Turkish neurosurgery最新文献

{"title":"Effects of Felbamate on Tissue Caspase-3 Levels, Histopathology, and Neurological Function in Rats with Early Spinal Cord Ischemia-Reperfusion Injury.","authors":"Muhammed Erkan Emrahoglu, Erdal Resit Yilmaz, Askin Esen Hasturk, Ekrem Yalcin, Muhammed Yusuf Hamurcu, Jafar Nouri Nojadeh, Emine Arik, Asli Ayaz, Engin Kayikci","doi":"10.5137/1019-5149.JTN.51831-26.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.51831-26.2","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To evaluate the potential neuroprotective effect of felbamate in a rat model of spinal cord ischemia-reperfusion injury. MATERIAL and METHODS: Twenty-one male Wistar albino rats were randomly assigned to three groups (n=7 each): control, ischemia, and felbamate-treated. Transient spinal cord ischemia was induced by abdominal aortic occlusion for 20 minutes, followed by reperfusion. Felbamate was administered via a nasogastric tube immediately after reperfusion at a dose of 20 mg/kg. Twenty-four hours after surgery, tissue caspase-3 levels were measured using an enzyme-linked immunosorbent assay, spinal cord sections were evaluated histopathologically using a semiquantitative composite injury score, and neurological function was assessed using the modified Tarlov scoring system. RESULTS: Tissue caspase-3 levels differed significantly across the three groups (ANOVA, F=205.19, p.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"710-717"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121068","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":"Functional Mapping-Guided Resection of Eloquent Diffuse Low-Grade Gliomas: A Single-Institution Experience from a Low-Middle Income Country.","authors":"Seif Tarek El-Swaify, Ahmed M Ashour, Mohamed Mostafa Aziz, Ashraf G Al-Abyad","doi":"10.5137/1019-5149.JTN.49066-25.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49066-25.2","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To report our experience in implementing functional mapping-guided resection for eloquent diffuse low-grade gliomas (DLGGs) in a low- and middle-income country (LMIC) setting. There are logistical barriers to achieving onco-functional balance through glioma surgery in LMICs. MATERIAL and METHODS: The study is a retrospective chart review of adult patients who underwent surgical resection of their DLGGs that were located within supratentorial eloquent brain areas (within 15 mm). Functional mapping-guided surgery was performed using electrophysiological brain mapping techniques, namely intraoperative neuromonitoring (IONM) with or without awake craniotomy (AC). The primary outcome was the rate of postoperative neurological deficits. The secondary outcomes were the extent of resection, the rate of surgical complications, the Engel Outcome Scale score, and the progression-free survival (PFS) rate. RESULTS: Twenty-eight patients were included (43% males), with a mean age of 37.5 years. Their median preoperative Karnofsky Performance Scale score was 90. The predominant histopathology was astrocytoma (n = 20, 71%), and the primary site was perirolandic in 19 patients (68%). Seizures were the most common presenting symptom (71%). Resection was performed using either IONM alone (39%) or combined with AC (61%). Gross total resection was achieved in 20 patients. Six patients (21%) developed postoperative complications. Patients were followed up for a mean of 39.9 months. At discharge, 12 patients (43%) had experienced new or worsened neurological deficits, but nine of them later showed significant improvement. Sixteen patients achieved Engel class 1 seizure control, and the median PFS was 34 months. Two patients died during the study period. CONCLUSION: This study demonstrates that our institution's protocol for integrating functional mapping into the surgical management of DLGGs achieves a solid onco-functional balance.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"646-657"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121071","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":"Patterns of Pedicle Wall Violations Following Thoracolumbar Stabilization in Osteoporotic and Non-Osteoporotic Patients.","authors":"Berkay Ayhan, Mehmet Emre Yildirim","doi":"10.5137/1019-5149.JTN.49543-25.2","DOIUrl":"10.5137/1019-5149.JTN.49543-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To investigate which pedicle level and wall were most affected by screw malposition in osteoporotic and non-osteoporotic patients undergoing thoracolumbar stabilization, and to determine whether significant differences existed between the groups.</p><p><strong>Material and methods: </strong>This retrospective study analyzed pedicle screw malpositions and the specific walls involved in thoracolumbar stabilization procedures performed between 2014 and 2025 using the freehand technique with fluoroscopic guidance by the same surgical team. A total of 972 patients were included: those with a T-score ≤-2.5 (osteoporotic group) and those with a T-score > -2.5 (non-osteoporotic group). Indications for surgery included traumatic vertebral fracture, spinal stenosis, recurrent disc herniation, spinal tumor, or spondylolisthesis. All patients underwent preoperative MRI, CT, bone mineral densitometry, and X-rays, as well as postoperative CT and X-rays. Patients with acute decompression without preoperative densitometry and those treated with vertebroplasty/kyphoplasty were excluded. In cases of malposition, postoperative CT scans were used to evaluate superior, inferior, lateral, medial, and anterior cortical breaches, and comparisons were made between groups.