Although our demographic data were similar to formerly collected Turkish MS data, we found that the distribution of the patients' clinical course differed if there was an absence of primary progressive MS and that there was a lower frequency of secondary progressive MS cases in our group of patients. We believe that less frequent oligoclonal band positivity and the difference we witnessed in the clinical course of disease in our study groups suggest that there is a need for further studies to compare all the biological and immunological differences between MS and tumefactive lesion cases, in order to reveal whether there are different pathogenetic mechanisms involved.

Cell proliferation markers are used in grading of brain tumors and in patient stratification for different treatments. Therefore, defining simple and accurate proliferation markers are of essential importance. Ki67 labeling index is widely studied, yet it is subject to interlaboratory variability. Ki67 protein is expressed on all cell cycle phases except G0 and does not precisely reflect proliferating cells. Counting mitotic figures (MFs) is used in World Health Organization grading of brain tumors (meningiomas), but the detection of MFs on conventional hematoxylin and eosin stained slides is very time consuming. Further, karyorrhexis and pyknosis in apoptotic or crushed cells may mimic mitotic morphology and falsify counting results. Histone H3 phosphorylation on serine-10 is specific to mitosis and phosphorylated histone H3 (PHH3) proliferation markers (as counts defined per area or as indices defined per cell numbers) are increasingly being used to evaluate proliferation in various tumors. Herein, we review current data on PHH3 proliferation markers in meningeal tumors. PHH3-staining highlights mitotic cells and makes easier of rapid grading by driving pathologist's attention on the most mitotically active areas. Thereby, it would function more sensitive in detecting MFs that might be otherwise overloked and more precise by reducing interobserver variability through allowing the pathologist to analyze if the stained nuclei exhibit morphologic features of mitosis.

Recognition of uncommon clinical and EEG findings of subacute sclerosing panencephalitis, especially in countries where subacute sclerosing panencephalitis has not been eliminated yet, could be helpful in prevention of misdiagnosis and delay in the management of improvable conditions.

No abstract

The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and ADC values of low-grade and atypical/anaplastic (high-grade) meningiomas. In addition, we compared the ADC and Ki-67 proliferative index values of the low-grade and atypical/anaplastic (high-grade) meningiomas. We concluded that there was an inverse correlation between the ADC and Ki-67 proliferation index values in meningiomas, and we have found statistically significant difference between the ADC values of the low-grade and high-grade meningiomas. ADC values can be used for histopathological characterization of the meningiomas and pre-surgical planning.

No abstract

ABSTRACTa convalescence period (17). This cranioplasty procedure intends to achieve two goals; one is the cosmetic improvement and the other is the functional improvement (31). Cranioplasty is one of the world's most ancient surgical procedures. The earliest known case has been identified in Peru, where a skull was unearthed with a thin gold plate covering the trepanation hole. Various autografts, allografts and xenografts have been used over the years in attempt to restore cranial vault following trepanation or trauma (3).Decompressive craniectomy has potential complications which effect long-term outcome (18,36). A very important but mostly unconsidered complication is the neurological dysfunction that can occur due to the absence of bone flap and distortion of the brain under retracted scalp. This may lead █ InTRODuCTIOn D ecompressive craniectomy (DC) has been previously described for the acute management of traumatic brain injury (1), ischemic stroke (30), subarachnoid hemorrhage (16), intracranial infections (7), dural sinus thrombosis (12), inflammatory conditions (4) and tumors (2) to decrease intracranial pressure when life-threatening. Vital importance of DC in neurological emergencies has been well understood and established over the past two decades (10,19). Although this procedure is a very helpful tool in management of acute patients, may also lead to further requirement for reconstruction and complications.Patients survived from the above mentioned acute neurologic states require reconstruction of the cranial vault following AIM: Failed cranioplasty attempts may lead to numerous complications in a broad spectrum including cosmetic problems, infection, neurological deterioration and even death. Selection of the most appropriate surgical technique for second and further surgical attempts for these patients still remains a debate. We aimed to share our experience and technical pitfalls on management of failed cranioplasty, particularly for patients with large cranial defects. MATERIAL and METhODS:A retrospective data analysis of cranioplasty cases in our series was performed including the time period between 2002 and 2012. Patients required recurrent cranioplasty were analyzed in detail. RESuLTS:Totally, 101 patients underwent cranioplasty for bony defect. Of 101 patients, eleven required a revision surgery due to infection or spontaneous resorption of the bone flap. All patients underwent revision cranioplasty with pre-surgical plaster cast mold technique modified from previous studies and/or tissue expansion technique. Polymethyl-metacrylate (PMMA) was used as substitute for reconstructions. Mean follow-up was 36 months. Two out of eleven cases (18.1%) developed major complications, which led to further revision. At the end, a satisfactory reconstruction was achieved for all patients.COnCLuSIOn: Our modified molded plaster cast technique is a safe and cost-effective approach for the revision of failed cranioplasty. We believe that the tissue expanding techniques have also great contribution to achi...

Microsurgical fenestration with keyhole craniotomy to provide passage between cysts to basal cisterns together with cystoperitoneal shunting during the same operation is still an effective and safe method in cases with symptomatic middle fossa arachnoid cysts in children.