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Amaç: Amacımız en çok bel ağrısını oluşturan patolojileri belirlemek, Bertolotti Sendromu’nun bu patolojiler arasındaki oranını ve olası cinsiyet-yaş ayrımını ortaya koymaktır. Lumbosakral Transisyonel Vertebra’ları Castellvi sınıflamasına göre gruplandırıp oranlarını bulabilmektir. Yöntem: Mart 2020-Ekim 2021 tarihleri arasında çoğunluğu bel ağrısı nedeniyle Sakroiliak eklem Manyetik Rezonans Görüntülemeleri çekilen 357 hastaya ait görüntüler ve raporlar kas iskelet sistemi radyolojisi üzerine özelleşmiş bir radyolog tarafından değerlendirildi. Bulgular: Bertolotti Sendrom’u olan hastaların ortalama yaşı 43.9, olmayan hastaların ortalama yaşı 44 olup Bertolotti Sendromu ile hasta yaşları arasında bir ilişki bulunmadı (p=0.976). Bertolotti Sendrom’lu hastaların yaş aralığı 15-77 yaş idi. Bertolotti Sendrom’lu hastaların %20’si 30 yaşının altında, %50’si 40 yaşının altında izlenmekteydi. Bertolotti Sendromlu olan ve olmayan hastaların cinsiyet dağılımına bakıldığında Bertolotti Sendromu’nda cinsiyet ayrımı izlenmedi (p=0.572). Castellvi sınıflamasına göre grupların görülme oranları Tip 1a’da %10, Tip 1b’de %11.4, Tip 2a’da %35.7, Tip 2b’de %17.1, Tip 3a’da %4.3, Tip 3b’de %12.9 ve Tip 4’de %8.6 olarak bulundu. Alt lomber ağrıya neden olan patolojilerin başlıcaları aktif-kronik sakroileitler, vertebra ve disk dejenerasyonları ile faset eklem artrozlarıydı. Başlıca gözüken bu patolojilerden sonra %2.8 görülme sıklığıyla en fazla izlenen patoloji Lumbosakral Transisyonel Vertebra’dan kaynaklı ağrı nedeni olan Bertolotti Sendromu’ydu. Sonuç: Çalışma sonuçlarımıza göre Bertolotti Sendromu, 30 yaşının altında görülmeye başlamakla birlikte yaş ile anlamlı bir ilişkisi bulunmamaktadır. Cinsiyet ayrımı göstermemektedir. Bertolotti Sendromu; sakroileit, osteodejenerasyon ve diskopatik değişikliklerden sonra en sık izlenen alt lomber ağrı nedenlerinden bir tanesidir. Bertolotti Sendromu etyolojisinde literatürde farklı hipotezler olup ortak bir görüş bulunmamaktadır. Bu nedenle çok sayıda hasta katılımının sağlanacağı çok merkezli araştırmalara ihtiyaç vardır.

PURPOSE The formation of pterygoalar (Pa) and pterygospinous (Ps) bars are controversial whether they are secondary ossifications with aging or phylogenetic remnant. Therefore we aimed to evaluate the presence of Pa and Ps bars in children on routine cranial computed tomography images. METHODS We retrospectively analyzed the cranial computed tomography images of 500 children under the age of 18. Besides the 0.5 mm axial images, maximum intensity projection and 3D reconstructions were also used. The existence of incomplete or complete Pa and Ps bars were investigated. RESULTS Incomplete and complete Pa bar was detected in 4.6% and 2.2% of the cases, respectively. Incomplete Ps bar was seen in 13.6% of the cases and complete was in 6%. In total, per 1000 sides, 12 (2.4%) complete and 27 (5.4%) incomplete Pa bars were detected. In the same way, 35 (7%) complete and 88 (17.6%) incomplete Ps bars were seen. The smallest age ossification detected was 5 months old. Additionally, the prevalence of Pa and Ps bars between the under and over 10 years old age groups were statistically significant. Aging increased the prevalence. CONCLUSION Considering our results, it seems that the ossification of Pa and Ps ligaments may not be solely related with aging.

