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    Application of syringosubarachnoid shunt through key-hole laminectomy Technical note
    (2000) Gezen, Ferruh; Kahraman, Serdar; Ziyal, İbrahim Mustafa; Çanakçı, Zafer; Bakır, Abdurrahman
    The authors describe the key-hole laminectomy technique (KHLT) for application of syringosubarachnoid shunts. This technique was used in 29 patients with noncommunicating syringomyelia. In all cases the shunts were inserted successfully without any peri- or late postoperative complications. The late follow-up magnetic resonance examinations revealed the clear collapse of syrinx in all cases. The authors advocate use of the KHLT because it is associated with less surgery-related trauma, epidural fibrosis, infection, and spinal instability.
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    Calvarial metastasis of a paraganglioma - case report and review of the literature
    (Elsevier Science Inc, 2000) Gezen, Ferruh; Ziyal, İbrahim M.; Baysefer, Alper; Kahraman, Serdar; Çıklatekerlioğlu, Özcan
    BACKGROUND Metastasis of a paraganglioma (PRG) to the calvarium is very rare. In this paper, the case of a 25-year-old male with metastasis of a PRG to the frontoparietal bone is described. CASE DESCRIPTION The patient presented with bulging on the left side of the head, headache, and weight loss. Magnetic resonance imaging (MRI) revealed a mass lesion in the left frontoparietal region that had destroyed both the external and internal table of the bone, extending under the skin and above the dura mater. After a frontoparietal craniotomy the tumor was removed totally. Histopathological examination revealed the "Zellballen," which are pathognomonic for a PRG. Systemic examination and radiological investigation revealed no primary tumor source. CONCLUSION Metastasis of a PRG to the calvarium is possible; radical removal of the tumor will provide a cure.
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    Review of 36 cases of spinal cord meningioma
    (Lippincott Williams & Wilkins, 2000) Gezen, Ferruh; Kahraman, Serdar; Çanakçı, Zafer; Bedük, Altay
    Study Design. Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome. Objective. To present the incidence, clinical presentation, localization, techniques, and long term results of surgically treated spinal meningiomas. Summary of Background Data. Meningiomas are common tumors of spinal neoplasm. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal meningiomas may recur, especially as a result of incomplete resection. Methods. Thirty-six consecutive patients with histologically confirmed spinal meningiomas were treated from 1980 to 1997. Neuroradiological diagnosis was made through myelogram in 20 patients, CT scan in 15 patients, and MRI in 16 patients. All patients were operated on via the posterior approach and using microsurgical technique and when necessary Cooper-Ultrasonic surgical aspirator (CUSA) and CO2 laser were also applied. The patients were followed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken except in recurrent tumors. Results. The most frequent site of spinal meningiomas was in the thoracic region. In 30 (83%) patients tumors were found to be completely intradural extramedullary during surgery. Total tumor resection was achieved in 35 (97%) of patients. In the follow-up period, 30 cases (83%) improved when compared to their preoperative conditions. There was one operative mortality (3%). A 66-year-old women died of pulmonary emboli. Conclusions. Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection improved the surgical results of spinal meningiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be performed in adjuvant therapy.