Turkish neurosurgery最新文献_第5页

Pre-Therapeutic Vascular Anatomical Evaluation in Penetrating Cerebrovascular Injuries: Insights from Two Cases. 穿透性脑血管损伤治疗前血管解剖学评价：两例体会。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.48836-25.2

Jinwei Lei, Gongbin Wei

{"title":"Pre-Therapeutic Vascular Anatomical Evaluation in Penetrating Cerebrovascular Injuries: Insights from Two Cases.","authors":"Jinwei Lei, Gongbin Wei","doi":"10.5137/1019-5149.JTN.48836-25.2","DOIUrl":"10.5137/1019-5149.JTN.48836-25.2","url":null,"abstract":"Penetrating cerebrovascular injuries (PCVIs) are often life-threatening, with trauma to the carotid or vertebral arteries potentially causing severe neurological deficits. This study aimed to retrospectively examine two cases of severe penetrating cerebrovascular injury with unstable hemodynamics that resulted in markedly different neurological outcomes. The first patient was struck by a high-speed metal rod, sustained injuries to the right common carotid and right vertebral arteries and was admitted to our hospital 10 h after the trauma. The second patient, who was stabbed, sustained an injury to the right vertebral artery and was admitted to our hospital 1 h after the trauma. Both patients had injuries in zone II of the right lateral neck. The first patient underwent ligation of the right vertebral artery and anastomosis of the right common carotid artery using an interposition graft from the autologous great saphenous vein, resulting in an asymptomatic infarction of the ipsilateral frontal lobe. The second patient only underwent ligation of the right vertebral artery, which ultimately led to an occipital lobe infarction and subsequent visual field deficits. These contrasting outcomes underscore the critical influence of cerebrovascular anatomical variations. Penetrating cerebrovascular injuries may pose significant risks of neurological impairment, particularly in the presence of important vascular anatomical variants. Revascularization should be considered as a primary treatment option for patients with cerebral vessel malformations.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"476-482"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145796","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}

引用次数: 0

Ruptured Vertebral Artery Aneurysm in a Patient with Loeys-Dietz Syndrome Type 4: A Sentinel Case Report. Loeys-Dietz综合征4型患者椎动脉动脉瘤破裂1例前哨病例报告。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.47954-24.0

Elizabeth E Wicks, Luke Silveira, Elnur Delahmetovic, John Muse, Brandon Liebelt, Bruce Tranmer

{"title":"Ruptured Vertebral Artery Aneurysm in a Patient with Loeys-Dietz Syndrome Type 4: A Sentinel Case Report.","authors":"Elizabeth E Wicks, Luke Silveira, Elnur Delahmetovic, John Muse, Brandon Liebelt, Bruce Tranmer","doi":"10.5137/1019-5149.JTN.47954-24.0","DOIUrl":"10.5137/1019-5149.JTN.47954-24.0","url":null,"abstract":"Loeys-Dietz Syndrome (LDS) is a rare, autosomal dominant connective tissue disorder with an estimated prevalence of less than 1 in 100,000. LDS results from one of several genetic mutations altering the transforming growth factor β (TGF-β) signaling pathway. LDS portends a higher risk of vascular pathology including dissections and aneurysms throughout the arterial system. Though not commonly described, this higher incidence of vascular pathology extends to the cerebrovascular system with several case reports of cerebral aneurysms in patients afflicted with LDS. Herein, we describe the case of a 39-year-old female with a family history of cerebral and aortic aneurysms who presented with acute onset headache, neck pain, and lower extremity paresis prompting a CT head and subsequent magnetic resonance angiogram remarkable for a subarachnoid hemorrhage secondary to rupture of a large fusiform V4 segment vertebral artery aneurysm. Formal angiogram confirmed this diagnosis, and endovascular treatment was pursued with coil embolization of the aneurysm and parent vertebral artery distal occlusion. Subsequent genetic testing confirmed the patient to be positive for the mutation indicative of type 4 LDS. Though rare, LDS should be considered as a possible diagnosis in patients presenting with aneurysmal subarachnoid hemorrhage when a family history of systemic vascular pathology is elicited. Confirmatory diagnosis of LDS appropriately spurs additional vascular imaging and family screening to proactively minimize the morbidity of this rare disease.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"471-475"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145776","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}

引用次数: 0

Impact of DNA Methylation Profiling on Central Nervous System Tumor Diagnosis and Management: A Pediatric Cohort Study from Türkiye. DNA甲基化分析对中枢神经系统肿瘤诊断和治疗的影响：来自<s:1> rkiye的一项儿科队列研究。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.50069-25.2

