Patient: Male, 11Final Diagnosis: Haberland syndromeSymptoms: SeizureMedication: —Clinical Procedure: Medical treatmentSpecialty: NeurosurgeryObjective:Rare diseaseBackground:Encephalocraniocutaneous lipomatosis (ECCL) was first announced as a new type of ectomesodermal dysgenesis in 1970 by Haberland and Perou. ECCL was first described in 1970, and approximately 60 cases have been reported since then. The classic triad of ECCL are skin, ocular, and central nervous system involvement, including conditions such as unilateral porencephalic cyst, ipsilateral lipomatous hamartoma of the scalp-eyelids-eye globe, cortical atrophy, cranial asymmetry, developmental delay, seizures, mental retardation, and spasticity of the contralateral limbs. The dermatological hallmark is a hairless fatty tissue nevus of the scalp called nevus psiloliparus.Case Report:An 11-year-old right-handed boy, born at full term, was referred to our clinic. His family had no consanguinity or history of neurocutaneous disease. The patient’s physical examination revealed a large hairless lesion on the right frontoparietal scalp called nevus psiloliparus. Beginning from the birth, a dermolipoma (an uncommon benign tumor) was reported to have occurred on the conjunctiva, mostly ipsilateral in his right eye and present on the ipsilateral side of the neurological abnormalities shown on magnetic resonance imaging and computed tomography. The patient had muscle weakness in left upper and lower extremities. He had a mild form of mental retardation.Conclusions:There is no specific treatment for ECCL. Management of ECCL is usually symptomatic. Surgical correction of a cutaneous lesion can be performed for cosmetic improvement. An early diagnosis of ECCL allows for early symptom treatment and improved patient quality of life.

Paragangliomas are neuro-endocrine tumors originating from the adrenal gland. They are usually benign and nonfunctioning, rarely seen in central nervous system. More than 90% of central nervous system paragangliomas are manifested as carotid and glomus jugulare tumors. Spinal paragangliomas are quite rare.The study was conducted through retrospective analysis of the files of the patients who had undergone surgery with pre-diagnosis of spinal intradural tumor between 2011 and 2017 and diagnosed with paraganglioma.A total of 8 patients (4 females and 4 males) were included in the study. Mean age of the patients was 51.1 years (28–64). Time to admission was mean 6.5 months (3 weeks–24 months). Recurrence was not observed in 7 patients, 1 patient is being followed up due to residual tumor.Treatment may be achieved through recognizing malignant transformation in patients who were not diagnosed histopathologically. We consider that quality of life of the patients may be improved through this way.

It was shown that the nontraumatic IEC are more frequent in older ages. In youngs, it can generally be embryologic or rarely of mechanical origin following trauma. Cranial trauma may be important for developing of IEC. Trauma may lead to inclusion of epidermal cells into the diploe of the skull and may be a reason of intradiploic epidermoid cyst in older age. The effect of older age, and gender difference on occurrence should be investigated.

Laboratory training models are essential for developing and refining surgical skills prior to clinical application of spinal surgery. A simple simulation model is needed for young residents to learn how to handle instruments and to perform safe lumbar approaches. Our aim is to present a practical laboratory model using a fresh sheep lumbar spine that allows to simulate lumbar microdiscectomy in humans. The material consists of a fresh cadaveric spine from a 2-year-old sheep. The surgical steps for lumbar microdiscectomy were conducted under the magnification of the operating microscope. The cadaveric sheep spine represents a useful model to train posterior lumbar microdiscectomy.

