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Publication Open Access Rare and challenging extra-axial brain lesions: CT and MRI fndings with clinico-radiological differential diagnosis and pathological correlation(AVES Ibrahim Kara [email protected] 105/9 Buyukdere Cad Mecidiyekoy,Sisli, Istanbul 34394, 2014) Demir, Mustafa Kemal; Kurtkaya-Yapıcıer, Özlem Sahan; Onat, Elif; Toktaş, Zafer Orkun; Akakın, Akın; Urgun, Kamran; Kılıç, Türker; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Onat, Elif, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Urgun, Kamran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyThere are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated du-ral neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clini-co-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management. © Turkish Society of Radiology 2014. © 2014 Elsevier B.V., All rights reserved.Publication Open Access Tetraventricular central neurocytoma: A rare presentation with imaging-pathologic correlation(Medknow Publications B9, Kanara Business Centre, off Link Road, Ghatkopar (E) Mumbai 400 075, 2015) Akakın, Akın; Yılmaz, Baran; Demir, Mustafa Kemal; Kurtkaya-Yapıcıer, Özlem Sahan; Toktaş, Zafer Orkun; Kılıç, Türker; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyCentral neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable prognosis. It accounts approximately 0.25-0.5% of intracranial tumors. In this report, we describe a very rare case of tetraventricular CN with imaging-pathologic correlation, and discuss their atypical features in a location together with treatment options. A 27-year-old man was admitted to the hospital with symptoms of progressive headaches of several months' duration. Magnetic resonance imaging of the brain revealed a well-circumscribed, lobulated intraventricular mass with numerous intratumoral cystlike areas. The mass was located in the enlarged lateral ventricles bilaterally extending to the third and the fourth ventricle. Surgical removal of the 4th ventricle component of the tumor was performed. Histomorphological and immunohistochemical findings of the tumor were consistent with CN. After pathological diagnosis, gamma knife surgery was performed. CN may present with atypical features in a location with a usual histopathological findings. To our knowledge, we described the third case of tetraventricular CN, which was partially treated with both surgical resection and radiosurgery. © 2015 Elsevier B.V., All rights reserved.Publication Open Access A case of split notochord syndrome: Presenting with respiratory failure in the neonatal period(International Advancement Center for Medicine and Health Research [email protected], 2016) Çoşkun, Yeşim; Akman, Ipek Özkan; Demir, Mustafa Kemal; Kurtkaya-Yapicier, Özlem Sahan; Somuncu, Salih; Çoşkun, Yeşim, Department of Pediatrics, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akman, Ipek Özkan, Department of Pediatrics, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Somuncu, Salih, Department of Pediatric Surgery, Bahçeşehir Üniversitesi, Istanbul, TurkeySplit notochord syndrome (SNS) is a very rare congenital anomaly. This report describes a male newborn with a neuroenteric cyst in the posterior mediastinum and multiple vertebrae anomalies presenting with respiratory failure and pulmonary hypertension. This report also discusses the embryological development and the etiologic theories of SNS. © 2017 Elsevier B.V., All rights reserved.Publication Open Access Intracranial leptomeningeal carcinomatosis in three cases from breast cancer demonstrated on f-18 fluorodeoxyglucose positron emission tomography/computerized tomography(Medknow Publications B9, Kanara Business Centre, off Link Road, Ghatkopar (E) Mumbai 400 075, 2017) Ortapamuk, Hülya; Demir, Mustafa Kemal; Ortapamuk, Hülya, Department of Nuclear Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, TurkeyLeptomeningeal carcinomatosis (LC) is an uncommon late manifestation of non-central nervous system (CNS) solid tumors. With prolonged survival in solid tumors, an increased frequency of metastases is noted in these tumors too. The detection of tumor cells in the cerebrospinal fluid remains the gold standard. Noninvasively, magnetic resonance imaging is frequently used for the diagnosis of LC. Although its low sensitivity of F-18 fluorodeoxyglucose positron emission tomography/computerized tomography (F-18 FDG