OBJECTIVEIntracranial infections are serious and life-threatening health problems. They may present as subdural empyemas or intracerebral abscesses. Surgical drainage and subsequent antibiotic treatment is the main technique for a satisfactory clinical outcome. The aims of this study were to present a 10-year intracranial infection series and discuss the surgical characteristics in the light of literature.METHODSFifty-two patients with intracranial infection underwent surgical treatment between 2008 and 2018. Eleven patients were female and 41 patients were male. The mean age was 40.46 years (range 10–75 years). Eighteen patients had intracerebral abscesses, and 34 had subdural empyemas. All patients underwent surgical treatment as well as an antibiotic regimen.RESULTSNo etiological agent was isolated in 29 (56%) cases. Bacterial agents were detected in 20 cases, while fungi were observed in 3 cases. Staphylococci species were the most common agents and were isolated in 8 (15%) cases. Endoscopic aspiration was performed in 3 cases, while surgical drainage and capsule resection via craniotomy was performed in 49 cases. An associated intracranial tumor was diagnosed in 2 patients with brain abscesses. Four (8%) patients died despite surgical and medical treatments.CONCLUSIONSSurgical treatment via craniotomy is an older method, but it is still the best to treat the intracranial infections not only for decompression of the brain but also to attain an accurate diagnosis. The abscess wall should always be histologically examined after surgery to rule out any intracranial tumor.

Background and aim: Creating potential clinical markers for risk assessment in patients with COVID-19 continues to be an area of interest. In this study, we aimed to evaluate whether serum albumin level and thrombocyte/lymphocyte ratio are related to the severity of the disease. Materials and methods:The patients were divided into two groups according to the severity of disease. Demographic data, serum albumin value, lymphocyte count, TLO-1 values (thrombocyte/lymphocyte ratio-1), the highest thrombocyte count during hospitalization, TLO-2 (thrombocyte/lymphocyte ratio-2) values formed by the highest thrombocyte count, were recorded.Results: There was no statistically significant differences (P > 0.05) in terms of sex, thrombocyte count at the time of admission, and highest thrombocyte count during hospital follow-up. There were statistically significant differences in terms of age, comorbidity, lymphocyte value at the time of hospitalization, lymphocyte count during hospital follow-up, TLO 1, TLO 2, and serum albumin values between the groups. The ICU group were found to be older, had higher rates of comorbidity, lower lymphocyte values, higher TLO 1-2, and lower serum albumin levels (P < 0.05). Conclusion:TLO-2 ratio above 260 and lymphocyte level below 1 103 cells/µL, would be a predictor of further intensive care unit need.

Lhermitte-Duclos disease (LDD) is a rare, slow-growing, benign lesion of the cerebellum. It is often seen in the second and fourth decades. This disease is extremely rare in childhood. A 6-year-old girl presented with loss of balance. A mass lesion in the right cerebellum was detected by magnetic resonance imaging. The patient underwent surgical removal of the lesion, and the histological diagnosis was dysplastic gangliocytoma (LDD). The patient was discharged without complication, and her balance improved in the follow-up period. In this report, we present this rare occurrence in childhood and discuss the clinical course and management. LDD is very rare in early childhood and should be considered in the differential diagnosis of posterior fossa lesions.

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Computer-based surgical planning associated with the production of custom-made titanium implants is a highly promising method for the treatment of cranial FD. Better radiological and cosmetic outcomes could be obtained by this technique with interdisciplinary work with medical designers.