PURPOSE Androgenetic alopecia (AGA) is the most common cause of hair loss in males. Physical examination and history are the most important examinations in diagnosis of the disease. As yet, there is no diagnostic method to be able to determine which individuals will develop AGA. Shear-wave elastography (SWE) is a novel diagnostic tool, which can evaluate tissue stiffness. Superb microvascular imaging (SMI) can determine low flow in microvessels. The aim of the current study was to determine whether or not AGA would develop in individuals with normal hair and a family history of AGA using B-mode US, SMI, and SWE. METHODS The study included 26 patients clinically diagnosed with AGA and a control group of 26 volunteers. RESULTS Thickness with the distance from the epidermis to the calvarium (ECD) on the hairline and cranial subcutaneous tissue thickness (CSTD) were determined to be statistically significantly thinner in the AGA group than in the control group (p

The anatomical variations of renal artery related with number, branching pattern and origin level have been well described. The variations regarding the course of the artery are limited and mainly related with its relation of vena cava inferior. However, diaphragmatic crus is also on the pathway of renal artery and this relationship might also have variations. Different from its usual precrural position, there are a few cadaveric dissections reported as retrocrural or transcrural renal artery. This is the report of a rare variant of renal artery course, where it was crossing between the fibers of diaphragmatic crus detected on CT angiography.

SUMMARY: The objective of this study was to evaluate the role of the variations of carotid artery course on the relationship between styloid process (SP) and internal carotid artery (ICA). Carotid CT angiography scans of 170 patients were retrospectively evaluated. The variability of the course of ICA were classified. The length and medial angulation of the SP were measured on coronal 3D images. On axial images, the shortest distance between the bone edge of the SP and ICA were measured. The distance between SP and ICA among the course patterns of carotid artery were compared statistically. In the comparison of distances between SP and ICA with respect to the course of ICA, the difference between straight and curving (p

Cerrahi bir girişim ile ana venöz yapılara yerleştirilen, cilt altı rezervuarları ile kapalı bir sistem olan port kateterler çocuk hastalarda uzun süreli intravenöz tedavi ihtiyaçlarını karşılamak üzere giderek artan sıklıkta kullanılmaktadır. Nadir olarak görülen, vasküler erozyon ile gelişen, kateterin bulunduğu venin plevral veya perikardiyal alana açılması ile oluşan venobronşial fistüller, geç dönem port kateter komplikasyonları arasında yer almaktadır. Bu çalışmada, hemoptizi gibi sonuçlara yol açabilen, port kateter çekilmesi işlemini zorlaştıran, bu özellikleri ile hayati risk içeren bir komplikasyon olan venobronşial fistüllü bir olguyu sunmayı amaçladık., Port catheters, which are a closed system with subcutaneous reservoirs, placed in the main venous structures with a surgical intervention, are increasingly used in pediatric patients to meet the long-term intravenous treatment needs. Venobronchial fistula, which is rarely seen, developed with vascular erosion and caused by opening the vein where the catheter is located to the pleural or pericardial area, is among the late stage port catheter complications. In this study, we aimed to present a case with venobronchial fistula, which can lead to consequences such as hemoptysis, complicates the port catheter removal procedure, and is a life-threatening complication with these features.

Arteriovenöz malformasyonlar intrakraniyal vasküler yapıların gelişimsel anomalileridir. Bunlar çoğu hastada intrakranial kanama ve epilepsiye neden olma potansiyeline sahip serebrovasküler malformasyonların en tehlikelisidir. Erkek ve kadınlarda eşit oranlarda görülürler. Yaygın olarak ikinci ve üçüncü dekadlarda bulguları ortaya çıkar. Etkilenen birçok insan yaşam boyu asemptomatik kalabilir. Bu olgu sunumunda, erken yaşta bulgu vermesi nadir olan arteriovenöz malformasyonun en önemli komplikasyonu olan serebral kanama ile başvuran 17 yaşındaki çocuk vaka sunulmuştur., Arteriovenous malformations are developmental anomalies of intracranial vascular structures. These are the most dangerous ones of cerebrovascular malformations that have the potential to cause intracranial hemorrhage and epilepsy in most patients. They are seen equally in men and women. Symptoms occur commonly in the second and third decades. Many affected people may remain asymptomatic for life. In this case report, a 17-year-old boy who presented with cerebral hemorrhage, which is the most important complication of arteriovenous malformation and rarely manifested at an early age, is presented.

