Browsing by Author "Mumcu, Cigdem"

Now showing 1 - 5 of 5

Controversies in Chronic Subdural Hematoma
(int Scientific information, inc, 2007) Kiymaz, Nejmi; Yilmaz, Nebi; Mumcu, Cigdem
Background: Various surgical methods are recommended for the therapy of chronic subdural hematoma (CSH). In this study, burr-hole continuous drainage (CD) and burr-hole one-time drainage (OTD) methods for the treatment of CSH are retrospectively compared. Materials/Methods: Fifty patients with CSH referred to this clinic between July 1995 and December 2003 were selected for treatment. Twenty-one patients were treated by the burr-hole OTD method and 29 patients received burr-hole CD therapy. The recurrence rates and the extension of the hematoma were evaluated with respect to the period of postoperative hospitalization to evaluate the most effective method. Results: The postoperative hospitalization period was 7.9 days in the burr-hole continuous drainage group and 17 days in the burr-hole one-time drainage group. Recurrence developed in two cases (6.8%) in the CD group and in six cases (28.5%) in the OTD group. When the pre- and postoperative hematoma extension in the CD group were compared, a significant degree of decrease was observed on post-op day 1. Extension of the hematoma was found to be minimal in the days following the modification. The width of the hematoma in the OTD group was also reduced at post-op day 1; however, the degree of this decrease was not significant. Conclusions: Continuous drainage therapy for CSH is superior to the one-time drainage method due to the shorter time of post-op hospitalization and to the reduced rate of recurrence.
Intradural Disc Herniation a Case Report and Review of the Literature
(Modestum Ltd, 2005) Yilmaz, Nebi; Kiymaz, Nejmi; Etlik, Omer; Mumcu, Cigdem
Intradural disc herniation (IDH) is a rare pathology. Intradural disc herniations comprise 0.26-0.30% of all herniated discs. The preoperative knowledge of an intradural herniation is important because it has an influence on the operative strategy. A 55-year-old man suffered from decrease in the motor function of the lower extremities and urinary incontinence. Noncontrast MRI exam showed the intradural disc with caudal migration of an excluded fragment at the L3-4 level. At surgery, the L3 and L4 laminas were removed and after dura had been openned, a nucleus pulposus was seen which compressed the conus medullaris to the right and left of the spinal canal. Every neurosurgeuon involved in spinal surgery must be aware of this rare patology which, when overseen during the intervention, could have disastrous consequences for the patient.
Penetrating Spinal Injury: Reports of Two Cases
(Turkish Assoc Trauma Emergency Surgery, 2009) Yilmaz, Nebi; Kiymaz, Nejmi; Mumcu, Cigdem; Demir, Ismail
Penetrating spinal cord injuries caused by stab wounds are rare. Such injuries may result from a direct lesion of the neural elements of the spinal cord, cord infarcts or, more rarely, intradural or epidural hematoma. In the present study, two cases with spinal cord and L4 root injuries caused by a knife are presented. The first case, a 22-year-old male, referred to our emergency outpatient clinic with a stab wound injury at the mid-section of his back. Neurological examination of this patient showed paraplegia, and spinal MRI displayed a total spinal cord lesion at the T7-T8 level. The wound was primarily sutured; however, during follow-up, CSF (cerebrospinal fluid) leakage continued and the patient was operated. The ruptured dura mater was primarily sutured in a surgical intervention that involved T7-T8 total laminectomy. The second patient referred to our emergency outpatient clinic with a torso injury caused by a sharp knife. The knife was embedded 2-3 cm deep at the wound site at the L3 level and the handle was broken. The patient was immediately operated and the broken and embedded metallic part of the knife was extracted.
Protective Effect of Sildenafil (Viagra) in Transient Spinal Cord Ischemia
(Karger, 2008) Kiymaz, Nejmi; Yilmaz, Nebi; Mumcu, Cigdem; Anlar, Omer; Ozen, Suleyman; Kayaoglu, Cetin Refik
Prospective study of the neuroprotective activity of sildenafil in a rat spinal ischemia model. The present study involved 21 male Sprague-Dawley rats. The animals were divided into 3 groups. Physiological serum was administered intraperitoneally to the 8 rats in the control group at the beginning of reperfusion for a period of 20 min after abdominal aortal occlusion. Sildenafil (Viagra((R))) was administered as a single 10mg/kg/day intraperitoneal dose to the 8 rats in the sildenafil group at the beginning of reperfusion after 20 min of abdominal aortal occlusion. No occlusion was performed and no agent was administered to the 5 rats in the sham group, but the abdominal aorta was reached by means of surgical intervention. Before the animals were sacrificed, several physiological and biochemical parameters were investigated, preoperative and postoperative motor functions were also assessed, and somatosensory evoked potential (SEP) monitoring and histopathological examinations were carried out. No differences were found between the physiological and biochemical parameters in each of the 3 groups. Neurological scoring performed after reperfusion demonstrated a significant improvement in the neurological results relative to those of the control group over 48 h in subjects that received sildenafil. These animals also showed better 24-hour SEP results, measured in terms of extended latency and decreased amplitude, than the control animals. A histopathological study showed reduced ischemic symptoms in rats that received sildenafil compared with those in the control group. However, no anomalies were observed in the sham group with respect to the histopathological and neurological findings. These results indicate that neurological damage due to spinal-cord ischemia-reperfusion injury can be reduced by sildenafil.
Surgical Treatment Outcome of Subdural Empyema: a Clinical Study
(Karger, 2006) Yilmaz, Nebi; Kiymaz, Nejmi; Yilmaz, Cahide; Bay, Ali; Yuca, Sevil Ari; Mumcu, Cigdem; Caksen, Huseyin
A retrospective study of 28 patients identified with subdural empyema ( SE) at the Department of Neurosurgery between the years 1995 and 2005 was carried out. SE occurred in all patients following bacterial meningitis. The six most frequently encountered clinical features included: ( 1) fever in 22 (79%) patients; ( 2) disturbed consciousness in 16 (57%) patients; ( 3) papilledema in 11 (39%) patients; ( 4) hemiparesis in 4 (14%) patients; ( 5) meningismus or meningeal signs in 4 ( 14%) patients, and ( 6) seizures in 3 (11%) patients. In the majority of cases, the most frequent causative pathogen of SE was Staphylococcus aureus. Surgery was performed on all patients, which included craniotomy in a group of 20 patients and burr hole drainage in a group of 8 patients. In conclusion, we believe that infants and young children should be carefully monitored following meningitis, in case of SE development, and that surgical intervention in patients presenting with meningitis may facilitate the development of SE. Furthermore, from a surgical point of view, our experience has led us to believe that craniotomy in comparison with burr hole surgery is the best surgical modality for management of SE as the recurrence rate of SE associated with burr hole surgery is high. Copyright (c) 2006 S. Karger AG, Basel.