Patient: Female, 36Final Diagnosis: Isolated C5 vertebra dislocationSymptoms: TetraplegiaMedication: —Clinical Procedure: C5 corpectomy and anterior stabilizationSpecialty: NeurosurgeryObjective:Rare diseaseBackground:Total spondylolisthesis, or dislocation of 1 cervical vertebrae, is only caused by high-energy trauma and is usually fatal. Cervical spine fractures and dislocations often cause 3-column structural damage to the cervical spine, injury to the spinal cord, and precipitating alignment of the cervical vertebrae, as well as cervical instability, which are detrimental, show poor prognosis, and are associated with high rates of mortality rate and disability.Case Report:We report an extremely rare case of isolated C5 dislocation caused by falling out of a tree, with sudden tetraplegia.Conclusions:Total spondylolisthesis or dislocation of 1 cervical vertebrae can be surgically treated with anterior approach because it is possible to completely remove the vertebra body, intervertebral disc, and bone fragments, to directly decompress the spinal cord with stabilization.

Patient: Female, 59Final Diagnosis: Spinal tuberculosisSymptoms: Back pain • tiredness • night sweatsMedication: —Clinical Procedure: Surgery and medical treatmentSpecialty: NeurosurgeryObjective:Challenging differential diagnosisBackground:The aim of this study was to draw attention to rare spinal infections in recurrent failed spinal surgeries.Case Report:A 59-year-old female was admitted to the hospital for back pain, which was assessed as a 9 on the visual analogue scale (VAS); the patient reported tiredness and night sweats. She had an operation for L3–4 far lateral disc herniation four years ago. Then another operation for L4–5 disc herniation six months ago and immediately three months later she has an operation with L3–4–5 fixation again. She had hypothyroidism, diabetes mellitus, and hypertension. Her daughter was cured of pulmonary tuberculosis 20 years ago. We performed an operation by L4–5 discectomy; all granulation formation with inflammatory processes were debrided and irrigated with antibiotics at levels of L3–5. The old fixation was controlled and replaced. Her back pain improved immediately after surgery; she had a score of 2 on the VAS. Two days after her surgery, our Infection Disease Department reported acid resistant bacillus (ARB+) in samples and began anti-tuberculosis medication.Conclusions:Spinal infections should always be taken into consideration in recurrent failed back surgeries.

Introduction: In this study, it is aimed to present a very rare liver subcapsular accumulation of a patient after ventriculoperitoneal shunt surgery who was diagnosed with Pseudotumor cerebri syndrome with progressive sight loss.     Case: The patient is a 38-year-old female who was diagnosed with lomber spondylose and later operated with stabilization and fusion surgery. Seven days after the operation her headaches became clear and blackout in her left eye was seen and she was observed with medical treatment. CSF  pressure of her was measured to be 25 cm/ water, so she was diagnosed as pseudotumour cerebri and taken to the operation immediately. On the 3rd day of post-operation, there occurred to be intense stomach ache and abdominal sensitivity of the case. After the scanning of abdominal CT,  7 cm of liquid collection was detected in the shunt distal of liver subcapsular area. Discussion: Liver pseudocyst should be considered, even if it is a rare complication when back striking abdominal pain and high liver enzymes are seen in patients with shunt dysfunction. USG and abdominal bt tests should be made for these patients. The drainage of the cyst and then the removal of the abdominal catheter should be applied.

AIM:To perform three-level decompression with a single-level corpectomy by modifying the fusion with anterior cervical corpectomy (ACC-F) method on a cadaver. MATERIAL and METHODS:The anterior cervical region of four whole-head cadavers was dissected. The corpectomy was performed under a surgical microscope with a MT4-20+ ultrasonic bone dissector (UBD) tip. Superior and inferior decompression were conducted and viewed with a 70° neuroendoscope using two types (vertically and horizontally oriented) of specially designed 23 mm-long, 90°-angled UBD tips. RESULTS:After neck dissection and the removal of the thyroid and cricoid cartilages, C5 corpectomy and adjacent-level discectomies were performed. Following discectomy and corpectomy, superior and inferior decompression were conducted with specially designed UBD tips and viewed with a 70° neuroendoscope. A three-level anterior cervical decompression was provided with a single-level corpectomy. CONCLUSION:This study demonstrated that two more level decompression is possible with a single-level corpectomy in the cervical region using the new technique.