Turkish neurosurgery最新文献

{"title":"Lumbar Function and Muscle Preservation Following Hybrid Surgery Versus Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis: A Preliminary Comparative Study.","authors":"Esin Nur Tasdemir, Murat Korkmaz, Gorkem Durak, Sahin Karalar, Turker Sahinkaya, Turgut Akgul, Bulent Bayraktar","doi":"10.5137/1019-5149.JTN.49086-25.3","DOIUrl":"10.5137/1019-5149.JTN.49086-25.3","url":null,"abstract":"<p><strong>Aim: </strong>To investigate lumbar motion and muscle change following hybrid surgery in adolescent idiopathic scoliosis (AIS).</p><p><strong>Material and methods: </strong>We conducted a prospective study design including 16 patients (14 female, 2 male) who underwent either hybrid surgery or selective thoracic fusion surgery (STF) for AIS. Trunk extensor and flexor muscle strength and endurance were assessed using an isokinetic dynamometer. Range of motion (ROM) of the lumbar region was measured by a dual inclinometer. Muscle mass was calculated by evaluating the paraspinal muscles at the L2 and L5 vertebral levels in T2W axial sections of the magnetic resonance imagings. The degree of fatty degeneration was assessed by the Goutallier classification.</p><p><strong>Results: </strong>The hybrid group comprised eight female patients with a mean surgical age of 14±1.7 years and a mean follow-up time of 16.4±8.8 months. The STF group included eight patients (six females, two males) with a mean surgical age of 14.6±1.8 and a mean follow-up time of 29.5±15.4 months were included. No significant difference was observed between the lumbar ROM, trunk flexion-extension strength, and endurance (p>0.05) of both groups. Similarly, no significant difference was observed between the paraspinal muscle cross-sectional area and the degrees of fatty degeneration in the patient's preoperative and last follow-up. Moreover, no differences were observed in the overall Scoliosis Research Society-22 scores between the two groups (p=0.442).</p><p><strong>Conclusion: </strong>These preliminary findings show that hybrid surgery preserves lumbar motion and does not cause iatrogenic damage to the paraspinal muscles, including the psoas major.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"420-432"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145784","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":"Professor Mahmut Gazi Yasargil: Memories from Little Rock 1994-2003.","authors":"Kenan I Arnautovic","doi":"10.5137/1019-5149.JTN.52036-26.0","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.52036-26.0","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 Special Issue in Memoriam Prof. M. Gazi Yaşargil","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304499","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":"Critical Appraisal and Recommendations on the Use of Neuroendoscopic Surgery for Hypertensive Brainstem Hemorrhage.","authors":"Yasin Taskin","doi":"10.5137/1019-5149.JTN.49541-25.3","DOIUrl":"10.5137/1019-5149.JTN.49541-25.3","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"339"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358339","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":"Evaluation of Drugs with Selective Inhibitors Targeting the Anti-Apoptotic Protein B-cell Lymphoma 2 (BCL-2) with Pro-Apoptotic and Antineoplastic Activities in Grade IV Glioblastoma.","authors":"Murat Baloglu, Tamer Tamdogan, Sevim Ondul, Mehmet Bakirtas, Ibrahim Yilmaz","doi":"10.5137/1019-5149.JTN.48543-25.1","DOIUrl":"10.5137/1019-5149.JTN.48543-25.1","url":null,"abstract":"<p><strong>Aim: </strong>To systemically review the efficacy, safety, and clinical applications of B-cell lymphoma 2 (BCL-2) family inhibitors such as venetoclax (ABT-199), navitoclax (ABT-263), and obatoclax (GX15-070) across different malignancies.</p><p><strong>Material and methods: </strong>A systematic search was conducted in the PubMed database following PRISMA guidelines. Studies evaluating the pharmacological effects, preclinical findings, and clinical trial data of venetoclax, navitoclax, and obatoclax were included in the analysis. Key outcomes, including efficacy, resistance mechanisms, and adverse effects, were synthesized from the analysis.