Browsing by Author "Cirak, B"

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Acute Ecg Changes and Chest Pain Induced by Neck Motion in Patients With Cervical Hernia -: a Case Report
(Westminster Publ inc, 2000) Güler, N; Bilge, M; Eryonucu, B; Cirak, B
We report two cases of acute cervical angina and ECG changes induced by anteflexion of the head. Cervical angina is defined as chest pain that resembles true cardiac angina but originates from cervical discopathy with nerve root compression. In these patients, Prinzmetal's angina, valvular heart disease, congenital heart disease, left ventricular aneurysm, and cardiomyopathy were excluded. After all, the patient's chest pain was reproduced by anteflexion of head, at this time, their ECGs showed nonspecific ST-T changes in the inferior and anterior leads different from the basal EGG. ECG changes returned to normal when the patient's neck moved to the neutral position. To our knowledge, these are the first cases of cervical angina associated with acute ECG changes by neck motion.
Bilateral Median Nerve Compression at the Level of Struthers' Ligament - Case Report
(Amer Assoc Neurological Surgeons, 2000) Aydinlioglu, A; Cirak, B; Akpinar, F; Tosun, N; Dogan, A
Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of thp median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.
Brainstem Lesions After Head Injury
(Amer Assoc Neurological Surgeons, 1999) Cirak, B; Unal, O; Isik, S; Kiymaz, N
Catamenial Mononeuropathy and Radiculopathy
(Amer Assoc Neurological Surgeons, 1999) Cirak, B; Guven, MB
Central Nervous System Lipomas
(Tohoku Univ Medical Press, 2002) Kiymaz, N; Cirak, B
The lipomas of the central nervous system are rare lesions of congenital origin and are located in the medial line and especially in corpus callosum. Intramedullary spinal lipomas can be seen in the life span of 30 years of age and most frequently coincide with initial puberty period. Magnetic resonance imaging and computerized tomography together with clinical trials are of crucial importance for diagnosis. The first case: A two-year-aged girl who had lipoma in quadrigeminal cistern and who suffered from encephalocraniocutaneous lipomatosis has been clinically studied. The fascial lipoma of the patient has been excised subtotally by the Plastic Surgeons; then the patient has underwent supracerebellar infratentorial operation where the intracranial lipoma has been excised by our team. The histopathology has been reported to be consisting of peripheric nerve tissue and calcification. The second case: A twenty-year-aged man with intramedullary lipoma localized between T1-T4 has been given our clinical trials. T1-T5 total laminectomy and subtotal excision were made for this patient. Due to the fact that the lipomas of central nervous system are rarely seen and are involved in nervous and calcific tissues except for fatty tissues they can be mistaken for hamartomatous masses. The total excision of the lipomas of central nervous system and especially the spinal intramedullary lipomas are quite difficult to be excised since they are tightly entangled with the neural tissue. So any attempt for total excision would be dangerous. Operation for decompression and biopsy is of primary concern.
Chiasmatic Glioblastoma of Childhood - a Case Report
(Munksgaard int Publ Ltd, 2000) Cirak, B; Unal, O; Arslan, H; Cinal, A
A 6-year-old girl presented with visual deterioration that had progressively worsened over 2 months. MR imaging revealed a sellar, para- and suprasellar lesion. Subtotal tumor resection was performed. Histopathological diagnosis was glioblastoma of the optic chiasma. Chiasmatic glioblastoma is rare in adults and extremely uncommon in children. Surgical resection implies a risk of severe endocrinologic and opthalmologic complications.
Clinical and Therapeutic Properties of Cushing's Disease in Childhood
(Karger, 1999) Cirak, B; Palaoglu, S; Akalan, N
Cushing's disease (CD) in adolescence and childhood is a rare pathology and has some different clinical and therapeutic characteristics than in adults. We report 3 cases treated surgically, with the diagnosis of CD, Their common complaints were short stature and obesity. Endocrinological investigations and radiological evaluation pointed out the diagnosis of CD for all children. They were operated on by the transsphenoidal route, and adenoma resection was performed. Histopathologic and immunohistochemical examination of the tissue specimens confirmed the diagnosis of CD, Long-term follow-up demonstrated weight loss and increase in height.
