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Item Behavioral functioning of school-aged children with non-syndromic craniosynostosis(SPRINGER, 2020-01-01) Zeytinoglu-Saydam, Senem; Ozek, M. Memet; Marcus, Justin; Crerand, CanicePurpose This study investigated the risk for children with non-syndromic craniosynostosis to develop behavioral problems during school age determined by the type of craniosynostisis, age at first surgery, and number of surgeries. Method Final sample consisted of 43 children aged between 6 years and 8 months and 17 years and 1 month (M = 10 years and 5 months). Behavioral problems were assessed with Child Behavioral Checklist (CBCL). Results Our sample had higher scores on the CBCL than the general populationItem Current Clinical Practice About Pediatric Midline Gliomas in the Scope of Molecular Era(TURKISH NEUROSURGICAL SOC, 2020-01-01) Tanrikulu, Bahattin; Ozek, M. MemetAIM: To share our clinical experience with surgical and adjuvant treatment strategies followed during the treatment of midline gliomas. MATERIAL and METHODS: Pediatric patients with midline gliomas who underwent surgery in our clinic between March 2016 and November 2019 were included. Tissue samples were obtained through surgical excision, open biopsy, or stereotactic biopsy. All samples were analyzed for ATRX, BRAFV600E, IDH1/2, H3K27M, and H3G34R mutations, EGFR and PGFRA amplifications, and PTEN loss. RESULTS: There were 7 (43.8\%) female and 9 (56.2\%) male pediatric patients in the study. Eight patients had thalamic, 5 patients had pontine, 2 patients had medulla oblongata and one patient had brachium pontis tumors. Presenting symptoms were headache, disequilibrium, ophthalmoplegia, and panic attack. Eleven tumors showed H3K27M mutation and were diagnosed as diffuse midline gliomas. BRAFV600E, ATRX mutations, PTEN loss, and EGFR amplifications were other molecular alterations detected within tumor samples. Patients with H3K27M mutant tumors had a shorter life span. Five patients were enrolled in an ONC201 trial. CONCLUSION: Although most midline gliomas are not amenable to gross total excision, obtaining tissue samples is mandatory for determining patients' exact diagnoses, tailored treatment plans, and eligibility for clinical trials. Stereotactic biopsy for midline gliomas is a safe and effective method.Item Changes in Callosal Angle After Successful Endoscopic Third Ventriculostomy Procedure in Pediatric Patients(TURKISH NEUROSURGICAL SOC, 2020-01-01) Tanrikulu, Bahattin; Ozek, M. MemetAIM: To determine whether callosal angle (CA) measurement, a diagnostic and prognostic tool used for normal-pressure hydrocephalus in adults, is a reliable radiological parameter for evaluating endoscopic third ventriculostomy (ETV) outcomes in pediatric patients. MATERIAL and METHODS: Forty-seven pediatric patients with hydrocephalus who underwent successful EN in our clinic between 2011 and 2015 were included in this study. Preoperative and postoperative three-month CA, lateral ventricle frontal horn (LVFH) width, Evans' index (El), and frontal-occipital horn ratio (FOR) parameters were recorded, with changes analyzed using a paired-samples t-test. RESULTS: There were 29 male and 18 female patients included within the cohort. For mean preoperative values, LVFH width was 58.8 +/- 14.9 mm, El was 0.43 +/- 0.09, FOR was 0.51 +/- 0.74, and CA was 78.5 degrees +/- 36.4 degrees. Separately, for mean postoperative values, LVFH width was 54 +/- 14.2 mm, El was 0.39 +/- 0.09, FOR was 0.47 +/- 0.07, and CA was 104.5 degrees +/- 32.6 degrees. The CA was increased and the LVFH width, El, and FOR were decreased in all patients within three months after surgery. The postoperative three-month change in CA was higher than those observed in the other parameters. CONCLUSION: Changes in CA after successful EN were dramatically higher than those in the other ventricular parameters. For this reason, we suggest CA be used as a radiological criterion during early radiological follow-up of patients after ETV.Item Surgical Results of Pediatric Patients with Hamartoma(KARE PUBL, 2020-01-01) Tanrikulu, Bahattin; Ozek, M. MemetObjectives: Hypothalamic hamartomas (HH) are congenital lesions present with gelastic seizures and precocious puberty. Disconnective surgery is a safe and effective treatment method in patients with HH. In this study, we aim to share demographic information, presenting symptoms, surgical complications and surgical outcomes in pediatric patients with HH who were operated in our clinic. Methods: In this retrospective study, 12 pediatric patients with HH, who were operated in Acibadem University, School of Medicine, Department of Neurosurgery, Division of Pediatric Neurosurgery and Epilepsy Surgery Clinic between years 2007-2018 were included. All clinical materials, including patient notes, cranial magnetic resonance imaging, electroencephalogram recordings and endocrinological data of patients, were collected. Variables evaluated in the statistical analysis were age, sex, presenting symptom, radiological appearance, treatment outcome. Surgical outcome was evaluated by the Engel classification system. Statistical analysis was performed using SPSS 20.0 software. Results:There were eight (66.7) males and four (33.3\%) females within the patient cohort. Median age at the time of diagnosis was 3.1 years (4 months-6 years). Median follow-up period was 98.3 months (24-177 months). Presenting symptoms were gelastic seizures in six (50\%) patients, precocious pu-berty in three (25\%) patients and both gelastic seizures and precocious puberty in three patients. All patients had disconnective surgery for HH. None of the patients had a postoperative neurological deficit. The seizure outcome in seven (77\%) of the nine patients with seizure were Engel class 1 after the surgery. Signs and symptoms of precocious puberty persist after surgery in three (50\%) of six patients who had presented with precocious puberty in the preoperative period. There was no statistically significant relationship between age, sex and type of HH (p 0.05). There was also no significant relationship between the type of HH and presenting symptom, operation route or treatment outcome (p>0.05). Conclusion: Disconnective surgery is a safe and effective treatment method in pediatric patients with HH. Since most of the patients presents with seizures and/or endocrinological problems, thorough preoperative and postoperative neurological and endocrinological follow-up is recommended.