PET/CT) on demonstrating CNS lesions, it could be useful in identifying the possibility of LC of breast carcinoma by giving high attention to the meninges. We discuss here three cases all of them having intracranial LC, where 18F-FDG PET/CT study helped us in the diagnosis of LC. To our knowledge, this is the second report about intracranial LC from breast cancer demonstrating on 18F-FDG PET/CT. © 2017 Elsevier B.V., All rights reserved.Publication Open Access Prepancreatic postduodenal portal vein(AVES İbrahim KARA 105/9 Buyukdere Cad Mecidiyekoy,Sisli, Istanbul 34394, 2017) Demir, Mustafa Kemal; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey[No abstract available]Publication Open Access A newborn with hemorrhagic meningoencephalitis due to Proteus mirabilis(2017) Çoşkun, Yeşim; Akman, Ipek Özkan; Yıldırım, Canan Kocaman; Demir, Mustafa Kemal; Çoşkun, Yeşim, Department of Pediatrics, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akman, Ipek Özkan,; Yıldırım, Canan Kocaman,; Demir, Mustafa Kemal,Neonatal meningoencephalitis is a severe condition for the developing brain of a newborn. Radiologic findings of necrosis and liquefaction due to hemorrhagic meningoencephalitis may be confused with brain abcess. In this article, we report a neonate having liquefaction necrosis due to hemorrhagic meningoencephalitis mimicing intracranial abscess due to Proteus mirabilis. We would like to describe the clinical course and evolution of brain imaging and emphasize the importance of the serial MR imaging (MRI). This record is sourced from MEDLINE®/PubMed®, a database of the U.S. National Library of MedicinePublication Open Access Visual qualitative evaluation of diffusion-weighted imaging, apparent diffusion coefficient quantification and Ki-67 proliferation index for predicting atypia in surgical meningiomas, Görsel kalitatif difüzyon-ağırlıklı görüntüleme incelemesi, açık difüzyon katsayısı kantifikasyonu ve Ki-67 proliferasyon indeksinin cerrahi meningiomlarda atipi tahminindeki yeri(Marmara University, 2018) Yilmaz, Baran; Sener, Süleyman; Hasanaov, Teyyub; Akakin, Akin In; Kurtkaya-Yapicier, Özlem Sahan; Demir, Mustafa Kemal; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Sener, Süleyman, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Hasanaov, Teyyub, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, TurkeyObjectives: The goal of this study was to investigate the efficiency of visual qualitative evaluation using diffusion-weighted (DW) imaging, apparent diffusion coefficient (ADC) quantification, and Ki-67 proliferation labeling index in grading intracranial meningiomas and compare the results with our reference standard for histopathology. Methods and Materials: Thirty-five consecutive patients with pathologically confirmed intracranial meningiomas were enrolled in the study. Their conventional magnetic resonance (MR), contrast-enhanced MR and DW images and ADC maps were investigated. Results: Eight patients (23%) had atypical meningioma (5 women and 3 men, mean age: 57.1±15.8 years), 27 (77%) had low-grade-typical meningioma (19 women, 8 men, mean age: 54.3±14.0 years). The most frequent histological subtype was the meningothelial type in both low-grade (37%) and atypical meningiomas (59%). The mean Ki-67 proliferation index for low-grade and atypical meningiomas were 2.31±1.44% (range: 1-5) and 7.37 ± 2.72% (range: 3-10), respectively. Meningiomas with Ki-67 proliferation index higher than 4% (except one) were atypical (P<0.001). In visual qualitative evaluation, diffusion restriction was significantly more common in atypical meningiomas (P<0.05). In quantitative evaluation, benign and atypical tumor groups had no significant difference in mean ADC values (P=0.471). Conclusion: We suggest that visual qualitative evaluation of DW imaging may be helpful to predict atypia and the risk of recurrence in patients with surgically treated meningiomas. © 2018 Elsevier B.V., All rights reserved.Publication Open Access Susac’s syndrome as a rare arterial stroke mimic(SAGE Publications Inc., 2019) Onat Demirci, Nuri; Hacımustafaoğlu, Ali Murat; Kenangil, Gülay Ozgen; Cevher, Ayşe Zeynep; Demir, Mustafa Kemal; Onat Demirci, Nuri, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Hacımustafaoğlu, Ali Murat, Department of Ophthalmology, Medical Park Göztepe Hospital, Istanbul, Turkey; Kenangil, Gülay Ozgen, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Cevher, Ayşe