Comparing Open Surgery With Endoscopic Releasing in the Treatment of Carpal Tunnel Syndrome
(Georg Thieme verlag Kg, 2002) Kiymaz, N; Cirak, B; Tuncay, I; Demir, Ö
Aim: The aim of this study is to retrospectively assess the complications and result of cases that underwent open surgery or endoscopic releasing for carpel tunnel syndrome. Method: A total of 50 cases of carpel tunnel syndrome, 30 of whom underwent endoscopic release using the biportal extra-bursal technique described by Chow, and the other 20 that underwent open surgery were included in the study. Average age of the cases was 41 (24-62),44 of them were females and 6 males. Results: Follow-up examinations of the patients at the first and third month after operation revealed no limitation of activity in 40 (80%) cases, minimal limitation in 4 (8%), moderate limitation in 5 (10%) and significant limitation in 1 (2%). Among the group that underwent endoscopic release, as a major complication, the median nerve was almost totally cut in a patient under-going endoscopic release. During the same operation setting perifascicular neurorrhaphy was done. Fourth and fifth digital nerve lesions occurred in three cases. Among the group that underwent open surgery fourth and fifth digital nerve injury occurred in one case, and in another case severe inflammation requiring reoperation occurred. Conclusion: Before intervention, cases of carpal tunnel syndrome should be examined well as regards which technique to use. Experience of the surgeon with the technique to be used should also be taken into consideration. Endoscopic carpal tunnel releasing, though a relatively easier procedure, leads to neurovascular injuries more frequently than open surgery; thus open surgery appears to be safer.
Congenital Infiltrating Lipomatosis of the Face With Cerebral Abnormalities
(Springer-verlag, 2000) Unal, O; Cirak, B; Bekerecioglu, M; Kutluhan, A; Ugras, S; Tali, T
The aim of this study was to describe a possible variant of encephalo-craniocutaneous Lipomatosis syndrome. Three cases of congenital infiltrating lipomatosis of the face, associated with cutaneous, subcutaneous, and cerebral abnormalities: are presented. This neurocutaneous syndrome appears very similar to encephalo-craniocutaneous lipomatosis syndrome but lacks the typical eye lesions.
The Effects of Endothelin Antagonist Bq-610 on Cerebral Vascular Wall Following Experimental Subarachnoid Hemorrhage and Cerebral Vasospasm
(Springer Heidelberg, 2004) Cirak, B; Kiymaz, N; Ari, HH; Ugras, S
Endothelin, a potent vasoconstrictor, has been found to increase in the cerebrospinal fluid and serum of patients following subarachnoid hemorrhage (SAH) and to play a major role in the development of cerebral vasospasm. The aim of this study is to investigate the role of endothelin-A antagonist BQ-610 in the experimentally performed cerebral vasospasm following SAH. Thirty New Zealand rabbits were divided into three groups (each n=10): group A, control group; Group B, SAH group; Group C, treatment (endothelin antagonist BQ-610 treated) group. In the study, the rabbits developed vasospasm after injection of intracisternal autolog blood into the cisterna magna. After cerebral vasospasm development, in group C, endothelin antagonist BQ-610 was injected intracisternally. Morphometrically, basilar artery lumen was constricted 25% and 62% compared to the control group (group A) in the endothelin treated group (group C) and the endothelin untreated group (group B), respectively. Histopathological findings of the basilar artery wall confirmed the therapeutic effect of endothelin antagonist in vasospasm development. Endothelin-A receptor antagonist BQ-610 has a therapeutic effect in the cerebral vasospasm following experimentally performed subarachnoid hemorrhage when used intracisternally.
Fronto-Orbitonasal Intradiploic Meningioma in a Child
(Karger, 2000) Cirak, B; Guven, MB; Ugras, S; Kutluhan, A; Unal, O
Intradiploic meningioma, which may be classified as a subgroup of intraosseous meningioma, is a rarely encountered disorder. To date, less than 10 cases have been reported. Here, we report a case of fronto-orbito-nasal intradiploic meningioma, A 12-year-old female with exophthalmos and diplopia was operated on for a cranial intradiploic mass lesion. Histopathological evaluation of the specimen confirmed the diagnosis of intradiploic psammomatous meningioma. Her exophthalmos did not change, but the diplopia disappeared. This case is unique in that it is an extensive case of intradiploic meningioma of the orbital roof and frontal base in a child. Intradiploic meningiomas generally are of psammomatous type. Especially tumors adjacent to the orbita cause exophthalmos; cases located on the other side of the calvarium may not cause any symptom or sign other than headache or sometimes a mass on the scalp. Treat ment, as with meningiomas located in the intracranial cavity, is total resection of the lesion. Copyright (C) 2000 S. Karger AG. Basel.
Iatrogenic Quadriplegia and Bone Wax - Case Illustration
(Amer Assoc Neurological Surgeons, 2000) Cirak, B; Unal, O
Intracranial Hemorrhage and Ventriculoperitoneal Shunts
(Amer Assoc Neurological Surgeons, 2000) Cirak, B; Savitz, M.H.
Is Fusion Necessary
(Amer Assoc Neurological Surgeons, 1999) Cirak, B; Guven, MB; Beatty, R.A.; Wirth, F.P.; Dowd, G.C.
