Ethem Beskonakli

Ankara Atatürk Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (32)46.73 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Although the history of neurosurgery in Anatolia goes back to 10 thousand years ago, modern surgery started in 1890 in Turkey. Neurosurgery in Turkey started in the first half of the 20th century. However, the earlier application of neurosurgical techniques was started in the late 19th century by general surgeons. Most of these applications included procedures for cranio-cerebral traumas and infections.
    World Neurosurgery 11/2012; · 2.42 Impact Factor
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    ABSTRACT: Tenosynovial giant cell tumor (TGT) rarely arises from the posterior coloumn of the cervical spine. Most lesions of TGT involve the tendon sheath and joint lining of the small joints of the fingers and hands, and consecutively the knee, ankles and feet, and hips. Rate of extra-articular presentation is about 5-15% in all cases. In this report, a case with paraparesis caused by TGT in the cervico-thoracic junction is presented. The clinical manifestations, diagnosis, and treatment of this unusual condition are discussed. In the treatment of TGT of the vertebral column, the main aim should be total surgical excision of the tumor.
    Turkish neurosurgery 01/2012; 22(6):769-71. · 0.53 Impact Factor
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    Ihsan Solaroglu, Ozerk Okutan, Ethem Beskonakli
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    ABSTRACT: The anatomy of a new ligament in the human spine the ATA is described. To describe a new ligament; the ATA, which lies between the dural sac and the ligamentum flavum at the L5 level and to discuss it's surgical importance. Postoperative cerebrospinal fluid (CSF) leakage translates into longer hospital stays with significant implications for the patient, the health care system, and society as a whole. To avoid injury to the dural sac during lumbar surgery, it is crucial to know the surgical anatomy and its variations. The length and the number of ATAs were examined in 14 consecutive patients, which underwent an L5 laminoflavectomy in our department. The ATA and its anatomic landmarks are described here for the first time in the literature. We named this ligament the ATA; reminding us to pay attention to the Terminal Attachment. The presence of the ATA is demonstrated in 10 patients (71%). There was a double ATA in four patients (40%). The mean length of the ATA was 7.7 ± 1.8 mm. The ATA originates from the dorsal surface of the dura mater at the level of the superior border of the superior facet of the S1 vertebra and projects toward the ligamentum flavum. Histologic examination of the ATA revealed fibrous connective tissue. In this preliminary study, we have described a new ligament, the ATA, between the dural sac and the ligamentum flavum at the L5 level. The ATA is an important structure that creates a potential risk for inadvertent dural lacerations during flavectomy. Dissecting the ATA before the flavectomy may be an important step in reducing postoperative cerebrospinal fluid leaks, which may result in significant benefits for patients and health care organizations.
    Spine 01/2011; 36(16):1268-72. · 2.45 Impact Factor
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    Journal of Clinical Neuroscience 08/2009; 16(8):1115. · 1.32 Impact Factor
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    ABSTRACT: The molecular mechanisms of the anti-apoptotic and anti-inflammatory properties of granulocyte-colony stimulating factor (G-CSF) following focal cerebral ischemia in rats were examined in this study. Sprague-Dawley rats were randomly divided into three groups: sham, middle cerebral artery occlusion (MCAO) non-treatment and MCAO with G-CSF treatment. Focal ischemia was induced with the suture occlusion method for 90 minutes, and treatment was given at the onset of reperfusion. All animals were killed 24 hours after reperfusion. Assessment included neurological scores, infarction volumes, histology, immunofluorescent staining and Western blotting. G-CSF significantly reduced the infarct volume and ameliorated the early neurological outcome scores. Western blot analysis showed that G-CSF treatment significantly elevated the cIAP2 levels and decreased the activation of caspase 3 in the ischemic cortex compared with the non-treated rats. Immunofluorescent works also showed that G-CSF treatment inhibited both neuronal and glial tumor necrosis factor alpha and interleukin 1beta expressions. The neuronal anti-apoptotic action of G-CSF may be mediated in part by the anti-apoptotic protein cIAP2. G-CSF also exerts anti-inflammatory actions after focal cerebral ischemia by preventing both neuronal and glial pro-inflammatory cytokine expressions.
