[Giant desmoid tumor in the neck]. / Boyunda dev desmoid tümör.

Desmoid tumor is a benign tumor which originates from musculoaponeurotic system, can reach greater sizes with local invasion among facial plans, and cause severe deformities, morbidity and even mortality by compression of adjacent structures. These tumors are rarely seen in the head and neck region. The treatment of advanced desmoid tumors of head and neck region is surgery and radiotherapy. In this paper, we present -to the best of our knowledge- the greatest desmoid tumor case of the head and neck region in the literature.

Brain perfusion MRI findings in patients with Behcet's disease.

OBJECTIVE: To search brain perfusion MRI (pMRI) changes in Behcet's disease (BD) with or without neurological involvement. MATERIALS AND METHOD: The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). RESULTS: There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. CONCLUSION: Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings.

Effects of contrast material on the metabolite ratios in single-voxel MR Spectroscopy of intraaxial brain tumors.

AIM: The purpose of our study was to determine whether the administration of contrast material affects the results of MR Spectroscopy (MRS) in different intraaxial brain tumors. MATERIALS AND METHODS: Thirty-three patients (median range 46.72 ± 2.95, range 9-77) with intraaxial brain tumors underwent MRS before and 5 min after intravenous administration of gadolinium based contrast material at the standard dose of 0.1 mmol/kg (Gadodiamide or Gd-DOTA). Metabolite ratios (N-acetyl aspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, and NAA/Cho) were calculated. RESULTS: There was no significant difference between the pre and postcontrast MRS spectra as regards to NAA/Cr (p:0.4), Cho/Cr (p:0.2), and NAA/Cho (p:0.2) ratios obtained from the intraaxial brain tumors. CONCLUSION: Contrast material administration did not change the metabolite ratios of MRS. Contrast administration would be useful in guiding voxel localization in MRS evaluation of intraaxial brain tumors.

Malignant intracerebral giant nerve sheath tumor in a 14-month-old girl with neurofibromatosis type 1: a case report.

INTRODUCTION: Malignant intracerebral nerve sheath tumor (MINST) is extremely rare and the origin is still unclear. The authors present the clinical, radiological, and pathological features of a malignant intracerebral giant nerve sheath tumor. CASE REPORT: A giant tumor in the right frontotemporoparietal lobes causing a midline shift was detected in a 14-month-old girl who presented with developmental delay, vomiting, and lethargy. The physical examination was consistent with neurofibromatosis type 1 (NF-1). Subtotal resection was performed and the histopathological examination revealed the diagnosis of MINST. DISCUSSION: There are only six cases of malignant intracerebral nerve sheath tumor in the literature. The presented case is the youngest and the occurrence of MINST in a 14-month-old girl may support the hypothesis of multipotent mesenchymal stem cell origin; however, the tumors which arise from multipotent mesenchymal stem cells may be seen in later stages of life. Another important feature of the presented case is the occurrence of MINST in NF-1. CONCLUSION: MINSTs are extremely rare tumors with unknown origin. The location, the degree, and the size of the tumor and the general condition of the patient are prognostic factors in MINSTs, like in other malignant tumors.

Ultrastructure protection and attenuation of lipid peroxidation after blockade of presynaptic release of glutamate by lamotrigine in experimental spinal cord injury.

OBJECT: Lamotrigine is an antiepileptic drug that inhibits presynaptic voltage-gated sodium channels and reduces the presynaptic release of glutamate in pathological states. Neuroprotective effects of this drug have already been demonstrated in cerebral ischemia models. The aim of the present study was to determine the effects of presynaptic glutamate release inhibition on experimental spinal cord injury (SCI). METHODS: A total of 66 adult Wistar rats were randomly allocated into 6 groups. Group I was the control group used to obtain normal blood samples and spinal cord specimens. Spinal cord injury was introduced by using the extradural clip compression technique, but no medication was given to Group II (trauma group) rats. Group III was treated with vehicle, and the same amount of dimethyl sulfoxide used in treatment groups was administered to these rats. A dose of 50 mg/kg lamotrigine was administered intraperitoneally to Group IV (pretreatment), Group V (peritreatment), and Group VI (posttreatment) rats 30 minutes before, during, and 30 minutes after SCI, respectively. Oxidative stress parameters and transmission electron microscopic findings were examined. RESULTS: Blockade of presynaptic release of glutamate by lamotrigine treatment yielded protective effects on the spinal cord ultrastructure even when administered after the SCI, but it prevented oxidative stress only when it was administered before or during the SCI. CONCLUSIONS: Currently, no available agent has been identified, that can block all the glutamate receptors at the same time. To prevent excitotoxicity in SCI, inhibiting glutamate release from the presynaptic buttons instead of blocking the postsynaptic glutamate receptors seems to be a more rational approach. Further research, such as neurobehavioral assessment, is warranted to demonstrate the probable neuroprotective effects of presynaptic glutamate release inhibition in SCI.

Epidural air entrapment after spinal surgery.

A case which had developed neurological complication because of compression due to air trapping in the epidural space after spinal surgery is presented with its clinical and radiological findings. Nitrous oxide can easily diffuse into the air-filled spaces in the body from the bloodstream and also increases the pressure of the air in the closed spaces. After the L4-5 discectomy procedure, weakness in dorsal flexion was occurred on the contra lateral leg. The patient was evaluated urgently with radiological examinations. Postoperative radiological findings showed air compression between L3 and L5 levels which occupied the epidural space. The surgical approach was not considered. Following the resolution of the air in the epidural space, neurological deficit was progressively improved. In order to prevent neurologic complication due to air trapping in spinal surgery, avoidance of using nitrous oxide and also irrigation of the surgical field with isotonic fluid is recommended.

Dorsolumbar junction spinal tuberculosis in an infant: case report.

The treatment of spinal tuberculosis is a challenging and controversial problem. The authors present the rare case of an 8-month-old infant with dorsolumbar junction tuberculosis. The child did not sit or stand and a hump was noted on his back. Radiological evaluations demonstrated destruction by a tuberculous abscess of the T-12 and L-1 vertebral bodies, extending into the psoas muscles and spinal canal. In addition to medical therapy, radical debridement and grafting were performed via an anterolateral approach. The follow-up period was 2 years. The difficulties in the management of spinal tuberculosis in infants are discussed.