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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 info@avesyayincilik.com 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 Metadata only Rare solitary primary osseous lesions of the spine in adults, challenges in ct and mr imaging diagnosis with pathological correlation, Yetişkinlerde Nadir Primer Omurga Kemik Kökenli Lezyonları, CT ve MR ile Tanısal Görüntülemenin Patolojik Korelasyonundaki Zorluklar(Ege University Press Bornova Izmir 35100, 2015) Toktaş, Zafer Orkun; Yilmaz, Baran; Akakin, Akin In; Demir, Mustafa Kemal; Kurtkaya-Yapicier, Özlem Sahan; Onat, Elif; Urgun, Kamran; Konya, Deniz; Toktaş, Zafer Orkun, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kurtkaya-Yapicier, Özlem Sahan, Bahçeşehir Üniversitesi, Istanbul, Turkey; Onat, Elif, Bahçeşehir Üniversitesi, Istanbul, Turkey; Urgun, Kamran, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Bahçeşehir Üniversitesi, Istanbul, TurkeyThis pictorial essay is a review of the computerized tomography and magnetic resonance imaging of a few solitary primary osseous lesions encountered in the adults. The lesions discussed include giant cell tumor, Langerhans cell histiocytosis, Paget'sdisease, plasmacytoma, fibrous dysplasia and osteoblastoma. Challenges in computerized tomography and magnetic resonance imaging diagnosis of these lesions are mentioned with clinicoradiological differential diagnosis, and include pathological correlation. Although active diagnosis and radiological familiarity of these lesions is crucial for preventing unnecessary examinations or procedures, pathological evaluation is mandatory to establish final diagnosis. © 2015 Elsevier B.V., All rights reserved.Publication Metadata only Mastoid antral ventilation tube, new treatment modality for reccurent otitis media with effusion and its long term results(E-Century Publishing Corporation 40 White Oaks Lane Madison WI 53711, 2015) Kutluhan, Ahmet; Tarlak, Behçet; Çetin, Hüseyin; Çallioǧlu, Elif Ersoy; Bozdemir, Kazim; Demir, Mustafa Kemal; Kutluhan, Ahmet, Department of Otolaryngology-Head and Neck Surgery, Ataturk Training and Research Hospital, Izmir, Turkey; Tarlak, Behçet, Department of Otorhinolaryngology, Şehit Kamil State Hospital, Gaziantep, Turkey; Çetin, Hüseyin,; Çallioǧlu, Elif Ersoy,; Bozdemir, Kazim, Department of Otolaryngology-Head and Neck Surgery, Ataturk Training and Research Hospital, Izmir, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, TurkeyObjectives: To evaluate the efficiency of mastoid antral ventilation tube (MAVT) treatment in recurrent/chronic otitis media with effusion (OME). Methods: 20 OME patients who were unsuccessfully treated with ventilation tube (VT) at least twice, who consented to MAVT and who were followed up at least three years were included in the study group. Control group comprised 10 patients who had the same characteristics and refused to undergo MAVT and underwent VT placement again. Pre-operative and post-operative otomicroscopic, hearing tests, and CT findings were compared between the groups statistically. Results: MAVT was placed into 24 ears of 20 patients. In the control group, VT was placed in 13 ears of 10 patients. Postoperatively, in the study group, one tympanic membrane with adhesion and nine membranes with retraction returned to their anatomic positions after MAVT. In the control group, 2 retracted tympanic membranes returned to normal position. There was significant difference between groups in terms of mastoid aeration (P = 0.006). Post-operative pure tone threshold values and mastoid aeration findings were statistically different from preoperative conditions. Conclusion: This preliminary study demonstrates that MAVT may be effective in the surgical treatment of recurrent/chronic OME. However, further studies with larger patient series should be carried out. © 2015 Elsevier B.V., All rights reserved.Publication Metadata only Conchal compression: Is it a new syndrome(E-Century Publishing Corporation 40 White Oaks Lane Madison WI 53711, 2015) Kutluhan, Ahmet; Demir, Mustafa Kemal; Bozdemir, Kazim; Çallioǧlu, Elif Ersoy; Kutluhan, Ahmet, Department of Otolaryngology-Head and Neck Surgery, Ataturk Training and Research Hospital, Izmir, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Bozdemir, Kazim, Department of Otolaryngology-Head and Neck