Turkish neurosurgery最新文献

{"title":"Evaluation of Neurosurgery Residency Training and Surgical Performance: A National Survey in Turkey.","authors":"Tolga Turkmen, Caner Unluer, Sahin Kenan Deniz, Ahmet Kayhan, Ilker Deniz Cingoz, Yagmur Eylem Ozkeles, Can Kivrak, Efekan Doruk, Hanside Setenay Unal, Ismail Akcin, Salih Tataroglu, Serhat Gundogdu, Sima Cebecik Cakir, Pelin Kuzucu, For Committe","doi":"10.5137/1019-5149.JTN.47455-24.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.47455-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To assess the number of independent surgical procedures performed, working hours, and satisfaction with training among residents in Turkey.</p><p><strong>Material and methods: </strong>An electronic survey was sent to all neurosurgery residency in Turkey through e-mail and social media group. The survey, which includes 37 questions primaly encompassed independently performed surgical procedures, work hours (post-night shift rest), satisfaction of educational activities.</p><p><strong>Results: </strong>The responses were collected from n=276 participants, representing 35% of the entire residents. Responses came from 88% (73/83) of all training programs in Turkey. The independent application more than fifteen rate for low-risk interventions (External ventricular drain (EVD) /intracranial pressure (ICP)-monitoring, supratentorial craniotomy, lumbar drainage, laminectomy) was approximately 50% in PGY 3 and 80% in PGY 4&5. %50 of PGY 4&5 residents performed more than fifteen procedures for hematoma, shunting, lumbar disc disease, and thoracic-lumbar (TL) trauma surgery. Post-night shift rest is implemented in the majority of training programs, with data revealing that it is statistically more widely adopted in training and research hospitals compared to other educational programs. 84% of responders found post-night shift rest beneficial.</p><p><strong>Conclusion: </strong>Post-night shift rest is implemented in the majority of training programs, and most residents find it beneficial. Only half of senior residents adequately apply general neurosurgery practices. However, it is predicted that resting after shifts could further shorten the overall training period and negatively impact the already low case numbers for residents. Therefore, it is crucial to organize and standardize training programs in a way that mitigates this negative effect. The fact that only a quarter of residents plan to practice their profession in Turkey raises serious concerns about the future sustainability of neurosurgical services at the national level.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"368-376"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radioanatomical Assessment of the Sphenoid Ridge in Chiari Type I Malformation.","authors":"Baran Can Alpergin, Umit Eroglu, Fatih Yakar, Umit Karadagoglu, Omer Mert Ozpiskin, Elif Gokalp, Muhammet Enes Gurses, Mert Cetin, Orhan Beger","doi":"10.5137/1019-5149.JTN.46851-24.3","DOIUrl":"10.5137/1019-5149.JTN.46851-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To compare the sphenoid ridge (SR) morphology in patients with Chiari type I malformation (CIM) with healthy subjects.</p><p><strong>Material and methods: </strong>Three dimensional (3D) computed tomography scans of 49 (25 men / 24 women) CIM patients aged 45.84±18.04 years, and 52 (26 men / 26 women) healthy subjects aged 43.46±11.62 years were included in the investigation. The angulation and dimension of SR were measured for both groups.</p><p><strong>Results: </strong>Compared with the controls, CIM patients had greater lesser wing (LW) length (p < 0.001) and LW width in the midline (p < 0.001), but shorter LW width in the midpoint (p=0.001), LW width in the lateral point (p < 0.001), and LW angle (p < 0.001). In CIM, two configurations regarding LW angle types were observed: Type B in 75 LWs (76.5%) and Type C in 23 LWs (23.5%). In controls, two configurations regarding LW angle types were observed: Type A in 35 LWs (33.7%) and Type B in 69 LWs (66.3%). The distribution of the types according to study groups demonstrated that CIM affected significantly LW angle types (p < 0.001).</p><p><strong>Conclusion: </strong>LW angle and length may represent middle fossa depth and anterior fossa width, respectively; thus, CIM subjects possess shallow middle fossa and wider anterior fossa.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"661-666"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not to Wait Too Long After Failed Surgery for Intractable Mesial Temporal Lobe Epilepsy: Results of Reoperation at a Tertiary Hospital.","authors":"Seyda Erdogan, Serdar Solmaz, Murat Zaimoglu, Atilla Erdem","doi":"10.5137/1019-5149.JTN.46820-24.4","DOIUrl":"10.5137/1019-5149.JTN.46820-24.4","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the causes and risk factors of seizure recurrence, as well as the outcomes of reoperation in patients who did not achieve sufficient seizure control following surgery for mesial temporal lobe epilepsy (MTLE).