Background As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. Methods FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. Results We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5 mm at the mandibular origin, 3.7 mm at the cheilion, 3.7 mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0 mm at the mandibular origin, 18.7 mm at the cheilion, 23.5 mm at the nasal ala). FA depth was varied between 5.98 mm and 6.62 mm at the mandibular origin, between 8.36 mm and 9.20 mm at the cheilion, between 9.52 mm and 10.51 mm at the nasal ala at a 95% confidence interval. Conclusions This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections.

This study aimed to peruse anatomic features of the cranial aperture of the optic canal (CAOC) for obtaining an extended morphometric dataset in children. Computed tomography images of 200 children were included in this retrospective work to analyze the shape, location and diameters of the CAOC. The CAOC area, width and height were observed as 17.53 ± 2.80 mm2, 6.12 ± 0.84 mm, and 4.35 ± 0.64 mm, respectively. The angle of the optic canal in axial plane was found as 39.28 ± 5.13°, while in sagittal plane as 16.01 ± 6.76°. The distance between the CAOC and the midsagittal line was 7.17 ± 1.48 mm. The CAOC was measured as 54.04 ± 5.23 mm and 42.55 ± 3.28 mm away from the anterior and lateral boundary of the anterior skull base, respectively. The CAOC shape was described as the tear-drop (186 foramina, 46.5%), triangular (156 foramina, 39%), oval (47 foramina, 11.8%), and round (11 foramina, 2.8%). The depth, angle and diameter measurements belonging to the CAOC were changing according to its shape or demographic data (e.g., sex and age). Therefore, preoperative radiologic evaluation containing the shape, location and size of the CAOC should be considered by multidisciplinary operating teams in terms of surgical interventions such as implant positioning.

In this study, we aimed to establish a quantitative threshold value in the diagnosis of subacromial impingement syndrome by measuring the thickness of the subacromial bursa during abduction and adduction. Forty-five patients with subacromial impingement syndrome and 54 healthy individuals underwent dynamic shoulder ultrasonography. The subacromial bursa, between the supraspinatus tendon margin and peribursal adipose tissue, was measured between the acromion and humeral head at its widest part. The subacromial impingement ratio was calculated by dividing the subacromial bursa thickness during abduction to the subacromial bursa thickness during adduction. Shapiro–Wilk test was used in the assessment of normal distribution of parameters. The mean subacromial bursa thickness in the abduction position was 1.8 ± 1.1 mm in the study group and 0.9 ± 0.3 mm in the control group. The mean subacromial bursa thickness in the adduction position was 0.9 ± 0.5 mm in the study group and 0.8 ± 0.3 mm in the control group. The subacromial impingement ratio showed a statistically significant difference between groups (p

The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients. CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group. Patients obtained scores between one and four with respect to portal hypertension findings, and the scores were compared with phrenic artery diameters. Child-Pugh and MELD scores of the patients were also calculated. The mean diameter of the right inferior phrenic artery in the patient group was larger than that in the control group (p

A 23-year-old male patient who presented with impaired kidney function tests attended to hospital for hemodialysis and underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) examination for the metabolic characterization of the intra-abdominal mass which was found in the ultrasonography. 18F-FDG PET/CT revealed a mass lesion adjacent to the liver which was hypermetabolic and the pathology of the lesion was determined as amyloidosis. To the best of our knowledge, the case with 18F-FDG PET/CT images of a huge amyloid mass is the first in the literature.

