Person: DAĞÇINAR, ADNAN
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DAĞÇINAR
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Publication Metadata only C2 anatomisi: Yüksek yerleşimli vertebral arter vakalarında vertebral arter mobilizasyonu ile C2 vida yerleştirilmesi.Kadavra diseksiyonu(2022-11-24) HARMAN, FERHAT; OĞLİN, VOLKAN; DAĞÇINAR, ADNAN; HARMAN F., OĞLİN V., BARAN O., Yılmaz M. Ö., Böyükyılmaz Ş., Orhun Ö., DAĞÇINAR A.Publication Metadata only Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder(SPRINGER, 2017) DAĞÇINAR, ADNAN; Thomas, David Terence; Yener, Sevim; Kalyoncu, Aybegum; Uluc, Kayihan; Bayri, Yasar; Dagcinar, Adnan; Dagli, Tolga; Tugtepe, HalilPurpose To evaluate the usefulness of somatosensory evoked potential as a screening tool for spinal pathologies in patients with treatment refractory overactive bladder. Methods This prospective study was performed between January 2011 and January 2014. Children > 5 years old with treatment refractory overactive bladder were enrolled after exclusion of anatomical and neurological causes of incontinence. All patients underwent urodynamic studies, spinal MRI, and somatosensory evoked potential (SEP). Sensitivity, specificity, PPV, and NPV were calculated for SEP. Results Thirty-one children (average age 8.3 +/- 2.9 years) were included in the study. SEP was abnormal in 13 (41.9%), and MRI was abnormal in 8 (25.8%) patients. SEP was found to have a sensitivity of 87.5%, a specificity of 73.9%, positive predictive value of 53.85%, and negative predictive value (NPV) of 94.4%. Conclusion In patients with treatment refractory OAB, SEP is an important tool for the screening of tethered cord/spinal pathologies. Our results suggest that a child with a normal SEP study in this group of patients may not require further investigation with MRI.Publication Metadata only Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient(S. Karger AG, 2018) DAĞÇINAR, ADNAN; Sarica C., Tanrikulu B., Sahin Y., Daǧçlnar A., Baltacioglu F., Bayri Y.Introduction: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. Case Report: We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. Conclusion: Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms. © 2018 S. Karger AG, Basel. Copyright: All rights reserved.Publication Metadata only How do presentation age and CSF opening pressure level affect long-term prognosis of pseudotumor cerebri syndrome in children? Experience of a single tertiary clinic(Springer Science and Business Media Deutschland GmbH, 2021) DAĞÇINAR, ADNAN; Ozturk G., Turkdogan D., Unver O., Dericioglu V., Aslan B., Dagcinar A.Background: Diagnosis and treatment of pseudotumor cerebri syndrome in children is still a challenge for clinicians. The aim of this study is to reveal the influence of presentation age and CSF opening pressure on long-term prognosis of pseudotumor cerebri and share our clinical data of the very young age (≤ 5-year) group. Method: This retrospective study includes the patients followed by the Marmara University Pediatric Neurology Clinic between years 2012 and 2020 diagnosed with definite, probable, or suggestive pseudotumor cerebri syndrome according to modified Friedman criteria. Patients were classified into three groups according to presentation age: group 1: ≤ 5 years old; group 2: 6–10 years; and group 3 > 10 years old. CSF opening pressure was also categorized into three groups as CSF < 20 cmH20; CSF 20–30 cmH20; and CSF > 30 cmH20. Results: One hundred three patients, 62.1% female (n = 64), were enrolled in the study. Group 1 consisted of 16 patients (60% male), group 2 consisted of 30 patients (63.3% female), and group 3 consisted of 57 patients (66.7% female). The mean CSF opening pressure did not differ between the three age groups in our study (p > 0.05). Treatment response was not correlated with CSF opening pressure. Papilledema presence and level of CSF opening pressure were independent of age (p > 0.05). Conclusions: Age at presentation and CSF opening pressure at diagnosis are not any predictive factors that influence long-term prognosis of pseudotumor cerebri syndrome in children. Evaluation and follow-up of children should be done in personalized approach. