Civan Islak

Publications (42)90.04 Total impact

• Article: Endovascular treatment of carotid cavernous sinus fistula: A systematic review.

  Bora Korkmazer, Burak Kocak, Ercan Tureci, Civan Islak, Naci Kocer, Osman Kizilkilic
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  ABSTRACT: Carotid cavernous sinus fistulas are abnormal communications between the carotid system and the cavernous sinus. Several classification schemes have described carotid cavernous sinus fistulas according to etiology, hemodynamic features, or the angiographic arterial architecture. Increased pressure within the cavernous sinus appears to be the main factor in pathophysiology. The clinical features are related to size, exact location, and duration of the fistula, adequacy and route of venous drainage and the presence of arterial/venous collaterals. Noninvasive imaging (computed tomography, magnetic resonance, computed tomography angiography, magnetic resonance angiography, Doppler) is often used in the initial work-up of a possible carotid cavernous sinus fistulas. Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of treatment for these lesions. The endovascular approach has evolved as the mainstay therapy for definitive treatment in situations including clinical emergencies. Conservative treatment, surgery and radiosurgery constitute other management options for these lesions.
  World journal of radiology. 04/2013; 5(4):143-55.
• Article: Cavernous hemangioma of the cavernous sinus misdiagnosed as a meningioma: a case report and MR imaging findings.

  Zehra Isik Hasiloglu, Murat Asik, Osman Kizilkilic, Sait Albayram, Civan Islak
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  ABSTRACT: Cavernous hemangioma (CH) is a benign vascular malformation. Intracranial CH is generally localized as an intracranial-intraaxial and responsible for 5-13% of all intracranial vascular malformations. Intracranial-extraaxial CHs are rare rather than intracranial-intraaxial CHs. Clinical findings, imaging characteristics, and surgical approach of extraaxial CHs are rather different than intraaxial CHs. Diagnosing cavernous sinus CH preoperatively is very important, but its radiological differential diagnosis is quite difficult. In this study, we present magnetic resonance imaging findings of a 48-year-old male who was considered preoperatively to have meningioma but was diagnosed with cavernous sinus CH during surgery by pathological examination.
  Clinical imaging 02/2013; · 0.73 Impact Factor
• Article: Total Agenesis of Superior Sagittal Sinus and Falx Cerebri in a Patient Suffering from Subacute Subdural Hematoma Crossing Midline.

  Burak Kocak, Zehra Isik Hasiloglu, Osman Kizilkilic, Naci Kocer, Sabri Aydin, Civan Islak
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  ABSTRACT: BACKGROUND AND IMPORTANCE:: Anatomic variations of the superior sagittal sinus (SSS) and falx cerebri (FC) are uncommon in that agenesis of these structures is extremely rare. We report an extremely rare anatomic variation, total agenesis of the SSS and FC, and briefly discuss it from anatomical, embryological, radiological, and clinical perspectives. CLINICAL PRESENTATION:: A 49-year-old woman presented with long-standing headache, gait disturbance, and nausea. Imaging studies showed bilateral subdural hematoma crossing the midline, dilated venous structures and perineural cysts, but SSS and FC. Following right-sided hemiparesis and consciousness disturbances, the subdural hematoma was evacuated from a left-sided parietal burr-hole because of thick hematoma in this side. After the surgical evacuation, the hemiparesis and consciousness disturbances were regressed; however, she still had severe headache. On account of ongoing headaches and related imaging findings, it was thought that she had possible spontaneous intracranial hypotension. She was treated with autologous epidural blood patch and recovered well. CONCLUSION:: Agenesis of the SSS and FC are extremely rare variations. Agenesis of the SSS results in development of alternative venous pathways and may lead to misdiagnosis as dural arteriovenous fistulas. Agenesis of FC may cause diagnostic confusion since subdural pathologies such as hematomas can cross the midline in rare occasions.
  Neurosurgery 01/2013; · 2.79 Impact Factor
• Article: Fused magnetic resonance angiography and 2D fluoroscopic visualization for endovascular intracranial neuronavigation.