Mehmet Arda Inan, Ayca Ersen Danyeli, Figen Soylemezoglu, Berrin Babaoglu, Bahattin Tanrikulu, Memet Ozek

{"title":"Impact of DNA Methylation Profiling on Central Nervous System Tumor Diagnosis and Management: A Pediatric Cohort Study from Türkiye.","authors":"Mehmet Arda Inan, Ayca Ersen Danyeli, Figen Soylemezoglu, Berrin Babaoglu, Bahattin Tanrikulu, Memet Ozek","doi":"10.5137/1019-5149.JTN.50069-25.2","DOIUrl":"10.5137/1019-5149.JTN.50069-25.2","url":null,"abstract":"Aim: To present a single-center experience, and to highlight the urgent need for multi-institutional collaboration in Türkiye and surrounding regions lacking access to methylation platforms, with the aim of enhancing diagnostic precision and neuropathological practice.Material and methods: All pediatric patients who underwent methylation?based tumor classification (MBTC) between November 2023 and July 2025 were retrospectively identified. Clinical, histological, and molecular data were extracted and correlated with methylation results. Concordance between histopathology and MBTC was categorized as concordant, minor discordance, major discordance, novel classification, or un-classifiable.Results: A total of 48 tumors were profiled (26 females [54%]; 22 males [46%]; median age, 6.5 years; range, 0?17). The most frequent localization was supratentorial (n=18, 36%). Of the entire cohort, concordance was 58%. Excluding unclassifiable cases, concordance among evaluable tumors was 67%. Discordance occurred in 11 cases (23%), including 6 (13%) with major discrepancies. Concordance was significantly associated with tumor localization (p=0.028) but not WHO grade (p=0.17) and classifier confidence (p=0.73).Conclusion: MBTC is a valuable complementary tool in the diagnostic workup of pediatric central nervous system (CNS) tumors, particularly in morphologically ambiguous and ultra-rare cases. It should be integrated with conventional histopathology rather than viewed as a replacement, as it may prevent prognostic misclassification and inappropriate treatment in selected patients.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"281-293"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358371","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}

引用次数: 0

A Comparative Study of Large Language Models in Turkish Neurosurgery Education Using a Mock Neurosurgery Board Examination. 使用模拟神经外科委员会考试的大型语言模型在土耳其神经外科教育中的比较研究。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.50196-25.3

Kivanc Yangi, Egemen Gok, Jiuxu Chen, Doga Yangi, Michell Goyal, Pravarakhya Puppalla, Kristina M Kupanoff, Baoxin Li, Ender Koktekir, Omer Hakan Emmez, Mark C Preul

{"title":"A Comparative Study of Large Language Models in Turkish Neurosurgery Education Using a Mock Neurosurgery Board Examination.","authors":"Kivanc Yangi, Egemen Gok, Jiuxu Chen, Doga Yangi, Michell Goyal, Pravarakhya Puppalla, Kristina M Kupanoff, Baoxin Li, Ender Koktekir, Omer Hakan Emmez, Mark C Preul","doi":"10.5137/1019-5149.JTN.50196-25.3","DOIUrl":"10.5137/1019-5149.JTN.50196-25.3","url":null,"abstract":"Aim: To evaluate Deepseek-R1, Gemini-2.0 Pro, ChatGPT-o3-mini-high, and GPT-4.5 on a mock neurosurgery board exam to assess their accuracy and educational value.Material and methods: We created a 50-question mock neurosurgery board examination and administered it to three major large language models (LLMs) and 10 Turkish senior residents. Next, we systematically evaluated their responses for accuracy, reasoning time, word count, and readability. Residents ranked the educational value of the LLM responses. The study also compared two recent ChatGPT versions, o3-mini-high and GPT-4.5, using the same test. Statistical comparisons were used to analyze the results.Results: In overall accuracy, all three LLMs achieved higher scores than residents, with Deepseek-R1 at 84%, ChatGPT o3 minihigh at 82%, and Gemini 2.0 Pro at 78%, compared to 58% for residents (p < 0.001). Deepseek-R1 required the longest reasoning time but provided the most organized responses. Gemini-2.0 Pro produced the most detailed and easy-to-read answers. Residents preferred the explanations from Deepseek-R1 and Gemini-2.0 Pro over those from ChatGPT-o3-mini-high (p < 0.001). ChatGPT-4.5 achieved 74% accuracy, higher than residents but lower than other LLMs. Compared with ChatGPT o3-mini-high, ChatGPT-4.5 produced longer, more complex responses while responding faster (p < 0.001).Conclusion: LLMs? higher scores on the mock board examination highlight their potential as auxiliary educational tools in neurosurgical training. The high accuracy of Deepseek-R1 and the clarity of Gemini-2.0 Pro?s detailed responses suggest uses with refinement as neurosurgical educational guides or in constructing board questions or training assessments.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"183-199"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358384","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}

