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Item The Effect of Quetiapine on Treatment of Experimental Acute Spinal Cord Injury(TURKISH NEUROSURGICAL SOC, 2018-01-01) Aytar, Murat Hamit; Civi, Soner; Kaymaz, Memduh; Ergun, Ertan; Kaymaz, Fevziye Figen; Pasaoglu, AydinAIM: It is well known that treatment modalities against secondary damage due to spinal cord injury (SCI) are very important. This phase has been researched in many experimental studies. Apoptosis is one of the major mechanisms of secondary damage on spinal cord. The present study was undertaken to determine if quetiapine, a 5-HT2 receptor blocker atypical antipsychotic agent can rescue neuronal cells from apoptosis in a SCI model. MATERIAL and METHODS: Thirty-two female Wistar rats were separated to 4 equal groups. Total laminectomy was performed at T5-7 level and spinal cord injury was produced by using the clip compression technique. Each rat from groups ``1 day{''} (D-I) and ``7 days{''} (D-II) was daily injected intraperitoneally with Quetiapine (10 mg/kg/day). No treatment was administered to the control groups ``1 day{''} (K-I) and ``7 days{''} (K-II). At the end of follow-up periods, all animals were sacrificed and spinal cords were removed. Apoptotic cells were evaluated by using immunohistochemical technique (TUNEL) in injured spinal cord specimens. RESULTS: There was a statistically significant difference while counting ApopTag positive cells, both at 1 day groups of K-I and D-I (p=0.00000008) and at 7 day groups of K-II and D-II (p=0.000005). Unlike the 1-day period, a statistically significant difference was found between grey and white matter ApopTag positive cells at the 7th day (p=0.0001). CONCLUSION: Quetiapine has a protective effect on secondary damage caused by SCI, while also can be used in post-traumatic stress disorder, depression and agitation as a versatile agent.Item Purely extradural spinal nerve root hemangioblastomas(MEDKNOW PUBLICATIONS \& MEDIA PVT LTD, 2016-01-01) Aytar, Murat Hamit; Yener, Ulas; Eksi, Murat Sakir; Kaya, Behram; Ozgen, Serdar; Sav, Aydin; Alanay, AhmetSpinal nerve root hemangioblastomas present mostly as intradural-extradurally. Purely extradural spinal nerve root hemangioblastoma is a very rare entity. In this study, we aimed to analyze epidemiological perspectives of purely extradural spinal nerve root hemangioblastomas presented in English medical literature in addition to our own exemplary case. PubMed/MEDLINE was searched using the terms ``hemangioblastoma,{''} ``extradural,{''} ``spinal,{''} and ``nerve root.{''} Demographical variables of age, gender, concomitant presence of von Hippel-Lindau (VHL) diseaseItem Open-door Laminoplasty with Preservation of Muscle Attachments of C2 and C7 for Cervical Spondylotic Myelopathy: Retrospective Study(TURKISH NEUROSURGICAL SOC, 2018-01-01) Secer, Halil Ibrahim; Harman, Ferhat; Aytar, Murat Hamit; Kahraman, SerdarAIM: Some restriction and complications, such as progression of kyphosis, incidence of axial neck pain and decrease of postoperative cervical range of motion are concern. We designed this retrospective clinical study to evaluate the effect of laminoplasty by preserving the muscle attachments of C2 and C7 spinous processes on range of motion (ROM), axial neck pain and cervical lordosis. MATERIAL and METHODS: Twenty-seven cases with cervical spondylotic myelopathy underwent open-door laminoplasty with the protection of muscle attachments to the C2 and C7 spinous process and laminae between 2007 and 2013. At the end of the follow-up, cases were evaluated with preoperative and postoperative modified Japanese Orthopedic Association (mJOA) scores, recovery rate, ROM, lordosis angle and visual analogue scale (VAS). Also, patients were divided into two groups and evaluated according to the magnetic resonance imaging (MRI) findings, with or without T2 signal change. RESULTS: The mean age of the patients was 66 years. The mean follow-up duration was 25 months. The postoperative mJOA scores were significantly higher than the preoperative mJOA scores (p<0.001). The recovery rate was 57.4\%. Although the postoperative VAS score was higher than the preoperative VAS score and the mean postoperative ROM was lower than the preoperative ROM there was no significant difference between preoperative and postoperative VAS score and ROM (p>0.05). The postoperative lordosis angle was significantly lower than the preoperative lordosis angle (p<0.05). There were no significant differences regarding the postoperative lordosis angle, ROM and mJOA scores with or without T2 signal change on MRI. CONCLUSION: Protection of the anatomic structures around the cervical spine such as the muscles and ligaments provides us better results regarding ROM and cervical axial pain.Item Usefulness of End-to-Side Bridging Anastomosis of Sural Nerve to Tibial Nerve : An Experimental Research(KOREAN NEUROSURGICAL SOC, 2017-01-01) Civi, Soner; Durdag, Emre; Aytar, Murat Hamit; Kardes, Ozgur; Kaymaz, Figen; Aykol, SukruObjective : Repair of sensorial nerve defect is an important issue on peripheric nerve surgery. The aim of the present study was to determine the effects of sensory-motor nerve bridging on the denervated dermatomal area, in rats with sensory nerve defects, using a neural cell adhesion molecule (NCAM). Methods : We compared the efficacy of end-to-side (ETS) coaptation of the tibial nerve for sural nerve defect repair, in 32 Sprague-Dawley rats. Rats were assigned to 1 of 4 groups : group A was the sham operated group, group B rats had sural nerves sectioned and buried in neighboring muscles, group C experienced nerve sectioning and end-to-end (ETE) anastomosis, and group D had sural nerves sectioned and ETS anastomosis was performed using atibial nerve bridge. Neurological evaluation included the skin pinch test and histological evaluation was performed by assessing NCAM expression in nerve terminals. Results : Rats in the denervated group yielded negative results for the skin pinch tests, while animals in the surgical intervention groups (group C and D) demonstrated positive results. As predicted, there were no positively stained skin specimens in the denervated group (group B)Item A Rare Case of Paraneoplastic Limbic Encephalitis leading to Epileptic Seizure in a Patient with Ovarian Carcinoma(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022-01-01) Aytar, Murat Hamit; Kilickan, Levent; Ustun, Cemal; Akkilic, Elvan CevizciParaneoplastic limbic encephalitis (PLE), a rare and diagnostically-challenging encephalopathy, is frequently associated with an underlying malign neoplastic tumor. Epileptic symptoms are uncommon but can be the first sign of the disease. We present a patient admitted to our intensive care unit (ICU) unit with epileptic seizure and a Glasgow Coma Scale (GCS) of six. All tests and investigations that had been utilized for this patient's diagnosis, including blood tests, serological analyses, magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF) test results were evaluated. The patient had been diagnosed with ovarian carcinoma within the last year. The patient's cancer history, her most recent complaints and MRI results were strongly suspicious for paraneoplastic limbic encephalitis. Her neurological condition improved rapidly in a few days with steroid therapy. This case showed that any neurological deterioration based on an ovarian oncologic disease can bring PLE to mind. The possibility of PLE must be taken into consideration in patients presenting with epileptic seizures after neoplastic diagnoses.