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    Bilateral epidural hematoma in a patient with human immunodeficiency virus infection: a case report
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2013) Kelten, Bilal; Karaoglan, Alper; Cal, Mehmet Alpay; Akdemir, Osman; Karanci, Turker
    Intracranial epidural haematomas are almost always secondary to head traumas and usually occur unilaterally. Bilateral intracranial epidural haematomas are rare, but the mortality is very high. In our case, we report a bilateral epidural haematoma in a 32 year old, HIV infected male patient who came to the emergency service with a head trauma because of a motor vehicle-pedestrian accident. The occurrence of bilateral epidural haematoma in an HIV infected patient is a rare condition as a result of head trauma in a lateral direction on one side. As a result of the vasculopathy and coagulopathy, which are complications of HIV infection, the cerebral vessels have a fragile structure that leads to complications that facilitate the development of contralateral intracranial epidural haematoma together.
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    Correlation between leptin and pro-inflammatory cytokines in cortical contusion injury model
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2011) Karaoglan, Alper; Akdemir, Osman; Cinar, Nilgun; Cal, Mehmet Alpay; Kelten, Bilal; Uzun, Hafize; Colak, Ahmet
    BACKGROUND The present study aimed to investigate time-dependent changes in leptin concentrations in brain tissue following experimental traumatic brain injury and to examine the relationship with cytokines. METHODS After circular craniectomy, 33 male Wistar-albino rats were positioned on a stereotaxic frame and subjected to cortical contusion injury and then divided into 3 groups based on the depth of deformation as: 0 mm (sham controls, n=3), 1.5 mm (moderate injury, n=15) and 2.7 mm (severe injury, n=15). Animals were sacrificed on the 1st, 3rd and 5th days post-injury. RESULTS One day after moderate injury, interleukin-1 beta (IL-1 beta), IL-6, tumor necrosis factor-alpha (TNF-alpha), and leptin levels were found to be markedly increased in the brain tissue. On the 3rd and 5th days, the levels returned to the sham-control levels. Following severe injury, IL-1 beta, IL-6 and TNF-alpha levels increased in correlation after the 1st day and reached the sham-control levels on the same days. However, leptin tissue levels decreased on the 1st and 3rd days and normalized to the sham-control levels on the 5th day. CONCLUSION Our results showed that the release of leptin is decreased in the early stage of severe injury. Thus, leptin replacement may play an important role in therapy in cases with severe traumatic brain injury.
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    Pneumorrhachis associated with bronchial asthma, subcutaneous emphysema and pneumomediastinum
    (Turkish Neurosurgery SOC, 2011) Karaoğlan, Alper; Cal, Mehmet Alpay; Orki, Alpay; Arpaözu, Bekir Muhsin; Çolak, Ahmet
    Pneumorrhachis is defined as the presence of air in the epidural space or subarachnoid space. The air may migrate along fascial planes from the posterior mediastinum, through the neural foramina, and into the epidural space. Pneumorrhachis is rare, and even more so in the paediatric population. Pneumorrhachis in itself usually is asymptomatic, does not tend to migrate and reabsorbs spontaneously. The combination of pneumomediastinum with epidural pneumorrhachis without thoracic trauma has rarely been reported in the literature. The present case report describes the presence of pneumomediastinum, subcutaneous emphysema, and pneumorrhachis in a child asthmatic patient who had a history of fever, violent cough.