Surgery, Ataturk Training and Research Hospital, Izmir, Turkey; Çallioǧlu, Elif Ersoy, Ataturk Training and Research Hospital, Izmir, TurkeyObjectives/Hypothesis: To describe the diagnostic criteria and treatments of concha compression syndrome (CCS). Patients and methods: Patients who reported at least 3 times rhinosinusitis attacks per year were considered in this study. All patients met the diagnosis criteria of rhinosinusitis based on clinical history, showed a nasal septal spur compressing concha on their endoscopic examination and had no findings of rhinosinusitis on their paranasal sinus CT scans but showed concha ondularis. These patients were recognized as suffering from CCS and consequently were surgically treated. Results: 85 patients diagnosed with CCS were included in this study. 25 of the patients were classified as middle, 53 as inferior and 7 as both middle and inferior CCS. Septal spur removal was performed on 16 of the patients whereas the remaining 69 patients received spur removal with septoplasty. After surgery, most of patients’ symptoms improved clinically. Conclusion: The importance and the necessity of further investigations into this newly-defined syndrome in the differential diagnosis of rhino-neurogenic symptoms is made clear by this study. © 2015 Elsevier B.V., All rights reserved.Publication Metadata only Association of collagen I, IX and vitamin D receptor gene polymorphisms with radiological severity of intervertebral disc degeneration in Southern European Ancestor(Springer Verlag service@springer.de, 2015) Toktaş, Zafer Orkun; Ekşi̇, Murat Şakir; Yilmaz, Baran; Demir, Mustafa Kemal; Özgen, Serdar; Kilic, Turker D.; Konya, Deniz; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ekşi̇, Murat Şakir, UCSF School of Medicine, San Francisco, United States; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Özgen, Serdar, Department of Neurosurgery, Acıbadem Mehmet Ali Aydınlar Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyPurpose: Several genomic loci have been previously found to be associated with intervertebral disc degeneration, so far. Data are mostly derived from northern European countries whereas data derived from Southern European Ancestor are limited. This study aimed to evaluate the association between radiological disease severity of lumbar disc degeneration and certain genetic loci in a sample of participants from Southern Europe. Methods: Seventy-five patients with mild to severe lumbar disc degeneration and 25 healthy controls were enrolled into the study. In each subject, each lumbar intervertebral disc was separately examined to obtain a total radiological score for disease severity. In addition, single-nucleotide polymorphisms of predefined genetic samples were analyzed in all participants: COL1A1 Sp1, COL9a2 Trp2, COL9a3 Trp3, and VDR TaqI. Results: Degeneration scores were significantly worse in cases with COL1A1 Sp1, COL9a3 Trp3, and VDR TaqI mutations, however, COL9a2 Trp2 mutation was not associated with a difference in the severity of disc degeneration. In addition, subjects with mutation in more than one gene sample (n = 20) had significantly worse degeneration scores than the remaining study participants (n = 80) (17.70 ± 2.72 vs. 21.81 ± 1.81, p < 0.001). Conclusion: Single-nucleotide polymorphisms occurring in COL1A1, COL9a3 and VDR genes seem to be associated with the development of lumbar disc degeneration in this cohort, possibly with even more pronounced association when multiple mutations are present in the same individual. By further prospective twin studies in associated genes and analyses of their relationship with environmental factors in an internationally sampled large cohort will make a more clear-minded conclusion about their association with disc degeneration, which would yield better appreciation and clinical planning of some predisposed people for these pathologies. © 2016 Elsevier B.V., All rights reserved.Publication Metadata only Immature ganglioneuroma of the thoracic spine with lipomatous component: A rare cause of scoliosis(Elsevier Inc. usjcs@elsevier.com, 2015) Demir, Mustafa Kemal; Kurtkaya-Yapicier, Özlem Sahan; Toktaş, Zafer Orkun; Yilmaz, Baran; Konya, Deniz; 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; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey[No abstract available]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 