Aim: The mostcommon cause of acute epidural hematoma (AEH) is parietotemporal bone fracturesdue to injury of the arteria meningea media. In this study, we aimed toinvestigate the factors affecting prognosis in patients operated with thediagnosis of acute epidural hematoma in our clinic. Methods: Between 2007 and2018, eighty-nine patients who were diagnosed as AEH in the Department ofNeurosurgery, Faculty of Medicine, Mersin University were included in thestudy. Patients were divided into groups according to the age, initial Glasgowcoma scale (GCS), neurological findings, location, extent and operation of AEH.The findings were compared according to mortality, morbidity, intensive careand discharge period. Results: Seventy-five of the patients weremale, 14 were female and the mean age was 25.7 years. The most commonlocalization of the hematoma was parietotemporal region in 31 (34.8%)patients.The hematoma was evacuated by craniotomy in 59 (66.3%) patients whilecraniectomy was done in 30 (33%) patients for treatment. The worst clinicaloutcomes were found in patients with GCS 8 and below after arrival. Thecomplications (44;0%) and mortality rates (52,0%) were found to be high in thosepatients and the mean hospitilization period was found as 18.3 days. Conclusion: Early diagnosis andtreatment, the presence of high GCS, age less than 18 years and hematomathickness less than 20 mm were found to be associated with good prognosis,while temporal location of the hematoma was predicted to be associated withpoor prognosis., Amaç: Akut epidural hematom(AEH) kafa travması sonrası sıklıklatemporoparietal kemik kırıkları nedeni ile arteria meningea medianınyaralanması sonucu görülmektedir. Bu çalışmada, kliğimizde akut epiduralhematom tanısı konularak opere edilen hastalarda, prognozu etkileyenfaktörlerin araştırılması amaçlanmıştır. Yöntem: Çalışmaya, 2007-2018yılları arasında Mersin Üniversitesi Tıp Fakültesi Beyin ve Sinir CerrahisiAnabilim Dalı’nda AEH tanısı alarak cerrahi yöntemle tedavi edilen 89 hastadahil edilmiştir. Hastalar yaşgrupları, geliş Glasgow koma skalası (GKS), nörolojik bulguları, AEH’nin yeri,genişliği ve yapılan operasyon şekline göre gruplara ayrılmıştır. Hastalardamortalite, morbidite, yoğun bakım ve hastane kalış sürelerine göre prognozkriterleri belirlenmeye çalışılmıştır. Bulgular:Hastaların 75’i erkek, 14’ü kadın olup, ortalama yaş 25.7 olarak tespitedildi. Hastalarda görülen en sık başvuru bulgusu şuur değişikliği idi (%66.9).Hematomun en sık görüldüğü lokalizasyon 31 (%34.8) hastada parietotemporalbölge olarak saptandı. Ellidokuz (%66.3) hastada kraniyotomi ile hematomboşaltılırken, 30 (%33.0) hastadakraniektomi ile hematom boşaltıldı. En kötü klinik sonuçlar geliş GKS’si 8 vealtında olan hastalarda tespit edilmiştir. Bu hastalarda komplikasyon (%44.0),mortalite (%52.0) oranı oldukça yüksek ve hastanede yatış sürelerinin (ortalama18.3 gün) uzun olduğu saptanmıştır. Hematom kalınlığı 20 mm üzerinde olanhastalarda komplikasyon ve mortalite oranı yüksek bulunmuştur. Sonuç: AEH’de erken tanı ve tedavininyanısıra geliş GKS’sinin yüksek olması, hastanın yaşının 18’den daha küçükolması ve hematom kalınlığının 20 mm’den küçük olması iyi prognozla ilişkiliolarak tespit edilmişken, hematomun temporal bölgede yer almasının kötüprognozla ilişkili olabileceği öngörülmüştür.

