Türe, U. | Harput, M.V.

Note | 2019 | Operative Neurosurgery17 ( 2 )

[No abstract available]

Harput, M.V. | Türe, U.

Article | 2018 | Operative Neurosurgery14 ( 4 )

[No abstract available]

Lafazanos, S. | Türe, U. | Harput, M.V. | Gonzalez Lopez, P. | Firat, Z. | Türe, H. | Yaşargil, M.G.

Review | 2015 | World Neurosurgery83 ( 5 ) , pp.836 - 841

Objective A challenging step of the paramedian supracerebellar-transtentorial approach is to expose the anterior portion of the mediobasal-temporal region (MTR), a step that seems most affected by the steepness of the tentorium. The objective of this study was to define magnetic resonance imaging measurements that can predict the level of challenge in exposing the anterior portion of the MTR. Methods Cranial magnetic resonance imaging studies of 100 healthy individuals were examined. The tentorial and occipital angles were measured, and the amount of brain tissue that remained hidden on the microscopic view in front of the petrous a . . .pex was indirectly estimated. These measurements were statistically compared with the cephalic index of each person. Results The mean values for the tentorial and occipital angles were 42° (range 25°-53°) and 98° (range 69°-122°), respectively. The results proved that the higher the tentorial angle, the higher the occipital angle and the greater the amount of hidden brain tissue. Of 100 persons, 3 (3%) were found to be dolichocephalic, 23 (23%) were mesocephalic, and 74 (74%) were brachycephalic. Statistical analysis proved that individuals with a dolichocephalic cranial shape have lower tentorial and occipital angles. Conclusions The results provide strong evidence proving that the lesser the tentorial and occipital angles, the easier the exposure of the anterior portion of the MTR during the paramedian supracerebellar-transtentorial approach. The tendency of the cranial shape toward dolichocephaly seems to have the same practical value in choosing the approach. It is easier to expose the anterior portion of the MTR in these individuals. © 2015 Elsevier Inc. All rights reserved Daha fazlası Daha az

Bayrak, Ö.F. | Gulluoglu, S. | Aydemir, E. | Türe, U.

Letter | 2013 | Journal of Neurosurgery118 ( 4 ) , pp.836 - 841

[No abstract available]

Serra, C. | Türe, U. | Krayenbühl, N. | Şengül, G. | Yaşargil, D.C.H. | Yaşargil, M.G.

Article | 2017 | World Neurosurgery97 , pp.438 - 452

Objective To describe the topographic anatomy of surgically accessible surfaces of the human thalamus as a guide to surgical exploration of this sensitive area. Methods Using the operating microscope, we applied the fiber microdissection technique to study 10 brain specimens. Step-by-step dissections in superior-inferior, medial-lateral, and posterior-anterior directions were conducted to expose the surfaces and nuclei of the thalamus and to investigate the relevant anatomic relationships and visible connections. Results There were 4 distinct free surfaces of the thalamus identified: lateral ventricle surface, velar surface, cistern . . .al surface, and third ventricle surface. Each is described with reference to recognizable anatomic landmarks and to the underlying thalamic nuclei. The neural structures most commonly encountered during the surgical approach to each individual surface are highlighted and described. Conclusions Observations from this study supplement current knowledge, advancing the capabilities to define the exact topographic location of thalamic lesions. This improved understanding of anatomy is valuable when designing the most appropriate and least traumatic surgical approach to thalamic lesions. These proposed surface divisions, based on recognizable anatomic landmarks, can provide more reliable surgical orientation. © 2016 Elsevier Inc Daha fazlası Daha az

Kadri, P.S. | De Oliveira, J.G. | Krayenbühl, N. | Türe, U. | De Oliveira, E.P.L. | Al-Mefty, O. | Ribas, G.C.

Article | 2017 | Operative Neurosurgery13 ( 2 ) , pp.258 - 270

https://hdl.handle.net/20.500.11831/1558

Atalay, B. | Türe, U.

Article | 2014 | Neurosurgical Review37 ( 2 ) , pp.339 - 346

Fixed atlantoaxial dislocations are difficult to treat and there is no consensus in the treatment protocol. Unilateral enlargement of the atlas-axis facet complex in fixed atlantoaxial dislocations is a very rare condition. These pathologies are usually quite unstable and surgical treatment is necessary in unreductable cases. A 52-year-old woman with a diagnosis of irreducible-fixed rotatory atlantoaxial dislocation presented with acute onset of dizziness, loss of balance, and tetraparesis. She was under 8 years of conservative follow-up. Review of radiology revealed unilateral C2 superior facet hypertrophy compressing the medulla a . . .nd obstructing the vertebral artery. To treat this condition, we have used a posterior midline approach and removed the lateral portions of the posterior rim of the foramen magnum and the assimilated posterior arch of C1. The V3 segments of the vertebral arteries were exposed bilaterally. The atlantoaxial joint complex on the left was hypertrophied compressing V3. We have removed hypertrophied lateral mass of the atlas and the hypertrophic superior articular facet of C2 for decompression. Patency of both vertebral arteries were checked intraoperatively by Doppler and indocyanine green angiography. We have fixated craniocervical junction on the same session. Patient was neurologically intact and she had confirmed fusion on the surgical site after three years of follow-up. This is a rare case of unilateral hypertrophy of the C2 superior articular facet in a fixed atlantoaxial rotatory dislocation. Progressive compression of medulla and the left vertebral artery leaded to clinical worsening of neurology in this case after 8 years of follow-up. Surgical treatment was necessary for neurological decompression and to establish stability. © 2013 Springer-Verlag Daha fazlası Daha az

Harput, M.V. | Gonzalez-Lopez, P. | Türe, U.