    Neurological Research 04/2009; 31(2):167-72. · 1.45 Impact Factor
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    ABSTRACT: Low-grade fibromyxoid sarcoma was first described in 1987 as a rare soft tissue neoplasm characterized by a bland and deceptively benign histological appearance but with aggressive behavior. A 20-year-old male patient presented with a recent history of headache and seizure. A right frontal mass was detected on MRI and he was operated upon to remove the intracranial mass. Histological examination revealed mildly atypical fibroblastic cells embedded within a myxoid matrix. Nuclear atypia and pleomorphism were minimal, and necrosis was not present. The lesion was diagnosed as a low-grade fibromyxoid sarcoma. Although primary intracranial low-grade fibromyxoid sarcoma has characteristic histological features, clinical and radiological correlation is necessary to make the correct diagnosis.
    Journal of Clinical Neuroscience 10/2008; 15(11):1298-301. · 1.32 Impact Factor
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    ABSTRACT: Congenital intracranial dermoid tumors are very rare. Supratentorial dermoid cysts have been more frequently reported over the past decade and they are known to have a predilection for the cavernous sinus. Dermoid tumors originating from the cavernous sinus are usually interdural and thus, presentation with ophthalmoplegia is uncommon. They are congenital benign tumors and are believed to originate from ectopic inclusion of epithelial cells during closure of the neural tube during embryonic development. The location of these dermoid lesions in the cavernous sinus and the complexity of the operative procedure for these lesions have been noted by several authors. In this report, we describe the case of a dermoid cyst that was embedded in the lateral wall of the cavernous sinus and review the literature relating to related cavernous dermoid lesions.
    Journal of Clinical Neuroscience 08/2008; 15(7):820-3. · 1.32 Impact Factor
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    ABSTRACT: Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder of unknown etiology that is characterized by ossification of the anterior longitudinal ligament of the spine and various extra-spinal ligaments. We present the case of a 54-year-old woman with progressive dysphagia due to DISH of the cervical spine, which is a relatively rare pathology in neurosurgical practice. The cervical osteophytes extending from C2 to C4 and external compression of the pharyngoesophageal segment by the large osteophytes were demonstrated by X-ray, magnetic resonance imaging, and computed tomography. Surgical removal of the large osteophytes and a shortterm nonsteroidal anti-inflammatory drug regimen led to the resolution of dysphagia. The clinical manifestations, diagnosis, and treatment of this unusual condition are discussed.
    Turkish neurosurgery 02/2008; 18(4):409-11. · 0.53 Impact Factor
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    ABSTRACT: A 45-year-old patient was found to have an intracranial sewing needle, located in the left frontal lobe. The needle was detected incidentally after minor head trauma. The clinical and radiological findings suggested that it might have entered the brain through the anterior fontanelle.
    Journal of Clinical Neuroscience 11/2006; 13(8):855-6. · 1.32 Impact Factor
  • E Beskonakli, I Solaroglu, K Tun, L Albayrak
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    ABSTRACT: Cerebral involvement in hydatid disease occurs in 1-4% of cases. There are few documented cases in the literature of intracranial hydatid cysts in unusual locations such as pons and thalamus. In this report, a case of 33-year-old male with primary intracranial hydatid cyst in the interpeduncular cistern is reported. This is the first such case in the literature.
    Acta Neurochirurgica 08/2005; 147(7):781-3; discussion 783. · 1.79 Impact Factor
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    ABSTRACT: The main objective was to evaluate the protective effect of erythropoietin on lung ultrastructure against damage in rats after traumatic brain injury. We used forty Wistar-Albino female rats weighing 170-200 gr. The rats were allocated into five groups. The first group was the control and the second was the craniotomy without trauma. The third group was the trauma group. The fourth and fifth groups were erythropoietin (1000 IU/kg) and vehicle (0.4 mL/rat) groups, respectively. A weight-drop method was used for achieving head trauma. Samples were obtained from pulmonary lobes 24-hour post injury. Lipid peroxidation levels were determined and electron microscopic scoring model was used to reveal the ultrastructural changes. Ultrastructural evaluation revealed pathologic changes in the trauma group compared with the control group (p < 0.05). Lipid peroxidation levels were found to be higher in the trauma group (p < 0.05). Erythropoietin significantly reduced both the ultrastructural pathologic changes and the lipid peroxidation levels in the treatment group (p < 0.05). Erythropoietin protects the ultrastructure of pneumocyte type II cells against damage after traumatic brain injury.