</p><p><strong>Results: </strong>Screw malposition rates were significantly higher in osteoporotic patients across all levels, particularly in thoracic vertebrae. The medial pedicle wall was most frequently affected in this group.</p><p><strong>Conclusion: </strong>In osteoporotic patients, transpedicular screw fixation using the freehand technique with fluoroscopic guidance was associated with higher malposition rates, especially involving the medial pedicle wall. These complications may be reduced through greater surgical experience and careful intraoperative technique.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"433-439"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145814","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":"Endovascular Treatment Versus Medical Management in Patients with Large Vessel Occlusion and Pre-Stroke Disability: A Systematic Review and Meta-Analysis.","authors":"Tian-Yi Zhang, Heng-Zhu Zhang, Dian Li, Yi-Qiao Hu","doi":"10.5137/1019-5149.JTN.49284-25.1","DOIUrl":"10.5137/1019-5149.JTN.49284-25.1","url":null,"abstract":"<p><strong>Aim: </strong>To assess the effectiveness and safety of endovascular treatment (EVT) versus medical management (MM) in stroke patients with premorbid disabilities.</p><p><strong>Material and methods: </strong>A systematic search was conducted in PubMed, Embase, and the Cochrane Library for studies on EVT in large vessel occlusion (LVO) patients with pre-stroke modified Rankin Scale (mRS) score of 2-4. The primary outcome was functional recovery, defined as returning to at least the pre-stroke mRS score within 90 days. The secondary outcomes included symptomatic intracranial hemorrhage (sICH) and 90-day mortality. The meta-analyses were conducted via random effects models.</p><p><strong>Results: </strong>Six cohort studies involving 2,106 patients were included. Compared with MM, EVT was associated with a higher likelihood of functional recovery (adjusted odds ratio [aOR], 3.26; 95% confidence interval [CI], 2.26-4.70; p.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"341-348"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145725","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":"Percheron Artery Implicance in Bi-Thalamic Stroke Following Endoscopic Endonasal Approach for Infundibulo-Neurohypophysitis: A Combination of Two Rare Entities.","authors":"Lucila Domecq Laplace, Mauro Ruella, Pablo Villanueva, Débora Adela Katz, María Florencia Battistone, Andrés Cervio","doi":"10.5137/1019-5149.JTN.47761-24.2","DOIUrl":"10.5137/1019-5149.JTN.47761-24.2","url":null,"abstract":"<p><p>Bi-thalamic stroke is rarely reported in the literature as a complication of an endonasal endoscopic procedure. It has been associated with presence of a Percheron artery variant, as well as with top of the basilar syndrome, both of which significantly increase patient surgical morbidity. Infundibulo-neurohypophysitis in turn, is an unusual inflammatory disorder affecting the infundibulum, the pituitary stalk, and the neurohypophysis. We present the case of a patient with visual impairment and an abnormal hormone profile compatible with infundibulo-neurohypophysitis, in whom tumor resection was conducted through an endoscopic endonasal approach (EEA). Patient developed postoperative bi-thalamic stroke due to Percheron artery infarct. A review of both conditions is included. This is the fourth case reported in the literature of a Percheron artery infarct, and to the best of our knowledge, the first linking it to endoscopic treatment of neurohypophysitis, itself an infrequent condition.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"158-162"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000284","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":"Hemostasis Versus Immunosuppression in Preventing Postlaminectomy Epidural Fibrosis: An Experimental Study in Rats.","authors":"Vaner Koksal, Tolga Mercantepe, Levent Tumkaya","doi":"10.5137/1019-5149.JTN.48680-25.2","DOIUrl":"10.5137/1019-5149.JTN.48680-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To compare haemostasis induced with tranexamic acid (TXA) and immunosuppression induced with infliximab (INF) as strategies to reduce epidural fibrosis (EF) in rat laminectomy model.</p><p><strong>Material and methods: </strong>Twenty-one male Sprague?Dawley rats were randomly assigned into control group (no treatment), TXA treatment group and INF treatment group (n=7 per group). TXA (10?20 mg/mL) and INF (1 mg/mL) were topically applied following L1?L3 laminectomy. Histopathological evaluation involving haematoxylin?eosin and Masson-Goldner?s Trichrome staining was conducted eight weeks postoperatively. EF severity, fibroblast density, inflammatory cell infiltration and neovascularisation were analysed.</p><p><strong>Results: </strong>Histopathological analysis showed that fibrosis scores were significantly lower in the TXA treatment group than in the control and INF treatment groups (p < 0.05). Moreover, TXA reduced fibroblast proliferation, inflammatory cell infiltration and collagen deposition. While INF exhibited moderate anti-fibrotic effects, it was less effective than TXA. No systemic side effects were observed in either treatment group.</p><p><strong>Conclusion: </strong>This study demonstrates that TXA prevents EF more effectively than INF following laminectomy. The findings also underscore that TXA is superior over INF in reducing EF. These results suggest that compared with INF-induced immunosuppression, TXA-induced haemostasis is the more effective strategy to minimise postoperative fibrosis in spinal surgery.