Browsing by Author "Kiymaz, N."

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Anal Protrusion of Ventriculo-Peritoneal Shunt Catheter: Report of Two Infants
(2004) Yilmaz, N.; Kiymaz, N.; Yilmaz, C.; Çaksen, H.; Yuca, S.A.
In general, treatment of hydrocephalus requires the application of a ventriculo-peritoneal shunt. Despite the peritoneal cavity being convenient for absorption of cerebrospinal fluid, multiple complications related to the shunt tends to develop within this area. The most frequent complications are abdominal. A rare complication can occurs with perforation of the organs located in peritoneal cavity by the catheter when infection occurs. Here we report two cases (because of unusual presentation) of shunt complication, they were operated for hydrocephalus. Acute traumatic anal protrusion of the peritoneal catheter occurred in the first case while a spontaneous anal protrusion during follow-up period, in the second case. The predisposing factors were thought to be previous abdominal infection and the use of trocar during operation in the first case and chronic irritative effect of the ventriculo-peritoneal catheter in the second case. © 2004, IOS Press. All rights reserved.
Bilateral Abducens Paralysis Following Head Injury: a Case Report
(2003) Yilmaz, N.; Arslan, M.; Kiymaz, N.; Demir, Ö.; Yilmaz, C.
Cranial nerve lesions often accompany head trauma. Olfactory, facial and vestibular nerves are the most commonly injured nerves. Optic and oculomotor nerve injuries are less frequently involved, and trigeminal, abducens and lower cranial nerves are rarely involved. The injury may occur in central nervous system or in the lower motor unit. Traumatic bilateral abducens paralysis is a very rare occurrence. It may follows cervical spine trauma and sixth nerve avulsion has been reported to complicate lumbar puncture. In this study, we describe an 11-year-old boy with bilateral abducens paralysis following hematoma in the left ponto-cerebellar angle and hemorrhage in the prepontine cisterns due to head trauma. Such hemorrhages might result in lesions in the supranuclear regions by traction on the nerve due to displacement of the pons and its nucleus as a result of direct pressure. © 2003, IOS Press. All rights reserved.
Central Diabetes Insipidus Following Intracranial Hemorrhage Due To Vitamin K Deficiency in a Neonate
(2005) Çaksen, H.; Odabaş, D.; Kaya, A.; Cesur, Y.; Kiymaz, N.; Etlik, Ö.; Turhan, S.
A previously healthy 30-day-old girl presented with seizures, irritability and inability to sleep for three days. Vitamin K was not given just after birth. She was lethargic. A multifocal clonic seizure was evident during examination. Anisocoria was diagnosed on eye examination. Brain magnetic resonance imaging showed intracerebral hemorrhage, ventricular dilatation, and hematoma in the left temporofrontal region extending to the hypothalamus. Central diabetes insipidus was diagnosed by water deprivation due to dehydration and hypernatremia, and then desmopressin was added to phenobarbital. The possible mechanism of central diabetes insipidus in our patient is damage of vasopressin pathway resulting from compression of hemorrhage. An operation of ventriculoperitoneal shunt was also performed due to hydrocephalus. While she was symptom-free except for neurological sequel during routine control examinations after discharging from hospital, the parents said that she died, most probably from bronchopneumonia, at the age of 7.5 months. In conclusion, we emphasize that prophylactic vitamin K should be administrated to all babies just after birth, and infants with intracranial hemorrhage should carefully be monitored for central diabetes insipidus.
Cerebellar Dermoid Cysts With Hydrocephalus
(2004) Çirak, B.; Kiymaz, N.; Kerman, M.
Intracranial dermoid cyst is a rare entity, accounting less than 1% of all intracranial tumors. The most common localization is midline at the posterior fossa. They usually cause symptoms related to compression, infection, hydrocephalus, or a combination of all. The controversy arises about the preoperative treatment planning. Since infection is a major risk in those patients, inserting a shunt at the same session of tumor removal may not be achieved. Total resection of tumor is a must. We present two cases of posterior fossa dermoid cysts with hydrocephalus as a complication. First case presented with the symptoms of meningitis. She had no hydrocephalus at the time of surgery. The second case had hydrocephalus but no sign of infection. Both cases needed ventriculo-peritoneal shunt insertion. Hydrocephalus may occur at any time during the course of the disease. But appropriate time of handling is important to avoid increased morbidity and mortality related to the shunt infection failure. © 2004, IOS Press. All rights reserved.