    The Journal of trauma 06/2005; 58(6):1252-8. · 2.96 Impact Factor
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    ABSTRACT: Spinal cord injury (SCI) involves a series of pathological events. Abnormal sodium influx has been implicated as one of the key events in the pathophysiology of the SCI. Pharmacological blockade of sodium channels can reduce secondary injury and increase recovery from trauma. The aim of the present study was to show the neuroprotective effect of phenytoin, a sodium channel blocker, after experimental SCI. Control and laminectomy-only groups were not injured. 50 g-cm weight drop injury was produced in the trauma group. In the treatment groups, methylprednisolone (30 mg/kg) and phenytoin (1 mg/kg, 10 mg/kg, or 30 mg/kg) were given intraperitoneally immediately after injury. Malondialdehyde (MDA) levels in the spinal cord samples were examined for lipid peroxidation. Spinal cord ultrastructure was evaluated and grading system was used for quantitative evaluation. Trauma increased tissue MDA levels. Treatment with methylprednisolone and phenytoin decreased MDA levels compared to trauma in all doses. Significant ultrastructural neuroprotection was observed with 30 mg/kg of phenytoin treatment according to general neural score. This ultrastructural neuroprotection of phenytoin was not different from methylprednisolone. Phenytoin appears to protect spinal cord against injury by decreasing lipid peroxidation and lessening neuronal damage associated with SCI in rats.
    Acta Neurochirurgica 05/2005; 147(4):405-12; discussion 412. · 1.79 Impact Factor
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    ABSTRACT: We aimed to demonstrate the time-dependent ultrastructural changes in pneumocyte type II cells following brain injury, and to propose an electron microscopic scoring model for the damage. Forty Wistar-Albino female rats weighing 170-200 g were used. The rats were allocated into five groups. The first group was the control and the second was the craniotomy without trauma. The others were trauma groups. Weight-drop method was used for achieving head trauma. Samples were obtained from the right and left pulmonary lobes at 2-, 8-, and 24-h intervals after transcardiac perfusion. An electron microscopic scoring model was used to reveal the changes. There were no ultrastructural pathological findings pointing to lung injury in any rat of the control groups. There was intense intracellular oedema in type II pneumocyte and interstitial oedema in the adjacent tissue in trauma groups. Oedema in mitochondria and dilatation in both smooth endoplasmic reticulum and Golgi apparatus was more evident in the 8- and 24-h trauma groups. The chromatin dispersion was disintegrated in the nucleus in all trauma groups. Scores of all trauma groups were significantly different from the controls (P<0.05). All trauma groups were different from each other at significant levels (P<0.05 for each trauma groups). The data suggested that ultrastructural damage is obvious at 2 h and deteriorates with time. The electron microscopic scoring model worked well in depicting the traumatic changes, which were supported by lipid peroxidation. Further experiments are needed to determine the exact outcome after brain death model.
    European Journal of Cardio-Thoracic Surgery 05/2004; 25(4):523-9. · 2.81 Impact Factor
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    ABSTRACT: Atlantooccipital fusion is complete or partial congenital fusion of the atlas to the base ofocciput. Basilar impression may complicate the clinical picture with the reduction of thevertical height of atlas causing odontoid or other bony structures project into foramenmagnum and medulla oblongata. This results in narrowing of the foramen magnum and leadsto neural compression. Authors present an unusual case in which the atlantooccipital fusionis complicated with the inverted hypertrophy of occipital condyles.
    Neuroanatomy. 01/2004;
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    ABSTRACT: Posterior transpedicular screw fixation has been widely used for the management of unstable lumbosacral spine caused by trauma, degenerative conditions, congenital defects and neoplasms. Knowledge of the pedicle diameters of the first sacral vertebra is crucial for safe placement of the screws. Thirty dry sacral specimens (18 male, 12 female) were used for study of the first sacral pedicles. Cephalad-caudad height, anterior-posterior width, transverse and sagittal angles, and depth of S1 pedicle were presented. The mean width of the pedicles were estimated as 22.5+/-2.6 mm and 22.2+/-2.8 mm; the heights were 13.6+/-2.3 mm and 13.6+/-2.7 mm; the depths were 50.7+/-3.7 mm and 51.8+/-3.5 mm for female and male, respectively. The mean transverse angles were 43 degrees +/-2.3 and 41 degrees +/-2.2; the sagittal angles were 19 degrees +/-2.9 and 19 degrees +/-3.7 for female and male, respectively. The depth and the angle of screw trajectory is as important as entrance point for pedicular screw placement to the S1 to avoid injury to the vascular structures anteriorly and nerve roots medially.