Is Indomethacin Harmful in Spinal Cord Injury Treatment? an Experimental Study
(Karger, 1999) Guven, MB; Cirak, B; Yuceer, N; Ozveren, F
This study was designed to analyze the effect of early indomethacin on the lipid peroxidation after spinal cord injury in rats. The use of anti-inflammatory drugs to affect delayed and secondary injury after trauma to the spinal cord has now become a matter of standard clinical practice. However, spinal cord injury remains an enormous clinical problem and research that may lead to improved treatment is to be encouraged and commended. Three experimental groups consisting of 40 rats each were formed. Using microsurgical technique, total laminectomy between T5 and T10 was performed. Spinal cord injury was achieved with an epidural aneurysm clip, and pharmacological treatment immediate after the injury was performed by injecting indomethacin intraperitoneally (i.p.) at a dose of 3 mg/kg to indomethacin-treated group. The three main groups were divided into subgroups of 8 rats each. It was planned to stop the biochemical reactions at a different time in each of these subgroups, by the application of liquid nitrogen to the spinal cord and paravertebral structures at the end of the 1st, 15th, 30th, 60th, and 90th minutes. All the spinal cords were removed and protected from further reactions by immersing in the liquid nitrogen tank. The lipid peroxidation levels were assessed by determining thiobarbituric acid reactive substances formation. The results of the study showed that the administration of 3 mg/kg indomethacin immediately after spinal cord injury induces lipid peroxidation to a significant degree (p < 0.05 one-way ANOVA and Tukey HSD tests) when compared to the saline-treated group. This result suggests that early posttraumatic indomethacin treatment may be harmful in spinal cord injury. Copyright (C) 2000 S. Karger AG, Basel.
Left Hemisphere and Male Sex Dominance of Cerebral Hemiatrophy (dyke-Davidoff Syndrome)
(Elsevier Science inc, 2004) Ünal, Ö; Tombul, T; Cirak, B; Anlar, Ö; Incesu, L; Kayan, M
Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease. (C) 2004 Elsevier Inc. All rights reserved.
Melatonin as a Free Radical Scavenger in Experimental Head Trauma
(Karger, 1999) Cirak, B; Rousan, N; Kocak, A; Palaoglu, O; Palaoglu, S; Kilic, K
Head trauma causes two kinds of injury in the neural tissue. One is the primary injury which occurs at the time of impact. The other one is a secondary injury and is a progressive process. Free radicals are produced during oxidative reactions formed after trauma. They have been thought to be responsible in the mechanism of the secondary injury. Some studies have been conducted to demonstrate the role of free oxygen radicals in neuronal injury. The alterations in the free radical level during the early posttraumatic period and the effect of a free radical scavenger on these alterations have not been studied as a whole. We aimed to demonstrate the free oxygen radical level changes in the early posttraumatic period and the effect of melatonin, which is a potent free radical scavenger, on the early posttraumatic free radical level. A two-staged experimental head trauma study was designed. In stage one, post-traumatic free radical level changes were determined. In the second stage, the effect of melatonin on the free radical level changes in the post-traumatic period was studied. Two main groups of rats each divided into four subgroups were studied. Rats in one of the main groups underwent severe head trauma, and malondealdehyde (MDA) levels were measured in the contused cerebral tissue at different time points. Rats in the other main group also underwent the same type of trauma, and melatonin was injected intraperitoneally at different time points after trauma. The MDA level alteration in the tissue was determined after the injection of melatonin. The MDA level increased rapidly in the early posttraumatic period. But in time, it decreased in the groups with only trauma. In the melatonin-treated group, the MDA level decreased after the injection of melatonin, when injected in the early posttraumatic period, compared to the control and trauma groups. However, melatonin increased MDA to a higher level than in the groups with only trauma and the control group when injected later than 2 h after trauma. The MDA level increases in the very early posttraumatic period of cerebral trauma and decreases in time. Melatonin, which is the most potent endogenous free radical scavenger, when injected intraperitoneally to the cerebral traumatized rats in the very early posttraumatic period, causes a significant decrease in the MDA level. But, melatonin, when injected more than 2 h after trauma, increases the MDA level in experimental cerebral trauma in rats. Copyright (C) 2000 S. Karger AG, Basel.
Pituitary Abscess Secondary To Neurobrucellosis -: Case Illustration
(Amer Assoc Neurological Surgeons, 1999) Güven, MB; Cirak, B; Kutluhan, A; Ugras, S
Primary Leptomeningeal Astrocytoma in a Child
(Blackwell Science Asia, 2000) Cirak, B; Caksen, H; Ugras, S; Unal, O
Regarding "acute Ecg Changes and Chest Pain Induced by Neck Motion in Patients With Cervical Hernia" -: in Response
(Westminster Publ inc, 2001) Güler, N; Bilge, M; Eryonucu, B; Cirak, B; Cirak, B.