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Öğe A case of spinal extradural angiolipoma(DRUNPP-SARAJEVO, 2012) Ozer, Hatice; Tuncer, Ersin; Gurelik, Mustafa; Oztoprak, Ibrahim; Egilmez, Reyhan; Ozum, UnalAngiolipoma is a benign tumor composed of mature adipocytes admixed with vascular elements. This article presents a case of spinal extradural angiolipoma in 52-year-old man, who underwent surgical treatment with preoperational diagnosis of schwannoma. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion.Öğe Chordoid Meningioma - A Case Report: Clinicopathological Features and Differential Diagnosis of an Uncommon Tumor(DE GRUYTER OPEN LTD, 2016) Ozer, Hatice; Tuncer, Ersin; Saray, Gonul; Gurelik, Mustafa; Oztoprak, Ibrahim; Egilmez, ReyhanMeningiomas are tumors that originate from the arachnoid cell and the majority are benign and grade I tumors according to World Health Organization. Chordoid meningioma is an uncommon variant of meningioma and corresponds to grade II tumor in the World Health Organization Classification of Tumors of the Nervous System 2007 because of its more aggressive behavior and increased likelihood of recurrence. A 75-year-old female was referred to the neurosurgery department complaining of headache, syncope, and seizure. Radiological examination revealed a mass lesion in the neighbourhood of the frontal lobe that destructed bone and was associated with peritumoral edema. The patient underwent surgery. The tumor was totally excised with the dura beneath. Histopathological examination showed that the tumor was composed of clusters and cords of small polygonal cells with fine chromatin and eosinophilic vacuolated cytoplasm embedded in a myxoid matrix, and also focal whorls of spindle-shaped cells. Two mitoses were seen in 10 high power fields. Vascular proliferation was observed in some tumoral areas. Bone invasion was present. Immunohistochemical analysis of the tumor cells revealed widespread strong membranous and cytoplasmic expression of epithelial membrane antigen. The Ki67 labeling index was 6-8%. All of these findings were consistent with a diagnosis of chordoid meningioma, the neoplasm was identified as grade II based on the World Health Organization Classification, 2007. In this report we present a case of chordoid meningioma without classical radiological findings of meningioma with areas of vascular proliferation that mimicked glial tumors at histopathologic examination.Öğe Clipping of large and giant aneurysms of anterior circulation(Turkish Neurosurgical Society, 2011) Kars, Hamit Zafer; Gurelik, MustafaAim: Surgical outcome for giant intracranial aneurysms (GIA) is suboptimal. Reasons for higher complication rates in large and GIA surgery are the occlusion of perforators or parent arteries during aneurysm clipping, or prolonged temporary occlusion of main arteries. In this article, results of clipping of large and GIAs of anterior circulation are presented. Material and Methods: Ten patients with large or GIAs in the anterior circulation were treated by clipping (10/19, 52%). The most common location was the middle cerebral artery (MCA, 5/10), followed by the anterior cerebral artery (ACA, 3/10), and internal carotid artery (ICA, 2/10). Five aneurysms were large (17-20 mm), five were giant (27-53 mm). Results: Uneventful aneurysm clipping was performed in eight, and cure was obtained in nine patients. Mortality and morbidity figures were 10% (1/10), and 0% (0/10), respectively. Mean follow up time is 2.8 years (range 1-10 years). Conclusion: Clipping is still the most common surgical method of dealing with these lesions. Clipping of all large and giant aneurysms of anterior circulation was achieved in our patients with 10% mortality and 0% morbidity rates. These rates are similar to figures reported in previous series. Clipping of large and giant aneurysms is still the best definitive treatment, and is applicable in majority of the patients.Öğe Mutation in the HTRA1 Gene in a Patient with Degenerated Spine as a Component of CARASIL Syndrome(TURKISH NEUROSURGICAL SOC, 2014) Bayrakli, Fatih; Balaban, Hatice; Gurelik, Mustafa; Hizmetli, Sami; Topaktas, SuatAIM: To show the mutation in HTRA1 gene in a patient suffering from CARASIL syndrome with degenerated spine as a component of the disease. MATERIAL and METHODS: We identified a family that one of the members had CARASIL syndrome in eastern Turkey and collected venous blood from available persons. The HTRA1 gene sequenced in all family members. RESULTS: C to T transition at position 1108 (c.1108 C>T) in exon 6, causing stop codon formation (R370X) was seen in the HTRA1 gene in a homozygous state in the CARASIL patient whereas it was heterozygous in other healthy family members. CONCLUSION: We demonstrated homozygous c.1108 C>T mutation in the HTRA1 gene causing a very rare syndrome, especially in the non-Japanese population, called CARASIL. Patients with degenerated spine and progressive clinical symptoms must be evaluated or reevaluated for other central nervous system symptoms and signs to rule out other diseases or syndromes.Öğe Nimodipine can improve cerebral metabolism and outcome in patients with severe head trauma(ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD, 2009) Aslan, Adem; Gurelik, Mustafa; Cemek, Mustafa; Goksel, Hakan Murat; Buyukokuroglu, Mehmet EminIn the present study, the effect of nimodipine was investigated in a patient with severe head trauma. Nimodipine was administered into the peripheral vein to prevent secondary neuronal damages in patients. The five patients in control group were treated according to the standard procedures without nimodipine. Other five patients in nimodipine group were treated with standard procedures plus nimodipine. Cerebral perfusion pressure (CPP), intracranial pressure (ICP), jugular venous oxygen saturation (SjvO(2)), jugular lactate and glucose levels were measured. Additionally, all patients were evaluated with Glascow outcome score (GOS) before discharge. It was found that CPP (p < 0.05) and SjvO(2) (p < 0.05)were significantly higher; but, ICP (p < 0.001),jugular lactate (p < 0.05) and jugular glucose (p < 0.05) were lower in nimodipine than that of control groups. Again, GOS values were significantly higher in nimodipine than that of control groups (p < 0.05). Results of this study revealed that nimodipine can improve cerebral metabolism and outcome in patient with severe head trauma. Thus, nimodipine may be considered as a protective agent against severe head trauma related neuronal injuries. (C) 2008 Elsevier Ltd. All rights reserved.