</p><p><strong>Results: </strong>Venetoclax demonstrated significant efficacy and a favorable safety profile in hematologic malignancies, particularly chronic lymphocytic leukemia and acute myeloid leukemia; however, no positive safety profile was observed in glioblastoma grade IV (GBM). Navitoclax combination treatments showed potential in various malignancies but were used in a limited manner due to dose-related thrombocytopenia. However, no clear data were available regarding its efficacy against GBM. Obatoclax demonstrated efficacy in preclinical studies; however, off-target effects and limited clinical success hindered its development. No clear data were available regarding its effectiveness against GBM. Resistance mechanisms, including upregulation of MCL-1 and BCL-xL, were commonly observed among these agents, highlighting the need for combination strategies.</p><p><strong>Conclusion: </strong>Venetoclax, navitoclax, and obatoclax represented significant advances in apoptosis-targeted therapy, with venetoclax emerging as the most clinically successful agent. However, resistance mechanisms and side effects were significant challenges, necessitating further preclinical and clinical studies to optimize the therapeutic potential of these agents.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"294-301"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358308","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":"Relationship Between Benign Intracranial Tumor Location and the Side of Spontaneous Cerebrospinal Fluid Leak.","authors":"Nese Keser, Mary Murphy, Aysegul Esen Aydin, Antti-Pekka Elomaa, Maria Karampouga, Niina Salokorpi, Anastasia Tasiou, Eleni Tsianaka, Stiliana Mihaylova, Ashviniy Thamilmaran, Zak Hodgson, Nurperi Gazioglu","doi":"10.5137/1019-5149.JTN.49011-25.3","DOIUrl":"10.5137/1019-5149.JTN.49011-25.3","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To present cases of spontaneous cerebrospinal fluid (CSF) rhinorrhea and otorrhea, and to conduct a systematic literature review examining the relationship between benign tumor location and the leak side. MATERIAL and METHODS: A PRISMA-based systematic review was conducted to evaluate studies on spontaneous CSF leaks caused by benign intracranial tumors, alongside three newly reported cases. RESULTS: All three cases exhibited CSF leaks ipsilateral to the tumor: Case 1 involved a pituitary ACTH-secreting macroadenoma with rhinorrhea; Case 2, a pineocytoma with hydrocephalus and nasal encephalocele; and Case 3, a petromastoid meningioma with otorrhea. In the systematic literature review, 28 of 125 studies met the inclusion criteria. The median patient age was 42 years, with a male-to-female ratio of 16:12. Macroprolactinoma was the most frequent tumor (25%), primarily located in the sella (46.4%). Tumors were located at the midline (39.3%), right side (35.7%), or left side (25%). The sphenoid sinus was the most common site of CSF leak (39.3%). The leak occurred through the right nostril (39.3%), left nostril (39.3%), both nostrils (10.7%), right ear (7.1%), and both the nostril and ear (3.5%). Hydrocephalus was present in 25% of cases. CONCLUSION: Although our cases demonstrated ipsilateral leaks, the literature review revealed equal rates of left-sided rhinorrhea, even with midline or right-sided tumors, suggesting skull base bone destruction alone does not explain CSF leaks, particularly in benign intracranial tumors outside mastoid involvement. Careful patient history regarding the side of rhinorrhea, comprehensive preoperative imaging, and hydrocephalus evaluation are essential for identifying the leak site and preventing complications, such as recurrent meningitis.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"744-754"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121088","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":"Perseus-The Protector of Mankind: Mesenchymal Stem Cell Transplantation may be a Promising Treatment for Neurological Diseases.","authors":"Yanmin Wang, Bo Huang, Huajiang Dong","doi":"10.5137/1019-5149.JTN.49202-25.0","DOIUrl":"10.5137/1019-5149.JTN.49202-25.0","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"175-177"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000329","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":"Evaluation of the Role of miRNAs Expression Profiles in Aneurysm.","authors":"Sara Khadem Ansari, Ebru Erzurumluoglu Gokalp, Emre Ozkara, Ozlem Aykac, Ertugrul Colak, Ezgi Susam, Beyhan Durak Aras, Atilla Ozcan Ozdemir, Sevilhan Artan","doi":"10.5137/1019-5149.JTN.48396-25.2","DOIUrl":"10.5137/1019-5149.JTN.48396-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the diagnostic and prognostic significance of miRNA signatures by identifying differences in miRNA expression between ruptured and unruptured intracranial aneurysm (IA) cases, as well as to pinpoint miRNAs that correlate with clinical severity in patients with aneurysmal subarachnoid hemorrhage (aSAH).