引用次数: 0

Evaluation of the First Cervical Vertebra Anatomy for Screw Fixation. 第一颈椎解剖结构对螺钉固定的评价。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.48751-25.4

Narmin Farajiband, Zuhre Ikiz, Hulya Ucerler

{"title":"Evaluation of the First Cervical Vertebra Anatomy for Screw Fixation.","authors":"Narmin Farajiband, Zuhre Ikiz, Hulya Ucerler","doi":"10.5137/1019-5149.JTN.48751-25.4","DOIUrl":"10.5137/1019-5149.JTN.48751-25.4","url":null,"abstract":"Aim: To conduct a morphometrical analysis of the atlas to facilitate the development of atlas-related treatment methods and demonstrate the variations in atlas anatomy to aid surgical approaches and reduce complications.Material and methods: The present study was conducted on 58 dry human atlas vertebrae supplied by the Ege University Faculty of Medicine, Department of Anatomy. Morphometrical analysis was performed using digital calipers.Results: The quantitative measurements were analyzed for screw fixation. The variations in the atlases were identified as spina bifida (1.7%), accessory foramen (on the right and left sides in 8.6% and 1.7%, respectively), canal for vertebral artery (1.7%, each on the right and left sides, and bilateral in 5.2%), and bipartite superior articular surface (on the right and left sides in 5.2% and 1.7%, respectively).Conclusion: Some of these anatomical variants may explain certain previously described clinical symptoms. The measurements obtained from the 58 atlas vertebrae and the variations observed during the study were discussed. The primary outcome of the present study was that the measurements of the vertebrae are different for every individual. Therefore, it is important to use imaging methods and examinations before screw placement and other surgical approaches.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"275-280"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358317","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}

引用次数: 0

Genetic Association Between Systemic Lupus Erythematosus and Cerebrovascular Disorders. 系统性红斑狼疮与脑血管疾病的遗传关系。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.48929-25.1

Yu Guo, Yonggang Xu, Chao Liu, Meilin Chen, Hengzhu Zhang, Wenmiao Luo

{"title":"Genetic Association Between Systemic Lupus Erythematosus and Cerebrovascular Disorders.","authors":"Yu Guo, Yonggang Xu, Chao Liu, Meilin Chen, Hengzhu Zhang, Wenmiao Luo","doi":"10.5137/1019-5149.JTN.48929-25.1","DOIUrl":"10.5137/1019-5149.JTN.48929-25.1","url":null,"abstract":"Aim: To evaluate the potential genetic differences between systemic lupus erythematosus (SLE) and cerebrovascular disorders (CVDs) patients.Material and methods: This genetic association study conducted Mendelian randomization (MR) analyses on the derived exposures and outcomes from summary statistics of genome-wide association studies (GWAS). This study employed univariate MR (UVMR) analysis, multivariable MR (MVMR) analysis, and meta-analysis, using data from large genomic databases such as the UK Biobank, FinnGen, and OpenGWAS. These methods aim to overcome confounding factors by using genetic variants as instrumental variables to infer causal relationships.Results: UVMR analysis revealed a genetic causal relationship between SLE and ischemic stroke, with a positive correlation (odds ratio [OR] 1.000367; 95% confidence interval [CI] 1.000074--1.00066; p=0.014). No evidence of a genetic causal relationship was found between SLE and other types of CVDs, including cerebral aneurysm, intracerebral hemorrhage, subarachnoid hemorrhage, stroke, and transient ischemic attack. MVMR analysis, after adjusting for confounders such as smoking and type 2 diabetes, confirmed the robustness of the association between SLE and ischemic stroke. Furthermore, a meta-analysis of multiple MR outcomes was conducted to verify the stability of the results (OR, 1.00037; 95% CI, 1.00008-1.00067).Conclusion: Our study enhances the understanding of the genetic basis between SLE and various CVDs, particularly suggesting a positive causal association between SLE and ischemic stroke, and we emphasize the need for further research.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"49-63"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000310","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}

引用次数: 0

In the Presence of a Giant: Reflections on Prof. M. Gazi Yaşargil's Life, Humanity, and a Conversation with Francis Crick. 在巨人面前：反思加齐·亚·<s:1>阿吉尔教授的人生、人性以及与弗朗西斯·克里克的对话。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.50696-26.0

