Turkish neurosurgery最新文献

{"title":"Results of a Long-Term Follow-Up on the Dry-Field Maneuver Application in Hemorrhage Control During Neuroendoscopic Procedures.","authors":"Elif Bolat, Elif Ezgi Cenberlitas, Tuncer Turhan","doi":"10.5137/1019-5149.JTN.49075-25.4","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49075-25.4","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To present the long-term follow-up results of dry-field maneuver in neuroendoscopy. MATERIAL and METHODS: The dry-field maneuver has been used in our clinic since 2012, leading to a retrospective review of patients undergoing neuroendoscopic procedures from 2012 to 2024. RESULTS: The dry-field maneuver was successfully implemented in 13 patients in our clinic, achieving effective control of bleeding without any postoperative complications. No neurological or vascular issues or deaths associated with this method were reported in any patient throughout the long-term follow-up period. CONCLUSION: The dry-field maneuver is a successful and reliable technique for controlling bleeding in neuroendoscopic procedures. It may also be used in certain cases during elective procedures.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"581-586"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655556","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":"Advanced Detection of a Small Intracranial Aneurysm Using Photon-Counting Computed Tomography Angiography.","authors":"Hakan Kardas, Eya Khadhraoui, Elie Diamandis, Daniel Behme, Maciej Pech, Sebastian Johannes Muller","doi":"10.5137/1019-5149.JTN.49203-25.4","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49203-25.4","url":null,"abstract":"<p><strong>Abstract: </strong>Using intravenous contrast, photon-counting computed tomography angiography (PCCT-A) provides detailed images of intracranial vessels. We report a case in which PCCT-A revealed a 1.5 mm aneurysm at the bifurcation of the middle cerebral artery that was not seen on magnetic resonance angiography. This case highlights the clinical value of PCCT-A in noninvasively detecting small intracranial aneurysms.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"615-619"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655559","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":"An Unusual Complication After Posterior Thoracolumbar Stabilization Surgery, Renal Hernia: A Case Report.","authors":"Ender Vergili, Irem Karaboga, Ali Murat Durdu, Eren Fatma Akcil, Mustafa Onur Ulu","doi":"10.5137/1019-5149.JTN.49696-25.2","DOIUrl":"10.5137/1019-5149.JTN.49696-25.2","url":null,"abstract":"<p><strong>Abstract: </strong>Grynfeltt-Lesshaft hernia is a rare type of posterolateral abdominal wall hernia that may be either congenital or acquired. Only a few cases have been reported following surgical procedures. The risk of herniation increases after surgeries involving this region due to the weakening of the musculofascial structures, particularly in operations involving the thoracolumbar junction. Proper dissection and reconstruction of the paravertebral and deep back muscles are therefore crucial in minimizing the risk of herniation. In this paper, we discuss the mechanisms underlying the development of Grynfeltt-Lesshaft hernia following posterior thoracolumbar stabilization surgery-a procedure that is increasingly performed in neurosurgical practice. We also address the predisposing factors and emphasize the importance of meticulous reconstruction of the musculofascial structures within the superior lumbar triangle to prevent this rare complication.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"624-626"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655568","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":"Downregulation of miR-221, miR-143, and miR-22 in Meningioma: Diagnostic Performance in a Single-Center Case-Control Study.","authors":"Salim Tekir, Emre Ozkara, Ebru Erzurumluoglu, Zuhtu Ozbek, Sevilhan Artan, Hulya Ozen, Ali Arslantas","doi":"10.5137/1019-5149.JTN.49747-25.3","DOIUrl":"10.5137/1019-5149.JTN.49747-25.3","url":null,"abstract":"<p><strong>Aim: </strong>To determine case-control differences in tissue miRNA expression and to quantify their ability to distinguish meningioma from nontumor dura.</p><p><strong>Material and methods: </strong>Tissue samples from 45 intracranial meningioma cases (WHO grade I, n = 22; grade II, n = 23) and 26 dura controls were analyzed. miRNA expression levels were measured by quantitative real-time PCR (qRT-PCR), normalized to U6, and relative expression levels were calculated using the 2-ΔΔCt method. Group and grade comparisons were performed using appropriate parametric or nonparametric tests. Diagnostic performance was evaluated using receiver operating characteristic (ROC) and area under the curve (AUC) values, with optimal cut-off points determined by the Youden index. Sensitivity and specificity were reported.