Article | 2014 | Operative Neurosurgery10 ( 3 ) , pp.426 - 435

BACKGROUND: During surgery for intrinsic brain lesions, it is important to distinguish the pathological gyrus from the surrounding normal sulci and gyri. This task is usually tedious because of the pia-arachnoid membranes with their arterial and venous complexes that obscure the underlying anatomy. Moreover, most tumors grow in the white matter without initially distorting the cortical anatomy, making their direct visualization more difficult. OBJECTIVE: To create and evaluate a simple and free surgical planning tool to simulate the anatomy of the surgical field with and without vessels. METHODS: We used free computer software (Osir . . .iX Medical Imaging Software) that allowed us to create 3-dimensional reconstructions of the cerebral surface with and without cortical vessels. These reconstructions made use of magnetic resonance images from 51 patients with neocortical supratentorial lesions operated on over a period of 21 months (June 2011 to February 2013). The 3-dimensional (3-D) anatomic images were compared with the true surgical view to evaluate their accuracy. In all patients, the landmarks determined by 3-D reconstruction were cross-checked during surgery with high-resolution ultrasonography; in select cases, they were also checked with indocyanine green videoangiography. RESULTS: The reconstructed neurovascular structures were confirmed intraoperatively in all patients. We found this technique to be extremely useful in achieving pure lesionectomy, as it defines tumor's borders precisely. CONCLUSION: A 3-D reconstruction of the cortical surface can be easily created with free OsiriX software. This technique helps the surgeon perfect the mentally created 3-D picture of the tumor location to carry out cleaner, safer surgeries. © 2014 by the Congress of Neurological Surgeons Daha fazlası Daha az

Manilha, R. | Harput, V.M. | Türe, U.

Article | 2018 | Operative Neurosurgery15 ( 1 ) , pp.426 - 435

[No abstract available]

Goga, C. | Türe, U.

Note | 2015 | Operative Neurosurgery11 ( 1 ) , pp.426 - 435

[No abstract available]

Türe, H. | Karacalar, S. | Ekşi, A. | Sarihasan, B. | Türe, U. | Çelik, F. | Tür, A.

Article | 2010 | Marmara Medical Journal23 ( 1 ) , pp.14 - 21

Objective: The aim of this study was to evaluate the analgesic efficacy of intravenous PCA using tramadol in patients, undergoing supratentorial tumor resection with craniotomy. Material and Method: One hundred and fifty patients with ASA I-II between 18 and 70 years of age scheduled for an elective supratentorial craniotomy for tumor resection, were assigned to receive standardized general anesthesia. Postoperative pain was assessed at standard time intervals using a visual analogue scale (VAS) score. When the VAS score was >3, 1 to 1.5 mg/kg of tramadol was administered intravenously and PCA using tramadol was started. For 48 h po . . .stoperatively, the VAS, Glasgow coma, sedation, comfort, and nausea and vomiting scores were assessed. Results: During the first 48 hours, 46% of the patients needed analgesic therapy and PCA with tramadol was adequate for these patients. Most patients needed analgesic drugs at 2 hours and their mean analgesic usage was higher at that point than at other periods in the first 2 h ( Daha fazlası Daha az

Türe, H. | Koner, Ö. | Aykaç, B. | Türe, U.

Article | 2010 | Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi38 ( 3 ) , pp.176 - 183

Aim: We aimed to investigate the stages of surgical procedure at which venous air embolism might occur, and complications related to echocardiography probe, anesthesia and position of the patient, and also to determine the incidence of venous air embolism during craniotomy performed in the sitting position under monitorization with transesophagial echocardiography (TEE) using our standard anaesthesia protocol. Material and Methods: Sixty ASA I- II patients, aged 18-70 years scheduled for elective craniotomy in the sitting position were enrolled into the study. TEE was used for monitorization of venous air embolism in patients receiv . . .ing standard anesthesia protocol. Air embolism seen on the monitor of TEE was classified as mild, moderate, severe and very severe (mild: If only air can be seen on screen, moderates if end-tidal carbon dioxide value falls >3 mmHg accompanied with air observed on the screen, severe: increase in heart rate or reduction in blood pressure accompanied with air seen on the screen, and very severe: hemodynamic deterioration requiring cardiopulmonary resuscitation). During the operation, air embolism, as well as any associated hemodynamic changes, precautions taken to prevent entry of air, therapeutic approaches to remove air embolism, and complications of anesthesia were recorded. The findings were expressed as means±SD. Results: In all patients, vena cava, right atrium, right ventricle and venous air entry could be easily monltorlzed echocardiographically. The frequency of air embolism was determined as 35% (n:21) (mild, n=12; moderate, n=9) in 14 of these patients, air entry was detected.during more than one surgical stage. During the postoperative period, pneumocephalus (n=1 ), and discoloration secondary to TEE probe (n=1 ) were found. Conclusions: In this study, air embolism could be detected easily with TEE, which is used for monitoring air embolism during craniotomy in the sitting position in all patients. Minor side effects related to TEE were reported Daha fazlası Daha az