Browsing by Author "Eseoglu, Metehan"

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Comparison of Simultaneous Shunting To Delayed Shunting in Infants With Myelomeningocele in Terms of Shunt Infection Rate
(Turkish Neurosurgical Soc, 2011) Arslan, Mehmet; Eseoglu, Metehan; Gudu, Burhan Oral; Demir, Ismail; Kozan, Abdulbaki; Gokalp, Abdulsemat; Kiymaz, Nejmi
AIM: Timing of shunt insertion in infants with myelomeningocele (MM) and hydrocephalus (HCP) has been debated. Many authors have suggested to perform the repair of MM and shunt insertion during same operation. However, there is also an opposite view. MATERIAL and METHODS: We analyzed retrospectively 166 patients who underwent MM Sac repair to evaluate whether there are difference between these two methods in terms of shunt infection rate. RESULTS: In the same session,V-P (ventriculoperitoneal) shunt placement was performed onto 65 infants within the first 48 hours of postnatal and 36 infants were operated 48 hours after birth. In separate sessions, repair of MM were performed onto 29 infants within the first 48 hours of postnatal and shunting was peformed 7 days after sac repair. 14 infants were performed MM sac repair 48 hours after birth, then shunt was applied 7 days after closure of MM. Shunt infection rate in concurrently operated groups was markedly high (12.3 % in early surgery, 33.3% in late surgery); in separatedly operated groups' shunt infection rate was lower (3.44% in early surgery, 14.29% in late surgery). CONCLUSION: We propose to perform V-P shunt placement and MM repair in separate sessions.
Presence of Accompanying Head Injury in Patients With Maxillofacial Trauma
(Turkish Assoc Trauma Emergency Surgery, 2012) Isik, Daghan; Gonullu, Hayriye; Karadas, Sevdegul; Kocak, O. Faruk; Keskin, Siddik; Garca, M. Fatih; Eseoglu, Metehan
BACKGROUND Patients with maxillofacial fractures are at high risk of accompanying traumatic cranial injuries. Prompt determination of head injury in these patients is crucial for improving patient survival and recovery. METHODS The records of 246 patients with maxillofacial fractures referred to the emergency department of our hospital between January 2006 and September 2009 were reviewed in this retrospective study. The patients' age and gender, cause, type and location of the maxillofacial fracture, and the cranial injuries were analyzed. RESULTS The mean age of the patients was 23.61 +/- 16.75 years (83.3% males and 16.7% females). Cranial injury was observed in 38 patients with maxillofacial trauma. While the risk of head injury was found to be 3.44-fold lower among patients with single facial bone fracture (p<0.001), the risk of experiencing head injury significantly increased in patients with multiple facial bone fractures (p<0.001). The risk of head trauma significantly increased in patients with fractures of the nasal bone, maxillary bone, mandibular bone, and with frontal region fractures (p<0.05 in each group). CONCLUSION The patients with multiple facial bone fractures should be investigated with regard to head injury even if they do not have clinical findings.
Relationship of Antioxidant Enzyme Activities With Myelomeningocele
(Turkish Neurosurgical Soc, 2012) Arslan, Mehmet; Melek, Mehmet; Demir, Halit; Eseoglu, Metehan; Gudu, Burhan Oral; Demir, Ismail; Cetin, Cigdem
AIM: To investigate the role of erythrocyte free radical scavenging enzyme activities (FRSE), carbonic anhydrase (CA) activity and malondialdehyde (MDA) in infants with myelomeningocele (MM). MATERIAL and METHODS: We compared antioxidant enzyme activities and MDA level in 40 individuals (10 infants with MM, 10 healthy infants; and mothers of these two groups) with age-matched subjects. Erythrocyte FRSE included catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPX) and glutathione-S- transferase (GST). RESULTS: CA, CAT, SOD, GPX and GST concentrations were lower in all of the infants with MM compared to healthy infants. The mothers of infants with MM also had lower CA, CAT, SOD, GPX and GST activities than healthy mothers. It was also found out that the MDA level as a marker of oxidative damage was higher in infants with MM and their mothers than in healthy infants and their mothers. CONCLUSION: Lower FRSE activities indicate an increased frequency of MM. Free radicals (FRs) such as MDA may play a significant role in the etiology of MM.