Zeynep, Third class medical student, Yeditepe University, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, TurkeySusac’s syndrome is an uncommon autoimmune microangiopathy characterised mainly by encephalopathy, hearing loss and branch retinal artery occlusions. We present here a case of Susac’s syndrome with initial isolated arterial stroke symptoms which are not an uncommon feature of the disease. © 2022 Elsevier B.V., All rights reserved.Publication Open Access Primary Sonic Hedgehog–activated dorsal brainstem medulloblastoma and ipsilateral cerebellar atrophy in an adult(SAGE Publications Inc., 2020) Demir, Mustafa Kemal; Kurtkaya-Yapicier, Özlem Sahan; Mert, Başak; Alshareefi, Wiaam; Bozbuǧa, Mustafa; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Department of Pathology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Mert, Başak, Bahçeşehir Üniversitesi, Istanbul, Turkey; Alshareefi, Wiaam, Bahçeşehir Üniversitesi, Istanbul, Turkey; Bozbuǧa, Mustafa, Department of Neurosurgery, Üsküdar Üniversitesi, Istanbul, TurkeyMedulloblastoma (MB) that arises outside the cerebellum from cells of the dorsal brainstem is rare. The most common subtype of MB in the dorsal brainstem is the Wingless (WNT) subtype that contains activating mutations in the WNT pathway effector CTNNB1. Ipsilateral cerebellar hemi-atrophy with a brainstem tumour is a finding that is usually documented with brainstem gangliogliomas as a possible specific imaging sign. We present a case of a 23-year-old female with progressive headache, imbalance on walking, double vision and difficulty in swallowing for a year. Magnetic resonance imaging demonstrated a mass with prominent restricted diffusion on the dorsal surface of the lower brainstem with ipsilateral cerebellar atrophy. The final histopathological diagnosis was a Sonic Hedgehog (SHH)-activated and TP53 wild-type primary lower dorsal brainstem MB. Primary SHH-activated TP53 wild-type dorsal brainstem MB is extremely rare, and as far as we know, the association of the tumour with ipsilateral cerebellar hemi-atrophy in an adult has never been reported. MB should be included in the differential diagnosis of focal dorsal brainstem tumours, even in the presence of ipsilateral cerebellar hemi-atrophy. © 2022 Elsevier B.V., All rights reserved.Publication Open Access Morphometry of common carotid artery and internal jugular vein in relation to gender and body side, Arteria Carotis Communis ve Vena Jugularis Interna'nin Cinsiyet ve Vücut Tarafina göre Morfometrisi(Gazi Universitesi [email protected], 2020) Ertem, Onder; Demir, Mustafa Kemal; Barut, Cagatay; Ertem, Onder, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Barut, Cagatay, Department of Anatomy, Bahçeşehir Üniversitesi, Istanbul, TurkeyIntroduction: The common carotid arteries originate from brachiocephalic trunk on the right and directly from the aortic arch on the left. These arteries are contained within the carotid sheaths together with the internal jugular veins and vagus nerves. The structures enclosed in carotid sheath are of great importance, since they provide most of the vascular supply of the head and neck. They exhibit a great deal of variation and are related with a number of pathologic conditions and invasive procedures. Objectives: Thus we focused on morphology of the common carotid artery (CCA) and internal jugular vein (IJV) to determine these possible variations. Methods: Neck magnetic resonance images of 81 individuals (38 females and 43 males) were evaluated retrospectively. Diameter of the lumen of the common carotid artery (CD) and the diameters of the lumen of the internal jugular vein (ID) were measured at the same level that is one slice inferior to the slice in which the bifurcation of the CCA is observed firstly. CCA intima-media thickness (CIMT), IJV intima-media thickness (IIMT), CCA-midline distance (CMD) and IJV-midline distance (IMD) were also measured at the aforementioned level. The measurements were evaluated in relation to gender and asymmetry. Results: The values measured for Right CMD, Right IMD, Left CD, Left CMD and Left IMD of males were greater than those of females (p<0.05). The results stressed various morphometric parameters and topography of the IJV and CCA. Conclusion: The results are suggested to be helpful in determination of normal values in terms of diagnostic purposes and treatment planning. © 2020 Elsevier B.V., All rights reserved.