</p><p><strong>Results: </strong>Compared with controls, meningioma tissues showed significant downregulation of miR-221, miR-143, and miR-22 (all p < 0.001), whereas miR-145 showed borderline significance (p = 0.052). Diagnostic discrimination was highest for miR-221 (AUC, 0.912; cut-off, ≤0.19; sensitivity, 91.11%; specificity, 88.46%), followed by miR-143 (AUC, 0.810; cut-off, ≤0.24; sensitivity, 71.11%; specificity, 92.31%) and miR-22 (AUC, 0.771; cut-off, ≤0.36; sensitivity, 82.22%; specificity, 65.38%). No significant differences in expression were observed between grade I and grade II tumors for any miRNA.</p><p><strong>Conclusion: </strong>Tissue miR-221, miR-143, and miR-22 are consistently downregulated in intracranial meningioma and demonstrate clinically meaningful diagnostic performance, with miR-221 showing the highest discriminatory accuracy. These findings support the potential integration of miRNA assays into tissue-based diagnostics and warrant multicenter validation to refine cut-off values and evaluate prognostic utility.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"371-376"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145510","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":"Endoscopic Endonasal Approach to Identify the Medial Corridor of the Cavernous Sinus: A Cadaveric Study with Clinical Correlation.","authors":"Aykut Gokbel, Savas Ceylan, Ayse Uzuner, Eren Yilmaz, Atakan Emengen, Musa Cirak, Burak Cabuk, Ihsan Anik","doi":"10.5137/1019-5149.JTN.49456-25.2","DOIUrl":"10.5137/1019-5149.JTN.49456-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To define the existence and precise anatomical boundaries of the medial corridor (MC) within the cavernous sinus (CS), using an endoscopic endonasal transsphenoidal approach, and to correlate these anatomical findings with clinical patterns of CS invasion in patients with pituitary adenomas.</p><p><strong>Material and methods: </strong>An endoscopic endonasal transsphenoidal technique was used to perform anatomical dissections on 10 CSs obtained from 5 adult cadaveric heads. Key neurovascular landmarks were systematically identified, and quantitative measurements of their spatial relationships were recorded. To establish clinical relevance, anatomical observations were correlated with radiological and intraoperative findings from 20 patients with pituitary adenomas demonstrating CS invasion on preoperative imaging.</p><p><strong>Results: </strong>The MC was consistently identified in all cadaveric specimens, confirming its reproducible anatomical presence. The mean distance between the anterior genu of the internal carotid artery (ICA) and the pituitary gland was 5.0 ± 1.5 mm. Clinical correlations revealed that pituitary adenomas preferentially invade the superior compartment of the CS via the MC prior to lateral and posterior extension. The oculomotor nerve (cranial nerve III) was a reliable anatomical landmark defining the lateral boundary of the MC.</p><p><strong>Conclusion: </strong>Comprehensive anatomical delineation of the MC is critical for refining endoscopic surgical strategies, maximizing the extent of safe tumor resection, and minimizing neurovascular morbidity. The consistently identified interval of approximately 5 mm between the anterior genu of the ICA and the pituitary gland provides a robust and practical intraoperative reference point for safe navigation through the MC of the CS.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"457-466"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145676","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":"Dural Amyloidoma Located in the Falx Cerebri and Spinal Dura: Two Case Reports.","authors":"Ilhan Aydin, Abdullah Safa Kursun, Muhsin Gunboz, Seda Okumus, Gokcen Gundogdu Unverengil, Erhan Emel","doi":"10.5137/1019-5149.JTN.47959-24.2","DOIUrl":"10.5137/1019-5149.JTN.47959-24.2","url":null,"abstract":"<p><p>Amyloidosis is a progressive disorder marked by the aggregation of insoluble fibrillar proteins in various tissues, leading to tissue damage. Localised amyloidosis, known as amyloidoma, is particularly rare in the central nervous system and may be mistaken for a neoplastic lesion due to similar radiological features. Consequently, the general treatment approach often involves total excision. However, it is important to consider that a biopsy of the amyloidoma, rather than total excision, may suffice for complete recovery when paired with appropriate systemic treatment. This report presents two rare cases of amyloidoma: one located in the falx cerebri and the other in the lumbar spine. Both cases were successfully operated on, with the patients recovering without complications following treatment. (1).