</p><p><strong>Material and methods: </strong>We retrospectively reviewed the hospital charts of patients with medically refractory MTLE who were operated between 1990 and 2021.</p><p><strong>Results: </strong>A total of 240 patients (127 females and 113 males) with medically refractory mesial temporal lobe epilepsy underwent resective epilepsy surgery. Of these, 12 (5%) required reoperation due to seizure recurrence after the initial surgery. Six out of the 12 patients with available seizure outcome data were included in the study. The cause of seizure recurrence in all patients was remnant tissue. The age at reoperation ranged from 17 to 59 years, and the time between the initial and final surgery ranged from 2 to 20 years. The seizure outcome was Engel Class I in all patients, with follow-up periods ranging from 4 to 21 years.</p><p><strong>Conclusion: </strong>Surgical failure is still prevalent in patients with MTLE, with inadequate resection frequently serving as the primary cause. Reoperation can considerably improve the seizure outcome. Delaying the opportunity for a second surgical intervention should be avoided.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"592-602"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basilar Artery Stenosis: Technical Tips to Prevent and Treat Hemorrhage during Angioplasty.","authors":"Zeferino Demartini Jr, Renato Fedatto Beraldo, Adriane Cardoso-Demartini","doi":"10.5137/1019-5149.JTN.46931-24.1","DOIUrl":"10.5137/1019-5149.JTN.46931-24.1","url":null,"abstract":"<p><p>To describe the strategies and techniques to improve the outcomes in intracranial hemorrhage during endovascular procedures, a case of a 60-year-old male with symptomatic basilar artery stenosis who underwent balloon angioplasty procedure following an iatrogenic basilar artery hemorrhage, is presented. Hemorrhage control and vessel wall reconstruction were achieved with heparin reversal, intermittent balloon inflation, and telescoping stents. In addition, immediate external ventricular drainage was able to control the intracranial hypertension. In conclusion, the ruptured of intracranial vessels is usually challenging to treat. Intermittent balloon inflation with telescoping stents can help stop bleeding.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"577-579"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supratentorial Intracranial Anomalies in Myelomeningocele Patients.","authors":"Larisa Andrada Ay, Ibrahim Alatas, Bahattin Ozkul, Revna Cetiner, Orkhan Alizada, Doga Ugurlar","doi":"10.5137/1019-5149.JTN.44183-23.7","DOIUrl":"10.5137/1019-5149.JTN.44183-23.7","url":null,"abstract":"<p><strong>Aim: </strong>To assess associated cerebral supratentorial anomalies in patients who underwent myelomeningocele repair in hopes of developing a better morphological apprehension of the forebrain?s anomalies in this category of patients.</p><p><strong>Material and methods: </strong>This retrospective observational study assessed 426 pediatric patients who underwent myelomeningocele repair between January 2013 and December 2020. Cranial MRIs with T1- and T2-weighted sequences were obtained as part of the postoperative assessment to determine the presence of associated supratentorial anomalies in pediatric patients following myelomeningocele repair.</p><p><strong>Results: </strong>The most common supratentorial anomalies identified in patients who underwent myelomeningocele repair are associated with the configuration of the corpus callosum (CC). Moreover, the complete agenesis of the CC was noticed in 9 (2.1%) subjects, whereas partial agenesis was identified in 148 (34.7%) subjects. Hypoplasia of the CC was observed in three (0.7%) patients. Gray matter heterotopia were the second most commonly observed supratentorial anomalies in 110 (25.8%) patients. Furthermore, the absence of the septum pellucidum was observed in two (0.47%) of the total patients. The widening of the interhemispheric fissure and abnormal maturation of the white matter were observed in 10 (2.34%) patients and 11 (2.58%) patients, respectively. Polymicrogyria, a consequence of abnormal cortical organization, was identified in 22.53% of the patients (96 patients) included in our series.