Role of the Trigeminal System on Posterior Communicating Artery Remodelization After Bilateral Common Carotid Artery Ligation
(Sci Printers & Publ inc, 2013) Aygul, Recep; Aydin, Mehmet Dumlu; Kotan, Dilcan; Demir, Recep; Ulvi, Hizir; Karalar, Mustafa; Eseoglu, Metehan
OBJECTIVE: To examine whether or not there is a possible relationship between the neuron density of trigeminal ganglion (TGG) and the severity of posterior communicating artery (PComA) vasodilation values after permanent bilateral common carotid artery ligation (BCCAL). STUDY DESIGN: This study included 25 rabbits. Both the common carotid arteries of 20 rabbits were explored and denervated. Five animals served as controls. Permanent BCCAL was applied in 15 of the 20 rabbits, and the other 5 were used as the SHAM group without ligation. All animals were followed for 2 months and then sacrificed. Their brains and cranial nerves were extracted and fixed in 10% formalin solution. The relationship between PComA vasodilation values and TGG neuron densities were compared. RESULTS: Elongation, convolution and enlargement were detected in all the basilar arteries of all ligated animals and 2 from the SHAM group. On histopathogical examination vascular wall thinning, luminal enlargement, flattened inner elastic membrane, flattened vessel muscle cells, endothelial desquamation and intimal erosions were detected. An inverse relationship was discovered between the neuron density of TGG and the severity of PComA vasodilation index. CONCLUSION: BCCAL may lead to important beneficial and hazardous histomorphological changes at the posterior communicating artery. The high neuron density of TGG may provide a beneficial effect by facilitating PComA enlargement via its vasodilatory properties for the increase of decreased cerebral circulation, although this situation may be hazardous for certain subjects with congenital or acquired cerebrovascular pathologies.
Spontaneous Migration of a Retained Bullet Within the Brain: a Case Report
(Turkish Assoc Trauma Emergency Surgery, 2012) Arslan, Mehmet; Eseoglu, Metehan; Gudu, Burhan Oral; Demir, Ismail; Kozan, Abdul Baki
Gunshot injury to the head is usually mortal, and spontaneous migration of a retained bullet is rare. We report the case of a 23-year-old man with a spontaneously migrated bullet within the brain. Cranial computerized tomography (CT) indicated that the bullet was lodged deeply in the left parietal region. The patient was conscious and had right homonymous hemianopsia. The bullet was close to the vital structures and deep-seated; therefore, surgical intervention was not considered. Two months after the injury, repeat CT revealed that the bullet had migrated posteriorly and caudally due to gravitational factors. Management of the retained bullet was controversial. Removal of a deep-seated bullet may cause additional neurological deficit, but migration of a retained bullet may cause damage to vital structures, producing significant neurological damage. We proposed that the bullet in the brain should be removed if it could be reasonably accessed without causing additional neurological damage.
Spontaneous Regression of Lumbar Disc Herniation Correlated With Clinical and Radiological Improvement: Case Report
(Journal Neurological Sciences, 2015) Cuce, Ferhat; Eroglu, Ahmet; Eseoglu, Metehan; Atabey, Cem; Deniz, Suleyman; Duz, Bulent
In recent years, the increase in the quality of imaging techniques is for diagnosis of lumbar disc hernia (LDH) accounted facilitate the diagnosis and follow-up an important development. Especially extruded LDH is started to be more frequent. Radicular pain is one of the most important complaints with extruded lumbar disc herniation in patients. Surgery is performed due to radiculopathy In many patients. Spontaneous regression of extruded lumbar disc herniation is a rare condition. In such extruded lumbar disc herniation cases, the contrast-enhanced MRI can give us several predictions associated with the prognosis of herniation. We aimed to present 21 years old male patient a case of regressed and extruded lumbar disc herniation without any surgical intervention, only with neurologic improvement together with radiological findings in light of literature.
Transorbital Orbitocranial Penetrating Injury Caused by a Metal Bar
(Medknow Publications & Media Pvt Ltd, 2012) Arslan, Mehmet; Eseoglu, Metehan; Gudu, Burhan Oral; Demir, Ismail
Transorbital intracranial injury is uncommon, representing 0.04% of penetrating head trauma with a high mortality rate. Orbital penetrating injuries may cause severe brain injury if the cranium is entered, typically via the orbital roof, the superior orbital fissure, or the optic canal. A 13-year-old male sustained a severe brain injury due to penetration of the right orbit with an iron bar. The bar entered the inferiomedial aspect of the orbit and emerged from the left occipital bone. Neurological examination revealed deep coma (GCS: E1M2V1) with fixed, dilated, and non-reactive pupils. The bar followed an intracranial trajectory, through the third ventricle and suprasellar cistern. The patient underwent an immediate exploration with removal of the bar. Unfortunately, he died 10 days postoperatively due to severe diencephalic injury with brainstem herniation. In this case report, we discuss the radiologic diagnosis and surgical management of transorbital orbitocranial injury by foreign body penetration.
Vancomycin-Resistant Enterococcus Ventriculitis in a Child
(Modestum Ltd, 2014) Kiymaz, Nejmi; Gudu, Burhan Oral; Eseoglu, Metehan; Demir, Ismail
One of the most frequently encountered problems associated with ventriculoperitoneal (VP) shunts which are used in the treatment of hydrocephaly is infection. Staphylococcus is considered the most prominent factor in VP shunt infections; Enterococcus is less likely to cause ventriculitis in such patients. A shunt ventriculitis was demonstrated in a 1.5-year-old boy. The VP shunts was removed and an external ventricular drainage system was inserted. Subsequently empiric vancomycin and cephotaxime treatment was started. Vancomycin-resistant Enterococcus faecium (VREF) began to proliferate in the cerebrospinal fluid culture, and therefore we initiated linezolid and imipenem therapy by the intravenous route. The patient underwent a VP shunt operation 45 days after. In this study, successful therapy with linezolid in VP shunt ventriculitis due to VREF is presented.