    Neuroanatomy. 01/2003;
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    ABSTRACT: Cystic lesions of the parasellar region are not uncommon and masquerade as a tumor both radiologically and clinically. True intrasellar arachnoid cysts are rare lesions and can easily be confused with intrasellar pituitary neoplasms, craniopharyngiomas, Rathke's cleft cysts, or even empty sella. The preoperative and peroperative distinction is obviously important because of the different treatment strategies and different prognosis. A 44-years-old woman with presenting symptoms of headache and decreased visual acuity with the initial diagnosis of either Rathke's cleft cyst or intrasellar arachnoid cyst is reported. The evaluations for differential diagnosis, commonly encountered pathological entities, treatment modalities and pathogenesis of intrasellar arachnoid cysts were discussed.
    Neuroanatomy. 01/2003;
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    ABSTRACT: The mortality and morbidity of acute subdural hematomas are still high although advanced diagnostic and treatment techniques. We evaluated 73 patients who were operated between 1995 and 2000 for acute subdural hematoma. The relation between mortality and morbidity rates and age, timing of surgery and Glasgow coma scala scores were analyzed. There was not statistically significant relation between age and mortality and morbidity rates. We concluded that Glasgow coma scala score at admission is an important prognostic factor and early surgery decreases mortality rate.
    Ulusal travma dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2001; 7(4):246-9.
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    ABSTRACT: It is generally accepted that the pineal gland is a neuroendocrine organ. Several recent experiments have shown that the pineal gland has functional and anatomical connections, particularly with the immune system, and therefore the gland is now recognized as an important immunoneuroendocrine organ in both man and animals. The present study investigates the effect of pinealectomy on some immune parameters, including hematological alterations, and the response of the brain tissue against infection caused by Staphylococcus aureus. Experiments were performed on two different age groups of rats (neonatal and young). The results showed a significant reduction of the plasma zinc level in the third week following pinealectomy, impairment of the hematological parameters including lymphocyte, erythrocyte, and leucocyte, and the deficiency of the brain response to the infective agent, particularly in pinealectomized neonatal rats. In view of these data and as described previously, the pineal gland has a main regulatory function in immune physiology, but our study indicates that only neonatal immune functions are significantly affected by pinealectomy.
    Neurosurgical Review 04/2001; 24(1):26-30. · 1.86 Impact Factor
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    ABSTRACT: Great variety exists in the indications and techniques recommended for the surgical treatment of syringomyelia-Chiari complex. More recently, magnetic resonance (MR) imaging has increased the frequency of diagnosis of this pathology and offered a unique opportunity to visualize cavities inside the spinal cord as well as their relationship to the cranio-cervical junction. This report presents 18 consecutive adult symptomatic syringomyelia patients with Chiari malformation who underwent foramen magnum decompression and syringosubarachnoid shunting. The principal indication for the surgery was significant progressive neurological deterioration. All patients underwent preoperative and postoperative MRI scans and were studied clinically and radiologically to assess the changes in the syrinx and their neurological picture after surgical intervention. All patients have been followed up for at least 36 months. No operative mortality was encountered; 88.9% of the patients showed improvement of neurological deficits together with radiological improvement and 11.1% of them revealed collapse of the syrinx cavity but no change in neurological status. None of the patients showed further deterioration of neurological function. The experience obtained from this study demonstrates that foramen magnum decompression to free the cerebro-spinal fluid (CSF) pathways combined with a syringosubarachnoid shunt performed at the same operation succeeds in effectively decompressing the syrinx cavity, and follow-up MR images reveal that this collapse is maintained. In view of these facts, we strongly recommend this technique, which seems to be the most rational surgical procedure in the treatment of syringomyelia-Chiari complex.
    European Spine Journal 01/2001; 9(6):553-7. · 2.47 Impact Factor
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    ABSTRACT: Osteosarcomas of the pelvic bone are rare. Neurological complication of osteosarcomas in this location is also rare. Diagnosis is not always easy, and misdiagnosis may occur due to pelvic bone destruction and nerve root compression. We present two cases of pelvic osteosarcoma with lumbosacral radicular symptoms who were previously thought to have lumbosacral herniated intervertebral disc.
    Neurosurgical Review 10/2000; 23(3):165-7. · 1.86 Impact Factor

Publication Stats

247 Citations
46.73 Total Impact Points

Institutions

  • 2011
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 1997–2009
    • Ankara Numune Training and Research Hospital
      Engüri, Ankara, Turkey
  • 1990–1996
    • Konya Numune State Hospital
      Conia, Konya, Turkey