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    The assessment of outcome after traumatic intracerebral hematomas: A clinical study of 34 cases
    (1998) Döşoğlu, Murat Servan; Orakdöğen, Metin; Ateş, Özkan; Somay, Hakan; Özdoğan, Cumhur; Tevrüz, Mahir
    Objective: Traumatic intracerebral hematomas (TICH's) occur with the multivectorial strength of the neural tissue in patients with a severe head injury. Prognosis is poor due to the generally accompanying intracranial and extracranial lesions. The treatment of these lesions are still controversial. Methods: This study was performed at Haydarpasa Numune Hospital, Department of Neurosurgery and consisted of 34 head injured patients who had intraparenchymal lesions greater than 2 cm in size. The effects of age, trauma mechanism, timing of admission after injury, Glasgow Coma Scale (GCS) score of the patients and multiplicity, midline shift, cisternal obliteration, localization and size of the lesions, and the choice of the treatment on the outcome are investigated and compared with nonparametric Kruskal-Wallis test. Results: The present study demonstrated that age, trauma mechanism, GCS, multiple lesions, midline shift, cisternal obliteration and localization had no effect on the final outcome of patients, but a significant correlation was found between the conservative treatment and hematomas less than 30 cc and early hospitalization in the minor head injured patients. Conclusion: Based on the results, it is argued that the medical treatment should be recommended for the lesions less than 30 cc.
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    Civilian gunshot wounds to the head
    (Masson Editeur, 1999) Döşoğlu, Murat; Orakdöğen, Metin; Somay, Hakan; Ateş, Özkan; Ziyal, İbrahim
    Background and Purpose. - Civilian Gunshot Wounds (GSWs) to the head are important causes of mortality. The severity of GSWs is related to several factors. Patients with GSWs tend to do very well or very poor depending on these factors. Methods. - We retrospectively reviewed 47 patients with GSWs to the head during the last 5 years. Clinical and radiological findings of cases are described. Statistical analysis was used to find the effects of all independent variables with mortality and the prognostic factors. Results. - Glasgow Outcome Scale results showed that 38 % of patients died, 13 % were moderately disabled and 49 % had good recovery at discharge. Patients with respiratory depression, hypovolemia, bilateral pupil dilatation, Glasgow Coma Scale (GCS) scores of 3 to 5, central bihemispheric and transventricular injury experienced 100 % mortality. The mortality rate was 58 % in patients with intracerebral or subdural hematoma, 78 % in multilobar injury, 14 % in unilobar injury and 57 % in self-inflicted wounds. The postoperative mortality was 27 %. Conclusion. - The manuscript describes the clinical experience of penetrating missile injuries in a Turkish civilian practice. Mortality and/or poor outcome are relatively high in spite of the cases wounded by low-velocity weapons. We should emphasize that following stabilization of vital signs, all patients with GCS scores of 3 to 5 should be evaluated immediately with CT and treated conservatively. If it is appropriate the patients with a GCS score higher than 8 should undergo surgery. Patients with GCS scores of 6 to 8 should be followed closely and treated with surgery when necessary even if they have poor prognosis.
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    Do repeated surgical interventions in patients with lumbar paraspinal Ewing's sarcoma increase survival by supporting pharmacological treatment? A comprehensive systematic review
    (2022) Yilmaz, Ibrahim; Karaarslan, Numan; Kaya, Yasin Emre; Somay, Hakan
    Aim: To present the medical and surgical treatment of a patient who was diagnosed with Ewing's sarcoma \r(EWS) in the paraspinal region and was operated on, in line with a comprehensive systematic literature review.\rMethod: A comprehensive and systematic literature search of electronic databases was performed. Keywords \rused were “EWS” and “EWS treatment”. Randomized, controlled clinical trials were included in the study. \rLetters to the editor, bibliographies, reviews, and meta-analyses were excluded. In addition, our EWS case was \rpresented in full detail.\rResults As a results of a comprehensive and systematic literature search of electronic databases, the full texts \rof the appropriate 323 studies conducted between the years 1786 to 2021 were retrieved and evaluated. In the \rcase we present here, the expandable mass was largely excised together with the invasive skin tissue. \rImmunohistochemical examination of the excised tumor tissue using vimentin antibody revealed that the mass \rwas compatible with EWS, a mesenchymal malignant tumor. \rConclusion: Many different pharmacological agents can be administered in different posologies and different \rcombinations before and after paraspinal/paravertebral lumbar surgery of EWS. Further studies containing \rmore cases from different races, gender must be performed to comprehensively evaluate the effects of repeated \rsurgical interventions of patients with EWS due to recurrence and/or residue, which may positively contribute \rto patient's survival and prognosis by giving more time to standard chemotherapy.