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    High-sensitivity C-reactive protein levels in cerebrospinal fluid and serum in severe head injury: relationship to tumor necrosis factor-alpha and interleukin-6
    (Churchill Livingstone, 2007) İş, Merih; Coşkun, Abdurrahman; Sanus, Galip Zihni; Tanrıverdi, Taner; Kafadar, Ali Metin; Hanımoğlu, Hakan; Gezen, Ferruh
    Recent studies have demonstrated the role of high-sensitivity C-reactive protein (hsCRP) in inflammatory diseases; however, it is unclear whether this molecule has a role after severe head injury (SHI). Our aim was to evaluate the levels of hsCRP in both cerebrospinal fluid (CSF) and serum from patients after SHI. The study focused on 11 patients with SHI and evaluated CSF and serum levels of hsCRP, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in a 10-day period following the head trauma. The values were compared with those from nine control patients, who had normal pressure hydrocephalus. In the CSF and serum of the patients after SHI HsCRP was found to be significantly higher, at all times, than in the controls; TNF-alpha and IL-6 levels were also higher in these patients. However, hsCRP levels did not correlate with either TNF-alpha or IL-6. TNF-alpha and IL-6 increased during the period immediately following the SHI and intrathecal levels were always higher than those of the serum. This study demonstrates for the first time that hsCRP reaches high levels in both CSF and serum in patients with SHI, and it may therefore be used as an inflammatory index. This finding suggests a need for further studies in this area, which are larger in scope than the present study.
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    A new ventricular index based on coronal brain magnetic resonance images in patients with idiopathic normal pressure hydrocephalus
    (Scientific and Technological Research Council Turkey, 2023) Yılmazsoy, Yunus; Arslan, Serdar; Özdemir, Adnan; Korkmazer, Bora; Kızılkılıç, Osman; Kafadar, Ali Metin
    Background/aim: The aim of this study was to assess the effectiveness of a new quantitative index for the diagnosis of idiopathic normal pressure hydrocephalus. Materials and methods: This retrospective study was conducted at Istanbul University Cerrahpasa Medical Faculty between January 2016 and November 2022. A total of 31 patients diagnosed with idiopathic normal pressure hydrocephalus were included in the study group and 48 patients were included in the control group. Measurement via the new Index was performed on a coronal section of magnetic resonance imaging at the level of the anterior commissure. Results: The new Index's mean diagnostic performance was 1.16 +/- 0.08 in the study group, significantly lower (p < 0.0001) than the mean of 1.43 +/- 0.10 in the control group. When a cutoff value of 1.23 was used for the new index, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96.1%, 90.7%, 80.6%, 98%, and 91.3%, respectively. Conclusion: The new Index described here is an effective, feasible, reproducible, highly sensitive, and specific quantitative method that can contribute to the improved diagnosis of patients with idiopathic normal pressure hydrocephalus.
  • Küçük Resim
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    Prolonged elevation of magnesium in the cerebrospinal fluid of patients with severe head injury
    (Taylor & Francis Ltd, 2007) Kafadar, Ali Metin; Sanus, Galip Zihni; İş, Merih; Coşkun, Abdurrahman; Tanrıverdi, Taner; Hanımoğlu, Hakan; Uzan, Mustafa
    Objectives: Several works have investigated the role of serum magnesium (Mg) concentrations in traumatic brain injury. However, there is restricted information about cerebrospinal fluid (CSF) levels of Mg in patients with severe head injury (SHI). We assessed the changes of Mg concentrations in CSF and serum in patients with SHI during the first 10 days after the trauma. Methods: Eleven patients with SHI were studied prospectively on days 1-3, 5 and 10 with analysis of CSF and serum levels of Mg and Ca. The control group consisted of nine patients with hydrocephalus. Results: CSF levels of Mg were significantly higher in patients than controls in the corresponding time points except on days 5 and 10 of trauma. The CSF Mg levels tended to decrease and the highest level was found on day 1 after trauma (2.81 +/- 0.65 mg/dl). In the control group, the CSF level of Mg was 1.95 +/- 0.66 mg/dl. No significant difference can be detected between controls and patients regarding serum Mg and Ca levels. In addition, significantly higher values of Ca in the CSF were observed in all time points after trauma in patients with SHI than in the controls. There was no correlation between the CSF and serum levels of Mg and Ca levels. Discussion: Our study demonstrates that in patients with SHI, CSF levels of Mg and Ca are elevated during the whole observation period. Further works should be designed in order to show the role and importance of CSF levels of ionized Mg in outcome of patients with SHI.