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Publication Metadata only Total spondylectomy of an L3 osteosarcoma, L3 osteosarkomuna total spondilektomi cerrahisi(2013) Yilmaz, Baran; Ekşi̇, Murat Şakir; Toktaş, Zafer Orkun; Konya, Deniz; Yilmaz, Baran, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ekşi̇, Murat Şakir, Department of Orthopedic Surgery-Spine Center, University of California, San Francisco, San Francisco, United States; Toktaş, Zafer Orkun, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Bahçeşehir Üniversitesi, Istanbul, TurkeyPrimary osteosarcoma is a rare malignant osseous tumor of vertebra. Prognosis has been improved with new technologies and surgical techniques. In modern era of spinal surgery en bloc resection has become more popular in these neoplasms. We presented a 19-year-old young man admitted to our clinic with low back pain. An L3 vertebral mass lesion was detected on MRI. CT-guided biopsy result was osteosarcoma. En bloc resection was planned. In the literature, intraoperative blood loss amounts were very high in osteosarcoma cases, so we decided to embolize the tumor pre-operatively. It worked in the surgery that only 700 ml of blood was lost. Although surgery was one staged (combined anterior and posterior approaches), it took 6 hours with 2 surgeons. Definitive diagnosis was osteosarcoma and the patient was referred to oncologists. Embolization should be kept in mind before vertebral tumor surgery to make it smooth and easy. © 2014 Elsevier B.V., All rights reserved.Publication Metadata only Isolated metastasis of breast cancer to the pituitary gland(Medknow Publications A-109, Kanara Business Centre, off Link Road, Ghatkopar (E) Mumbai 400 075, 2014) Ekşi̇, Murat Şakir; Hasanov, Teyyub; Yilmaz, Baran; Akakin, Akin In; Bayri, Yasar; Bozkurt, Süheyla Uyar; Kilic, Turker D.; Ekşi̇, Murat Şakir, UCSF School of Medicine, San Francisco, United States; Hasanov, Teyyub, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Bayri, Yasar, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Bozkurt, Süheyla Uyar, Department of Pathology, Marmara Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey[No abstract available]Publication Metadata only Hypersexuality after bilateral deep brain stimulation of the subthalamic nucleus for Parkinson's disease(Medknow Publications B9, Kanara Business Centre, off Link Road, Ghatkopar (E) Mumbai 400 075, 2014) Akakin, Akin In; Yilmaz, Baran; Urgun, Kamran; Ekşi̇, Murat Şakir; Afşar, Nazire; Kilic, Turker D.; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Urgun, Kamran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ekşi̇, Murat Şakir, UCSF School of Medicine, San Francisco, United States; Afşar, Nazire, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey[No abstract available]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 Treatment of syringomyelia due to Chiari type I malformation with syringo-subarachnoid-peritoneal shunt(Korean Neurosurgical Society, 2015) Akakin, Akin In; Yilmaz, Baran; Ekşi̇, Murat Şakir; Kilic, Turker D.; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ekşi̇, Murat Şakir, Department of Orthopedic Surgery-Spine Center, University of California, San Francisco, San Francisco, United States; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyChiari type I malformation is a tonsillar herniation more than 3 mm from the level of foramen magnum, with or without concurrent syringomyelia. Different surgical treatments have been developed for syringomyelia secondary to Chiari’s malformations: craniovertebral decompression with or without plugging of the obex, syringo-subarachnoid, syringo-peritoneal, and theco-peritoneal shunt placement. Shunt placement procedures are useful for neurologically symptomatic large-sized syrinx. In this paper, authors define the first successful treatment of a patient with syringomyelia due to Chiari type I malformation using a pre-defined new technique of syringo-subarachnoid-peritoneal shunt with T-tube system. © 2021 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 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 A case of pituitary apoplexy following posterior lumbar fusion surgery(American Association of Neurological Surgeons jnevro@virginia.edu, 2015) Akakin, Akin In; Yilmaz, Baran; Ekşi̇, Murat Şakir; Kilic, Turker D.; Akakin, Akin In, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ekşi̇, Murat Şakir, UCSF School of Medicine, San Francisco, United States; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyPituitary adenoma is a common primary brain neoplasm. Pituitary apoplexy (PA) is a rare complication of pituitary adenoma and occurs as the result of sudden tumor growth and following different comorbidities. The authors describe the first case of PA following posterior lumbar fusion surgery performed while the patient was prone. In patients with a preexisting pituitary adenoma, thorough clinical and laboratory investigations should be conducted using an interdisciplinary approach before any planned surgery. In unknown cases of pituitary adenoma, PA should be kept in mind for the differential diagnosis in a case with headache, nausea, vomiting, ophthalmoplegia, visual loss, and electrolyte imbalance concurrent with an ongoing disease state. © 2016 Elsevier B.V., All rights reserved.