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  • PublicationOpen 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, Turkey
    Medulloblastoma (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.
  • PublicationOpen 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, Turkey
    Introduction: 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.
  • PublicationOpen Access
    Abdominal variant of lemierre’s syndrome in a patient with pancreatic adenocarcinoma, Pankreas adenokarsinomlu bir hastada abdominal lemierre sendromu
    (Logos Medical Publishing, 2021) Furuncuoǧlu, Yavuz; Öven, Bala Başak; Mert, Başak; Yilmaz, Enis Çağatay; Demir, Mustafa Kemal; Furuncuoǧlu, Yavuz, Department of Internal Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Öven, Bala Başak, Department of Medical Oncology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Mert, Başak, School of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Enis Çağatay, School of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey
    Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre’s syndrome. Patients with gastrointestinal malignancies, especially those who undergo surgeries, are susceptible to the abdominal variant of Lemierre’s syndrome. Timely diagnosis is required to avoid the life-threatening complications of the abdominal variant of Lemierre’s syndrome. Diffusion-weighted magnetic resonance imaging (MRI) might be very useful in differentiating this disease from liver metastasis in patients with malignancies. Radiologists and clinicians need to be aware of this challenging condition to prevent misdiagnosis, since prompt treatment is often lifesaving. © 2021 Elsevier B.V., All rights reserved.
  • PublicationOpen Access
    Kidney Transplantation and COVID-19: Two Case Reports
    (Elsevier Inc., 2021) Tekin, Sabri; Özdoğan, Hatice; Demir, Mustafa Kemal; Soultan, Hagar Elsayed Akram; Zafar, Sadia; Tekin, Sabri, Department of Organ Transplantation, Bahçeşehir Üniversitesi, Istanbul, Turkey; Özdoğan, Hatice, Department of Internal Medicine, Ercis State Hospital, Van, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Soultan, Hagar Elsayed Akram, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Zafar, Sadia, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey
    Immunocompromised populations are at great risk of the current 2020 global emergency of coronavirus disease 2019 (COVID-19), and treatment of kidney transplant recipients with COVID-19 is currently not declared. Hence, the purpose of the study is to set a clear treatment regimen. We report here a therapeutic course of 2 patients who underwent transplant surgery in March 2020 and got infected soon after. Since the transplant, these 2 patients have received triple maintenance immunosuppressive therapy with oral tacrolimus, mycophenolate mofetil (MMF), and prednisone, and they have been regularly followed up at our hospital. The tacrolimus trough level was between 10 and 12 ng/mL. After the diagnosis of COVID-19, MMF was stopped and the tacrolimus dose was reduced so that blood level was between 4 and 6 ng/mL. The first patient was a 30-year-old man who, despite being treated with hydroxychloroquine, favipiravir, oseltamivir, and azithromycin therapy, died because of the presence of other comorbidities. The second case was a 58-year-old man who fully recovered from COVID-19 pneumonia with treatment with methylprednisolone, MMF, azithromycin, favipiravir, hydroxychloroquine, and reduction in immunosuppression dosage. This reflects the importance of using glucocorticoids in the treatment of COVID-19 along with other medications and the decreased mortality rate associated with their use. © 2021 Elsevier B.V., All rights reserved.
  • PublicationOpen Access
    Acute disseminated encephalomyelitis-like presentation after an inactivated coronavirus vaccine
    (Springer Science and Business Media Deutschland GmbH, 2021) Ozgen Kenangil, Gulay; Ari, Buse Cagla; Guler, Cagan; Demir, Mustafa Kemal; Ozgen Kenangil, Gulay, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ari, Buse Cagla, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Guler, Cagan, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey
    [No abstract available]
  • PublicationOpen Access
    Magnetic Resonance Imaging of Unusual Neoplasms Related to Foramen of Luschka: A Review for Differential Diagnosis
    (Georg Thieme Verlag, 2022) Demir, Mustafa Kemal; Ozdamarlar, Umut; Yilmaz, Baran; Akakln, Akln; Kilic, Turker D.; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ozdamarlar, Umut, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yilmaz, Baran, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akakln, Akln, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey
    There are many types of neoplasms in or around the foramen of Luschka (FL), and definitive diagnosis in some cases requires knowledge of imaging findings. The uncommon and challenging neoplasms with FL involvement considered in this study are exophytic brainstem glioma, primary glioblastoma of the cerebellopontine angle (CPA), primary anaplastic ependymoma of the CPA, choroid plexus papilloma of the FL, solitary FL choroid plexus metastasis, extraskeletal myxoid chondrosarcoma of the jugular foramen, paraganglioma of the jugular foramen, exostosis of the jugular foramen, psammomatous meningioma in the lateral cerebellar medullary cistern, epidermoid tumor of the fourth ventricle, and a hypoglossal schwannoma. These neoplasms may have overlapping clinical and imaging features, but some have relatively distinct imaging features. Knowledge of the key clinical and magnetic resonance imaging features of these unusual lesions with FL involvement is important for radiologists to improve diagnostic ability and to assist the referring physician in the appropriate management of the patient. © 2022 Elsevier B.V., All rights reserved.