PURPOSE To reveal the presence and nature of exiting points of supraorbital region neurovascular structures and determine the distances of those structures to midline with computed tomography images by taking into account gender and sides in patients with migraine. METHODS The study was conducted retrospectively on computed tomography images of 70 migraine and 70 control patients with a mean age of 39.5 ± 13.8 years (range: 18-80). Presence and nature (foramen or notch) of exiting points of neurovascular structures in terms of side and gender in both groups, and the distances of these structures to the midline of the face were evaluated. RESULTS In migraine and control groups, the most commonly seen structure was single notch. Coexistence of foramen and notch was statistically significant in migraine and female migraine groups than control and female control groups (P

To assess the incidence of anatomical variations of the paranasal region on computed tomography in migraine patients compared with control subjects.Paranasal computed tomography scans of 2 groups consisting of 50 migraine patients and 50 control subjects were evaluated, retrospectively. The presence of anatomic variations and the unilateral or bilateral presence of these variations were noted. Appropriate statistical tests were performed to compare the migraine and control groups, using a threshold P value of 0.05 for statistical significance.The migraine group included 39 female and 11 male patients with mean age of 39.9 (range: 18-65) years. The control subject group included 29 female and 21 male patients with mean age of 41.9 (range: 18-73) years. Anatomic variations noted included nasal septal deviation and spur, paradoxical curvature of middle concha, agger nasi cell, infraorbital ethmoidal (Haller) cells, sphenoethmoidal (Onodi) cells, supraorbital ethmoidal air cells, concha bullosa, uncinate bulla, and pneumatized crista galli. Of these variations, only the presence of Haller cells was statistically significantly higher in the migraine group compared with controls (P = 0.007). The unilateral presence of Onodi (P 0.001), unilateral presence of supraorbital ethmoidal air cells (P = 0.012), and bilateral presence of concha bullosa (P = 0.016) were statistically significantly higher in the migraine group. There was no statistically significant difference between the unilateral or bilateral presence of Haller cells in migraine patients compared with controls (P 0.05).Radiographic assessment of the paranasal sinuses is useful to elucidate potential points of pathology in migraine patients. The specific contribution of Haller cells to migraine headache symptoms and safe methods for surgical decompression warrant further study.

Cerebellar liponeurocytoma (CLN) is a very rare tumor of central nervous system, classified as glioneuronal tumor by the latest classification of World Health Organization (WHO) in 2016. There are limited data in the literature about biologic behavior, growth pattern and radiological features of this tumor. In this case report, we operated a big calcified CLN patient who had denied any surgical procedures suggested by an another institute and had been followed for 4 years.

Klippel Trenaunay Sendromu kapiller malformasyonlar, yumusak doku veya kemik hipertrofisi ve superfisiyel varikoz venler ile karakterize nadir gorulen konjenital anomalidir. 29 yasinda erkek hasta alt ekstremitede agri, sislik sikayeti ile basvurdu. Fizik muayenede sag alt ekstremitede yaygin varikoz venler, ekstremitede uzunluk ve kalinlik artisi, ciltte hiperpigmente alanlar saptandi. Klippel Trenaunay Sendromu tanisi konuldu ve derin venoz sistemi degerlendirmek uzere Doppler US, BT anjiografi, MR anjiografi tetkikleri yapildi. Popliteal veni aplazik olan hastada semptomatik tedavi yontemleri tercih edildi. Klippel Trenaunay Sendromu tanili hastalarda BT ya da MR anjiografi derin venoz sistemi degerlendirmede onemlidir. Derin venoz sistemde aplazi varligi cerrahi tedavi icin kesin kontraendikasyondur.

Eagle syndrome is defined as symptomatic elongation of the styloid process or calcification of the stylohyoid and stilomandibular ligament. The syndrome was described by WW Eagle in 1937. The styloid process is located between the internal and external carotid arteries and laterally in the tonsillar fossa. Patients with cerebrovascular ischemia causing syncope or hemiparesia due to Eagle syndrome are rarely published in the literature. The authors presented a patient with recurrent cerebrovascular attacks due to long styloid process.