  Naci Kocer, Osman Kizilkilic, Drazenko Babic, Danny Ruijters, Civan Islak
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  ABSTRACT: Advanced transluminal neurovascular navigation is an indispensable image-guided method that allows for real-time navigation of endovascular material in critical neurovascular settings. Thus far, it has been primarily based on 2D and 3D angiography, burdening the patient with a relatively high level of iodinated contrast. However, in the patients with renal insufficiency, this method is no longer tolerable due to the contrast load. The authors present a novel image guidance technique based on periprocedural fluoroscopic images fused with a preinterventionally acquired MRI data set. The technique is illustrated in a case in which the fused image combination was used for endovascular treatment of a giant cerebral aneurysm.
  Journal of Neurosurgery 12/2012; · 2.96 Impact Factor
• Article: Carotid stenting with low-dose contrast medium for patients with moderate-to-severe chronic renal insufficiency: Keyhole carotid stenting.

  Burak Kocak, Osman Kizilkilic, Bora Korkmazer, Ercan Tureci, Naci Kocer, Civan Islak
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  ABSTRACT: Herein, we describe a new carotid stenting approach for four patients with moderate-to-severe chronic renal insufficiency, who have a glomerular filtration rate (GFR) between 15 and 59mL/min/1.73m(2), using a minimum dose of contrast medium (12mL at a 50% dilution) and SmartMask™ technology as an alternative to carotid endarterectomy.
  European journal of radiology 10/2012; · 2.65 Impact Factor
• Article: Endovascular treatment of extracranial vertebral artery stenosis.

  Burak Kocak, Bora Korkmazer, Civan Islak, Naci Kocer, Osman Kizilkilic
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  ABSTRACT: Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery (VA) stenosis seems a safe, effective and useful technique for resolving symptoms and improving blood flow to the posterior circulation, with a low complication rate and good long-term results. In patients with severe tortuosity of the vessel, stent placement is a real challenge. The new coronary balloon-expandable stents may be preferred. A large variability of restenosis rates has been reported. Drug-eluting stents may be the solution. After a comprehensive review of the literature, it can be concluded that percutaneous angioplasty and stenting of extracranial VA stenosis is technically feasible, but there is insufficient evidence from randomized trials to demonstrate that endovascular management is superior to best medical management.
  World journal of radiology. 09/2012; 4(9):391-400.
• Article: Early and midterm results of complex cerebral aneurysms treated with Silk stent.

  Murat Velioglu, Osman Kizilkilic, Hakan Selcuk, Burak Kocak, Ercan Tureci, Civan Islak, Naci Kocer
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  ABSTRACT: INTRODUCTION: Endovascular treatment of intracranial aneurysms has been an effective treatment option. In this paper, we report our experience with the Silk stent (SS) for endovascular treatment of complex intracranial aneurysms and present periprocedural events, immediate results, delayed complications, and imaging and clinical follow-up results. METHODS: We retrospectively examined angiographic images and clinical reports of 76 consecutive patients with 87 intracranial aneurysms who were treated with SSs between March 2008 and June 2011. RESULTS: All aneurysms could be successfully covered technically using implanted SSs, with an overall mortality of 6.6 %. Two transient morbidities (2.6 %) and three permanent morbidities due to embolic events (3.9 %) were observed. Unexpected procedural technical events occurred in 18 procedures (18/78, 23.1 %). Control angiographies were performed in all 71 patients with 82 aneurysms (100 %). Mean angiographic follow-up time was 17.5 ± 11.1 months [range 2-48 months]. Sixteen of the 71 patients with 19 aneurysms had only early angiographic controls in the first 6 months while remaining 55 patients with 63 aneurysms (77.5 %) had late controls after 6 months. Overall control angiographic occlusion rates were as follows: 87.8 % (72/82) total occlusion, 8.5 % residual aneurysm filling, and 3.7 % residual neck filling. The general in-stent stenosis rate in controls was 5.6 % and the stented parent artery occlusion rate was 4.2 %. Five (6.6 %) aneurysms ruptured after stent implantation in our series. CONCLUSION: The Silk stent is an effective tool for the treatment of challenging aneurysms, which have previously demonstrated higher re-growth rates and technical problems, despite unexpected higher hemorrhage rates after treatment and deployment difficulties.
  Neuroradiology 06/2012; · 2.82 Impact Factor
• Article: Utility of VasoCT in the treatment of intracranial aneurysm with flow-diverter stents.

