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Oligosarcoma is a recently identified entity characterized by sarcomatous changes originating from oligodendroglioma. As of our current understanding, sarcomatous components are infrequent in glial tumors. The World Health Organization (WHO) classification describes sarcomatous features as a rare pattern in grade 3 oligodendrogliomas. In this report, we present a 42-year-old man diagnosed with oligosarcoma. The patient initially presented with a lesion in the right parietotemporal area 9 years ago, and the pathological diagnosis was oligodendroglioma. Nine years later, a recurrent lesion in the same area was observed. Histomorphological evaluation of the recurrent lesion revealed distinct glial and sarcomatous components. The diagnosis of oligosarcoma was made based on histologic assessment; however, additional histochemical (reticulin-rich sarcomatous area), immunohistochemical, and molecular evaluations were also conducted. Immunohistochemical marker expression patterns in oligosarcoma have been reported variably in the literature. In our patient, the sarcomatous component exhibited p53 and OLIG2 immunohistochemical expression. Molecular analysis revealed IDH and TERT mutations, as well as 1p/19q and CDKN2A deletions. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare trace elements (zinc (Zn), iron (Fe) and cadmium (Cd)) in tissue samples of classic meningiomas and glioblastoma multiformes. Methods: This study was performed in the pathologically diagnosed classic meningioma and glioblastoma multiforme specimens (20 specimens in each group and a total of 40 specimens) obtained from operations. Measurements of trace elements were performed with Shimadzu AA 680 atomic absorption spectrophotometer and p<0.05 was considered as statistically significant. Results: The level of iron in classic meningioma specimens was slightly higher than that in glioblastoma multiforme specimens; however it did not reach statistically significant level (p = 0.17). Although the level of cadmium in classic meningioma specimens was slightly higher than that in glioblastoma multiforma specimens; it did not reach statistically significant level (p =0. 35). The level of Zinc in classic meningioma specimens were statistically higher than that in glioblastoma multiforme specimens (p = 0.02). Conclusion: We consider that our findings might have been valuable data for new researches and can contribute to worthwhile information on pathogenesis of meningioma and glioblastoma multiforma. [ABSTRACT FROM AUTHOR]

Aim: To investigate the surgical value of MER recordings and improve surgical technique by demonstrating the consistency between preoperative radiological STN volume and intraoperative neurophysiological STN length., Material and Methods: Sixty-one patients with PD were enrolled. The volumes of the STN were measured using magnetic resonance images 3-dimensional volume reconstructions of stereotactic magnetic resonance images. MER were performed in all patient and the maximal electrophysiologic length of the STN was recorded each patient. In the postoperative period, the permanent electrode was modeled and reconstructed in 3D, and the longest distance traveled in the STN was calculated., Results: A total of 61 patients who underwent surgery between 2012-2022 were included in the study. Thirty-six (59%) of the patients were male, and 25 (41%) were female. A total of 122 STNs were performed with 166 electrodes. The most common end alignment used was center with 86. STN length averaged 4.9 mm (0-10.5 mm). The mean STN volume was 0.11 cm3. The STN Volume of men were significantly higher than women. The STN Length, Volume, and the target MER length showed a positive correlation significantly., Conclusion: With radiological advances, it is possible to better visualize the target points and define the boundaries better, and direct methods can be used more in making targeting plans. MER records obtained during surgery and STN dimensions in presurgical planning show compatibility, and it is seen that there may be differences between the right and left sides because of brain shifting. Although radiology is increasingly providing better support, electrophysiological recordings provides real-time information on the electrodes? locations and give the opportunity to surgical team choosing alternative target.

Aim: To investigate the relationship between clinical features and prognosis of the hippocampal sclerosis (HS) cases and International League Against Epilepsy (ILAE) histopathology classification., Material and Methods: A hundred patients with refractory epilepsy who were operated with the diagnosis of the Mesial Temporal Lobe Epilepsy were included in the study. Socio-demographic characteristics, clinical and family histories, post-operative ILAE and Engel epilepsy scores and diagnostic tests were recorded. At the same time, all of the pathological specimens were classified according to the new semi-quantitative ILAE classification. A significant statistical relationship was investigated between clinical data and HS-ILAE groups., Results: There were 36 male 64 female patients. The mean follow-up period was 6.5 years. 75% of the cases were HS-ILAE type 1, 19% HS-ILAE type 2, 6% were unidentifiable. FCD3A was detected in 3 patients. The HS-ILAE Type 2 ratio was high on the rightsided cases. In addition, HS-ILAE Type 1 ratio was high in patients with early seizure onset and long duration of epilepsy. There was no significant relationship between long-term ILAE and Engel epilepsy outcome scores and HS-ILAE types., Conclusion: Resection of mesiotemporal structures in hippocampal sclerosis provides seizure control in at least two-thirds of cases. Histopathological findings may help us understand the epileptogenicity-prognosis of HS. The relationship between ILAE histopathology classification and clinical factors will become more obvious in the future. According to our study, there was a relationship between onset age of epilepsy, epilepsy duration, lesion side and HS-ILAE types. The reinforcement of these relationships with larger series will benefit clinicians.