AIM: Perception, definition and tolerance of pain vary individually because of its subjective character. This study aimed to determine the perception differences between patients with mechanical low back pain (MLBP) and their physicians regarding the assessments of the patients' pain severity. MATErIAL and METHods:181 patients with MLBP and 2 physicians took part in the study. Before the initial examination, the patients filled out a questionnaire consisting of demographic data, pain characteristics, Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS). The patients' forms were concealed from the physicians. Then physicians examined their patients and rated their pain severity using a different VAS form. rEsuLTs:The mean age of the patients was 36.2±12.3 years. 64.6% (n:117) were female, 71.9% (n:13) were highly educated and 57.1% (n:103) were obese. Physicians always rated the patients' pain severity significantly lower than the patients rated their own pain regardless of all demographic data (p<0.001). Correlation between the VAS scores of patients and physicians were detected as 0.41 (p <0.001) and the power of the study was calculated as 91.5%. The mean MODQ score of the patients was calculated as 54.4±21.1. Reliability of the questions in MODQ was calculated as alpha:0.87. A moderate correlation between VAS ratings and MODQ was observed (r:0.52, p<0.001). CoNCLusIoN:As a main factor directly affecting many outcomes, good communication between patient and physician, is essential to assess the patients' pain more accurately.KEywords: Modified Oswestry disability questionnaire, Pain severity, Pain perception differences, Visual analog scale ÖZ AMAÇ: Ağrı algısı, ağrının tanımı ve toleransı, subjektif karakteri nedeniyle, kişiden kişiye değişiklik gösterir. Çalışmanın amacı, hastaların ağrı şiddetini değerlendirmeleri konusunda, mekanik bel ağrısı (MBA) olan hastalar ile doktorları arasındaki algı farklılıklarını ortaya koymaktır. yÖNTEM ve GErEÇLEr: Çalışmada, MBA'sı olan 181 hasta ve 2 hekim yer almaktadır. Muayeneye başlamadan önce, demografik bilgiler, ağrı karakterleri, Modifiye Oswestry Özürlülük Anketi (MOÖA) ve Vizüel Analog Skala (VAS)'dan oluşan bir anket formu, hastalar tarafından dolduruldu. Hastaların formları, doktorlardan gizlendi. Sonra doktorlar, hastalarını muayene ettiler ve farklı bir VAS formu doldurarak hastalarının ağrı şiddetini puanladılar.BuLGuLAr: Hastaların; ortalama yaşı 36,2±12,3, %64,6'sı (n:117) kadın , %71,9'u (n:13) yüksek öğrenim görmüş ve %7,1'i (n:103) obez idi. Demografik bilgilerden bağımsız olarak, hekimler hastalarının ağrı şiddetini, hastaların kendi ağrı şiddetlerini puanladıklarından, her seferinde belirgin olarak daha düşük puanladılar (p<0,001). Hastaların ve hekimlerin VAS skoru arasındaki oran 0,41 (p <0,001) olarak saptandı ve bu çalışmanın gücü %91,5 olarak hesaplandı. Hastaların ortalama puanı MOÖA'ya göre 54,4±21,1 idi. MOÖA'daki soruların güvenilirliği alpha:0,87 olarak hesaplandı. VAS puanları ve MOÖA arasındaki ortalama or...

BACKGROUND Deep-seated intracranial lesions are challenging to resect completely and safely. Fluorescence-guided surgery (FGS) promotes the resection of malignant brain tumors (MBTs). Classically, FGS is performed using microscope equipped with a special filter. Fluorescence-guided neuroendoscopic resection of deep-seated brain tumors has not been reported yet. OBJECTIVE To evaluate the feasibility, safety, and effectiveness of the fluorescence-guided neuroendoscopic surgery in deep-seated MBTs. METHODS A total of 18 patients with high-grade glioma (HGG) and metastatic tumor (MT) underwent fluorescein sodium (FS)-guided neuroendoscopic surgery. Tumor removal was carried out using bimanual microsurgical techniques under endoscopic view. The degree of fluorescence staining was classified as “helpful” and “unhelpful” based on surgical observation. Extent of resection was determined using magnetic resonance imaging (MRI). Karnofsky Performance Status (KPS) score was used for evaluation of general physical performances of patients. RESULTS A total of 11 patients had HGG, and 7 had MT. No technical difficulty was encountered regarding the use of endoscopic technique. “Helpful” fluorescence staining was observed in 16 patients and fluorescent tissue was completely removed. Postoperative MRI confirmed gross total resection (88.9%). In 2 patients, FS enhancement was not helpful enough for tumor demarcation and postoperative MRI revealed near total resection (11.1%). No complication, adverse events, or side effects were encountered regarding the use of FS. KPS score of patients was improved at 3-mo follow-up. CONCLUSION FS-guided endoscopic resection is a feasible technique for deep-seated MBTs. It is safe, effective, and allows for a high rate of resection. Future prospective randomized studies are needed to confirm these preliminary data.

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