A retrospective analysis of 108 patients admitted to the hospital for hemoptysis in the year 2000 was performed. The aim of the study was to clarify the etiologic distribution of hemoptysis and the relation of etiology to the severity and recurrence of it. Of the cases, 79 were men and 29 were women, and the mean age was 51.74 +/- 17.51. In 77 of the cases it was the first attack, while in 31 it was recurrent. According to the severity of hemoptysis, it was classified as "mild" (<30 cm3), "moderate" (30-100 cm3), "severe" (100-600 cm3) and "massive" (>600 cm3). Lung cancer was the leading cause of hemoptysis (34.3%) followed by bronchiectasis (25.0%), tuberculosis (17.6%), pneumonia (10.2%) and pulmonary embolism (4.6%). Statistical analysis by chi-square test revealed that most of the lung cancer patients had mild hemoptysis (odds ratio 3.5; P<0.05), and the most frequent etiology in recurrent hemoptysis was bronchiectasis (odds ratio 3.25; P=0.01). Most of the lung cancer patients were male (P=0.002). The two leading causes of hemoptysis in our study are similar to many previous reports. The high rate of tuberculosis in our study is probably due to the high prevalence of tuberculosis in our country.

Congenital hypoplasia of the posterior arch of the atlas (C1), a developmental failure of chondrogenesis, is a rare anomaly and may range from partial clefts to total agenesis of the posterior arch. Ossification of the posterior arch usually occurs between the 3rd and 5th years of life. The incidence of posterior arch anomalies of the atlas is between 0.69% and 2.95%. For the evaluation of the patient, cervical lateral plain radiography, 2D or 3D reconstructed CT and MRI are very useful and important tools in initial diagnosis. Surgery is the treatment of choice in symptomatic compression. Excision of the posterior arch is performed. during surgery. After the surgery, patients may be followed up for instability and treated as necessary. A patient, admitted to the emergency department with head and neck trauma after a traffic accident is presented in this article. C1 hypoplasia was determined after detailed imagining studies and the radiology department consulted. When upper cervical anomalies are found in a young patient, the patient should be evaluated in detail with advanced radiological studies to avoid misinterpretation as fractures, luxation, osteolysis or instability. Consulting a radiologist could help making an accurate diagnosis and deciding on current therapeutic interventions.KeywOrds: Atlas, Hypoplasia, Posterior, Arch, Congenital, Anomaly ÖZKondrogenezdeki doğumsal bozukluk sonucu oluşan atlasın arka yayının gelişimsel eksikliği nadir bir anomalidir ve kısmi yarık oluşumundan atlasın arka yayının tam yokluğuna kadar gidebilir. Arka yayın kemikleşmesi 3-5 yaşlar arasında olur. Atlasın arka yayı anomalilerinin insidansı %0.69-2.95 arasındadır. Hastayı değerlendirmek için servikal lateral direkt grafi, 2 ve 3 boyutlu rekonstrüksiyonlu bilgisayarlı tomografi ve magnetik rezonans inceleme çok yararlı ve önemli tanı araçlarıdır. Semptomatik bası varlığında cerrahi bir tedavi seçeneğidir. Cerrahide arka yayın eksizyonu uygulanmaktadır. Cerrahi sonrasında hastalar instabilite için takip edilmeli ve gerektiğinde tedavi edilmelidir. Bu makalede, trafik kazası sonrası acil servise baş ve boyun travması ile gelen bir hasta sunulmaktadır. Detaylı radyolojik çalışmalar sonrası, atlas hipoplazisi saptanmış ve sonrasında hasta radyoloji bölümüne konsülte edilmiştir. Genç hastada üst servikal anomaliler saptandığında; kırık, luksasyon, osteoliz ve instabilite hasta ayrıntılı yanlış yorumlardan kaçınmak için hasta radyolojik incelemelerle ayrıntılı değerlendirilmelidir. Radyoloji uzmanına yapılan konsultasyon kesin tanıya ve doğru tedavi edici girişimlerin yapılması için karar verilmesine yardım olmaktadır.

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Background and Context:Minimally invasive percutaneous vertebral augmentation techniques; vertebroplasty, and kyphoplasty have been treatment choices for vertebral compression fractures (VCFs). The purpose of this study is to evaluate the outcomes of the patients who underwent vertebroplasty or kyphoplasty regarding complications, correction of vertebral body height, kyphosis angle and pain relief assessment using visual analog score (VAS) for pain.Materials and Methods:A retrospective review of the hospital records for 100 consecutive patients treated with kyphoplasty or vertebroplasty in our department database. Patients with osteoporotic compression fractures, traumatic compressions, and osteolytic vertebral lesions, including metastases, hemangiomas, and multiple myeloma, were included in the study. Preoperative and postoperative VAS pain scores, percentages of vertebral compression and kyphotic angles were measured and compared as well as demographic characteristics and postoperative complications. Mobilization and length of stay (LOS) were recorded.Results:One hundred patients were treated by 110 procedures. 64 patients were operated on due to osteoporosis (72 procedures). Twelve patients were operated on because of metastasis (13 procedures), 8 patients were operated on because of multiple myeloma (9 procedures). Five patients had two surgeries, 1 patient had 3 surgeries, and 1 patient had 5 surgeries. The mean preoperative VAS was 74.05 ± 9.8. In total, 175 levels were treated, 46 levels by kyphoplasty and 129 by vertebroplasty. The mean postoperative VAS was 20.94 ± 11.8. Most of the patients were mobilized in the same day they of surgery. Mean LOS was 1.83 days. Six patients had nonsymptomatic leakage of polymethlymethacrylate, and patient had epidural hematoma, which was operated on performing hemi-laminectomy.Conclusions:Percutaneous vertebroplasty and balloon kyphoplasty are both effective and safe minimally invasive procedures for the stabilization of VCFs. However, complications should be kept in mind during decision making.

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.

Percutaneous vertebroplasty (PV) is one of the alternative treatments for vertebral fractures. Reported significant complications include pain, radiculopathy, spinal cord compression, pulmonary embolism, infection and rib fractures. In this report, we highlight intradural cement leakage which is a rare complication of the procedure. A 49 year old man with a T12 compression fracture due to multiple myeloma was referred to the neurosurgery department from the orthopaedics and traumatology clinic after developing a right lower limb weakness following percutaneous vertebroplasty with polymethylmethacrylate. An urgent thoraco-lumbar magnetic resonance imaging was performed. The T1 and T2-weighted images demonstrated intradural extramedullary and epidural cement leakages which were hypointense on both sequences. Total laminectomy was performed at T12 and L1 and two epidural cement collections were excised on the right. Then, a dural incision from T12 to the body of L1 was done and cement material seen in front of the rootlets excised without any nerve injury. The patient was discharged after a week and referred to the haematology clinic for additional therapy of multiple myeloma. Although the cement leakage was extensive, the right leg weakness improved significantly and he began to walk with assistance 3 months later. Good quality image monitoring and clear visualisation of cement are essential requirements for PV using polymethylmethacrylate to prevent this complication from the treatment.

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