Metadata only Gamma Knife treatment of low-grade gliomas in children(Springer Verlag service@springer.de, 2015) Ekşi̇, Murat Şakir; Yilmaz, Baran; Akakin, Akin In; Toktaş, Zafer Orkun; Kaur, Ahmet Cemil; Demir, Mustafa Kemal; Kilic, Turker D.; Ekşi̇, Murat Şakir, University of California, San Francisco, San Francisco, United States; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kaur, Ahmet Cemil, Department of Pathology, Medical Park Göztepe Hospital, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyBackground: Low-grade gliomas have good overall survival rates in pediatric patients compared to adults. There are some case series that reported the effectiveness and safety of Gamma Knife radiosurgery, yet they are limited in number of patients. We aimed to review the relevant literature for pediatric low-grade glial tumors treated with stereotactic radiosurgery, specifically Gamma Knife radiosurgery, and to present an exemplary case. Case description: A 6-year-old boy was admitted to clinic due to head trauma. He was alert, cooperative, and had no obvious motor or sensorial deficit. A head CT scan depicted a hypodense zone at the right caudate nucleus. The brain magnetic resonance imaging (MRI) depicted a mass lesion at the same location. A stereotactic biopsy was performed. Histopathological diagnosis was low-grade astrocytoma (grade II, World Health Organization (WHO) classification, 2007). Gamma Knife radiosurgery was applied to the tumor bed. Tumor volume was 21.85 cm3. Fourteen gray was given to 50 % isodose segment of the lesion (maximal dose of 28 Gy). The tumor has disappeared totally in 4 months, and the patient was tumor-free 21 months after the initial treatment. Discussion and conclusion: The presented literature review represents mostly single-center experiences with different patient and treatment characteristics. Accordingly, a mean/median margin dose of 11.3–15 Gy with Gamma Knife radiosurgery (GKRS) is successful in treatment of pediatric and adult low-grade glial tumor patients. However, prospective studies with a large cohort of pediatric patients should be conducted to make a more comprehensive conclusion for effectiveness and safety of GKRS in pediatric low-grade glial tumors. © 2015 Elsevier B.V., All rights reserved.Publication Metadata only Lumbar Spinal Immature Ganglioneuroma with Conus Medullaris Invasion: Case Report(S. Karger AG, 2015) Yilmaz, Baran; Toktaş, Zafer Orkun; Akakln, Akln; Demir, Mustafa Kemal; Kurtkaya-Yapicier, Özlem Sahan; Konya, Deniz; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakln, Akln, 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; Konya, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyGanglioneuroma (GN) is a benign rare tumor that originates from neural crest cells. It shares a common histogenic family with ganglioneuroblastoma and neuroblastoma and represents the most benign and differentiated form of the group. The most common locations of the GNs are the mediastinum and retroperitoneum. We report an extremely rare case of lumbar spinal GN with conus medullaris invasion and extradural paraspinal extension. A 10-year-old girl presented with a history of worsening lower-back pain and an intermittent tingling sensation in the left leg. Neurological examination revealed reduced sensation in the left L2-L5 dermatomes. Magnetic resonance imaging revealed an intra- and extradural mass extending from the D11 to L5 vertebral body level. There was conus medullaris invasion by the tumor. After L1-L5 laminotomies, the patient underwent tumor resection. Histopathological diagnosis was immature GN. GNs occurring within the spinal column are rare and may grow to a large size. Despite the size and the common involvement of both intra- and extraspinal compartments, the prognosis is usually excellent after complete excision using microsurgical techniques. © 2016 Elsevier B.V., All rights reserved.Publication Metadata only Progressive osseous heteroplasia and scoliosis(Elsevier Inc. usjcs@elsevier.com, 2015) Demir, Mustafa Kemal; Toktaş, Zafer Orkun; Akakin, Akin In; Yilmaz, Baran; Gürol, Tayfun; Saritaş, Yaʇmur; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Gürol, Tayfun, Bahçeşehir Üniversitesi, Istanbul, Turkey; Saritaş, Yaʇmur, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey[No abstract available]