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Bilateral high-level percutaneous cervical cordotomy in cancer pain due to lung cancer: A case report
(Elsevier Science, 2006-07-11) Bekar, Ahmet; Kocaeli, Hasan; Abaş, Faruk; Bozkurt, Merlin; Tıp Fakültesi; Tıp Fakültesi; Beyin ve Sinir Cerrahisi Ana Bilim Dalı; Anesteziyoloji ve Reanimasyon Ana Bilim Dalı; 6603677218; 6603500567; 8546184300; 16202046200
Background: Computed tomography–guided high-level percutaneous cordotomy has been used unilaterally or bilaterally for the treatment of localized intractable pain in malignancies. Case Description: A 57-year-old man was admitted to the hospital with the complaint of intractable pain involving the left side of the chest, axillary region, and shoulder. He was operated for small cell lung cancer on the left side in December 2003 and received radiotherapy and chemotherapy. His neurological examination was normal. Magnetic resonance imaging of the thorax revealed contrast- enhancing lesions on the left side extending to mediastinum and pleura. His pain was relieved completely after the first cordotomy procedure, and he was discharged from the hospital on the second postoperative day. The patient was readmitted to the hospital with the complaint of severe unilateral chest pain like the initial pain on the right side 4 days after cordotomy. The CT-guided bilateral high-level percutaneous cordotomy was performed with a 15-day interval. Conclusion: The CT-guided bilateral high-level percutaneous cordotomy can be used in the treatment of intractable upper trunk pain in patients with cancer without pulmonary dysfunction.
Comparison of ventricular drainage in poor grade patients after intracranial hemorrhage
(Taylor and Francis, 2005-09) Yılmazlar, Selçuk; Abaş, Faruk; Korfalı, Ender; Tıp Fakültesi; Nöroşirürji Ana Bilim Dalı; 0000-0003-3633-7919; AAH-5070-2021; 6603059483; 8546184300; 7004641343
Objectives: The selection of patients and treatment criteria for acute hydrocephalus and intracranial pressure (ICP) after intracranial hemorrhage remains unclear. In general neurosurgical practice, there is a tendency to use external ventricular drainage (EVD) for the patients. This study was undertaken to analyse the complications and efficiency of the different treatment modalities. Methods: The effects, complications and outcome of ventricular drainage on high ICP and hydrocephalus were analysed retrospectively in 109 patients with intracranial hemorrhage. All the patients were assessed using the Glasgow Coma Scale, computed tomograph and ICP monitoring. We excluded patients over the GCS of 8. All patients underwent a procedure for ICP monitoring plus ventricular cerebrospinal fluid (CSF) drainage. Sixty-one patients were managed with one (single) EVD system; 12 patients needed two EVD systems consecutively, while 23 patients underwent an EVD procedure followed by permanent ventriculoperitoneal (VP) shunt insertion. Thirteen patients were treated only by VP shunt for ventricular drainage. The infection rate and outcome 9 months after hemorrhage were analysed. Results: The infection rates were 8.1% in the one-EVD group, 33.3% in the two-EVD group (one EVD versus two EVD, p < 0.05), 8.6% in the EVD-VPgroup and 7.7% in the VP shunt group. The mortality rates were 73.7% in the one-EVD group, 83.8% in the two-EVD group, 47.8% (p < 0.05) in the EVD-VPgroup and 53.8% (p < 0.01) in the VP shunt group. Discussion: This study indicates that single and short-term use of EVD and/or early VP shunting are associated with a low risk of infection. Furthermore, early VP shunting may protect the brain from the irregular control of intracranial hypertension and may allow more time for resolution of CSF circulation and significantly lowers the mortality rates.
Neuroprotective effects of postconditioning on lipid peroxidation and apoptosis after focal cerebral ischemia/reperfusion injury in rats
(Türkiye Nöroşirürji Derneği, 2010-01) Abaş, Faruk; Alkan, Tülin; Gören, Bülent; Taşkapılıoğlu, Özgür; Sarandöl, Emre; Tolunay, Şahsine; Tıp Fakültesi; Tıp Fakültesi; Tıp Fakültesi; Tıp Fakültesi; Biyokimya Ana Bilim Dalı; Beyin ve Sinir Cerrahisi Ana Bilim Dalı; Fizyoloji Ana Bilim Dalı; Tıbbi Patoloji Ana Bilim Dalı; 0000-0002-2593-7196; ABE-1716-2020; AAH-1718-2021; ABB-8161-2020; AAH-1792-2021; 8546184300; 6601953747; 6602543716; 6506852772; 55943324800; 6602604390
AIM: Apoptosis after cerebral ischemia/reperfusion (I/R) injury leads to the process of cell death. The deal therapeutic approach would target the apoptosis after I/R. Ischemic postconditioning is a recently discovered neuroprotective strategy that involves the application of brief mechanical reperfusion with a specific algorithm at the onset of reperfusion following an ischemic period. MATERIAL and METHODS: Transient MCAo was performed on male SD (275 +/- 25g) rats with intraluminal thread insertion for 2hrs. Rats (n:36) were treated with postconditioning after 60 minutes of occlusion. The postconditioning algorithm was 30 secs of brief reperfusion followed by 30 secs of MCAo and this cycle was repeated 3 times at the onset of reperfusion. RESULTS: After I/R injury, % change of the malonyldialdehyde (MDA) levels in the cortex, which is an index of lipid peroxidation, was found significantly higher in the I/R group. On the other hand postconditioning upregulated Bcl-2 and Bax translocation to the mitochondria, and caspase-3 activity and also reduced oxidative stress levels. CONCLUSION: These findings indicated this neuroprotective effect is most likely achieved by antiapoptotic mechanisms through caspase pathways.