</p><p><strong>Conclusion: </strong>This study confirms that, except for hydrocephalus and Chiari malformation, other associated cerebral supratentorial anomalies may be observed in patients with myelomeningocele. However, only limited research has confirmed the interconnection between the cerebral supratentorial anomalies and cognitive function. Therefore, this study emphasizes the necessity for further supplementary studies, in conjunction with accurate postnatal followups, in order to assess the real significance and repercussions of these anomalies on neurological development and also to establish how these structural changes in brain anatomy translate clinically.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy in Children with Myelomeningocele: A Single-Center Retrospective Cohort Study and Review of the Literature.","authors":"Esra Ulgen Temel, Deniz Menderes, Ayse Serdaroglu, Ebru Arhan","doi":"10.5137/1019-5149.JTN.47393-24.2","DOIUrl":"10.5137/1019-5149.JTN.47393-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To examine the prevalence of epilepsy and other associated cortical abnormalities in patients with Myelomeningocele (MMC), and to present our findings along with a review of the literature.</p><p><strong>Material and methods: </strong>A retrospective chart review was conducted with MMC patients followed in our pediatric neurology outpatient clinic between 2015 and 2020.</p><p><strong>Results: </strong>The study included a total of 23 patients ranging in age from 7 months to 19 years with a median follow-up period of 36 months. The frequency of epilepsy was 43.5% (n=10). Hydrocephalus was present in 20 patients (87%) patients, and 18 patients (78.3%) had concomitant central nervous system anomalies. Epilepsy was diagnosed in 52.6% of the patients with a ventriculoperitoneal shunt but none of those without a shunt.</p><p><strong>Conclusion: </strong>Our study revealed a high incidence of epilepsy among patients with MMC, in contrast to the available literature. As the life expectancy of patients with MMC continues to increase, secondary clinical manifestations such as epilepsy may become more evident. Furthermore, most research on the prevalence of epilepsy and seizures among individuals with MMC was conducted approximately two decades ago. Further studies should examine the changing incidence.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"603-608"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Segmentation and Connectivity of the Uncinate Fasciculus.","authors":"Sevki Serhat Baydin, Ozan Barut, Baris Kucukyuruk, Ozan Hasimoglu, Necmettin Tanriover","doi":"10.5137/1019-5149.JTN.49120-25.2","DOIUrl":"10.5137/1019-5149.JTN.49120-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To provide a detailed anatomical segmentation of the uncinate fasciculus (UF) and to identify its cortical and subcortical connections using complementary white matter dissection and diffusion-weighted imaging tractography techniques.</p><p><strong>Material and methods: </strong>Human cadaveric cerebral hemsipheres were used to perform fiber dissections of the UF using the Klingler technique. The tract was anatomically segmented based on its spatial relationships with surrounding structures. In parallel, high-resolution diffusion MRI data from healthy subjects were analyzed using deterministic tractography methods to reconstruct the UF and validate the anatomical segmentation.</p><p><strong>Results: </strong>Dissection studies revealed three distinct segments of the UF-temporal, insular, and frontal-based on their anatomical trajectories. Tractography findings supported this segmentation and demonstrated specific patterns of connectivity: the temporal segment connected the anterior temporal lobe to the amygdala and insula; the insular segment traversed the limen insulae; and the frontal segment projected to Brodmann areas 10, 11, 47, as well as the anterior cingulate cortex. These findings were consistent across all subjects.</p><p><strong>Conclusion: </strong>This study presents a novel three-segment model of the UF, integrating findings from both dissections and tractography. The identified connectivity patterns enhance our understanding of frontal-temporal network organization and provide valuable insights for neurosurgical approaches and neuropsychiatric research.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"652-660"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effects of tDCS on Calcium and Glutamate Excitotoxicity in a Cerebral Ischemia? Reperfusion Rat Model.","authors":"Guven Akcay, Filiz Demirdogen, Dilcan Kotan, Tuba Gul, Ali Yilmaz, Yusuf Muslum Ergul, Cagla Celik","doi":"10.5137/1019-5149.JTN.46166-23.6","DOIUrl":"10.5137/1019-5149.JTN.46166-23.6","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the therapeutic effects of transcranial direct current stimulation (tDCS) on calcium and glutamate excitotoxicity caused by ischemia?reperfusion (IR).