</p><p><strong>Material and methods: </strong>Peripheral blood samples were collected from 50 IA patients (25 without rupture and 25 with rupture) and 25 healthy controls. In the ruptured group, analyses were performed on samples collected on Days 3 and 5 after SAH. The clinical severity and outcomes of the disease were assessed using Fisher grades, WFNS grades, Hunt-Hess grades, and the Modified Rankin Scale.</p><p><strong>Results: </strong>We found that the expression levels of miR-21-5p and miR-15a were significantly altered in unruptured aneurysms (UA) patients compared to controls. The expression levels of 10 miRNAs were significantly decreased in ruptured aneurysms (RA) patients compared to controls. The ruptured group also exhibited an upregulation of 16 miRNAs relative to the unruptured group. Furthermore, we noted a significant increase in miR-24 expression in RA patients between Days 3 and 5, suggesting its potential role in the progression of aSAH. miR-9p-3p and miR-497 were found to be associated with aSAH severity. Moreover, the levels of miR-451a, miR-146a-5p, miR-502-5p, and miR-497 were significantly lower in patients with poor outcomes compared to those with favorable outcomes.</p><p><strong>Conclusion: </strong>These findings suggest that specific miRNAs may serve as potential diagnostic and prognostic biomarkers for IA and subsequent SAH, particularly on Day 3 following aSAH.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000304","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":"Effective Management of Brainstem Tumors: A Study of 22 Patient Experiences.","authors":"Ersin Haciyakupoglu, Evren Yuvruk, Ayca Ersen Danyeli, Sebahattin Haciyakupoglu","doi":"10.5137/1019-5149.JTN.46779-24.2","DOIUrl":"10.5137/1019-5149.JTN.46779-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the surgical outcomes, extent of resection, and postoperative clinical improvement in 22 patients with brainstem tumors.</p><p><strong>Material and methods: </strong>We performed surgery on 22 patients with brainstem tumors using various approaches to access the pathology. Our goal was to achieve gross total resection wherever feasible, although this was not possible in all cases. Spontaneous breathing was preferred during surgery, and resection was halted if any disturbance occurred. Bipolar or monopolar coagulation was avoided, and smooth compression and irrigation were used for bleeding control. Neuromonitoring was employed during surgery for all patients.</p><p><strong>Results: </strong>Among the 22 patients included in this study, 4 presented with long tract symptoms, 3 had hydrocephalus, 5 had papillary stasis, 4 had cerebellar findings, 3 had gait disturbances, 1 had respiratory disturbance, and 1 had dysphagia. Gross total resection was achieved in 10 patients, near-total resection in 4, and partial resection in 8.</p><p><strong>Conclusion: </strong>Surgery enables histologic diagnosis, relieves mass effect, and improves symptoms in brainstem tumors. While gross total resection is ideal, it should not be insisted on in infiltrative tumors; partial or subtotal resection may provide long-term benefit in focal and exophytic lesions. Careful neuromonitoring and anatomical planning are essential to minimize morbidity.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"119-135"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000322","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":"Brain Metastases in Pediatric Extracranial Solid Tumors: A 20-Year Experience in Challenging a Rare Diagnosis.","authors":"Dilek Gul, Beste M Atasoy, Burcu Tufan Tas, Adnan Dagcinar, Zerrin Ozgen","doi":"10.5137/1019-5149.JTN.49617-25.5","DOIUrl":"10.5137/1019-5149.JTN.49617-25.5","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the clinical features, treatments, and outcomes of pediatric patients with brain metastasis from extracranial solid tumors, which has been known as a rare condition.