Aim: To compare sinonasal complications after microscopic and endoscopic approaches for pituitary adenomas., Material and Methods: At our clinic, sinonasal complications occurred in 31 patients who underwent microscopic transsphenoidal surgery between 2007 and 2014 and in 32 patients who underwent endoscopic transsphenoidal surgery between 2014 and 2016. We statistically compared the complications observed during endoscopic sinonasal examination performed by an otorhinolaryngologist., Results: Sinonasal pathology occurred in 22 of the 31 patients (70.9%) in the microscopy group (Group 1) and 19 of the 32 (59.3%) in the endoscopy group (Group 2). Of the 31 patients in Group 1, 13 had nasal septal perforation, 13 had nasal synechiae, three had anosmia, two had hyposmia and one had saddle nose deformity. In Group 2, no patient had nasal septal perforation, whereas eight had nasal synechiae, one had anosmia, 11 had hyposmia, and 4 had infection., Conclusion: There were no statistically significant differences in sinonasal complications (e.g. synechiae, anosmia, deformity, and sinusitis) between the two groups. Although the perforation rate (especially for perforations in the middle portion of the septum) was statistically greater in Group 1 than in Group 2, the hyposmia rate was statistically greater in Group 2 than in Group 1.

Background: Surgery is apparently superior to prolonged medical therapy in therapy of efficacy and safety for mesial temporal lobe epilepsies. We ‑ as a new center ‑ presented outcome results and possible outcome predictors of 50 consecutive patients with hippocampal sclerosis underwent resective epilepsy surgery., Methods: Between 2006 and 2011, fifty patients with intractable mesial temporal lobe epilepsy due to hippocampal sclerosis underwent anterior temporal lobectomy and they were followed-up at least 1 year postoperatively. Detailed neuropsychological tests, video-electroencephalography monitoring and magnetic resonance imaging with epilepsy protocol were obtained for all patients. Standard anteromedial temporal lobectomy was performed. Modified Engel and ILAE classifications were used for seizure outcome. All morbidities were recorded. Demographic variables, diagnostic tests and early postoperative outcome were analyzed for possible predictors of the ultimate seizure outcome., Results: Fifty patients were evaluated. The mean follow-up duration was 47,1 month (range, 12-75 months). The favorable outcome at 1 year was 90% and 82% according to Engel and ILAE classifications respectively. These rates were almost same at the end of follow-up period (92% and 82% respectively). The completely seizure free rate at one year was 80% and decreased to 68% at the end of the follow-up. There was no mortality. Morbidity rate was 10% and none of them was permanent. Triple concordance of the noninvasive tests (neuropsychological tests, video- electroencephalography monitoring and magnetic resonance imaging) and favorable seizure outcome at the first year were predictors of the ultimate seizure outcome (P=0.01 and P=0.04 respectively)., Conclusions: Our findings demonstrated that anteromedial temporal lobectomy is a safe and effective treatment method in well-chosen patients with hippocampal sclerosis. This surgical procedure can be performed with a low rate of morbidity even in relatively new epilepsy surgery center.

Objective: The resection of the odontoid process via an extended endoscopic endonasal approach has been recently proposed as an alternative to the microscopic transoral method. We aimed to delineate a minimally invasive endoscopic transnasal odontoidectomy and to describe the endoscopic anatomy of the anterior craniovertebral junction (CVJ)., Materials and Methods: The anterior CVJ of 14 fresh adult cadavers were selectively accessed via a binostril endoscopic endonasal approach using 0- and 30-degree endoscopes., Results: The nasopharynx was widely exposed without removing any of the turbinates and without performing a sphenoidotomy. Occipital condyles and lateral masses of the C1 vertebra have been exposed inferiorly at lateral margins of the exposure, in addition to the foramen lacerum, which came into view at the superolateral corner of the operative field. The anterior arch of C1 and the upper 1.5 cm of the odontoid process of C2 have been removed via a minimally invasive endoscopic transnasal approach in all dissections., Conclusions: We propose the selective odontoidectomy as a minimally invasive method for the endoscopic endonasal removal of the odontoid process. By using this approach, turbinates and the sphenoid sinus remain unharmed. In addition, this approach may be used in exposing pathologies situated laterally at the anterior CVJ, such as the lateral masses of atlas and occipital condyles.