  Osman Kizilkilic, Naci Kocer, George Emmanuel Metaxas, Drazenko Babic, Robert Homan, Civan Islak
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  ABSTRACT: The small size and tortuous anatomy of intracranial arteries require that flow-diverter stents in the intracranial vasculature have a low profile, high flexibility, and excellent trackability. However, these features limit the degree of radiopacity that can be incorporated into the stents. Visualization of these stents and the degree of stent deployment using conventional radiographic techniques is suboptimal. To overcome this drawback, the authors used a new combined angiography/CT suite that uses flat-panel detector technology for higher resolution angiography. The authors present their preliminary experience in the imaging of flow-diverter stents in 31 patients in whom VasoCT was used with a new flat-panel detector angiographic system. Intraarterial VasoCT was performed after flow-diverter stent deployment in all cases. In 4 of these cases, balloon angioplasty or telescopic stent deployment-related decisions were made after checking VasoCT images. At 3- and 6-month follow-up in 27 patients, digital subtraction angiography was performed in 12 patients and intravenous VasoCT in 11 patients. Twenty-three of 31 patients had their aneurysm occluded during short-term follow-up, and 4 of the 31 patients still had minimal residual filling of the aneurysms. None of the 27 patients had stenosis of the parent artery. The authors found that VasoCT provides clear visualization of flow-diverter stents. The images obtained both intraarterially and intravenously are very promising. The initial results provide a high confidence and reproducibility rate for further utilization of this new technique.
  Journal of Neurosurgery 05/2012; 117(1):45-9. · 2.96 Impact Factor
• Article: Macrocephaly-Capillary Malformation Syndrome in a Newborn With Tetralogy of Fallot and Sagittal Sinus Thrombosis.

  Tugba Erener Ercan, Funda Oztunc, Tiraje Celkan, Meltem Bor, Osman Kizilkilic, Mehmet Vural, Yildiz Perk, Civan Islak, Beyhan Tuysuz
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  ABSTRACT: Macrocephaly-capillary malformation syndrome is characterized by cutaneous vascular malformations with associated anomalies as macrocephaly, macrosomia, hemihypertrophy, hypotonia, developmental delay, lax joints, loose skin, polysyndactyly, and neuroimaging abnormalities. We present a newborn with a prenatal diagnosis of macrosomia and tetralogy of Fallot. He also had macrocephaly; a high forehead; capillary hemangioma on the forehead, upper lip, and philtrum; generalized loose skin; postaxial polydactyly of both hands and feet, with neuroimaging findings of polymicrogyria and thrombosis in sagittal sinus and sinus rectus. His condition was diagnosed as macrocephaly-capillary malformation syndrome in the neonatal period and he died suddenly during sleep at 6 months of age. The clinical course in this syndrome is not as benign as was previously thought. Careful follow-up of these patients with particular emphasis on neuroradiologic and cardiologic evaluation might help decrease the risk of sudden death and to improve long-term outcome.
  Journal of child neurology 03/2012; · 1.59 Impact Factor
• Article: Diffusion-weighted imaging findings in brain death.

  Hakan Selcuk, Sait Albayram, Ercan Tureci, Zehra Isik Hasiloglu, Osman Kizilkilic, Emin Cagil, Naci Kocer, Civan Islak
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  ABSTRACT: The purpose of the present study was to determine the role of diffusion-weighted imaging (DWI) and to investigate the use of DWI in the diagnosis of brain death (BD). We prospectively evaluated 22 patients diagnosed with clinical BD (9 women, 13 men; mean age, 39.63 ± 15.1 years; age range, 9-66 years). All clinical criteria for BD were present in all 22 patients before magnetic resonance imaging, including a positive apnea test. For all cases, DW images, T2-weighted images, and fluid-attenuated inversion recovery were obtained. Thirteen distinct neuroanatomical structures were selected for analysis in all the cases. For each region of interest, the mean, standard deviation, and range of the average apparent diffusion coefficient (ADCav) values were obtained. For BD patients, ADC values in all neuroanatomical structures were significantly lower than those for control subjects. We determined how ADC values in all structures were related to the diagnostic condition as well as the appropriate threshold ADC values to classify a subject as BD or control. The sensitivity, specificity, positive and negative predictive values, and correct classification rate of ADC cutoff values to distinguish BD from control groups were 100%. DWI might be used as a noninvasive confirmatory test for the diagnosis of BD in the future.
  Neuroradiology 07/2011; 54(6):547-54. · 2.82 Impact Factor
• Article: A case of primary Sjögren's syndrome presenting primarily with central nervous system vasculitic involvement.

