six. RESULTS: In the PRP group, CSF leakage occurred in one (5%) patient, and none developed meningitis. Partial skin necrosis occurred in three (15%) patients and wound dehiscence in three (15%) patients. In the group that did not receive PRP, CSF leakage occurred in nine (45%) patients, meningitis in seven (35%), partial skin necrosis in 13 (65%), and wound dehiscence in seven (35%) patients. The rate of CSF leakage and skin necrosis in the PRP group was significantly (p<0.05) lower than that in the PRP group. Furthermore, wound closure and healing were also improved in the PRP group. CONCLUSIONS: We have shown that PRP treatment of postoperative meningomyelocele infants facilitates healing and lowers the risk of CSF leakage, meningitis, and skin necrosis.
The Role of Matrix Metalloproteinase as Biomarkers for Neural Tube Defect
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Akyol, M.E.; Ebiri, F.N.D.; Taspinar, F.; Yüksek, V.; Tuncer, O.; Arslan, M.; Taspinar, M.
Neural Tube Defect (NTD) is one of the most common congenital malformations. It is crucial to determine the prognostic, predictive, or therapeutic genetic factors for preventing NTD. The formation of the extracellular matrix (ECM) plays an essential role in migrating neural crest cells. Matrix metalloproteinases (MMPs) play a significant role in cell migration in ECM organization. The role of expressions and activation of MMP in NTD is unknown. This study aimed to investigate the roles of MMP-1,-2, and 9 gene expressions as biomarkers for NTD. Peripheral blood samples and NTD tissues were collected from 40 newborn babies diagnosed with NTD, which were also divided into subgroups based on pathology, and peripheral blood samples from only 20 healthy babies were taken for control. After total RNA isolation from blood and tissues, MMP-1,-2,-9 gene expressions were analyzed by Quantitative Real-Time PCR (RT-PCR). There was no difference between the control group and the NTD group in terms of MMP expressions in blood samples (p>0.05). A statistically significantly higher MMP-1 expression was found in Meningocele and Myeloschisis than in Encephalocele (p=0.014). A significant difference was found between the tissue and blood samples of the Meningomyelocele patient group regarding MMP-9 expression (p=0.019). There was no significant relationship between Ca2+, B12, and Folate levels, NTD, and MMP genes expressions (p>0.05). Even though MMP genes were not different between control and NTD groups, they were found to vary between different subgroups and can serve as biomarkers. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.