Harput, M.V. | Türe, U.

Article | 2017 | Operative neurosurgery (Hagerstown, Md.)13 ( 5 )

[No abstract available]

Harput, M.V. | Türe, U.

Article | 2017 | Neurosurgical focus43 ( Video )

This is the case of a 14-year-old female who presented with headache and seizures. Cranial magnetic resonance imaging revealed an arteriovenous malformation (AVM) located at the posterior portion of the right-sided fusiform gyrus. Cerebral angiography showed that the AVM was fed mainly by branches from the inferior temporal trunk of the posterior cerebral artery. The main venous drainage was to the right transverse sinus through the tentorial vein. The AVM was totally excised through the paramedian supracerebellar-transtentorial approach with the patient in a semisitting position. Postoperative MRI and cerebral angiography confirmed . . . the total resection. The patient was discharged on the 5th postoperative day without neurological deficit. The video can be found here: https://youtu.be/QPrUl8AP7G8 Daha fazlası Daha az

Türe, U. | Kaya, A.H.

Book Part | 2011 | Cavernous Malformations of the Nervous System , pp.161 - 172

Introduction Cerebral cavernous malformations (cavernomas) are one of the four types of cerebrovascular malformations. The other three are arteriovenous malformations, capillary telangiectases, and venous malformations [1]. A sporadic and a hereditary form of cavernous malformations have been described [2]. These lesions are well-circumscribed, consisting of closely packed and enlarged capillary-like vessels. They do not contain intervening parenchyma and, histologically, the vascular channels (which resemble dilated capillaries) are lined by a single layer of vascular endothelium surrounded by a layer of dense fibrous tissue [3, 4] . . .. Cavernous malformations account for 5% to 10% of vascular malformations in the central nervous system. Eighty percent are located supratentorially, with a mostly superficial preference, and these histopathologically benign lesions occur in 0.1% to 0.9% of the population [5–8]. © Cambridge University Press 2011 Daha fazlası Daha az

Kaya, A.H. | Sam, B. | Celik, F. | Türe, U.

Article | 2006 | Neurosurgical Review29 ( 4 ) , pp.322 - 326

The injection of cadaver brains is invaluable for anatomic study, but cadavers that have been properly handled are not easy to obtain. A large number of cadavers pass through forensic departments around the world, and these cadavers could provide hundreds of research specimens, though they remain in the forensic unit for only a short time. The injection of a silicone mixture that quickly solidifies during autopsy would provide greater numbers of fresh specimens for study. The authors describe a technique for injecting a self-curing silicone mixture that can be used on autopsy specimens in a forensic unit. This technique does not int . . .erfere with routine autopsy findings. We describe the preparation of the mixture and autopsy specimens, the injection process, and the method for removing injected brains from cadavers. The solidifying process took a 1-h duration in this injection method and was in accord with autopsy procedure. The arterial bed was satisfactorily filled, and even small perforating branches and pial anastomoses were well demonstrated. Injecting autopsy specimens with the quick-solidifying silicone mixture allows anatomical studies of specimens even from cadavers admitted to forensic departments for only a short time. This method can provide neurosurgery laboratories with sufficient numbers of specimens appropriate for various studies. © Springer-Verlag 2006 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

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

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

Manilha, R. | Harput, V.M. | Türe, U.

Article | 2018 | Operative Neurosurgery15 ( 1 ) , pp.438 - 452

[No abstract available]

Karlikaya, G. | Çitçi, B. | Türe, U. | Bingöl, Canan Aykut

Article | 2009 | Journal of Neurological Sciences26 ( 2 ) , pp.165 - 170

Scientific Background: During surgeries near the motor cortex the sensori-motor cortex is commonly identified with anatomical markers by the surgeon. These surgeries may be associated with a high risk of motor deficits and preoperative functional magnetic resonance imaging, tractography, or intraoperative electrophysiological techniques such as phase reversal somatosensorial evoked potential (PR-SEP) monitoring and/or cortical stimulation methods may be used to decrease the rate of postoperative deficits. PR-SEP has been reported to be an easy and reliable technique to exactly localize the central sulcus. Objectives: The aim of this . . . study is to report the results of PR-SEP studies performed in our institution in surgeries near the motor cortex. Material and Methods: Eleven male and 4 female patients with ages between 11-68 were monitorized with PR-SEP during the period of February 2006-2008 at Yeditepe University Hospital, Neurological Sciences Department. Results: In 13 patients (%86,6) the central sulcus was localized with PR-SEP, and none of our patients had a new postoperative motor deficit. In 2 patients (%13,3) the central sulcus localization was not successful. Conclusions: It has been reported that, PR-SEP is an easy method to localize the central sulcus and is successful in 80-90 % of the cases. Similarly in our study this method was succesfull in 86% of the patients. We conclude that as an addition to the preoperative imaging techniques and intraoperative anatomical localization, PR-SEP is an easy and reliable method to guide the surgeon for the surgeries near the motor cortex in order to decrease the postoperative motor deficits Daha fazlası Daha az

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

Harput, M.V. | Türe, U.

Letter | 2018 | Operative neurosurgery (Hagerstown, Md.)15 ( 3 ) , pp.14 - 21

[No abstract available]

Brogna, C. | Millesi, M. | Fiengo, L. | Richardson, M. | Bhangoo, R. | Ashkan, K. | Türe, U.

Note | 2018 | Clinical Neurosurgery82 ( 2 ) , pp.14 - 21

[No abstract available]