The petrosphenoidal ligament (PSL) forms the roof of Dorello’s canal in which the abducens nerve courses. An ossified PSL may play a role in abducens nerve palsy although it is controversial. Therefore, we aimed to investigate the incidence and the imaging features of PSL ossification using multidetector computed tomography (MDCT). Consecutive head CT scans, performed between January 2014 and May 2014, were retrospectively evaluated by two radiologists to look for a partial or complete ossification at the expected site of the PSL using axial, reformatted coronal and sagittal images. We found 46 patients (32 men, 14 women) with ossification of the PSL out of 523 head CT scans (46/523, 8.8 %). A total of 61 PSL ossifications (31 unilateral; 15 bilateral) were found in 1,046 petroclival regions (61/1,046, 5.8 %). Of these 61 ossifications, 34 (34/523, 6.5 %) were on the right and 27 (27/523, 5.1 %) were on the left; 38 (38/1,046, 3.6 %) were classified as partial and 23 (23/1,046, 2.2 %) were classified as complete. Ossification of the PSL is not a rare finding on MDCT. This imaging technique can reliably demonstrate the imaging features of an ossified PSL.

To investigate the anatomical variations in the origins of the thyroid arteries on CT angiography images. The presence and the origins of the superior thyroid artery, the inferior thyroid artery, and the thyroidea ima artery were retrospectively evaluated based on carotid CT angiography examinations. The bifurcation level of the common carotid artery with respect to the cervical vertebrae and disc spaces was also determined. A total of 640 patients were included in the study. The right and left superior thyroid arteries arose from the external carotid artery in 413 (64.5%) and 254 (39.7%) patients, from the bifurcation of the common carotid artery in 131 (20.5%) and 148 (23.1%) patients, and from the common carotid artery in 90 (14.1%) and 226 (35.3%) patients, respectively. We could not observe the right and the left superior thyroid arteries in 6 (0.9%) and 12 (1.9%) of the patients, respectively. However, the right and left inferior thyroid arteries were not identified in 14 (2.2%) and 45 (7%) of the patients, respectively. The thyroidea ima artery was detected in 2.3% of the patients. The visualization of thyroid arteries on CT angiography images enables the anatomy of the arterial supply system of the thyroid gland to be explored in a noninvasive manner prior to surgery.

Amac: Dinamik bilgisayarli tomografi tetkikinde ovaryan venlerde izlenebilen reflu acisindan arteriyel ve erken portal venoz faz goruntuleri karsilastirilmistir. Yontem: Ocak 2010-Mart 2016 tarihleri arasinda klinigimizde yapilan dinamik bilgisayarli tomografi tetkikleri retrospektif olarak incelendi ve 125 hasta calismaya dahil edildi. Kontrast madde verilmeye baslanmasindan sonra 25. saniyede (arteriyel faz) ve 60. saniyede (erken portal venoz faz) elde edilen goruntuler incelendi. Ovaryan venlerdeki reflu varligi degerlendirildi. Sol ve sag ovaryan venlerin caplari olculdu. Bulgular: Yuz yirmi bes hastanin 29'unda (%23,2), hem arteriyel hem de erken portal venoz fazda sol ovaryan vende reflu saptandi. Otuz uc (%26,4) hastada sadece erken portal venoz fazda sol ovaryan ven reflusu tespit edildi. Kirk dokuz (%39,2) hastada erken portal venoz fazda sag ovaryan ven reflusu gozlendi. Sol ovaryan ven capi ortanca degerlerinin; sol ovaryan vende sadece erken portal venoz fazda reflusu olanlarda reflu olmayanlara gore daha yuksek (p=0,016), her iki fazda da reflusu olanlarda reflu olmayanlara gore cok daha yuksek (p