</p><p><strong>Material and methods: </strong>The IR model was generated by transient middle cerebral artery occlusion. tDCS treatment was applied at 1 mA for 30 min daily at the 2 < sup > nd < /sup > , 24 < sup > th < /sup > , and 48 < sup > th < /sup > h of IR. The motor and cognitive functions and the concentrations of Ca < sup > 2+ < /sup > , glutamate, and N-methyl-D-aspartate receptor (NMDAR) in the hippocampus tissues were evaluated.</p><p><strong>Results: </strong>Results showed a reduction in motor and cognitive functions in the IR group compared with that in the sham group, whereas these functions increased in the IR+tDCS group compared with those in the IR group. Ca < sup > 2+ < /sup > , glutamate, and NMDAR concentrations were higher in the IR group than in the sham group but lower in the IR+tDCS group than in the IR group.</p><p><strong>Conclusion: </strong>These results suggest that tDCS treatment improves motor and cognitive dysfunctions after IR and exerts therapeutic effects on learning and memory through the regulation of Ca < sup > 2+ < /sup > and glutamate excitotoxicity.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"749"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryotoxic Effects of Sunset Yellow in Congenital Neural Tube Defect Formation in Early-Stage Chick Embryos: A Histopathological Study.","authors":"Fatih Toprak, Dila Sener Akcora, Dilek Akakin, Ezgi Akar, Selin Tural Emon","doi":"10.5137/1019-5149.JTN.48040-24.2","DOIUrl":"10.5137/1019-5149.JTN.48040-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the embryotoxic effects of Sunset Yellow (SY) exposure on neural tube development in an experimental model of chicken embryos.</p><p><strong>Material and methods: </strong>Sixty fertilized special pathogen-free (SPF) Leghorn genus chick embryos were used. Three experimental groups were determined, comprising the control group (0.1 ml saline), daily intake dose [2.5 mg/kg Sunset Yellow FCF E110 (SY)], and high dose [5 mg/kg SY] groups (n=20). SPF status was determined on day 0 when eggs were placed in the incubator. Eggs were injected at the 30th hour of incubation, and incubated for the following 72 hours.</p><p><strong>Results: </strong>Upon light microscope examination, in the control group the surface ectoderm was intact, the neural tube was closed, and the neuroepithelium, basement membrane surrounding the neuroepithelium, notochord, and somites were all normal. In the daily intake dose SY group, four examples of neural tube defects (NTDs) were observed. Six instances of NTDs were observed in the high-dose SY group. The high-dose group had a statistically significant increase in the number of embryos with NTDs compared to other groups (p=0.0004).</p><p><strong>Conclusion: </strong>These results suggest that SY consumption can cause irregular neural tube development. SY should not be ingested in high doses for extended periods of time, should be regulated even when used as an additive, and should be avoided during pregnancy. Further studies are needed in a wider range of dose groups to observe the embryotoxic effects of SY on neuronal development.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"701-708"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Role of Biomarkers Using Liquid Biopsy in the Diagnosis of Meningiomas.","authors":"Hasiba Karimi, Sadaf Mahfooz, Imran Khan, Busra Karacam, Kerime Akdur, Guven Gonen, Elif Burce Elbasan, Mustafa Aziz Hatiboglu","doi":"10.5137/1019-5149.JTN.46743-24.3","DOIUrl":"10.5137/1019-5149.JTN.46743-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the diagnostic potential of c-MYC, FABP7, GATA4, and MAOB in meningioma patients by analyzing their expression in serum samples.</p><p><strong>Material and methods: </strong>The study included 20 patients who underwent surgical resection for intracranial meningiomas. Tumor and serum samples were collected during the surgical procedure. Real-time polymerase chain reaction (RT-PCR) was performed to measure the expression of FABP7, GATA4, c-MYC, and MAOB in both tumor tissues and serum samples.</p><p><strong>Results: </strong>The expression levels of MAOB, c-MYC, and GATA4 were significantly higher in grade 2 meningioma tumor tissues compared to grade 1 tumors (p=0.031, p=0.041, and p=0.003, respectively). Similarly, patients with grade 2 meningiomas had significantly higher MAOB expression in their serum compared to patients with grade 1 meningiomas (p=0.032). In addition, the serum levels of FABP7 and MAOB were significantly higher in meningioma patients compared to healthy controls (p < 0.05).</p><p><strong>Conclusion: </strong>The findings of this study suggest that FABP7 and MAOB expression in serum may serve as diagnostic markers for meningiomas. However, additional studies with larger cohorts are necessary to validate these results.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"783-791"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}