Browsing by Author "Berkman, Mehmet Zafer"

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Intraoperative Neurophysiological Monitoring to Prevent New Neurological Deficits in Spinal Tumor Cases
(TURKISH NEUROLOGICAL SOC, 2014-01-01) Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Silav, Gokalp; Berkman, Mehmet Zafer; Elmaci, Ilhan; Ozgen, Serdar
Objective: Intraoperative neurophysiological monitoring was carried out in patients with spinal cord tumors. These patients were retrospectively evaluated for new postoperative neurological deficits. Materials and Methods: A total of 32 spinal tumor cases (8 cervical, 14 thoracic, 10 lumbosacral), 17 male and 15 female, patients between 2-66 years of age (mean 44.1 +/- 20) operated in our center were evaluated. All of our cases were monitored with somatosensory evoked potentials (SEP) muscular motor evoked potentials (MEP) and free run electromyography. Spinal MEP (D wave), bulbocavernosus reflex (BCR) and pudendal SEP were obtained in appropriate cases. Results: Five cases presented with temporary new postoperative neurological deficits in the form of strength loss. Neurophysiological recordings of all of these patients showed either temporary or permanent deterioration during surgery. The tumor was removed completely or almost completely in 26, near-completely in 4 and partially in 2 cases and none of our cases had a new permanent deficit. Conclusion: The functional integrity of the lateral and dorsal columns of the spine can be assessed by SEP and muscular MEP recording. Additional information about the neurological tissue is given by spinal MEP, BCR and pudendal SEP in suitable cases. We did not experience any false positive or negative results in our cases and we believe that the combined use of intraoperative spinal and MEP in spinal column located tumors gives reliable information about postoperative neurological outcome.
Prognostic Factors in Patients who Underwent Aneurysmal Clipping due to Spontaneous Subarachnoid Hemorrhage
(TURKISH NEUROSURGICAL SOC, 2016-01-01) Orakdogen, Metin; Emon, Selin Tural; Somay, Hakan; Engin, Taner; Ates, Ozkan; Berkman, Mehmet Zafer
AIM: Despite technical and medical advances, aneurysmal subarachnoid hemorrhages (SAH) continue to be a challenging pathology, associated with high rates of morbidity and mortality. In this regard, a definition is required of the various prognostic indicators of an SAH. The aim of the present retrospective study is to examine the various prognostic factors of the clinical outcomes of the patients who underwent a neurosurgical clipping of aneurysms due to aneurysmal SAH. MATERIAL and METHODS: The data of 104 patients that had suffered an aneurysmal SAH were analyzed. The baseline demographic, clinical and radiological data were all analyzed. The prognostic study was derived from an analysis of these variables. Relationship between prognostic factors and outcome was evaluated by univariate and logistic multivariate regression analysis. RESULTS: This study has identified unfavorable outcomes on the Glasgow Outcome Scale at discharge after the surgical treatment of aneurysmal SAH associated with increased age, poor World Federation of Neurosurgical Societies (WFNS) grade on admission, higher Fisher's grade on admission computed tomography scan, larger aneurysm, and clinical vasospasm. In a multivariate logistic regression analysis, age, high WFNS grade, positive clinical vasospasm and size of aneurysm were found to be independent risk factors for mortality. The presence of hydrocephalus, number of aneurysms, positive risk factors, and the presence of Doppler vasospasm did not reach statistical significance. CONCLUSION: The most important prognostic factors in patients undergoing surgery due to aneurysmal subarachnoid hemorrhage were WFNS grade, age, size of aneurysm and clinical vasospasm.