Background: The aim of this study is to investigate the effect of anatomic differences on the relationship between renal artery and diaphragmatic crus via the touch of two structures. Materials and methods: The study included dynamic computed tomography (CT) scans of 308 patients performed mainly for characterisation of liver and renal masses. Anatomic differences including the thickness of the diaphragmatic crus, the localisation of renal artery ostium at the wall of aorta, the level of renal artery origin with respect to superior mesenteric artery were evaluated. Statistical relationships between renal artery-diaphragmatic crus contact and the anatomic differences were assessed. Results: Thickness of the diaphragmatic crus at the level of renal artery origin exhibited a statistically significant relationship to renal artery-diaphragmatic crus contact at the left (p < 0.001) and right side (p < 0.001). There was a statistically significant relationship between high renal artery origin and renal artery- -diaphragmatic crus contact at the left (p < 0.001) and right side (p = 0.01). The localisation of renal artery ostium at the wall of aorta (right side, p = 0.436, left side, p = 0.681) did not demonstrate a relationship to renal artery-diaphragmatic crus contact. Conclusions: Thickness of the diaphragmatic crus and high renal artery origin with respect to superior mesenteric artery are crucial anatomic differences determining the relationship of renal artery and diaphragmatic crus. (Folia Morphol 2018; 77, 1: 22–28)

Background Hemangiondothelioma is a rare vascular tumor that can occur in the bone. Temporal bone involvement has been reported extremely rare in the literature. Case Radiological examination of a one-year-old girl who was admitted due to facial paralysis revealed vascular tumor of the temporal bone and Galen vein aneurysm. Pathological examination showed retiform hemangioendothelioma. She was treated with propranolol, prednisolone, vincristine, and endovascular embolization followed by oral sirolimus. With sirolimus treatment, a partial response was obtained first, then the tumor remained stable and sirolimus treatment was discontinued. No progression was observed in the disease after discontinuation of treatment. Conclusion In this article, a case of hemangioendothelioma originating from the temporal bone is discussed in the light of other case reports in the literature.

Summary Background Ophthalmoplegia secondary to a traumatic dissecting aneurysm in the cavernous segment of internal carotid artery (ICA) is a relatively rare entity. Anticoagulant or antiplatelet therapy is the preferred treatment option for carotid dissections. However, endovascular interventions are noninvasive and alternative methods to surgery, especially in cases of aneurysms that do not respond to medical therapy. Case Report We report of a 19-year-old man presenting with left-sided, total ophthalmoplegia after a traffic accident. Magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) revealed a dissection beginning at the cervical segment of internal carotid artery (ICA) together with a dissecting aneurysm in the cavernous segment. A stent was placed in the narrowed and dissected segment of ICA, and the dissecting aneurysm of the cavernous segment was successfully managed with a stent-assisted coil embolization. After the endovascular treatment of the aneurysm, a full recovery of cranial nerve function was achieved. Conclusions Immediate diagnosis and appropriate therapy of dissecting aneurysms is necessary for good clinical outcomes in cases of ophthalmoplegia.

Native kidney function can still contribute to the total renal function after preemptive renal transplantation, and the primary problems of native kidneys such as tubular disorders may persist or reappear in the post-transplantation period. Bartter syndrome is a rare hereditary tubulopathy characterized by renal salt wasting, hypokalemia, metabolic alkalosis, and normotensive hyperreninemic hyperaldosteronism. In this case report, we described a patient who presented with episodes of recurrent hypokalemia, hypomagnesemia, and metabolic alkalosis in the post-transplantation period, probably due to the tubular disorder of the native kidneys. The primary kidney disease had not been adequately investigated in the pre-transplant period, and Bartter syndrome was the most likely diagnosis. Identifying primary kidney disease in the pre-transplantation period is important for patient follow-up.

