Browsing by Author "Gudu, Burhan Oral"

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Bowel Perforation at the Delayed Stage After Shunt Surgery: Case Report
(derman Medical Publ, 2012) Arslan, Mehmet; Yazici, Taner; Gudu, Burhan Oral; Demir, Ismail
Ventriculoperitoneal shunt surgery is common used procedure in the treatment of hydrocephalus. This invasive procedure has been associated with several abdominal complications. Bowel perforation from peritoneal catheter is rare, but is an important complication; if early diagnosis is established severe ventriculitis and sepsis may develop ascending infection from gasrointestinal flora migrating thorough catheter. A 7.5-year-old, ventriculoperitoneal shunted girl with hydrocephalus was admitted for recurrent meningitis. Computed tomographic scan revealed peritoneal catheter perforating the sigmoid colon. Bowel perforation should be considered definitely if there is recurrent meningitis without the rectal extrusion of peritoneal catheter in patients with shunt.
Cavernous Hemangioma Presenting as a Giant Cervical Mass: a Case Report
(Turkish Neurosurgical Soc, 2010) Kiymaz, Nejmi; Yilmaz, Nebi; Ozen, Suleyman; Demir, Ismail; Gudu, Burhan Oral; Kozan, Abdulbaki
Intramuscular hemangiomas of the head and, neck are rare congenital vascular tumors and are sparsely reported. Hemangiomas account for approximately 7% of benign tumors and usually present as a mass that suddenly enlarges. Hemangiomas are mostly seen on the trunk and extremities, but can also appear on the head and neck region. A 10-year-old boy was referred to our clinic for puffiness and swelling on the right side of his neck. Neurological examination was normal, but we observed an advanced degree of restriction in neck movement. An MRI study showed a soft tissue mass 9x8x5 in size. The mass was totally extracted by surgical intervention and pathological analysis revealed that it was a cavernous hemangioma. The patient's neck movement returned to normal after surgery. No relapse occurred during 1-year follow-up.
Cervical Spinal Dysraphism
(Karger, 2010) Kiymaz, Nejmi; Yilmaz, Nebi; Gudu, Burhan Oral; Demir, Ismail; Kozan, Abdulbaki
Objective: Cervical spinal dysraphism is a rare congenital spinal pathology. The results obtained from our series are compared with the results obtained from other series of studies in the literature. Methods: Seven patients with cervical myelomeningocele and meningocele who underwent surgery between January 1996 and March 2009 at the YYU Faculty of Medicine in the Department of Neurosurgery were retrospectively studied. Results: The referral ages of the patients (6 females and 1 male) varied between 4 days and 4 months (median 1 month). A stalk lesion covered with a dysplastic skin formed as a sac and located at the cervical midline was demonstrated in all of the patients. Cervical myelomeningocele was present in 4 patients, while cervical meningocele was present in 3 patients; however, Chiari type II malformation and hydrocephaly were present in 3 patients with myelomeningoceles. Diastematomyelia and a filum terminal lipoma were present in 1 of the patients. Conclusion: In this series, in contrast to the literature, we noted that the number of girls with spinal dysraphism with a cervical myelomeningocele and meningocele was greater than the number of boys. Chiari type II malformation, hydrocephaly and motor weakness in patients with cervical spinal dysraphism are less frequent when compared to patients with caudal spinal dysraphism. The structure of the sac is also more durable and, accordingly, a cerebrospinal fluid leakage is uncommon. Copyright (C) 2011 S. Karger AG, Basel
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.
A Craniocervical Teratoma With an Encephalocele-Like Appearance
(Turkish Neurosurgical Soc, 2012) Kiymaz, Nejmi; Demir, Ismail; Gudu, Burhan Oral
Teratomas are rare congenital tumors. Teratomas frequently occur in adult ovaries, but can be located primarily in the sacrococcygeal zone and intracranial compartment in newborns. Teratomas are rare in the head and neck region. Teratomas arise following a sequence of cells derived from more than one germ layer at different regions of the body due to a change in location of germ cells, and contain ectodermic, endodermic, and mesodermic tissues. Herein we detail the follow-up and treatment of a newborn with a mass that was located at the back of the head and was referred to our Neurosurgery Clinic with a pathologic diagnosis of a grade II-III immature teratoma resembling an encephalocele.
