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    Demographic Characteristics of 796 Patients Operated for Lumbar Disc Herniation in Thrace Region, Turkey
    (Derman Medical Publ, 2016) Delen, Emre; Akinci, Ahmet Tolgay; Tutunculer, Banu; Memis, Muzaffer; Kunduracilar, Nebile Muge; Sahin, Soner
    Aim: This study was designed was to determine the demographic characteristics of patients operated for lumbar disc herniation in Thrace Region, Turkey. Material and Method: We retrospectively searched our data to find out patients who had one sided, one level and only one spinal surgical intervention for herniated lumbar disc. Results: Among 796 cases, 336 (4256) were men and 460 (5831:) were women. The level of the pathology is determined as LI - 2 for 4 cases (0.56b), L2 - 3 for 15 cases (1.9%), L3 - 4 for 5 I cases (6.4%), L4 - 5 for 412 cases (51.8%) and as L5 - 51 on 314 cases (39.4%). While a total of 70 cases (8.9%) were identified on upper -levels ( LI - 2. L2 - 3, L3 - 4); 726 cases (91.1%) were found to be on lower -levels ( L4 - 5, L5 - Si). A mild positive correlation between the pathology level and physical activity intensity (P e 0.05, P = 0.103) has been demonstrated: as well as a strong negative correlation between pathology level and mean age (P < 0.05. P = -0.404). Discussion: The demographic characteristics are consistent with the literature. Physical activity intensity influence on lower -level herniations might have significance due to the large sample size. The strong negative correlation between pathology level and mean age suggests that the degeneration raises the frequency of upper -level herniations.
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    The Effect of Cerebral Oxygen Saturation Changes on Early Postoperative Neuropsychological Function in Patients Undergoing Cranial Surgery
    (Turkish Neurosurgical Soc, 2023) Hekimoglu Sahin, Sevtap; Copuroglu, Elif; Delen, Emre; Tutunculer, Banu; Sut, Necdet; Colak, Alkin; Sagiroglu, Gonul
    AIM: To compare the incidence of postoperative neuropsychological dysfunction in patients managed with cerebral saturation monitoring versus traditional approaches.MATERIAL and METHODS: A hundred patients undergoing elective intracranial surgery were divided into two groups to receive intraoperative management via cerebral saturation monitoring (Group O) or the conventional approach (Group C). The postoperative neuropsychological function was evaluated by the antisaccadic eye movement test (ASEM) and the Mini-Mental State Examination (MMSE). These tests were performed preoperatively and postoperatively on the first, second, and fifth days. The time for the modified Aldrete score to reach 9 (MAS 9), adverse effects, and pain using a Visual Analog Scale (VAS) scores were recorded.RESULTS: Patient characteristics and surgery data were not statistically different. The MAS 9 of group O was significantly lower than that of group C (p<0.001). The MMSE at the postoperative 1, 2, and 5 days were significantly higher in Group O compared to Group C (p<0.001). ASEM was similar between groups. Group O was subdivided according to the type of surgery applied with diagnosis, and there were no statistically significant between-group differences in terms of areas under the curve for the cerebral regional oxygen saturation. There was no between-group difference regarding the mean arterial pressure at any time perioperatively. The heart rate at 80, 90, 100, and 110 min intraoperatively was significantly higher in group C than in Group O.CONCLUSION: Intraoperative cerebral oxygenation monitoring can reduce patient mortality and morbidity by allowing early postoperative neurological evaluation to detect potential neurocognitive deficits.
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    Effect of Giving Brochures to Ventriculoperitoneal Shunted Children's Mothers About Preventing Shunt Infections
    (Aves Yayincilik, Ibrahim Kara, 2020) Unver, Seher; Tutunculer, Banu; Ozkan, Zeynep Kizilcik; Findik, Ummu Yildiz
    Objective: The aim of this study was to evaluate and compare the effectiveness of giving oral information and printed informative brochures on information and application levels of mothers with VP shunted children to prevent infections. Material and Methods: A prospective, randomized controlled trial design was conducted. Nine mothers in the study group were given printed informative brochures after a 15-minute oral informative session, whereas nine mothers in the control group were given only oral information. The effectiveness of these interventions was assessed at 15th and 90th days. Results: Mothers in both groups achieved significantly higher information and application level scores at 15th and 90th days when compared to their initial evaluation (p<0.05). In the study group, 90 days after the informative session, the mothers achieved statistically higher information level scores than the mothers in the control group (U=8.000, p=0.019). Conclusion: Giving printed informative brochures is more effective than giving only oral information on mothers' knowledge about preventing VP shunt infections. Printed informative brochures about preventing VP shunt infections could improve mothers' level of knowledge in the long term and avoid shunt infections.
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    The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akinci, Ahmet Tolgay; Akturk, Yener; Tutunculer, Banu; Orakdogen, Metin; Simsek, Osman
    BACKGROUND: The optimal timing of intervention for aneurysmatic subarachnoid hemorrhage is one of the historically controversial issues in neurosurgery. Although numerous studies investigated the subject, they had many limitations due to the nature of the disease. Early and ultra-early interventions have gained more and more supporters in recent decades. Nevertheless, the effects of the early and ultra-early intervention on the outcome of the disease are far from clarity. METHODS: A single-center retrospective cohort study was carried out at Trakya University Medical Faculty Training and Practice Hospital. The study includes data on all patients admitted with an aneurysmal subarachnoid hemorrhage between January 1, 2001, and December 31, 2005. Patients were divided into two groups according to their WFNS grade status: Good (I-III) or poor (IV-V) grades. Patients are also classified according to their Glasgow Outcome Scale score: Unfavorable (1-2) or favorable (3-5) outcomes. Data were analyzed statistically, and the effects of the early and ultra-early intervention on the outcome were assessed. RESULTS: A total of 580 patients were admitted in the study period. Among them, 494 were eligible for the study. The median age (interquartile range) was 55 (18) years. While 244 (49.4%) patients were women, 250 (50.6%) patients were men. Three hundred and fourteen (63.6%) patients were operated, and 25 patients (5.1%) were undergone endovascular treatment. The ultra-early intervention was achieved in 60 (12.1%) patients and 142 patients (28.7%, including the previous ultra-early intervention group) early intervention was achieved. A meaningful outcome difference was present between the poor-grade ultra-early treatment group and the rest (p=0.007). Analogously, a meaningful outcome difference was present between the poor-grade early treatment group and the rest (p<0.001). CONCLUSION: This study supports the growing trend toward early or ultra-early intervention in aneurysmatic subarachnoid hemorrhage. Our findings showed that both early and ultra-early interventions have positive effects on the outcome in poor-grade aneurysmatic subarachnoid hemorrhage patients. Future studies with more homogenized and larger samples should be realized to clarify the optimal timing of intervention for aneurysmatic subarachnoid hemorrhage.
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    Neutrophil to Lymphocyte Ratio and Serum Biomarkers : A Potential Tool for Prediction of Clinically Relevant Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage
    (Korean Neurosurgical Soc, 2023) Kula, Osman; Gunay, Burak; Kayabas, Merve Yaren; Akturk, Yener; Kula, Ezgi; Tutunculer, Banu; Sut, Necdet
    Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.