Cerebral Hemiatrophy Associated With Hematological and Developmental Disorders
(2004) Ünal, Ö.; Çaksen, H.; Kiymaz, N.; Dilek, I.; Kayan, M.; Anlar, Ö.
The etiology of cerebral hemiatrophy may be congenital or acquired. Trauma, infection, vascular abnormality, ischemic and hemorrhagic conditions may be the etiologic factors in acquired type. There is limited information about its association with other disorders in the literature. We presented three new cases of cerebral hemiatrophy associated with some hematological and developmental disorders. Cerebral hemiatrophy was associated with thalassemia major in a 10-year-old girl, acute myeloblastic leukemia and Marfan syndrome in a 23-year-old man, and craniosynostosis in a 1-year-old boy. To the best of our knowledge, thalassemia major, myeloblastic leukemia, Marfan syndrome and craniosynostosis have not been reported in cerebral hemiatrophy in the literature. © 2004, IOS Press. All rights reserved.
Does Pregnancy Induce or Enhances Low Back Pain
(2006) Kiymaz, N.; Yilmaz, N.; Zeteroǧlu, Ş.; Yazici, T.
Forty-eight pregnant women out of 166 referred to our obstetrics and gynecology outpatient clinic due to back pain between February and March 2003 were included in the present study. A questionnaire booklet was prepared for age, weight gain during pregnancy, number of parities, existence of any back pain in their former pregnancies, the start of back pain during pregnancy, physical work conditions and route of previous labour information. These patients were followed for a period of 1.5 years after labour. The factors that influenced back pain in the pregnant patients were: multiparity, former back pain during pregnancy, and weight gain during pregnancy. We determined lumbar discopathy at a ratio of 79.1% using MRI (Magnetic Resonance Imaging) study of the lumbar vertebrae in patients with back pain lasting more than a one year. © 2006 VSP.
Extra-Axial Subarachnoid Ependymoma Mimicking a Pca Schwannoma
(Turkish Neurosurgical Society, 2005) Yilmaz, N.; Kiymaz, N.; Mumcu, Ç.; Bayram, I.
The presentation, diagnosis, and treatment are described for a patient with an ependymoma involving the left cerebellopontine angle (PCA). A 34-year-old woman had left facial paralysis, hearing loss and headache in 8 months. Computerized tomography (CT) revealed a mass lesion of the left PCA which was enhanced homogeneously. Magnetic resonance imaging also (MRI) showed the mass in the left PCA which was high-intense on T1-weighted images, iso- and high-intense on T2-weighted images and homogeneously enhanced by administration of Gd-DTPA. The patient was operated on and the tumor was totally removed. Histopathological examination of the specimen revealed a typical ependymoma. The postoperative course was uneventful with complete resolution of the symptoms on admission. We present here an unusual case of PCA ependymoma located within the PCA and exhibiting no continuity with the ventricular systems. The radiological and clinical features of the tumour mimicked a PCA schwannoma.
A Giant Cervical Osteochondroma
(TIP ARASTIRMALARI DERNEGI, 2005) Kiymaz, N.; Doǧan, A.; Yilmaz, N.; Mumcu, Ç.
A giant solitary osteochondroma in 17-year-old-boy was reported. Osteocondromas usually involves the long bones, scapulae, pelvic bones and seldom occurs in the axial skeleton. A 17-year-old boy presented with a swelling at the rear of the neck and an advanced degree of limitation in the movements of his neck. A hard mass sized approximately 7x8 cm was revealed in this region. Cervical x-ray and CT revealed the mass involving the sixth cervical vertebrae. Giant cervical osteochondroma operated and the mass was successfully excised. Osteochondromas that consists the largest portion of benign bone tumors at the spine is seldom. Therefore we are introducing a osteochondroma case located at the lower cervical region where an advance degree of limitation in neck movements that displays no any neurological symptoms and that reaches a very wide mass in size, and which is assumed as unusual.
Recurrent Pleomorphic Adenoma of Orbit: Case Report
(Turkish Neurosurgical Society, 2005) Yilmaz, N.; Kiymaz, N.; Etlik, Ö.; Mumcu, Ç.; Bayram, I.
Pleomorphic adenoma is the most common epithelial tumors of the human lacrimal gland, comprising about 50% of all the tumors. Although malignant transformation is not frequent, intraoperative tumor spill or inadequate resection may be associated with an increase in the recurrence rate of pleomorphic adenoma. Postoperative irradiation following tumor resection appears to decrease the probability of recurrence. In this study, we present a 37-year old woman with recurrent pleomorphic adenoma of the lacrimal gland eight months after the first operation.