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Publication Metadata only The Effect of Untethering on Urologic Symptoms and Urodynamic Parameters in Children With Primary Tethered Cord Syndrome(ELSEVIER SCIENCE INC, 2015) DAĞÇINAR, ADNAN; Yener, Sevim; Thomas, David Terence; Hicdonmez, Tufan; Dagcinar, Adnan; Bayri, Yasar; Kaynak, Ayten; Dagli, Tolga E.; Tugtepe, HalilOBJECTIVE To evaluate urinary system symptoms (USSs) and urodynamic parameters (UPs) before and after untethering in children with primary tethered cord syndrome (pTCS). METHODS USSs and UPs of patients undergoing untethering for pTCS during the period January 2008-July 2012 were evaluated preoperatively and at the postoperative third and 12th months. For analysis, patients were separated into 4 groups according to the presence of USSs: group 1, USSs preoperative positive and postoperative negative; group 2, USSs preoperative positive and postoperative positive; group 3, USSs preoperative negative and postoperative positive; group 4, USSs preoperative negative and postoperative negative. Preoperative and postoperative USSs and UPs were compared. RESULTS Forty patients (average age, 7.2 years, follow-up of 2.8 years) were included. There were 13 patients in group 1, 11 in group 2, 3 in group 3, and 13 in group 4. All patients showed improvement when preoperative and postoperative USSs and UPs were compared. There was no correlation between USSs and UPs, both preoperatively and postoperatively. USSs and UPs at the postoperative third and 12th months were similar. Patients with no USS showed the most significant improvement in UP after untethering. CONCLUSION Our study has demonstrated that untethering in patients with pTCS improves urologic symptoms and UPs. However, there is no correlation between improvement in symptoms and urodynamic findings. Urodynamic changes are similar at the postoperative third and 12th months. As the most significant improvement was seen in patients without USSs, it is important that these patients undergo urodynamic studies preoperatively and postoperatively. (C) 2015 Elsevier Inc.Publication Metadata only Prevention of brisk hyperactive response during selective dorsal rhizotomy in children with spasticity: Isoflurane versus sevoflurane maintenance anesthesia(ELSEVIER SCI LTD, 2009) DAĞÇINAR, ADNAN; Konya, Deniz; Gercek, Arzu; Dagcinar, Adnan; Baykan, Nigar; Ozek, Memet M.In children with spasticity, deep tendon reflexes are hyperactive and even stimulation of normal dorsal rootlets can produce exaggerated full-strength, single-twitch responses in the muscles they innervate. This phenomenon is called the brisk hyperactive response (BHR). The aim of this study was to compare the efficacy of 2 volatile anesthetics, isoflurane and sevoflurane, for suppressing the confounding effect of BHR during selective dorsal rhizotomy (SDR) in children with spasticity. The subjects were 54 consecutive children of American Society of Anesthesiology physical status III who were scheduled for SDR. After tracheal intubation, each child was randomly assigned to Group I (isoflurane; n = 27) or Group S (sevoflurane; n = 27). There was no significant difference between the mean operation times in Groups I and S (200 +/- 40 vs. 220 +/- 35 minutes, respectively; p = 0.0559). Thirteen patients in Group I (48.1%) and 5 in Group S (18.5%) exhibited BHR during stimulation of the dorsal rootlets (odds ratio 4.086; p = 0.0418). Three of these 18 patients (2 in Group I and 1 in Group S) experienced hypertension and tachycardia simultaneously with BHR (odds ratio 4.086; p = 1.0). The results suggest that sevoflurane is more effective at preventing BHR and might be a better choice for anesthetic management of children with spasticity undergoing SDR. (C) 2008 Elsevier Ltd. All rights reserved.Publication Metadata only Challenges in the management of a 7 years old child with thyrotropin-secreting pituitary adenoma and the review of the literature(2023-01-01) KIRKGÖZ, TARIK; GÜRPINAR TOSUN, BUŞRA; ELTAN, MEHMET; HALİLOĞLU, BELMA; KAYGUSUZ, SARE BETÜL; SEVEN MENEVŞE, TUBA; BOZKURT, SÜHEYLA; ÖNEŞ, TUNÇ; GÜRAN, TÜLAY; DAĞÇINAR, ADNAN; BEREKET, ABDULLAH; DEMİRCİOĞLU, SERAP; KIRKGÖZ T., Abali S., Seker A., GÜRPINAR TOSUN B., ELTAN M., Helvacioglu D., HALİLOĞLU B., KAYGUSUZ S. B., Yavas Abali Z., SEVEN MENEVŞE T., et al.Introduction: Thyrotropin-producing pituitary adenoma (TSHoma) is a very rare disease, representing less than 1% of the pituitary tumours, present with elevated thyroid hormones and normal/high TSH concentrations. Case Presentation: A 7-year-old boy with nervousness was referred by his psychiatrist for elevated free T4, T3 and TSH levels. Initial evaluation revealed an elevated -subunit.Pituitary MRI demonstrated a macroadenoma. The patient underwent a trans-sphenoidal