</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"163-167"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000335","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":"Brainstem Cavernoma: A Benign Lesion in a Malignant Location.","authors":"Servet Inci, Baylar Baylarov","doi":"10.5137/1019-5149.JTN.48860-25.2","DOIUrl":"10.5137/1019-5149.JTN.48860-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To present our surgical experience with brainstem cavernomas and to emphasize the importance of the brainstem's internal structures.</p><p><strong>Material and methods: </strong>Based on the clinical data of 25 symptomatic patients who underwent surgery for brainstem cavernomas, we reviewed their radiological findings, surgical indications, surgical timing, postoperative remnants, and outcomes. We also performed a statistical analysis of seven parameters that, based on our clinical experience, may influence outcomes in these challenging cases.</p><p><strong>Results: </strong>There were 14 male and 11 female patients, with a mean age of 36.6 years (range: 20-66 years). All patients were symptomatic and had experienced at least one episode of bleeding. Complete resection was achieved in 23 patients (92%), while two (8%) required reoperation for residual cavernoma. Postoperative mortality occurred in one patient (4%) due to malignant hyperthermia. As a result, the mean modified Rankin Scale (mRS) scores at admission, discharge, and last follow-up were 2.44, 2.14, and 1.86, respectively. Statistical analyses demonstrated that preoperative neurological status was an important parameter affecting outcome (p=0.002).</p><p><strong>Conclusion: </strong>Brainstem cavernoma is a benign pathology, but it occurs in a malignant location. Therefore, advanced techniques, such as tractography, neuronavigation and neuromonitoring, should be employed in these challenging cases. However, we believe that a thorough knowledge of brainstem neuroanatomy and meticulous surgical technique are even more critical.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"360-370"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145534","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":"Distal Junctional Failure in Posterior Thoracolumbar Surgery: An Analysis of Spinopelvic Alignment and Surgical Outcomes.","authors":"Numan Karaarslan, Hidayet Safak Cine, Ece Uysal, Mehmet Ali Kahraman, Emre Herdan, Mohammed Aladdam, Abdullah Talha Simsek, Mahmut Demirkol, Burak Bayraktar, Yunus Emre Ozbilgi","doi":"10.5137/1019-5149.JTN.47941-24.4","DOIUrl":"10.5137/1019-5149.JTN.47941-24.4","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the incidence, risk factors, and spinopelvic alignment parameters associated with distal junctional failure (DJF) following posterior thoracolumbar stabilization surgery.</p><p><strong>Material and methods: </strong>This retrospective cohort study included 40 patients who underwent thoracolumbar stabilization between 2018 and 2024. Patients were divided into two groups: those who developed DJF (n=20) and those who did not (n=20, control group). Radiographic evaluations, including pre- and postoperative lateral radiographs, were used to assess spinopelvic parameters such as lumbar lordosis (LL), pelvic incidence (PI), and PI-LL mismatch. Statistical analyses were conducted to examine the correlation between these parameters and DJF occurrence.</p><p><strong>Results: </strong>The DJF group exhibited a significant postoperative reduction in LL and an increase in PI-LL mismatch compared to the control group, which maintained better sagittal alignment postoperatively (p < 0.05). Patients with higher preoperative PI-LL mismatch were more likely to develop DJF, highlighting the importance of preoperative planning and correction to prevent this complication.</p><p><strong>Conclusion: </strong>Optimizing spinopelvic alignment, particularly LL and PI-LL mismatch, is crucial for reducing the risk of DJF after thoracolumbar stabilization surgery. Future studies should aim to refine surgical techniques and strategies to enhance postoperative outcomes and minimize complications.