Metastatic Myxoid Liposarcoma of the Scalp: Case Report
(Ortadogu Ad Pres & Publ Co, 2012) Kiymaz, Nejmi; Yilmaz, Nebi; Gudu, Burhan Oral; Demir, Ismail; Gokalp, Abdulsemat
Liposarcomas are the second most frequent soft tissue sarcomas occurring in adults after malignant fibrous histiocytomas; however, liposarcomas rarely occur on the scalp. A mass was detected on the hairy skin of a 38-year-old male patient who had undergone surgery for a mass on the posterior aspect of the right thigh and had been diagnosed with a myxoid liposarcoma 3 years earlier. The patient had undergone total bulk excision and the histopathologic examination of the mass lesion revealed liposarcoma metastasis. Chemotherapy was initiated. Relapse or metastasis did not develop during 3 years of follow-up. Here we present a patient with a myxoid liposarcoma, which metastasized from the posterior side of the right thigh to the scalp.
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.
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.
Study of the Neuroprotective Effect of Ginseng on Superoxide Dismutase (Sod) and Glutathione Peroxidase (gsh-Px) Levels in Experimental Diffuse Head Trauma
(Springer Wien, 2013) Demir, Ismail; Kiymaz, Nejmi; Gudu, Burhan Oral; Turkoz, Yusuf; Gul, Mehmet; Dogan, Zumrut; Demirtas, Sezin
The purpose of our study was to investigate the effect of ginseng on antioxidant enzyme levels in brain damage following experimental diffuse head trauma in rats. The neuroprotective effect of ginseng was also studied. In this study, rats were divided into four groups, and the rats in group 1 received no intervention. In group 2, the rats were administered 50 mg/kg ginseng, injected intraperitoneally at 1, 24 and 48 h, and the effect of ginseng on normal tissues was studied. No drugs were administered to the rats in group 3 who had previously experienced diffuse head trauma using Feeney's falling weight method. In group 4, rats underwent Feeney's falling weight method, leading to diffuse head trauma, and they were given 50 mg/kg ginseng intraperitoneally 1, 24 and 48 h after head trauma. Rats were killed 72 h after head trauma and their brain tissues extracted for histopathological and biochemical studies. Histopathological study of brain cross sections in the trauma group demonstrated neurons in the trauma region and surrounding area, which generally had a dark-colored eosinophilic cytoplasm and a pyknotic nucleus, while the nuclei of neurons were located peripherally. However, brain cross sections in group 4 from rats given ginseng after head trauma showed fewer neurons with eosinophilic cytoplasm, pyknotic and peripheral nuclei in the trauma region and surrounding area. No statistically significant difference in the tissue SOD level was observed; however, the GSH Px level in group 4 was significantly reduced compared to that in group 3. After affecting the GSH Px level and reducing histopathological scores, ginseng was found to display antioxidant and neuroprotective activity.
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.
Vomiting and Dysphagia Due To Fractured of Allograft After Anterior Cervical Discectomy and Fusion
(derman Medical Publ, 2012) Arslan, Mehmet; Hiz, Ozcan; Yazici, Taner; Kotan, Cetin; Gudu, Burhan Oral
Anterior cervical discectomy and fusion (ACDF) is commonly performed for cervical disk disease. Establishing Fibular allograft after discectomy is frequently applied. A variety of complications may occur such as dysphagia, dyspnea, bilateral vocal cord paralysis, recurrent laryngeal nerve paralysis, internal juguler venous thrombosis, cervical screw extrusion, bone graft extrusion, vascular injury and epidural hematoma. Dysphgia is the most common complication after ACDF and its etiology is still obscure. It usually improves in 6 months, but remains as a significant problem for some patients. Graft extrusion is a well -recognized complication. We present the case of 44 - year - old woman with dysphagia and persistent vomiting due to collapsed fibula allograft. She had undergone anterior C 5-6 discectomy and fusion with fibula allograft at our institute 7 months before. Her lateral cervical radiography showed collapsed fibula allograft, which was extruded toward the esophagus, at cervical 5-6 level. Fractured bone graft was removed by anterior cervical approach. After surgery, the patient's complaints were improved. Dysphagia has been very frequently reported due to various causes after ACDF. Whereas, feeling of nausea and vomiting have never been reported. Also extrusion or collapse of bone graft following ACDF has rarely been reported.