Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.

Background and aim:The hippocampus, which has a central role in cognitive and behavioral activities, is one of the most sensitive parts of the brain to systemic inflammatory diseases. This animal study aims to comprehensively investigate the possible inflammatory, oxidative, and apoptotic effects of periodontitis on the hippocampus.Methods: Sixteen male Sprague-Dawley rats were randomly assigned to two groups: control and experimental periodontitis (Ep). In the Ep group, periodontitis was induced by placing 3.0 sutures sub-paramarginally around the necks of right and left mandibular first molars and maintaining the ligatures in place for 5 weeks. Following the euthanasia, mandibula and hippocampus samples were collected bilaterally. Alveolar bone loss was measured histomorphometrically and radiologically on the right and left mandibles. On the right hippocampal sections histological (Caspase-3, TNFα, and 8-OHdG) and the left hippocampal sections, biochemical (IL-1β, Aβ 1-42 , MDA, GSH, and TAS levels) evaluations were performed.Results: Histopathological changes associated with periodontitis were limited (p > .05). A slight increase in caspase-3 positive neuron density in EP rats showed that apoptotic changes were also limited (p > .05). 8-OHdG activity, on the other hand, was significantly higher compared to controls (p < .05). In biochemical analysis, there was a significant increase in IL-1β levels and oxidative membrane damage (MDA) (p < .05) whereas Aβ 1-42 and antioxidant marker (GSH and TAS) levels were slightly increased (p > .05). Conclusion:Periodontitis causes marked increases in IL-1β levels and oxidative stress in the hippocampus, but limited degenerative and apoptotic changes.

Nöroleptik malign sendrom (NMS) antipsikotik ilaç kullanımı sonrasında ortaya çıkabilen ciddi bir klinik tablodur. Antipsikotik kullanan tüm hastalarda dozdan bağımsız olarak gelişme riski bulunsa da etiyolojisi tam olarak aydınlatılamamıştır. Ateş, rijidite, bilinç bulanıklığı, serum kreatin fosfokinaz (CPK) yüksekliği ve otonomik disregülasyon bulguları ile seyretmektedir. Son yıllarda NMS tanı ölçütlerini tam olarak karşılamayan ve atipik özellikler sergileyen olgular da bildirilmektedir. Ayırıcı tanıda güçlüklere yol açan bu durumun erken tanı ve tedavisi önem arz etmektedir. Bu çalışmada parenteral birinci kuşak antipsikotik ilaç uygulanması sonrasında yüksek ateş, bilinç durumunda değişiklik, rijidite ve aşırı terleme bulguları gelişen ancak serum CPK yüksekliği beklenilen seviyelerde olmayan 47 yaşındaki dwarfismli kadın hastadaki atipik özellikleri olan NMS klinik görünümü literatür bulguları eşliğinde sunulmuştur. Özel gruplarda antipsikotik ilaç tedavisi düzenlenirken pek çok karıştırıcı faktörün bulunduğu unutulmamalı ve atipik özellikli NMS konusunda dikkatli olunmalıdır.

Background: In parallel with the development of neuroimaging methods, become increasingly possible to explore the relationship between mental disorders and structural brain lesions. It is aimed to examine the relationship between the clinicalfeatures and psychopathologies of psychiatric patients and their anomalies. Methods: Two hundred-six female patients who were treated in Clinic of Psychiatry, Rize Training and Research Hospital between01/Jan/2016 and 31/Dec/2021 and had brain magnetic resonance imaging (MRI) were included in this study. Sociodemographic and clinical characteristics data form was recorded for each patient. Simultaneously, the size and location of the anomalies were recorded by scanning the brain MRI. Results: When the brain MRI scans of the patients were evaluated, 56% of 206 patients had at least one of the related anomalies. Enlarged Virchow-Robin space (VRS) in 2.4%, mega cisterna magna (MCM) in 14.6%, total empty sella (ES) in 8.3%, partial ES in 27.7%, cavum vergae (CV) in 1.9%, hippocampal remnant cyst (HRC) in 17%and 6.8% had arachnoid cyst (AC) findings. When the sociodemographic data and clinical characteristics of the patients were compared with the brain MRI findings, a significant correlation was found between the presence of MCM and the use of antidepressant medication (p=0.026). A significant correlation was found between the presenceof AC, disease duration and regular treatment history (p=0.0002). No significant correlation was found between otherdata and MRI (p>0.05). Conclusions: In our study, it is noteworthy that a higher rate of anomaly was detected in brain imaging of caseswith a history of psychiatric diagnosisand treatment comparedto the general population.

Metamfetamin, Dünya çapında sıklıkla suistimal edilen ve güçlü bağımlılık yapıcı etkileri olan amfetamin türevi bir maddedir. Kronik metamfetamin kullanımı bir süre sonra dopaminerjik reseptör yoğunluğunda değişikliklere yol açar. Özellikle mezolimbik sistem ve striatumdaki dopaminerjik sistemler üzerinde etkilidir. Duyarlılık ve bağımlılıkla sonuçlanır. Dopaminerjik sistemdeki bu değişiklik psikotik belirtileri açıklayabilir. Bununla birlikte metamfetaminin neden olduğu psikoz mekanizması ve cinsiyete özgü özellikler tam olarak aydınlatılabilmiş değildir. Son yıllarda yapılan çalışmalarda metamfetamin ve benzeri uyarıcıların şizofreni ve ilişkili bozuklukların görülme sıklığında artışa neden olduğu ortaya konulmuştur. Metamfetamin psikozu şizofreni benzeri klinik özelliklere sahiptir. Hatta bazen birbirlerinden ayırt etmek oldukça güçtür. Bu olgu sunumunda tek seferlik ve düşük doz metamfetamin kullanımı sonrası psikotik bozukluk gelişen bir kadın olgu ele alınmıştır.