tumour resection (TSS) which showed positive immunohistochemical staining for TSH, growth hormone, and prolactin in tumoral tissue. Euthyroidism was achieved for one year after TSS, then, recurrence of tumour with elevated TSH and thyroid hormone levels necessitated a re-operation with TSS followed by gamma-knife radiosurgery. The euthyroid state was achieved and lasted for 2.5 years this time, but, due to the recurrence, medical treatment had been commenced with cabergoline and octreotide. Euthyroidism was maintained for the last 4 years on monthly octreotide treatment. A repeat MRI demonstrated no pituitary mass but a mass in the sphenoidal sinus had been detected. Removal of this mass by surgery did not achieve euthyroidism. 68Ga-DOTA-TATE PET/CT showed residual tissue extending from the pituitary region to the sphenoid sinus.The patient\"s bone age was advanced 2 years at diagnosis which became 4 years in one year after the diagnosis and remained so throughout follow-up, leading to a final height of -3.3 SDS below his target height at the age of 16 years. Conclusion: The diagnosis, treatment, and follow-up of TSHomas are challenging and short stature due to accelerated bone maturation is a complication of paediatric TSHomas.Publication Metadata only Pediatrik dev torakolumbosakral araknoid kiste bağlı kord herniasyonu olgusu(2021-10-31) OĞLİN, VOLKAN; BAYRİ, YAŞAR; DAĞÇINAR, ADNAN; ŞİMŞEK, İSMAİL; SAKAR, MUSTAFA; SÖNMEZ, ÖZCAN; Şimşek I., Oğlin V., Sönmez Ö., Sakar M., Bayri Y., Dağçinar A.Araknoid kistler; araknoid membranın altında oluşan selim, neoplazi içermeyen, içi sıvı dolu yapılardır. Bu kistler genellikle insidental olarakgörüntülemeler sırasında saptanır ve belirti vermedikçe tedavi edilmeleri gerekmez. Semptomatik olduklarındaysa; valsalva manevralarıylaartabilen sırt ve bel ağrısı, radiküler ağrı veya kronik miyelopati gibi bulgu ve belirtilere sebep olabilirler (4).Pediatrik yaşta daha sık görülen araknoid kistler, genellikle konjenitaldir (1). Spinal araknoid kistler dahaçok torakal seviyelerde ve vertebranın dorsalinde konumlanırlar. Ortalama üç vertebra uzunluğundadırlar veT3-T6 seviyeleri arasında daha sık görülürler (5). Dev araknoid kistler nadirdir ve bugüne kadar literatürde çokaz sayıda vaka bildirilmiştir (3,6). Çalışmamızdaki amacımız kliniğimizde tedavi edilmiş dev araknoid kist olgusunun yönetimini sunmaktırPublication Metadata only Cervical meningocele causing symptoms in adulthood - Case report and review of the literature(LIPPINCOTT WILLIAMS & WILKINS, 2006) DAĞÇINAR, ADNAN; Konya, Deniz; Dagcinar, Adnan; Akakin, Akin; Gercek, Arzu; Ozgen, Serdar; Pamir, Mustafa N.Simple meningoceles are infrequent forms of dysraphism and are often benign. These lesions are usually associated with other congenital spinal anomalies, and are typically diagnosed in childhood. Most become symptomatic in childhood because of, progressive spinal cord or nerve root tethering. This article describes the case of a 47-year-old man who presented with a sac in his posterior cervical region that had been leaking colorless fluid for 3 months. He was also having difficulty walking and complained of stiffness in his lower extremities. Cervical magnetic resonance imaging revealed a cystic mass in the region of the C4 to C5 laminae. Partial laminectomies were performed (lower portion C4 lamina, upper portion C5 lamina), the sac was totally excised, and tissue tethering the spinal cord were cut. There was no recurrence of symptoms in 12 months of follow-up. Although in cases where a cervical meningocele-myelomeningocele is detected at any time, early treatment is essential to eliminate the high risk of future neurological impairment. This is the first report of an untreated cervical meningocele manifesting symptoms in adulthood.Publication Metadata only Septal DNET: Nadir bir olgu sunumu(2021-10-31) ÇEKİÇ, EFECAN; YARALI, AHMET TUĞRUL; SAKAR, MUSTAFA; BAYRİ, YAŞAR; DAĞÇINAR, ADNAN; ŞİMŞEK, İSMAİL; Şimşek I., Yılmaz N., Çekiç E., Yarali A. T., Sakar M., Bayri Y., Dağçinar A.Disembriyoplastik nöroepitelyal tümörler sıklıkla çocukluk çağında,dirençli epilepsi ile bulgu veren ve genellikle temporal yerleşimli tümörlerdir.Ekstraaksiyal yerleşimi nadir görülmekte olup daha çok intraventriküler,kaudat ve septum pellucidumda görülür.Septal DNET,DNET in bir varyantı olarak görülse de adölesan yaş grubunda KİBAS bulgularıyla prezente olur.Benign seyirlidir,adjuvan terapi ihtiyacı olmaz.Çalışmamızda hastanemize başvuran böyle bir vakanın takdimini amaçlamaktayız.