  Zehra Isik Hasiloglu, Sait Albayram, Koray Tasmali, Burak Erer, Hakan Selcuk, Civan Islak
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  ABSTRACT: Sjögren's syndrome is primarily a chronic systemic autoimmune disease that affects exocrine organs. Neurologic symptoms frequently present as peripheral neuropathy due to small vessel vasculitis. Type and prevalence of central nervous system involvement are still controversial. In this report, we present a 35-year-old woman with primary Sjögren's syndrome with central nervous system vasculitic involvement.
  Rheumatology International 02/2011; 32(3):805-7. · 1.88 Impact Factor
• Article: Regression of neointimal hyperplasia of an intracranial stent: 6 years follow-up of a wide-necked aneurysm.

  Aylin Hasanefendioglu, Bayrak Bayrak, Naci Kocer, Civan Islak, Sait Albayram, Osman Kizilkilic, Batuhan Kara
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  ABSTRACT: We present a case of wide-necked giant aneurysm located at the P1-P2 segment of the posterior cerebral artery. The initial goal for treatment of the aneurysm was hemodynamic flow redirection with subsequent thrombosis so the procedure and involved stent placement to the neck of the aneurysm without any filling material. During follow up, significant in-stent stenosis due to intimal hyperplasia was found at the 6th month on digital subtraction angiography. Regression of in-stent neointimal stenosis at the 18th month and a total disappearance at the 76th month were observed on follow-up angiograms. Illustrating the reversibility of neointimal hyperplasia during a long follow up period was the main goal of this case report.
  Turkish neurosurgery 01/2010; 20(1):90-5. · 0.62 Impact Factor
• Article: Endovascular treatment of aneurysms associated with fenestrated A1 segment of anterior cerebral artery: report of two cases.

  Michael Mantatzis, Osman Kizilkilic, Sait Albayram, Naci Kocer, Civan Islak
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  ABSTRACT: Fenestration in A1 segment of anterior cerebral artery is a rare entity. Treatment of aneurysms derived from a fenestrated artery may be more challenging because the fenestrations provide specific difficulties. A thorough radiologic work-up driven by high clinical suspicion is needed. Endovascular treatment, although it has been tried only once, appears to be the treatment of choice. We successfully treated 2 cases using endovascular techniques and can conclude that endovascular treatment is a safe and effective treatment of aneurysms associated with this rare variation in the A1 segment of ACA.
  Journal of neuroimaging: official journal of the American Society of Neuroimaging 09/2009; 21(2):165-9. · 1.72 Impact Factor
• Article: Management of Cushing's disease using cavernous sinus sampling: effectiveness in tumor lateralization.

  Nurperi Gazioglu, Mustafa Onur Ulu, Fatma Ozlen, Sait Albayram, Civan Islak, Naci Kocer, Buge Oz, Necmettin Tanriover, Demet Ozgil Yetkin, Sadi Gundogdu, Ozer Acbay, Pinar Kadioglu
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  ABSTRACT: The aim of this study was to determine the accuracy of bilateral cavernous sinus sampling (CSS) in preoperative tumor lateralization (right/left) within the pituitary in patients with Cushing's disease (CD). The study consisted of 26 consecutive patients who had undergone CSS followed by transsphenoidal surgery (TS) for CD between 2000 and 2006 at our institution. The magnetic resonance imaging (MRI) of the selected patients either revealed a normal pituitary or a lesion <or=6mm within the gland. Simultaneous bilateral CSS with corticotropin releasing hormone (CRH) stimulation were performed in all cases and the data was analyzed in relation to the results of the MRI studies, intraoperative and pathological findings and the outcome. Early remission was achieved in 23 patients (88%) and CSS predicted the correct localization of the adenoma in 22 patients (85%). No lateralization (elevated levels in both sides) was detected during CSS in two patients, due to lesions within the central part of the pituitary. In four cases, there was a false positive lateralization, in which no microadenoma could be located in the lateralized side of the pituitary, resulting in no remission. There were no complications related to the CSS. CSS in CD seems to be a valuable and safe diagnostic tool, which can predict the correct location of the pituitary adenoma in 85% of the cases.
  Clinical Neurology and Neurosurgery 04/2008; 110(4):333-8. · 1.58 Impact Factor
• Article: Intrathecal gadolinium-enhanced MR-cisternography in spontaneous intracranial hypotension associated with Behcet's syndrome.

