Browsing by Author "Kozan, Abdulbaki"

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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.
Intraoperative Csf Pressure Measured and Vp Shunted Hydrocephalic Newborns' Radiological Follow Up for One Year
(2012) Kozan, Abdulbaki; Arslan, Mehmet
Yenidoğanlarda en sık görülen konjenital hastalıklardan biri de hidrosefalidir. Hidrosefali; BOS dolaşımındaki obstrüksiyondan, yetersiz emilimden ve/veya aşırı üretimden kaynaklanan, ventrikül içinde anormal BOS birikiminin neden olduğu yüksek intrakraniyal basınç ve ventriküler dilatasyonla karakterize klinik bir tablodur. Tedavisinde cerrahi uygulanmaktadır. Günümüzde en sık kullanılan cerrahi yöntem, komplikasyon oranının yüksekliğine rağmen ventriküloperitonel şant uygulamasıdır. Opere edilen hidrosefalili hastaların takipleri beyin MRG ve BT ile yapılmaktadır. Burada ventrikül / beyin parankimi oranı Evans, bifrontal, sella medya, bikaudat vb. indekslerle değerlendirilip, şantın çalışıp çalışmadığı veya şanttan ne kadar fayda gördüğü araştırılır.Çalışmamıza 18 erkek, 18 kız olmak üzere toplam 36 hidrosefalisi tanısı almış yenidoğan dahil edildi. Bu hastaların VP şant uygulamaları sırasında per-op BOS basınçları ölçüldü ve ortalama BOS basınç değeri 5.4 mm/hg bulundu. Post-op klinik takiplerinde hastalar 6. ve 12. aylarda kontrole geldiklerinde beyin MRG ile radyolojik takibi yapıldı. 7 hastada Evans ve diğer indekslerde artış olup klinik durumları da dikkate alınarak şant disfonksiyonu kabul edilip, tekrar operasyona alındı. BOS örneği alınıp sonucuna göre şant sistemi revize edildi veya yenisi ile değiştirildi. Bu hastaların sonraki kontrollerinde tüm indekslerde düşüş saptandı.VP şant uyguladığımız hastaların ilk, 6. ve 12. aylardaki indeks değerleri istatiksel analize tabi tutulduğunda değerler arasında anlamlı bir düşüş olduğu (p<0.05) bulunmuştur. İndeks değerlerinin kendi aralarındaki çoklu karşılaştırmalarında da pozitif yönde güçlü bir ilişki bulunmuştur (p<0.05). VP şant uygulanan hidrosefalili yenidoğanlarda İlk 6 aydaki beyin parankiminde artış % 15.7, sonraki 6 aylık zaman diliminde ise beyin parankimindeki artış % 6.9 olarak bulunmuştur.Sonuçta gelişebilecek komplikasyonlarına rağmen VP şant uygulaması hala hidrosefali tedavisinde en çok uygulanan yöntemdir. Gerek operasyon esnasında steriliteye maximum dikkat etmek, gerekse post-operatif dönemde bu hastaların takiplerinin iyi yapılması ve ailelerinin bu konuda bilinçlendirilmesi şant uygulamalarındaki başarıyı arttıracaktır.