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Objective. Endocan has been shown to be a marker for several cancers and may show degree of malignancy. The aim of this study is to assess tissue levels of endocan in common brain tumors, namely, meningiomas, low-grade gliomas (LGGs), and high-grade gliomas (HGGs). Patients and Methods. Endocan was assayed by commercially available enzyme linked immunosorbent assay (ELISA) kits in a total of 50 brain tumors (20 meningiomas, 19 LGGs, and 20 HGGs) and 15 controls. The results were compared to control brain tissues. Results. Each tumor group showed significant higher levels of endocan compared to controls (p < 0.05). In addition, endocan levels showed steady increase from the least (meningiomas) to the most (HGGs) malignant tumors and positive correlation was noted between the degree of malignancy and endocan level (p = 0.0001). Conclusion. Endocan, a vital molecule for angiogenesis, is expressed in common brain tumors and results suggest that endocan could be a marker for malignancy.

Lumbar disc hernia is common disease, affecting about 5% of the population. Many studies to date reported regression of disc herniation without surgical intervention. Medical records of the patients who applied to the spine clinic in an outpatient setting were retrospectively reviewed. Age, sex, radiological findings, neurological examinations, and medical treatments of the patients were evaluated. Male patients constituted 52.6% of the cases (n = 40) and 47.4% (n = 36) were female. The ages of the patients ranged from 25 to 82 years, with a mean of 48.5 ± 12.1 years. Visual analog scale (VAS) measurements ranged from 0 to 8 and the mean was determined as 2.65 ± 1.98. The VAS score of pain severity of 12 (15.78%) cases was 0, VAS score of 39 (51.31%) cases was 1 to 3, VAS score of 20 (26.31%) cases was 4 to 6, VAS score of 5 (6.57%) cases was 7 to 10. Eighteen (23.68%) of the cases underwent neuropathic pain treatment for more than 6 months. Fifteen (19.7%) patients also developed permanent motor deficits. Findings of our study show that there was no direct association between radiological improvement and clinical improvement. Indication for surgery still existed in a high number of patients, substantial of which developed permanent motor deficits. Current results suggest that we need to advise our patients in favor of early surgery as soon as indication for surgery is established upon neurological and radiological examination.

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Authors present an 11-year-old female admitted with a 3-month history of painless forehead mass. The mass was located in the left frontal area and was pronounced on inspection and palpation. Neurologic examination revealed no abnormalities. The patient was diagnosed for acute lymphoblastic leukemia 5 years ago and had been treated. The patient was under observation by the pediatric oncology clinic with remission state since 3 years. Brain computed tomography and magnetic resonance imaging revealed a cystic bone lesion in the right frontal bone. A preoperative diagnosis of myeloproliferative disorder was made and it was surgically resected and cranioplasty with porous polyethylene sheets (Medpor, Porex Surgical Inc, GA) was performed in the same stage. Pathologic examination revealed an aneurysmal bone cyst. The patient recovered with complete resolution of symptoms. Although rare lesions, aneurysmal bone cysts must be considered in the differential diagnosis of calvarial mass lesions.

Cervical disc herniation is a condition which arises from compression of cervical spinal nerve root by the degenerated disc and vast majority of the patients are aged between 30 and 40 years. Spontaneous regression of cervical disc was first reported by Kriegerand Maniker in 1992. Our study is the second large series in literature. Besides, 4 patients are the first who were shown to have resorption in C 4-5. The records of patients diagnosed with cervical disc herniation who applied to the Spine Polyclinic between 2014 and 2018 were reviewed retrospectively. The files of the patients who were recommended surgery with the diagnosis of cervical disc herniation were examined. Patients who did not accept surgery on their own initiative, but who attended our outpatient clinic for a check-up were included in the study. Of a total of 14 patients, 28.57% (n = 4) were male and 71.43% (n = 10) were female. Mean age of the patients was 40.79 (range 25–60). The results of the study indicate that likelihood of spontaneous regression is higher in para-central or foraminal disc compared to central disc hernias. Although there are a limited number of case reports in the literature, conservative treatment seems to be a good option in patients without neurological deficits, with foraminal disc hernias and not requiring emergency surgery.

In the literature, various surgical techniques and approaches have been developed previously, and morphometric studies have been conducted using either imaging methods or cadavers (1,2,4,5,6,9,10,15). However, most of the cadaveric studies were conducted using formalin and alcohol-fixed cadavers, and they were comprised of small sample sizes (1,2,15). Unfortunately, formaldehyde can cause structural changes in the brainstem, which can affect the morphometric values. █ INTRODUCTION T he surgical management of fourth ventricle and brainstem pathologies, particularly with regard to tumors, remains a surgical challenge (8). Therefore, a detailed knowledge of the anatomy of the area involved, and a determination of the safe entry points are key factors involved in a successful surgical outcome (3). AIM: To investigate the external anatomy of the fourth ventricle and dorsal brainstem using morphometric data, which could be useful for preoperative surgical planning. MATERIAL and METHODS: Between January 2017 and December 2017, 42 fresh adult cadavers were investigated for the measurements of the cadaver brainstems and fourth ventricle, and they were recorded by photography. Measurements were evaluated according to body mass indexes (BMIs) of the patients. We also investigate the visualization of facial colliculus and stria medullaris on brainstem. RESULTS: A total of 42 fresh cadavers with a mean age of 45.38 ± 16.41 years old were included in this research. We found no statistically significant difference between measurements and BMIs. Facial colliculus was visualized in 92.9% (n=39), but it could not visualized in 7.1% (n=3) of the subjects. When the right side of the stria medullaris was examined, one bundle was seen in 59.5% (n=25) of the subjects, two bundles were seen in 31% (n=13) of the subjects, and 3 bundles were seen in 9.5% (n=4) of the subjects. When the left side of the stria medullaris was examined, one bundle was seen in 57.1% (n=24) of the subjects, two bundles were seen in 33.3% (n=14) of the subjects, and three bundles were seen in 9.5% (n=4) of the subjects. CONCLUSION: Knowledge of the normal morphometry of the dorsal brainstem as it has been reported in this study will help one to assess distortions in any preoperative imaging studies and surgical planning.

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.