Appendiceal mucocele is defined as enlargement of the appendix due to the intraluminal accumulation of mucoid material. It is an unusual lesion with variable, nonspecific clinical manifestations. Imaging plays an important role in the diagnosis and evaluation of the mucocele. Preoperative diagnosis is mandatory for proper surgical intervention to prevent perforation and spillage of the mucinous material into the peritoneal cavity, which otherwise results in pseudomyxoma peritonei [1–3]. Development of a mucocele in a patient who previously underwent an appendectomy is an extremely rare entity, with only a few case reports in the literature [2–5]. In this paper, we report a case of a mucocele due to mucinous cystadenocarcinoma in a patient with a history of previous appendectomy who presented with acute abdomen-like symptoms. Preoperative diagnosis was made based on the sonographic ‘‘onion skin sign.’’

Diabetic striatopathy is a rare and life-threatening manifestation of diabetes mellitus. The disease commonly affects individuals of Asian descent, females, and the elderly. Patients usually present with hemiballism-hemichorea caused by nonketotic hyperglycemia. Hemiballism-hemichorea is defined as involuntary continuous random appearing movement involving one side of the body. This movement disorder may develop secondary to stroke, diabetic striatopathy, neoplasm, infection, Wilson's disease, and thyrotoxicosis. Despite being rare, prompt recognition of a hyperglycemia-induced hemiballism-hemichorea is essential because the symptoms are reversible with correction of hyperglycemia. Diagnosis is possible based on blood analysis and neuroimaging findings. Laboratory tests reveal raised blood glucose and hemoglobin A1C levels which indicate poorly controlled diabetes. Neuroimaging provides suggestive findings of diabetic striatopathy which are hyperattenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging in the basal ganglia. In this case report, our aim is to present neuroimaging findings in an adult man with sudden onset of hemiballism associated with nonketotic hyperglycemia.

Sürmeli-Döven S, Delibaş A, Gürses İ, Kayacan UR, Coşkun-Yılmaz B, Esen K, Korkmaz E, Özaltın F. Hemolytic uremic syndrome and IgA nephropathy in a child: Coincidence or not? Turk J Pediatr 2018; 60: 81-85. A previously healthy 18-month old boy, presenting with diarrhea, anemia, thrombocytopenia and acute renal failure was admitted to our hospital. Hemolytic uremic syndrome (HUS) was diagnosed with his clinical and laboratory findings. His stool was negative for Shiga toxin producing E. coli (STEC). During follow-up he developed respiratory distress, hypertrophic cardiomyopathy and seizure. His genetic tests for atypical HUS (aHUS) were negative. His clinical and histological findings indicated hemolytic uremic syndrome and immunglobulin A nephropathy (IgAN). The patient responded to steroid treatment and plasma exchange therapy with peritoneal dialysis. We discuss the probable connection between HUS and IgAN.

Visualization of the abducens nerve in its petroclival segment still remains challenging. We aimed to investigate the detectability of the petroclival segment of the abducens nerve and to evaluate the role of the size of the petroclival venous confluence (PVC) in the visibility of the nerve using contrast-enhanced fast imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI). We retrospectively evaluated the contrast-enhanced FIESTA images of 237 patients (female/male: 127/110; mean age: 49.0 ± 14.7). Two radiologists divided the imaging findings of the petroclival segments of the abducens nerves into three groups: 0 (not visualized), 1 (partially visualized), and 2 (completely visualized). Another radiologist measured the anteroposterior diameter of the PVC from the clival bony surface to the inner layer of dura at the dural entrance level of the abducens nerve. One-way analysis of variance, Tukey’s test, and receiving operating curve analysis were performed. Among 474 abducens nerves, 76 were classified as group 0 (76/474, 16.03 %), 100 were classified as group 1 (100/474, 21.10 %), and 298 were classified as group 2 (298/474, 62.87 %). There was significant difference in mean anteroposterior diameters of the PVC for each group (group 0, 0.95 mm; group 1, 1.80 mm; group 2, 2.51 mm). The cut-off values for the differentiation of group 0 from group 1 and group 1 from group 2 were found to be 1.35 and 2.09 mm, respectively. Abducens nerve in its petroclival segment can be reliably identified using contrast-enhanced FIESTA MRI especially in those with a greater anteroposterior diameter of the PVC.