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.

No abstract

AIM:To compare volumetric changes of intracranial arachnoid cysts (IACs) in different surgical techniques. MATERIAL and METHODS:Sixty-six patients who underwent IAC surgery in our department between 2010 and 2020 were studied retrospectively. Based on the surgical technique, clinical and volumetric changes, postoperative complications, recurrence rates, and length of hospital stay were statistically compared. RESULTS:Microsurgical fenestration (MF) was performed on 32 (48.5%) patients, endoscopic fenestration (EF) on 17 patients, cystoperitoneal shunt (CPS) on 11 patients, and EF + CPS in six patients. The mean IAC volume change rate was 68.54 mL, and the mean cyst volume change rate was 40.68%. The MF technique produces a significantly greater mean cyst volume change than the EF technique. The mean volume change in sylvian IAC is 4.8 times greater than in posterior fossa IAC, a significant difference. The mean cyst volume change is four times greater in patients with skull deformity than in patients with balance loss, and this difference is statistically significant. In patients with cranial deformity, the mean cyst volume change is 2.6 times greater than in patients with neurological dysfunction. This difference is also statistically significant. The volume of IAC decreased more in patients with postoperative complications, with a significant difference between the postoperative complication and the change in IAC volume.CONCLUSION: MF can achieve better volumetric reduction in IAC, particularly in patients with sylvian arachnoid cysts. However, more volumetric reduction increases the risk of postoperative complications.

No abstract

Aims:Split cord malformations (SCM) are congenital anomalies of the spine. The spinal cord is divided into two hemicords in the vertical plane. With foot and spine deformities, the skin lesions on the midline, even at the level of the lesion, at the back are the main signs of SCM. It is divided into two types as Type I (Diastometamyelia) and Type 2 (Diplomyelia). We retrospectively reviewed our cases with SCM and presented our results.Methods:In our department, 27 cases of SCM in 2012-2018 were surgically treated. Of these, 23 were Type I, 4 were Type II. In type I SCM, the bone septum was removed, the hemicords were assembled in a single dura, and the spinal cord was released. In type II SCM, fibrous band was removed and spinal cord was released.Results:All patients were recovered well after surgery. No mortality had been occured. Cerebrospinal fluid (CSF) fistula was seen in 4 patients. The complications such as CSF fistula, infection or wound problems were properly managed. Conclusions:In this paper, we tried to mention about preoperative preparation, intraoperative surgical steps and postoperative period of SCMs. Surgical technique and steps were especially emphasized. SCMs should be treated surgically as soon as possible after the birth in order to avoid neurological and urological deterioration.