No abstract

Since the risk of injury for variated branches is higher, understanding the anatomical variations of plexus brachialis and its extensions are significant importance during surgical intervention.

BACKGROUND: Craniocerebral gunshot wounds (CGW) are the most lethal injuries of the cranium. CGW is mostly secondary to military conflicts but may also be seen in civilian life. These injuries also have severe consequences, such as epilepsy, hydrocephalus, infection and late-term cognitive dysfunctions. The present study aims to present our series of CGW and to discuss the prognostic factors and consequences of these injuries. METHODS:The data of patients who were treated in our department for CGW between 2011 and 2019 were retrospectively reviewed in this study. The injury type, wounding site, surgical management and outcomes were analyzed. Radiological evaluation was also performed. RESULTS:Thirty patients were treated with the diagnosis of CGW. All of the patients were male and the mean age was 27.9 years. The frontal lobe was affected in 12 (40%) patients, while temporal lobe in eight, occipital lobe in six, parietal lobe in three, and posterior fossa in one patients. Twenty-three patients underwent surgical treatment, seven patients were treated conservatively. Thirteen (43.3%) patients died despite the treatment. CONCLUSION:Mortality in CGW is high. Ventricular injuries, bihemispheric or midline injuries, perforating injuries, brain stem injuries and low GCS score at admission are prognostic factors for CGW. Appropriate management is mandatory to obtain a better clinical outcome.

A 10-year old boy who had undergone a ventriculoperitoneal (V/P) shunt because of hydrocephalus at 10 days of age was doing well until 20 days ago, when he began to experience headache and seizures. CT scan reveraled dilated lateral ventricles and calcification at the shunt site. X-rays showed an unusual calcification pattern around the shunt tube and rupture of the tube between the mastoid bone and clavicle. The patient underwent surgery and the shunt was changed completely. The ventricles became small in the follow-up. Even though V/P shunts may induce fibrous tissue formation and calcification around the tube, there are a few cases of shunt rupture and calcification of shunts in the literature. Possible mechanisms of the rupture and calcification are discussed in this paper.keywOrds: Shunt, Calcification, Rupture ÖZOn günlük iken hidrosefali tanısı ile ventriküloperitoneal (V/P) şant takılan 10 yaşında erkek çocuğu 20 gün öncesinde baş ağrısı ve nöbet şikayeti ortaya çıkana dek iyi imiş. Çekilen tomografisinde lateral ventriküllerde genişleme ve şant tarafında kalsifikasyon izlendi. Röntgende ise şant tüpü çevresinde sıra dışı bir kalsifikasyon olduğu ve tüpün mastoid kemik ile klavikula arasında koptuğu görüldü. Çocuk ameliyata alınarak şant komple değiştirildi. Takiplerinde ventriküllerin küçüldüğü görüldü. V/P şantlar tüp çevresinde fibröz doku formasyonu ve kalsifikasyon oluşumunu uyarmakla birlikte literatürde şantların kalsifikasyonu ve kopması çok nadir bildirilmiştir. Kalsifikasyonun ve kopmanın muhtemel mekanizmaları bu yazıda tartışıldı.anaHtar sÖZcÜkLer: Şant, Kalsifikasyon, Kopma

No abstract

BACKGROUND: This study aims to investigate the clinical outcomes of patients who underwent closed continuous lumbar drainage (CLD) for post-traumatic cerebrospinal fluid (CSF) fistula and to compare with those of non-traumatic patients. METHODS:The data of patients who were treated in the department of neurosurgery between January 2018 and December 2019 and underwent CLD were analyzed. The diagnosis, demographic characteristics, CSF results and clinical outcomes of these patients were evaluated. The outcomes of the patients with dura defect and CSF fistula due to trauma were compared with patients who underwent CLD for other diagnoses. RESULTS:In this study, 45 patients underwent CLD for 51 times. The mean age was 38.84 years, and 27 (60%) of the patients were male. Seven (15.55%) patients underwent CLD due to post-traumatic CSF fistula and 38 patients after tumor or malformation surgery. While five patients developed CSF fistula due to dura defect after gunshot injury, two patients developed CSF fistula secondary to motor vehicle accident. Staphylococcus Epidermidis was isolated in one patient among post-traumatic CSF fistula patients while Serratia Marcescens was isolated in patients with CSF fistula secondary to posterior fossa tumor surgery. While none of the seven patients died during the follow-up period in post-traumatic group, one of the 38 patients with CLD secondary to tumor surgery was lost due to sepsis in the follow-up period.CONCLUSION: CLD in post-traumatic CSF fistulas is a safe and effective treatment method. Especially in patients with gunshot wounds, CLD should be performed before revision surgery in the treatment of CSF fistula. Studies with different parameters are needed in larger trauma populations.

No abstract

No abstract