</p><p><strong>Material and methods: </strong>Over a 20-year period, 520 children treated for extracranial solid tumors in our radiotherapy clinic were reviewed, and 12 cases (2.2%) of brain metastases were identified. The primary tumors included neuroblastoma (n=5), osteosarcoma (n=3), Ewing sarcoma (n=2), rhabdoid tumor of the kidney (n=1), and Wilms tumor (n=1). Retrospective analysis was performed to evaluate tumor and treatment features. Overall survival was measured from the initial diagnosis. Overall survival after brain metastasis, local control, and brain metastasis progression-free survival were calculated from the time of brain metastasis diagnosis to death.</p><p><strong>Results: </strong>Median follow-up was 31 months (range, 13-72 months). Brain metastasis developed at a median of 13 months after primary diagnosis (range, 3-69 months). Most brain metastases were supratentorial and solitary, with nine of 12 patients (75%) having solitary lesions and eight of 12 (67%) having supratentorial lesions. Surgical excision was performed in 9 patients (75%). Radiotherapy was administered locally (20-30 Gy, n=7) or to the craniospinal axis (21.6 or 23.4 Gy, n=2). Ten patients died during follow-up, 70% of whom did not experience cranial progression. Local control rate for irradiated lesions was 81.5% (median duration: 22 months). The brain metastasis-free survival was 71.4% (95% confidence interval [CI]: 2.59%-55.41%) with a median of 10 (range, 1-41) months. The 2-year survival rate was 58.3% (95% CI: 6.15%-71.84%). The 2-year overall survival rate after brain metastasis was 16.7% (95% CI: 7.13%-21.53%).</p><p><strong>Conclusion: </strong>Brain metastasis remains rare in pediatric solid tumors. Most patients died from extracranial disease progression rather than cranial relapse. Radiotherapy can effectively relieve symptoms and may delay the progression of brain metastasis. Guidelines may help optimize the treatment of patients with brain metastasis.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"450-456"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145448","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":"Beyond Human 'Eyes' in Neurosurgical Exams: Success of Artificial Intelligence (ChatGPT-4o, Grok, and Gemini) in the Image-Based Questions of Turkish Neurosurgical Society Proficiency Board Exams.","authors":"Alperen Sozer, Gokberk Erol, Ozan Yavuz Tufek, Batuhan Sozer, Merve Buke Sahin, Mustafa Caglar Sahin","doi":"10.5137/1019-5149.JTN.49058-25.2","DOIUrl":"10.5137/1019-5149.JTN.49058-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the impact of generative artificial intelligence and large language models (LLMs) on medical training and neurosurgical education, specifically focusing on their emerging capabilities in image interpretation.</p><p><strong>Material and methods: </strong>This study evaluated the performance of three major LLMs (ChatGPT-4o, Grok, and Gemini) on imagebased neurosurgical proficiency board questions and compared their latest versions.</p><p><strong>Results: </strong>Real-life candidates answered correctly 70.75% of the time. LLMs answered correctly 47.38% of the time and were significantly outperformed by the candidates. Prompt selection was found to significantly influence the performance of GPT and Grok, but not Gemini. Matching and significantly outperforming the candidates was only possible by combining the best answers from all three LLMs across four runs.</p><p><strong>Conclusion: </strong>Although previous research has demonstrated strong capabilities of LLMs in text-only questions, this the results of the present study revealed that image analysis abilities of these models need further improvement when compared to actual candidates. Furthermore, the impact of prompt selection and repeated questioning should be emphasized, particularly when seeking correlation with the real-life exam results.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"200-210"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358345","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}