Paulo Abdo do Seixo Kadri

{"title":"In the Presence of a Giant: Reflections on Prof. M. Gazi Yaşargil's Life, Humanity, and a Conversation with Francis Crick.","authors":"Paulo Abdo do Seixo Kadri","doi":"10.5137/1019-5149.JTN.50696-26.0","DOIUrl":"10.5137/1019-5149.JTN.50696-26.0","url":null,"abstract":"Prof. M. Gazi Yaşargil's influence on modern neurosurgery is immeasurable-technically, scientifically, and humanistically. Yet those who had the privilege of working closely with him know that his greatest contributions were not limited to the microscope. During my fellowship at the University of Arkansas for Medical Sciences (2002-2004), under the mentorship of Prof. Ossama Al-Mefty, I had the extraordinary opportunity to observe Prof. Yaşargil in the operating room, in the laboratory, during lectures, on academic travels, and in private life alongside Mrs. Dianne Yaşargil. These experiences shaped my career and worldview in ways I continue to discover years later. Among the countless memories, one stands alone as a testament to his intellectual courage and humility: a 2003 visit to the Salk Institute, where he engaged in an elegant discussion on consciousness with Nobel Laureate Francis Crick. Their exchange-on the claustrum, neuroanatomy, and the nature of awareness-revealed the depth of Prof. Yaşargil's understanding of the human brain and his unyielding commitment to truth, even in the presence of another scientific titan. This reflection offers personal recollections of a man whose legacy endures not only through his technical revolutions, but through the humanistic and philosophical compass he imparted to generations of neurosurgeons.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 Special in Memoriam Prof. M. Gazi Yaşargil","pages":"2-6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304484","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}

引用次数: 0

Microvascular Decompression for Hemifacial Spasm without the Use of Neuromonitoring and Fix Retraction: A Single-Center Experience. 信函：在不使用神经监测和固定牵伸的情况下，微血管减压治疗面肌痉挛：单中心经验。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.47634-24.0

Xu Hao, Ding Lei, Shao Qiang

引用次数: 0

Practice Patterns of Percutaneous Vertebroplasty: A Survey of Neurosurgeons. 经皮椎体成形术的实践模式：神经外科医生的调查。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.51506-26.2

Murat Ozcan Yay, Ferhat Harman

{"title":"Practice Patterns of Percutaneous Vertebroplasty: A Survey of Neurosurgeons.","authors":"Murat Ozcan Yay, Ferhat Harman","doi":"10.5137/1019-5149.JTN.51506-26.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.51506-26.2","url":null,"abstract":"Abstract: AIM: To characterize current vertebral augmentation practices among neurosurgeons in Türkiye, with particular emphasis on patient selection, procedural approaches, complication experience, and postprocedure osteoporosis management. MATERIAL and METHODS: A national, cross-sectional, anonymous, web-based survey was conducted among neurosurgeons practicing in Türkiye. Data on clinician and institutional characteristics, indications and timing for vertebral augmentation, technical preferences, perceived complications, and approaches to secondary fracture prevention were collected using a questionnaire. Data were analyzed descriptively. RESULTS: Most respondents reported routinely performing vertebral augmentation at their centers, and many indicated substantial cumulative procedural experience. Clinical decision-making was primarily guided by pain severity and MRI-based fracture acuity. Support for vertebroplasty or kyphoplasty was highest for acute or subacute painful osteoporotic fractures refractory to conservative treatment. In contrast, support was lower for patients with chronic and traumatic fractures without neurologic deficit. Technical practice was relatively uniform, most commonly involving unilateral transpedicular access, local anesthesia with sedation, and single C-arm fluoroscopy. Cement leakage and adjacent-level fractures were frequently reported as lifetime experiences. Only a small minority of respondents reported having a written postprocedure osteoporosis protocol, and routine use of antiresorptive or anabolic therapy was limited. CONCLUSION: Vertebral augmentation is widely used by neurosurgeons in Türkiye in a selective, patient-centered manner. Although technical practice is relatively consistent, structured secondary fracture prevention after vertebral augmentation is uncommon, highlighting an important opportunity to improve long-term outcomes.","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"689-700"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121065","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}

引用次数: 0

Critique of the Case Report on Multiple Intracranial Aneurysms Concurrent with a Clinoid Meningioma. 多发性颅内动脉瘤并发斜坡状脑膜瘤病例报告述评。

Turkish neurosurgery Pub Date : 2026-01-01 DOI: 10.5137/1019-5149.JTN.47579-24.0

Muhammad Ikrama, Muhammad Usama, Shifa Israr

引用次数: 0