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    Evaluation of neurogranin levels in a rat model of diffuse axonal injury
    (Nencki Inst Experimental Biology, 2024) Baskurt, Ozan; Aydin, Seckin; Avci, Idris; Nayir, Pinar Ozay; Aydin, Mehmet Volkan
    Diffuse axonal injury (DAI), one of the most common and devastating type of traumatic brain injury, is the result of the shear force on axons due to severe rotational acceleration and deceleration. Neurogranin (NRGN) is a postsynaptic protein secreted by excitatory neurons, and synaptic dysfunction can alter extracellular NRGN levels. In this study, we examined NRGN levels in serum and cerebrospinal fluid (CSF) after experimental DAI in terms of their diagnostic value. Experimental DAI was induced using the Marmarou technique in male Wistar albino rats. Serum and CSF NRGN levels of the sham group, one-hour, six-hour, 24-hour, and 72-hour post-DAI groups were measured by ELISA method. DAI was verified by staining with hematoxylin-eosin and beta-amyloid precursor protein in the rat brain samples. While no histopathological and immunohistochemical changes were observed in the early hours of the post-DAI groups, the staining of the beta-APP visibly increased over time, with positivity being most frequent and intense in the 72-hour group. It was found that serum NRGN levels were significantly lower in the 6-hour group than in the sham group. The serum NRGN levels in the 24-hour group were significantly higher than those in the sham group. This study showed a dichotomy of post-DAI serum NRGN levels in consecutive time periods. NRGN levels in CSF were higher in the one-hour group than in the sham group and returned to baseline by 72 hours, although not significantly. Our study provides an impression of serum and CSF NRGN levels in a rat DAI model in consecutive time periods. Further studies are needed to understand the diagnostic value of NRGN.
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    Germinoma Misdiagnosed as Lymphocytic Hypophysitis
    (Galenos Publ House, 2023) Sahin, Serdar; Baskurt, Ozan; Comunoglu, Nil; Kadioglu, Pinar; Gazioglu, Nurperi
    [Abstract Not Available]
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    Hemorrhagic transformation of ischemic stroke in a patient with Fahr's disease
    (Springernature, 2023) Baskurt, Ozan
    BackgroundFahr's disease is a very rare inherited neurodegenerative disorder characterized by diffuse and symetric intracranial calcification of the bilateral basal ganglia and cerebellum. Although the disease is slowly progressive, several acute forms have been described. We would like to present a very rare case of Fahr's disease with an ischemic stroke and its hemorrhagic transformation.Case presentationA 70-year-old woman presented to our emergency department with rapid cognitive decline, dysarthria and right limb weakness. Cranial computed tomography showed diffuse and symmetric hyperdense areas at the level of the bilateral dentate nuclei of cerebellar hemispheres and basal ganglia, suggestive of calcification consistent with Fahr's disease on a background of thyroidectomy history, and effacement in the left caudate region. The patient was admitted to the intensive care unit with suspected left cerebral ischemic stroke. Because of clinical deterioration with increasing drowsiness and right hemiplegia, a control computed tomography scan was performed. Upon detection of a 6 * 8 cm lesion corresponding to an intracerebral hematoma in the left temporoparietal area with intraventricular component, she underwent surgery. The patient did not become hemodynamically stable and died on post-operative day 3.ConclusionsThe calcium deposits in the walls of the cerebral vessels in Fahr's disease may exacerbate inflammatory processes leading to disruption of the blood-brain barrier. In addition, peripheral blood extravasation into the disrupted blood brain barrier due to ischemic stroke may lead to hemorrhagic transformation.
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    Prognostic significance of prolonged corrected QT interval in cerebral contusion
    (Wolters Kluwer Medknow Publications, 2023) Yavuz, Ahmed Yasin; Baskurt, Ozan; Kurtulus, Yunus; Avci, Idris
    Background & objectives: Cerebral contusion (CC) results in a release of catecholamines, autonomic dysfunction and neural stimulation that can lead to a number of cardiac adverse events, so it is critical to determine these. So the objective of this study was to investigate the prognostic significance of electrocardiographic changes, particularly the effects of a prolonged corrected QT (QTc) interval in CC. Methods: In this retrospective cohort study, 110 patients with CC were evaluated. Age, sex, concomitant diseases, Glasgow Coma Scale on admission, radiological assessment of the contusion (location, size, course and presence of cerebral oedema), need for surgical intervention, length of hospital stay and the extended Glasgow Outcome Scale (GOS-E) were statistically analysed within the QTc interval by routine electrocardiography (ECG) on admission. Results: The prolonged QTc interval was found to be associated with a higher incidence of cerebral oedema and a significantly higher risk of needing surgery. Patients with a prolonged QTc interval had a significantly larger contusion volume, greater midline shift and longer hospital stay, so their GOS-E score was significantly lower. A prolonged QTc interval on admission resulted in a hospital stay of more than eight days (sensitivity: 0.97 and specificity: 0.86), a higher risk of midline shift of more than 0.45 cm (P=0.006, sensitivity: 0.80 and specificity: 0.99) and a GOS-E score of <7 (sensitivity: 0.97 and specificity: 0.85). Interpretation & conclusions: ECG changes on admission showing a prolonged QTc interval have prognostic significance in CC. This simple and easily applicable information should be taken into consideration at the time of clinical decision making which may prevent an adverse events survivor.
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    Rapid Recurrence of Glioblastoma After 12 Days Despite Gross Total Resection
    (Ali Cangül, 01.08.2024) Avci, Idris; Baskurt, Ozan; Şeker, Selim; Kurtuluş, Yunus; Çal, Mehmet Alpay
    To present a unique case of rapid recurrence of glioblastoma after 12 days despite gross total resection. Glioblastomas are highly mortal and aggressive tumors. Despite advancements in therapy, gross total resection, radiotherapy, and chemotherapy, the recurrence rate is high and overall survival is short. We report a unique case of a patient with recurrence of glioblastoma in just 12 days despite gross total resection, which has not been previously reported in the literature. A 65-year-old woman complained of headaches and disturbance of speech for three days. On magnetic resonance imaging (MRI), a 5x4.5 cm diffuse contrast-enhanced mass lesion was detected. The patient underwent elective surgery in which the lesion was completely removed. Postoperative MRI scans revealed that the tumor was completely removed. She was released from the hospital on her postoperative 6th day. On the postoperative 12th day the patient was brought to our hospital with seizures and somnolence. On radiological images, a mass lesion in the same surgical area was detected. She underwent surgery in which the recurrent mass lesion was completely removed. Biopsy results correlated with those of the previous surgery. The reason why glioblastomas are such mortal tumors is their high recurrence rate. Overall recurrence occurs between 32-36 weeks after surgery. Serial neuroimaging should be performed to monitor potential relapse. Early recurrence before 3 months is very rare. A case like ours in which the tumor re-occurred just 12 days after total resection shows that there is still research to be done to understand the recurrence characteristics of glioblastoma.