Aim: One of the most important causes of failed back surgery is the development of epidural fibrosis. Many methods and substances have been used to prevent the development of epidural fibrosis after laminectomy. In this study, effects of "manuka honey" on epidural fibrosis development after laminectomy was evaluated in rats., Material and Methods: Subjects were divided into two groups:In Group-1 (n=8);only laminectomy was carried out in the L1 level; in group-2 (n=8), laminectomy was carried out in the L1 level and manuka honey was applied to the area. The related vertebral columns were removed en bloc 6 weeks later. Leveled sections with thicknesses of 6 mm were obtained from paraffin blocks., Results: In the grading made based on the fibroblast count and scar tissue degree, it was found that epidural fibrosis developed significantly less in the group-2 as compared to the group-1, and the difference was statistically significant., Conclusion: It was shown in our study that manuka honey reduces the degree of epidural fibrosis in rats following laminectomy. We believe that manuka honey, which can be used safely in the clinic for surgical wounds, can be used routinely to prevent development of epidural fibrosis following laminectomy.

Aim: Implant-related infections are still a significant problem in spinal surgical procedures. Many drugs and methods have been tried to prevent implant-related infections. Our objective in this study was to evaluate whether royal jelly, which was found to hinder the growth of MRSA, has any preventive role in the prognosis of an infection in rats in an implant-related infection model., Material and Methods: Rats were divided into 3 groups of eight rats. Group-1 consisted of rats that underwent only a spinal implant, group-2 included those rats that were inoculated bacteria together with a spinal implant and group-3 was administered royal jelly in addition to a spinal implant and infection., Results: The amount of bacteria that grew in vertebral columns and implants was more in Group-2 than in Group-3, which meant that the number of bacteria colonies that grew was more quantitatively. This difference was found to be statistically significant in vertebral columns, but not in implants., Conclusion: Royal jelly could not fully prevent the MRSA infection in this model, but decreased the severity of infection noticeably. More objective and promising results may be obtained if royal jelly can be used at regular intervals in a different model to be designed with respect to implant-related infections.

Background: Chronic subdural hematomas are the most common type of intracranial hemorrhage among the elderly. There is a substantial recurrence rate after evacuation by burr-hole surgery. In this study, we aimed to determine the predictors of recurrence after single burr-hole evacuation of chronic subdural hematomas., Methods: We retrospectively analyzed 292 consecutive patients with chronic subdural hematoma. Clinical parameters, anamnesis, and previous anticoagulant drug use have been evaluated with univariate and multivariate analyses to determine predictors associated with recurrence., Results: At least a second surgery was needed in 43 of 292 (14.7%) patients. We showed that recurrence rate was significantly higher in patients with bilateral subdural hematoma, after univariate and multivariate analyses (23.1% versus 11.4%). We did not find any significant relationship between recurrence rate and age, gender, hypertension, and/or diabetes mellitus in anamnesis, preceding head trauma, and time interval between trauma and the operation, previous anticoagulant, and/or antiaggregant therapy., Conclusion: After analysis of all evaluated factors, only bilateral hematoma was found correlated with high recurrence rate (p = 0.01), probably due to previous brain atrophy or existing coagulopathy., (Georg Thieme Verlag KG Stuttgart · New York.)

Aim: Glioblastoma is the most common and highest-grade infiltrative astrocytoma. It is usually associated with a bad prognosis. Histological grading is highly predictive of an aggressive behavior, with a mean survival rate of 1 year. Nonetheless, individual patient survival can vary substantially, ranging from 1 month to over 5 years. Several distinct clinical parameters and molecular alterations have recently been described in glioblastoma. The present study compares clinical, radiologic and therapeutic parameters in a series of glioblastomas to identify prognostic factors., Material and Methods: We evaluated 50 cases who were operated on for intracranial glioblastoma between January 1998-March 2004 retrospectively. All clinical records, radiological records and management modalities were evaluated as prognostic value., Results: The mean survival time was 7.5 months (range, 1-18 months). We confirmed the patients' age, gender, Karnofsky Performance Scale score at discharge, postoperative radiotherapy and reoperation as decisive prognostic factors after multivariate analyses., Conclusion: We could show that some clinical parameters and treatment modalities were associated with prognosis. Younger age, male gender, higher Karnofsky Performance Score at discharge, total surgical resection, radiotherapy and reoperation were predictor for better prognosis.