Solitary Melanoma of the Central Nervous System: Case Report
(Lippincott Williams and Wilkins, 2015) Beyazal, M.; Yavuz, A.; Kiymaz, N.; Yilmaz, D.
Primary melanoma of the central nervous system (CNS) is a rare entity, thus the diagnostic and therapeutic experience is based on a limited number of published cases. The diagnostic dilemma of solitary CNS melanoma is whether it is primary. Primary CNS malignant melanoma has more favorable prognosis than metastatic disease according to the published reports in the literature. Primary melanoma of the CNS may occur as intra-axial or extra-axial mass lesions or may be presented as meningeal spread. We describe the clinical features of 23-year-old male patient with solitary cerebral melanoma, including magnetic resonance imaging and histopathologic findings in light of literature. © 2013 Wolters Kluwer Health, Inc.
Surgical Treatment of Craniocervical Decompression Without Chiari Malformation in Syringomyelia
(2005) Yilmaz, N.; Kiymaz, N.; Mumcu, Ç.
We aimed to describe a patient without Chiari malformation who was treated via craniocervical decompression and by creating cisterna manga with an autologous fascia graft, and who displayed a clinical and radiological improvement in the post-operative period. Syringomyelia is a chronic and progressive disease with cavitation and gliosis in the spinal cord. It is more common in adulthood and often involves the cervical region. Due to the fact that craniocervical decompression therapy is successful in syringomyelia with Chiari malformation, this surgical treatment is currently controversial in syringomyelia without Chiari malformation. A 33-year-old male applied to our clinic with numbness and weakness in his left hand that had lasted for 2 years, but his condition had worsened in recent months, with neck pain before over previous the 8 months and a walking disturbance that had appeared 7 months before. Syringomyelia was found between the C2 and T8 vertebrae levels on magnetic resonance imaging (MRI) scans. The patient was diagnosed with syringomyelia and underwent suboccipital decompression. Cisterna magna was created by duraplasty with a fascia lata graft. Consequently, craniocervical decompression might be accepted as a treatment method of choice in patients with syringomyelia without Chiari malformation.
Traumatic Lumbar Fracture-Dislocation Related To Spina Bifida Occulta: Case Report
(2005) Kiymaz, N.; Yilmaz, N.; Mumcu, Ç.
Traumatic lumbar fracture-dislocation is a rare condition. Congenital spinal deformities may facilitate the occurrence of this case. We diagnosed spina bifida occulta accompanied at the same level by a L2 anterior dislocation which resulted from a vehicle in-site traffic accident in a 35-year-old female patient. Posterior intervention was carried out during therapy, and reduction and stabilization were performed by means of a T12-L1 and L2-L3 trans-pedicular screw. In patients with a congenital spinal anomaly the effect of spinal traumas may be greater than normal. Therefore, spinal traumas in patients with a congenital spinal anomaly should be assessed more carefully.
Trigeminal Neuralgia Caused by Intracranial Epidermoid Tumor: Report of a Case and Review of the Different Therapeutic Modalities
(American Society of Interventional Pain Physicians, 2004) Cirak, B.; Kiymaz, N.; Arslanoglu, A.
Trigeminal neuralgia (TGN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. Paroxysms typically last for 1 to 2 seconds. Etiology includes compression of the trigeminal nerve by vascular structures, tumors and multiple sclerosis plaques in the medulla spinalis. TGN is rather rare as a presenting symptom with intracranial tumors. Epidermoid tumors comprise 1% of all intracranial tumors. The majority of epidermoid tumors are located at the pontocerebellar angle, the third ventricle, and the suprasellar region. Symptomatology is not different from other tumors located at the same sites. Trigeminal neuralgia may be caused by tumor compressing the nerve itself, an inflammatory response to the epidermoid tumor or vascular compression of the nerve. We describe the case of a 30-year-old female presenting with right-sided facial pain. Her past history revealed multiple teeth extractions done to relieve facial pain. Radiological evaluation, including magnetic resonance imaging (MRI), showed a pontocerebellar angle (PCA) epidermoid tumor. TGN resolved completely after total tumor resection. A temporary facial paralysis consequent to surgical removal of the tumor improved 6 months postoperatively, and she remained pain-free, without medications.