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"229-236"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358315","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":"The Role of DTI and DTT in the Evaluation of Cervical Extramedullary Tumors.","authors":"Zeynep Firat, Cumhur Kaan Yaltirik, Aysegul Gormez, Osman Melih Topcuoglu, Gazanfer Ekinci, Ugur Ture","doi":"10.5137/1019-5149.JTN.48739-25.2","DOIUrl":"10.5137/1019-5149.JTN.48739-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in establishing the relationship between cervical extramedullary tumors and the spinal cord with reference to, especially treatment planning, clinical outcome prediction and diagnostic accuracy.</p><p><strong>Material and methods: </strong>This was a retrospective study conducted on 15 patients diagnosed with cervical extramedullary tumors, wherein each patient underwent standard 3.0-T magnetic resonance imaging, DTI, and DTT to evaluate microstructural changes and neural tract displacement. Fractional anisotropy (FA) values were examined, and the relationship of tractography results with clinical presentation and outcomes was evaluated.</p><p><strong>Results: </strong>FA values revealed disturbances in the microstructure, which exhibited marked changes in lesion areas compared with that of normal tissue and displaced spinal cord (DSC). The DTT of each patient revealed neural tract anomalies or deformities related to the degree of their clinical symptoms. Receiver operating characteristic curve analysis demonstrated the excellent diagnostic accuracy of FA in separating lesions from normal tissue (AUC = 0.880) and DSC (AUC = 0.840).</p><p><strong>Conclusion: </strong>FA values could help particularly in detecting early myelopathic changes due to cervical cord displacement, which might be a critical indication for surgical decisions. This study supports the usage of DTI and DTT in evaluating cervical extramedullary lesions, surgical planning, and outcome prediction by exposing microstructural changes and lesion-tract relationships.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000351","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":"In Memoriam: Professor M. Gazi Yaşargil.","authors":"Robert F Spetzler","doi":"10.5137/1019-5149.JTN.52035-26.0","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.52035-26.0","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 Special Issue in Memoriam Prof. M. Gazi Yaşargil","pages":"38-40"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304428","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":"Early and Effective Surgical Treatment of Ossified Cephalohematoma Using a Simple Technique.","authors":"Nuri Serdar Bas, Akin Ozturk, Abdurrahim Tekin, Engin Can, Evren Sonmez, Lokman Ayhan, Suna Dilbaz, Idil Bas, Serdar Cevik","doi":"10.5137/1019-5149.JTN.49815-25.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49815-25.2","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To retrospectively analyze infants treated with early surgical management using the simple excision technique and discusses the outcomes in light of the existing literature. MATERIAL and METHODS: Ten infants with OCH who underwent surgery were included in this study. The following parameters were recorded: age, sex, mode of delivery (normal vaginal delivery, cesarean section, vacuum extraction, or forceps delivery), presence of hematologic disorders or bleeding diathesis, comorbidities or anomalies, lesion localization, lesion size, duration of surgery and anesthesia, estimated blood loss, need for transfusion, postoperative complications, neurological findings, presence of additional pathologies, classification type, duration of hospital stay, and postoperative follow-up period. RESULTS: The mean age of the 10 infants was 3.7 months, with a male-to-female ratio of 9:1. The OCH was located in the occipital region in one patient, the parietal region in eight patients, and bilaterally in the parietal region in one female infant. The lesion size ranged from 37 to 90 mm. The duration of surgery ranged from 40 to 80 min, while anesthesia lasted between 70 and 120 min. The mean intraoperative blood loss was 30 mL. All patients were discharged within an average of 2 days. According to Wang's classification, all cases were categorized as Type 1. The follow-up period ranged from 1 to 66 months. CONCLUSION: Initial management of cephalohematoma should involve careful monitoring. However, when ossification occurs, early neurosurgical intervention is advisable. Early surgical treatment of OCH using the simple excision technique is a safe, effective, and minimally invasive approach associated with short operative time, minimal blood loss, and excellent cosmetic and functional outcomes. Therefore, early surgical management should be considered the preferred treatment option for OCH.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"553-560"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655546","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":"Letter to Editor: Impact of Obesity on Subarachnoid Hemorrhage-Induced Cerebral Vasospasm: An Experimental.","authors":"Hasan Caliskan","doi":"10.5137/1019-5149.JTN.49136-25.2","DOIUrl":"10.5137/1019-5149.JTN.49136-25.2","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"337-338"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358346","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}