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    Instant and early efficacy of gamma knife treatment on trigeminal neuralgia
    (Kare Publishing, 2018) Altınok, Ayşe; Karancı, Türker; Özbek, Arif; Albayrak, Serdar Baki
    OBJECTIVE Trigeminal neuralgia (TN) is a common craniofacial pain syndrome manifested by the episodes of severe lancinating pain along the sensory region of the trigeminal nerve. Vascular compression theory has been postulated as the main cause of TN in the root entry zone of the trigeminal nerve. Microvascular decompression surgery is the most effective surgical option for the treatment of TN. Gamma knife surgery (GKS) is a minimally invasive treatment for drug-resistant trigeminal neuralgia (TN). We aimed to investigate the instant and early pain relief in 12 consecutive patients. METHODS This clinical study was conducted at the Department of Radiation Oncology, Medipol University, Turkey. The patient population consisted of 12 consecutive patients having medically refractory TN, with a median age of 60.5 (ranging from 50 to 77 years). Patients underwent GKS between March and January 2016, using the Gamma Knife Perfexion Model. A single 4 mm isocenter was positioned in the cisternal portion of the trigeminal nerve, and the mean maximum dose of 65 Gy (60-70 Gy) was delivered. RESULTS Satisfactory pain relief without any major complications was evident in all patients. The pain relief started after 1 hour to 3 days following the gamma knife procedure. CONCLUSION As a novel contribution to the relevant literature, instant and early pain relief was evident in all patients. In this context, a randomized prospective clinical trial with a larger patient population is necessary to optimize the instant and early efficacy of GKS in the treatment of TN.
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    Persistent sciatalgia due to a wandering bipolar forceps tip after posterior lumbar stabilization: A case report
    (Georg Thıeme Verlag Kg, 2016) Gömleksiz, Cengiz; Tokmak, Mehmet; Yaka, Umut; Arslan, Erhan; Özbek, Muhammed Arif; Albayrak, Serdar Baki
    There are several reports in the literature about the retained surgical materials as a cause of radicular pain or sensory impairment after spinal surgery. We report a patient with a persistent radicular pain in the distribution of left S1 nerve dermatome following lumbar stabilization surgery. Retained bipolar forceps tip has not been reported previously in the literature as a cause of sciatalgia after posterior lumbar surgery.
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    Revisiting a historical phenomenon: Myodil droplets in the subarachnoid space
    (Medknow Publications & Media Pvt Ltd, 2018) Ertan, Gülhan; Ulus, Sıla; Albayrak, Serdar Baki; Cila, Ayşenur
    Myodil (iodophenylundecylic acid, a fatty acid) is an oil-based positive contrast media that has been widely used in myelography, ventriculography, and cisternography. [1] However, the use of oil-based contrast agents has been stopped long ago because of the potentially severe complications arising from their usage, including arachnoiditis and anaphylaxis. Thus, images of remnant material of intradural oil-based contrast are rarely encountered nowadays. We present a patient in whom incidentally detected myodil remnants were seen on computed tomography (CT). Additionally, we obtained and present the follow-up CT and magnetic resonance images (MRI) of this patient.
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    The axon protective effects of syringic acid on ischemia/ereperfusion injury in a rat sciatic nerve model
    (Turkish Neurosurgical Society, 2017) Tokmak, Mehmet; Şehitoğlu, Müserref Hilal; Yüksel, Yasemin; Güven, Mustafa; Akman, Tarık; Aras, Adem Bozkurt; Yaka, Umut; Gömleksiz, Cengiz; Albayrak, Serdar Baki; Coşar, Murat
    AIM: In the relevant literature, there is no experimental study that investigated the axon protective effects of syringic acid- a polyphenol compound- with an anti-oxidant capacity on ischemia/reperfusion injury. MATERIAL and METHODS: The rats were randomly divided into four groups: Control group (no medication or surgical procedure), Sham group, Syringic acid group, and Methyprednisolone (MP) Group. lschemia was achieved by abdominal aorta clamping and all animals were sacrificed 24 hours after ischemia. Harvested sciatic nerve segments were investigated histopathologically and for tissue biochemistry. RESULTS: lschemic fiber degeneration scores were found significantly lower in syringic acid and MP groups than sham group. Additionally, apoptosis-related cysteine peptidase caspase-3 immunostaining scores were lower in syringic acid and MP groups. Biochemically, superoxide dismutase and nuclear respiratory factor 1 values were significantly higher in syringic acid group compared to those of control and sham groups while malondialdehyde levels were significantly lower in the syringic acid group. CONCLUSION: Syringic acid reduces oxidative stress and axonal degeneration in rat sciatic nerve after ischemia/reperfusion injury. Therefore, syringic acid may play a role in the treatment of peripheral nerve injuries due to ischemia/reperfusion.
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    Topical application of cyclosporine reduces epineurial fibrosis: Gross post-surgical, histopathological and ultrastructural analysis in a rat sciatic nerve model
    (Turkish Neurosurgical Soc, 2017) Çetinalp, Nuri Eralp; Albayrak, Serdar Baki; İsmailoğlu, Özgür; Temiz, Nail Çağlar; Solmaz, İlker; Tanrıöver, Gamze; Demir, Necdet
    AIM: To investigate the anti-scarring potential of topical cyclosporine on rat sciatic nerves. MATERIAL and METHODS: Both sciatic nerves were exposed in 24 adult male albino Wistar rats, and an abrasion injury was made on the biceps femoris close to the sciatic nerve. Cotton pads soaked with cyclosporine (5 mg/mL) and saline (0.9% NaCl) were placed around the nerves for 10 minutes in the experimental group and control group, respectively. All rats were sacrificed 8 weeks later and the sciatic nerves were examined. Epineurial adhesions were assessed using light and electron microscopy. Quantitative histological parameters, epineurial thickness, and scar density were evaluated in the histological investigation. RESULTS: Significantly fewer epineurial adhesions were observed in the cyclosporine group in the post-surgical assessment, and the histopathological and ultrastructural examinations of the nerve segments than in the controls. The cyclosporine- treated animals had a statistically significant reduction in the density and quantity of epineurial scarring compared with the controls. CONCLUSION: Topical cyclosporine effectively reduces epineurial scar formation on rat sciatic nerves.