Pituitary apoplexy as a cause of internal carotid artery occlusion
(Elsevier, 2008-04) Doğan, Şeref; Kocaeli, Hasan; Abaş, Faruk; Korfalı, Ender; Tıp Fakültesi; Nöroşirürji Ana Bilim Dalı; AAI-6531-2021; 7102693077; 6603500567; 8546184300; 7004641343
Occlusion of intracranial arteries by pituitary apoplexy with resulting infarction is a rare occurrence. A 50-year-old man who presented with a history of sudden onset of frontal headache and visual impairment was admitted to another medical centre and MRI revealed a non-enhancing sellar lesion with suprasellar and infrasellar extension. Thereafter, the patient's consciousness deteriorated progressively and he showed signs of herniation; he was then referred to our centre for further evaluation. CT scanning revealed infarction of the left internal carotid artery territory. Transcranial resection of the tumour followed by a large decompressive craniotomy restored the blood flow in the internal carotid artery. Histological examination revealed the tumour to be a pituitary adenoma that contained formed blood elements. The patient's neurological status did not improve and he died on the ninth postoperative day despite vigorous treatment for controlling intracranial pressure. This case study documents a rare presentation of pituitary apoplexy that caused signs of raised intracranial pressure due to mechanical obstruction of an internal carotid artery with resulting infarction.
Risk factors and complications of intracranial pressure monitoring with a fiberoptic device
(Elsevier, 2009-02) Bekar, Ahmet; Doğan, Şeref; Abaş, Faruk; Caner, Burcu; Korfalı, Gülşen; Kocaeli, Hasan; Yılmazlar, Selçuk; Korfalı, Ender; Caner, Burcu; Tıp Fakültesi; Tıp Fakültesi; Anestezi ve Reanimasyon Ana Bilim Dalı; Nöroşirürji Ana Bilim Dalı; 0000-0003-3633-7919; AAI-6531-2021; AAH-5070-2021; 7102693077; 6603677218; 8546184300; 25027089000; 6701462594; 6603500567; 6603059483; 7004641343
We prospectively investigated the complications associated with intraparenchymal intracranial pressure (ICP) monitoring using the Camino intracranial pressure device. A fiberoptic ICP monitoring transducer was implanted in 631 patients. About half of the patients (n = 303) also received an external ventricular drainage set (EVDS). The durations (mean +/- SD) of ICP monitoring in patients without and with an EVDS were 6.5 +/- 4.4 and 7.3 +/- 5.1 days, respectively. Infection occurred in 6 patients with only an ICP transducer (6/328, 1.8%) and 24 patients with an EVDS also (24/303, 7.9%). The duration of monitoring had no effect on infection, whereas the use of an EVDS for more than 9 days increased infection risk by 5.11 times. Other complications included transducer disconnection (2.37%), epidural hematoma (0.47%), contusion (0.47%), defective probe (0.31%), broken transducer (0.31%), dislocation of the fixation screw (0.15%), and intraparenchymal hematoma (0.15%). In conclusion, intraparenchymal ICP monitoring systems can be safely used in patients who either have, or are at risk of developing, increased ICP.
Total ossification of choroid plexus papilloma mimicking calcified petrous bone pathology
(Karger, 2006-02-08) Kocaeli, Hasan; Yılmazlar, Selçuk; Abaş, Faruk; Aksoy, Kaya; Tıp Fakültesi; Nöroşirurji Ana Bilim Dalı; 0000-0003-3633-7919; AAH-5070-2021; 6603500567; 6603059483; 8546184300; 6701720577
Unusual complications and presentations of intracranial abscess: Experience of a single institution
(Elsevier, 2008-04) Kocaeli, Hasan; Hakyemez, Bahattin; Yılmaz, Emel; Korfalı, Ender; Bekâr, Ahmet; Yılmazlar, Selçuk; Abaş, Faruk; Tıp Fakültesi; Tıp Fakültesi; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Mikrobiyoloji Ana Bilim Dalı; Beyin Cerrahisi Ana Bilim Dalı; Nöroradyoloji Ana Bilim Dalı; 0000-0003-3633-7919; 0000-0002-3425-0740; AAI-2318-2021; AAH-5070-2021; 6602527239; 6603500567; 6603677218; 6603059483; 8546184300; 22037135100; 7004641343
Background: Complicating events and unusual presentations associated with intracranial abscess are rare but potentially fatal conditions. This study was undertaken to shed light on the unusual complications and presentations of intracranial abscess treated at a single institution. Methods: We retrospectively reviewed 116 cases of intracranial abscesses that were treated at our institution over the last 10 years and identified 11 (9.4%) cases with unusual complications. Results: These complications consisted of (1) rupture within the abscess, (2) hemorrhage into the abscess, (3) hemispheric infarction due to ICA thrombosis, (4) acute visual loss due to pituitary abscess, (5) acute neurologic deterioration due to rapid gas fori-nation within the abscess, (6) acute hydrocephalus, (7) trigeminal neuralgia, (8) fungal abscess developing secondary to intracranial extension of a temporal bone tumor, (9) Cryptococcus abscess with different morphology, (10) pontine infarction, and (11) sigmoid sinus thrombosis. Sinusitis accompanied 8 (72.7%) of the cases, and there were 5 (45.4%) mortalities. Culture results were unyielding in 4 patients, whereas Streptococcus species were identified in 4 and fungi in the rest. Conclusion: Intracranial abscesses and their complications still continue to be challenging entities in the neurosurgical practice. Our experience may provide an informational source for those who are taking care of patients with intracranial abscess.

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