  • PublicationOpen Access
    Diffuse Idiopathic Colonic Varices: Demonstration Using Multiplanar Reconstructions from Triphasic Computed Tomography
    (Galenos Publishing House, 2023) Demir, Mustafa Kemal; Ecertastan, Ozge; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ecertastan, Ozge, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey
    [No abstract available]
  • PublicationOpen Access
    Correction to: Acute disseminated encephalomyelitis-like presentation after an inactivated coronavirus vaccine (Acta Neurologica Belgica, (2021), 121, 4, (1089-1091), 10.1007/s13760-021-01699-x)
    (Springer Science and Business Media Deutschland GmbH, 2023) Kenangil, Gülay Ozgen; Ari, Buse Cagla; Guler, Cagan; Demir, Mustafa Kemal; Kenangil, Gülay Ozgen, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ari, Buse Cagla, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Guler, Cagan, Department of Neurology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey
    Contrary to the previous clinical reasoning about a possible relationship or the patient's status with vaccination, the final histopathological diagnosis of the case reported in Acute disseminated encephalomyelitis-like presentation after an inactivated coronavirus vaccine was a high grade glioma proven by the biopsy, which was unrelated to the vaccine. The authors apologize for any misunderstanding. © 2023 Elsevier B.V., All rights reserved.
  • PublicationOpen Access
    Coincidence of Asymptomatic Aorto-left Atrial Fistula and Aneurysmatic Aberrant Right Subclavian Artery: The Relevance of Multidetector Computed Tomography Angiography
    (Galenos Publishing House, 2024) Demir, Mustafa Kemal; Güler, Mustafa; Ecertastan, Ozge; Akinci, Okan; Eyiişler, Vedat; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Güler, Mustafa, Department of Cardiovascular Surgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ecertastan, Ozge, Intern Medical Student, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akinci, Okan, Clinic of Radiology, University of Health Sciences, Istanbul, Turkey; Eyiişler, Vedat, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey
    [No abstract available]
  • PublicationOpen Access
    Ectopic Pituitary Neuroendocrine Tumors/Adenomas Around the Sella Turcica
    (Galenos Publishing House, 2024) Demir, Mustafa Kemal; Ertem, Onder; Kilic, Deniz; Akinci, Okan; Ecertastan, Ozge; Konya, Deniz; Kilic, Turker D.; Demir, Mustafa Kemal, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Ertem, Onder, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akinci, Okan, Clinic of Radiology, University of Health Sciences, Istanbul, Turkey; Ecertastan, Ozge, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kilic, Turker D., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey
    Functional or non-secretory ectopic pituitary neuroendocrine tumors (PitNET) can form around the sella turcica during the development of the adenohypophysis by differentiating and detaching from the pharyngeal roof. These tumors usually appear in the sphenoid sinus, clivus, cavernous sinus, infundibulum, and suprasellar cistern. Ectopic PitNETs typically display the characteristic magnetic resonance imaging findings of pituitary adenomas. However, preoperative diagnosis of PitNETs is usually challenging because of the variety of clinical and imaging presentations, locations, and sizes. Ectopic suprasellar PitNETs resemble mass lesions in the pituitary stalk. Ectopic cavernous sinus of PitNETs are typically microadenomas in the medial wall. Ectopic sphenoclival tumors are characterized by more aggressive tumor activity than the other ectopic PitNETs. Although ectopic PitNETs are exceedingly rare, they should be considered as a differential diagnosis for masses around the sella turcica. Treatment of the disease should be individualized and may include medical care, surgical resection, gamma-knife radiosurgery, and radiotherapy. © 2024 Elsevier B.V., All rights reserved.