  Sait Albayram, Aysegul Gunduz, Sabahattin Saip, Harun Ozer, Fatih Gulsen, Naci Kocer, Civan Islak
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  ABSTRACT: We report a 32-year-old woman diagnosed with spontaneous intracranial hypotension (SIH) and Behcet's Syndrome. Suspicion of SIH was based on cervical MRI findings, and magnetic resonance (MR)-cisternography revealed dural leaks bilaterally at lumbar region. MR-cisternography is a recently performed technique and gaining importance in demonstration of CSF fistula.
  Headache The Journal of Head and Face Pain 05/2007; 47(4):613-6. · 2.52 Impact Factor
• Article: Follow-up of extracranial vertebral artery stents with Doppler sonography.

  Fatih Kantarci, Ismail Mihmanli, Mehmet Sait Albayram, Hakan Barutca, Fatih Gulsen, Naci Kocer, Civan Islak
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  ABSTRACT: OBJECTIVE: The objective of our study was to determine the Doppler sonography findings suggestive of restenosis in the follow-up of patients treated by stent placement in the extracranial vertebral artery. CONCLUSION: Follow-up of vertebral artery stents with Doppler sonography may be performed by direct insonation of the stent or by indirect measurements from the V2 segment (the part of the vertebral artery that courses within the intervertebral foramina). The V2 segment Doppler sonography measurements may guide future examinations and provide essential information regarding the proximally deployed stent.
  American Journal of Roentgenology 10/2006; 187(3):779-87. · 2.78 Impact Factor
• Article: MR Imaging of pial melanosis secondary to a posterior fossa melanotic ependymoma.

  Sait Albayram, Efsun Urger, Buge Oz, Ali Kafadar, Civan Islak, Naci Kocer
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  ABSTRACT: A 36-year-old man presented with trouble speaking and bilateral progressive hearing loss. MR imaging and histopathologic results revealed a posterior fossa melanotic ependymoma. Pial surfaces appeared hyperintense on T1-weighted images and hypointense on T2-weighted images. Histopathologic examination revealed that tumor cells and interstitial spaces had abundant melanin accumulation. There was no evidence of hemosiderin in tumor cells and in interstitial spaces. Pial melanin accumulation secondary to a posterior fossa melanotic ependymoma explained our MR findings.
  American Journal of Neuroradiology 05/2005; 26(4):804-8. · 2.93 Impact Factor
• Article: Re: Vertebrobasilar junction aneurysms associated fenestration: experience of five cases treated with Guglielmi detachable coils. Surg Neurol 2004;61:248-54.

  Civan Islak, Fatih Kantarci
  Surgical Neurology 12/2004; 62(5):470; author reply 470-1. · 1.67 Impact Factor
• Article: Breast cancer metastasis involving pterygopalatine fossa: a cause of trigeminal neuralgia.

  Sait Albayram, Ibrahim Adaletli, Hakan Selcuk, Fatih Gulsen, Civan Islak, Naci Kocer
  Headache The Journal of Head and Face Pain 11/2004; 44(9):927-8. · 2.52 Impact Factor
• Article: Endovascular treatment of a congenital dural caroticocavernous fistula.

  Sait Albayram, Hakan Selcuk, Sila Ulus, Dogan Selcuk, Naci Kocer, Civan Islak
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  ABSTRACT: Carotico-cavernous sinus fistula is a rare anomaly in infancy. We report a 3-month-old boy with progressive symptoms and threatened visual loss requiring urgent therapeutic intervention. Embolization using n-butyl 2-cyanoacrylate was performed with immediate and dramatic results.
  Pediatric Radiology 09/2004; 34(8):644-8. · 1.67 Impact Factor