Öğe Role of SOD2 Ala16Val polymorphism in primary brain tumors(SPANDIDOS PUBL LTD, 2019) Tas, Ayca; Silig, Yavuz; Pinarbasi, Hatice; Gurelik, MustafaThe present study aimed to investigate the possible association between the genetic polymorphism of the enzyme superoxide dismutase 2 (SOD2, also known as manganese-dependent SOD), Ala16Val (rs4880), and primary brain tumor risk in the Turkish population. Frequency of the SOD2 gene rs4880 polymorphism was identified in 225 Turkish individuals (120 controls and 105 patients with primary brain tumor) by polymerase chain reaction-restriction fragment length polymorphism. Subject demographics and clinical characteristics were also recorded. The findings were evaluated using logistic regression and chi(2) tests. Logistic regression analysis indicated that smoking did not increase the risk for primary brain tumor [ odds ratio (OR)= 0.77, 95% confidence interval (CI)= 0.44-1.33, chi(2)= 0.352, P= 0.860]. Similarly, there was no statistically significant difference in the family history of cancer incidence between the control subjects and the primary brain tumor patients (OR= 0.81, 95% CI= 0.39-1.71, chi(2)= 0.340, P= 0.560). There was no significant association of the histopathological type, genotype/ allele frequencies and inheritance models of tumor with the gene variants among the patients with primary brain tumor. In summary, the results of the present study indicated that the Ala16Val polymorphism of the SOD2 gene was not associated with primary brain tumor risk in the Turkish population studied.Öğe A safe and effective method for treatment of chronic subdural haematoma(CANADIAN J NEUROL SCI INC, 2007) Gurelik, Mustafa; Aslan, Adem; Gurelik, Bilge; Ozum, Unal; Karadag, Ozen; Kars, H. ZaferObjective: Burr-hole irrigation and burr-hole drainage without irrigation are the most popular methods for treatment of chronic subdural haematoma. It is not well known if irrigation is necessary or which method has a higher recurrence rate. We compared the recurrence rates of those two methods. Materials and Methods: Forty-two patients were treated by burr-hole irrigation (irrigation group), whereas 38 patients were treated by burr-hole drainage (drainage group). Recurrence rate and its relation with sex, age, haematoma localization and aetiology were investigated in both groups. Results: There was no significant difference between recurrence rates of the two groups. There was also no correlation between recurrence rate and age, sex, haematoma localization, or aetiology. Conclusions: There was no significant difference between recurrence rates of the two groups. Since the burr-hole drainage method is simpler to carry out, its use may be preferable.Öğe Unilateral laminotomy for decompression of lumbar stenosis is effective and safe: A prospective randomized comparative study(2012) Gurelik, Mustafa; Bozkina, Cemal; Kars, Zafer; Karadag, Ozen; Unal, Ozum; Bayrakli, FatihObjective: The purpose of this study is to determine the efficacy and safety of unilateral laminotomy for decompression of lumbar stenosis (LS). Although minimally invasive procedures are gaining increasing popularity in the treatment of spinal disorders, minimally invasive techniques are not standard in the surgical treatment of lumbar stenosis yet. Methods: Fifty-two consecutive patients with lumbar stenosis were randomized to two treatment groups (unilateral laminotomy for decompression-Group 1, decompressive laminectomy-Group 2). Maximum walking distance (MWD), Oswestry Disability Index (ODI), spinal MRI and CT, and flexion-extension radiography were used to assess clinical outcome, adequacy of decompression and postoperative instability. Results: Excellent-good clinical outcome was obtained in 88% of patients in Group 1 and in 69% of patients in Group 2. Increase in MWD and dural sac area after surgery were adequate in both groups. Postoperative spinal instability occurred in five patients in Group 2, none in Group 1. There was no surgical complication in the groups. Conclusions: Unilateral laminotomy for decompression is an effective and safe technique for treatment of LS. This technique ensures adequate decompression and good clinical outcome. It does not cause spinal instability.Öğe Variation in the BRCA2 gene in a child with medulloblastoma and a family history of breast cancer(AMER ASSOC NEUROLOGICAL SURGEONS, 2011) Bayrakli, Fatih; Akgun, Bekir; Soylemez, Burcak; Kaplan, Metin; Gurelik, MustafaThe fact that BRCA genes operate as tumor suppressors is evident from the genetics of the different human disorders caused by inherited mutations. Germline mutations affecting 1 allele of either BRCA1 or BRCA2 confer susceptibility to different types of cancers such as breast cancer and medulloblastoma. A family with a history of cancer was identified in Eastern Turkey in which one of the family members (a 13-year-old boy) had medulloblastoma. Venous blood was collected from available family members. The BRCA1 and BRCA2 genes were sequenced in the patient with medulloblastoma and the healthy father. An Asn372His homozygous variation was noted in the BRCA2 gene in the patient with medulloblastoma whereas the variation was heterozygous in the healthy father. A biallelic homozygous variation was demonstrated in the BRCA2 gene, which is important in medulloblastoma suppression, and may have caused medulloblastoma formation in the 13-year-old boy. Further investigations in large human populations with medulloblastoma are necessary for further delineation of BRCA gene malfunctions and their relationship to medulloblastoma formation, and to clarify the therapeutic implications of these malfunctions. (DOI: 10.3171/2011.8.PEDS11210)