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"89-98"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000102","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":"Revascularization in Pediatric Patients with Moyamoya Disease.","authors":"Emre Durdag, Baran Babayigit, Mustafa Mazican, Sibel Catalca, Ben Ali Omari, Soner Civi, Cagatay Andic, Halil Ibrahim Suner, Ozgur Kardes, Ilknur Erol, Kadir Tufan, Cem Yilmaz","doi":"10.5137/1019-5149.JTN.47854-24.2","DOIUrl":"10.5137/1019-5149.JTN.47854-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the patients who underwent surgery with a diagnosis of Moyamoya disease (MMD), and to contribute to the literature from a single-center in Türkiye.</p><p><strong>Material and methods: </strong>Patients were evaluated retrospectively based on age, symptoms, history of cerebrovascular events (CVE), genetic disorders, pre-operative (pre-op) radiological stage, surgical technique, post-operative (post-op) improvement, and post-op radiological staging. The absence of new CVEs and reduced seizure frequency were considered indicators of clinical improvement.</p><p><strong>Results: </strong>A total of 7 patients, 4 of whom had bilateral MMD, underwent surgery. The average age was 11.8 ± 5 years. 4 patients (57%) presented with cerebrovascular events as symptoms, and the remaining 3 patients (43%) presented with headaches. Cranial digital subtraction angiography (DSA) revealed that the patients were in advanced stages (Suzuki Stage 4.9 ± 1.1). Encephalo Duro Arterio Myo Synangiosis (EDAMS) surgical technique was performed on 10 hemispheres, and a combined bypass (EDAMS + direct) was performed on 1 hemisphere. Clinical improvement was observed approximately 6 months postoperatively. During followup, disease progression in the contralateral hemisphere with associated symptoms was noted in 4 patients, and these patients subsequently underwent surgery on the contralateral hemisphere. The average time between the first and second surgeries was 15 ± 7.7 months. Post-operative follow-up was conducted with DSA, and radiological success was defined as Lucia Stage 2 ± 0.85. No clinical difference was observed between craniotomy and craniectomy as surgical techniques. No differences were found between vessel selection and clinical outcomes.</p><p><strong>Conclusion: </strong>The EDAMS protocol has proven to be an effective treatment method for pediatric patients with MMD. Postoperative clinical improvements are rapidly observed, followed by radiological improvements. Patients may experience progression from unilateral to bilateral disease, which can progress quickly.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"64-73"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000361","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":"Madison Microneurosurgery Initiative: A Tribute to Professor M. Gazi Yaşargil's Legacy in Microvascular Surgery Training. Part I - A Brief History of Microsurgery and Yaşargil's Contributions.","authors":"Abdullah Keles, Mustafa Kemal Baskaya","doi":"10.5137/1019-5149.JTN.50985-26.0","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.50985-26.0","url":null,"abstract":"<p><p>In the late 1960s, Professor M. Gazi Yaşargil began to systematically incorporate microsurgery into neurosurgical practice, grounded in anatomical expertise and intensive, systematic laboratory training followed by clinical application. Using the operative microscope, he introduced microsurgical techniques and redefined surgical anatomy that had long existed but remained largely unseen. By exploiting natural cisternal pathways to achieve pure lesionectomy, he reintroduced operability for complex pathologies and established new standards in modern neurosurgery. Yaşargil's early contributions to microvascular training and neurosurgical practice exemplify enduring principles from which neurosurgical professionals at all stages can continue to draw guidance. Our exposure to his work-through lectures, publications, and personal communications-profoundly shaped our own approach to neurosurgery and ultimately informed the philosophy underlying our global neurosurgery efforts, embodied in the Madison Microneurosurgery Initiative. This manuscript reviews the historical foundations of microneurosurgery through Yaşargil's early career, his formative laboratory work in Burlington, Vermont, and the systematic clinical implementation of microsurgery in Zurich, distilling key lessons derived from these pioneering experiences. A companion manuscript (Part II) describes how these principles were translated into structured curricula and implemented through contemporary microsurgical training and our global neurosurgery efforts.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 Special Issue in Memoriam Prof. M. Gazi Yaşargil","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304487","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}