AIm: Surgical approaches to Meckel's cave (MC) are often technically difficult and sometimes associated with postoperative morbidity. The relationship of surgical landmarks to relevant anatomy is important. Therefore, we attempted to delineate quantitatively their anatomy and the relationships between MC and surrounding structures. mAteRIAl and methods:With the aid of a surgical microscope, MC and its contents were studied in 15 formalin-fixed cadaver head specimens. Measurements were made and their relationships were observed. Results:The distance from the zygomatic arch and the lateral end of the petrous ridge to MC was 26.5 and 34.4 mm, respectively. The distance from the arcuate eminence, the facial nerve hiatus, and the foramen spinosum to MC was 16.6, 12.8 and 7.46 mm respectively. The TG lay 5.81 mm posterior to the foramen ovale. The distance from the abducens, trochlear and oculomotor nerves to the trigeminal ganglion was 1.87, 5.53 and 6.57 mm respectively. The distance from the posterior and the anterior walls of the sigmoid sinus to the trigeminal porus was 43.6 and 33.1 mm respectively. The trigeminal porus was on average 7.19 mm from the anterior wall of the internal acoustic meatus. ConClusIon:The anatomical landmarks as presented herein regarding MC may be used for a safer skull base approach to the region. BulGulAR: Zigamatik arkusun ve petroz kenarın lateral sonunun Meckel cave'e ortalama uzaklığı sırasıyla 26,5 ve 34,4 mm idi. Arkuat eminens, fasiyal sinir hiatus ve foramen spinosumun Meckel cave'e ortalama uzaklığı sırasıyla 16,6, 12,8 ve 7,46 mm idi. Trigeminal ganglion foramen ovale'nin 5,81 mm arkasında yerleşmiştir. Abdusens, trohlear ve okülomotor sinirlerin trigeminal gangliona ortalama uzaklıkları sırasıyla 1,87, 5,53 ve 6,57 mm idi. Sigmoid sinüsün arka ve ön duvarlarının trigeminal porus'a ortalama uzaklıkları sırasıyla 43,6 ve 33,1 mm idi. Trigeminal porus internal akustik meatusun anterior duvarından ortalama 7,19 mm uzakta idi. sonuÇ: Meckel cave ile ilgili sunulan anatomik belirteçler ve onların anatomik özellikleri ile ilgili bilgiler bu bölgeye güvenli bir yaklaşım için yararlı olabilir.

AIm: Pituitary abscess is a disorder characterized with central nervous system (CNS) infection, mass effect, and endocrine dysfunction. These abscesses generally occur due to hematogenous spread in conditions such as paranasal sinusitis, sepsis, and where the blood brain barrier breaks down. This paper aims to discuss four cases of preoperatively diagnosed pituitary abscess in the light of the literature. Results: All the patients showed fever, systemic signs of toxemia and endocrine dysfunction at the time of diagnosis. In these cases, a preoperative diagnosis of the disease was made thanks to characteristic MRI findings. The four cases were operated by the transnasal transsphenoidal approach and histopathological and microbiological studies were performed for surgical specimens.ConClusIon: Pituitary abscesses are rare disorders responsible for a high mortality risk. Mortality and morbidity can be reduced by early surgical drainage and appropriate antibiotic treatments. Additionally, these cases should be closely followed-up in terms of pituitary insufficiency, surgical complications and infection.

The risk for development of hypophyseal adenoma may be greater in patients with the 2G allele. In cases of existing hypophyseal adenoma, those with the homozygous 2G allele tend to be invasive.

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.

Teratomas account for 3% of all childhood tumors, with the majority occurring in the sacrococcygeal region and in the ovary. Intradural spinal teratomas are extremely rare dysembryogenetic tumors. Spinal cord teratomas may be extradural, intradural or intramedullary. Intramedullary ones are the least frequently seen. We have extensively reviewed the literature for intramedullary spinal cord teratomas in children. Although an intramedullary teratoma of the conus medullaris in children is a rare entity, it should be considered in the differential diagnosis of masses involving the conus medullaris.

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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...