European Journal of Clinical and Experimental Medicine T.19, z. 3 (2021)

URI dla tej Kolekcjihttp://repozytorium.ur.edu.pl/handle/item/6847

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Basal ganglia calcifications is not inconsequential in pediatric cases
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Tatar, Sertaç; Uzunhan, Tuğçe Aksu; Bezen, Diğdem; Önder, Hakan
Introduction. Basal ganglia calcification (BGC) in pediatric population is rare and is considered as a pathological finding. Various causes may be responsible for BGC including hypoparathyroidism, various infectious, toxicities or hereditary disorders. Aim. We aimed to present a 8 year old boy presented with generalized seizure and bilateral small amount of globus pallidum calcifications on neuroimaging studies leading to the diagnosis of idiopathic hypoparathyroidism, which is a treatable cause of seizure. Description of the case. A 8-year-old boy presented to our emergency department with generalized seizure for the first time in his life. There was no history of previous head trauma and his family history was unremarkable. Neurological examination revealed no pathological findings. Radiological imaging studies revealed only bilateral small amount of globus pallidus calcifications. He was referred to the pediatric endocrinology department for further evaluation of the hypocalcemic convulsion, where laboratory investigations revealed idiopathic hypoparathyroidism as the cause of hypocalcemic convulsion with exclusion of the other causes. Conclusion. Even a small amount of BGC in pediatric patients may be the sign of primary hypoparathyroidism and should be evaluated with serum electrolyte levels for early diagnosis and for the prevention of multisystemic complications of hypoparathyroidism.
Diffusion weighted imaging in differentiation of the clear cell RCC from the major non-clear cell RCC subtypes
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Kış, Naciye; Erok, Berrin
Introduction. Renal cell carcinoma (RCC) is the most common malignant renal tumor in adults accounting for 80-90% of primary malignant adult renal neoplasms. RCC represents a very heterogenous groups of tumors with a number of distinct histological varieties, of which the major 3 subtypes are clear cell RCC (70-80%), papillary RCC (13-20%), and chromophobe RCC (5%). Imaging features are varied from solid and relatively homogenous appearance to markedly heterogenous appearance with cystic changes, hemorrhage and necrosis. The use of diffusion weighted imaging (DWI) for RCC subtyping and also for differentiation of high grade and low grade tumors has been showed to be useful in many studies in the literature. Aim. In this study, we aimed to determine the comparative contribution of DWI in differentiation of the clear cell RCC from the major non-clear cell RCC subtypes at standard high b-value (1000 s/mm2) versus low b-value (500 s/mm2). In addition, we also aimed to assess the diagnostic performance of DWI for differentiating high grade clear cell RCC from low grade clear cell RCC based on Fuhrman grades in our patients. Material and methods. 62 cases with a prediagnosis of RCC according to MRI findings including DWI sequence with histological verification and subtyping of renal cortical tumor following a total or partial nephrectomy were included in the study. Results. Among 62 cases, 46 were male and 16 were female, with mean age of 59.5 ± 15.7. Pathological diagnoses of 62 cases were as follows, clear cell RCC, (44) papillary cell RCC (14) and chromophobe cell RCC (4). They were divided into two groups as clear cell RCC group (44 cases) and non-clear cell RCC group (18 cases). There was no statistically significant difference between the mean ADC values of clear cell and non-clear cell groups at b-value of 1000 s/mm2 (p>0.05). However, the mean ADC level for clear cell RCC group at b-value of 500 s/mm2 were significantly higher than for non-clear cell RCC group (p<0.05). When a value of 0.99x10-3 mm2/s was set as cut-off for ADC at b-factor of 500 s/mm2, differentiation was achieved with a high sensitivity (91%) and specificity (56%). Regarding the diagnostic performance of DWI for differentiating high from low Fuhrman grades clear cell RCCs, there was no statistically significant difference between the ADC values of Grade I-II clear cell RCC cases and Grade III-IV clear cell RCC cases at b-factor of 1000 s/mm2 (p>0.05). However, ADC values for grade III-IV group was statistically significantly lower than ADC values for Grade I-II group at b-factor of 500 s/mm2 level. Conclusion. ADC measurements at moderate b-value of 500 s/mm2 were more sensitive in subtyping and grading of RCC cases. This technique can be used in clinical practice as a fast and additional sequence in abdominal MRI.
Pericallosal berry aneurysm associated with azygous anterior cerebral artery – a case report
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Win, Nu Nu; Tatar, Sertaç
Introduction. Azygos anterior cerebral artery is a rare variant of the anterior segment of the circle of Willis caused by an unusual fusion of the normally paired A2 segments of the anterior cerebral artery (ACA). Despite its rare occurrence, it is associated with various vascular and structural cerebral abnormalities, particularly berry aneurysms. Aim. We aimed to present a case of a 41-year-old female patient who presented to our neurology department with complaints of headache. Description of the case. She had a positive paternal history of aneurysmal subarachnoid hemorrhage. Magnetic resonance angiography (MRA) of her brain revealed an azygos ACA (bifurcating into two pericallosal arteries) which was associated with a saccular aneurysm at its bifurcation point. She was referred to the interventional radiology department for preventive endovascular treatment. Conclusion. Azygos ACA carries a high risk of aneurysm development and its occlusion can potentially compromise blood supply to both cerebral hemispheres. It is therefore crucial for clinicians to be aware of its significance and to report its presence in angiographic studies.
Posttraumatic arachnoid cyst rupturę and delayed acute subdural hygroma
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Kıbıcı, Kenan
Introduction. Subdural hygromas (SDGs) are the accumulation of fluid in the subdural space. Arachnoid cysts (ACs) on the other hand are common cerebrospinal fluid (CSF) containing lesions of the central nervous system, located within the subarachnoid space. They are generally found incidentally on neuroimaging studies and remain asymptomatic throughout the life. Rupture into the subdural space resulting in subdural hygroma (SDG) is relatively rare. Aim. We aimed to show the importance of the radiological follow up in head trauma patients having large ACs. Description of the case. We report a case of a 69-year-old male patient with a known large Galassi type III AC, presented to our hospital with traumatic brain injuries and re-presented with acute posttraumatic SDG in association with AC rupture. Conclusion. This case emphasizes the importance of radiological follow up in head trauma patients having large ACs to reveal and appropriately manage traumatic subdural collections.

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Przeglądanie European Journal of Clinical and Experimental Medicine T.19, z. 3 (2021) według Autor "Erok, Berrin"