Mustafa K Başkaya

University of Wisconsin–Madison, Madison, Wisconsin, United States

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Publications (159)386.53 Total impact

  • Ravi K Garg · Kenneth S Lee · Sarah C Kohn · Mustafa K Baskaya · Ahmed M Afifi
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    ABSTRACT: Diagnostic tools for evaluating the supraorbital rim in preparation for nerve decompression surgery in patients with chronic headaches are currently limited. We evaluated the use of sonography to diagnose the presence of a supraorbital notch or foramen in 11 cadaver orbits. Sonographic findings were assessed by dissecting cadaver orbits to determine whether a notch or foramen was present. Sonography correctly diagnosed the presence of a supraorbital notch in 7 of 7 cases and correctly diagnosed a supraorbital foramen in 4 of 4 cases. We found that sonography had 100% sensitivity in diagnosing a supraorbital notch and foramen. This tool may therefore be helpful in characterizing the supraorbital rim preoperatively and may influence the decision to use a transpalpebral or endoscopic approach for supraorbital nerve decompression as well as the decision to use local or general anesthesia.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 10/2015; DOI:10.7863/ultra.14.12015 · 1.54 Impact Factor
  • Tevfik Ylmaz · Ulaş Ckla · Mustafa K Başkaya
    Neurosurgery 08/2015; DOI:10.1227/NEU.0000000000000964 · 3.62 Impact Factor
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    ABSTRACT: Selection of recipient vessels for head and neck microvascular surgery may be limited in the previously dissected or irradiated neck. When distal branches of the external carotid artery (ECA) are unavailable, additional options for arterial inflow are needed. Here we propose high ligation of the ECA and transposition toward the lower neck as an alternative. After obtaining institutional approval, patients who underwent head and neck tumor resection and simultaneous free flap reconstruction were identified over a 5-year period. Patients whose recipient artery was listed in the operative report were included. Chart review was performed to identify patient demographics, operative details, and patient and flap complications. In cases where the ECA was used, the artery was traced distally with care taken to protect the hypoglossal nerve. The ECA was then divided and transposed toward the lower neck where an end-to-end microvascular anastomosis was performed. The recipient artery used for head and neck microsurgery was available for 176 flaps, and the facial (n = 127, 72.2%) and external carotid (n = 19, 10.8%) arteries were most commonly used. There were 0 flap thromboses in the ECA group compared to 3 flap thromboses that occurred with other recipient arteries (P = 1.00). No cases of first bite syndrome or hypoglossal nerve injury were identified. The ECA may be transposed toward the lower neck and used for end-to-end microvascular anastomosis without complication of hypoglossal nerve injury or first bite syndrome. This method may be considered an alternative in patients with limited recipient vessel options for head and neck microsurgery. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. © 2015 Wiley Periodicals, Inc.
    Microsurgery 07/2015; DOI:10.1002/micr.22448 · 2.42 Impact Factor
  • Ulas Cıkla · Kutluay Uluç · Mustafa K Baskaya
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    ABSTRACT: Giant posterior circulation aneurysms pose a significant challenge to neurovascular surgeons. Among various treatment methods that have been applied individually or in combination, clipping under hypothermic circulatory arrest (HCA) is rarely used. We present a 62-year-old man who initially underwent coil occlusion of the right vertebral artery (VA) for a 2.5 cm giant vertebrobasilar junction (VBJ) aneurysm. His neurological condition had declined gradually and the aneurysm grew to 4 cm in size. The patient underwent clip reconstruction of giant VBJ aneurysm under HCA. His postoperative course was prolonged due to his preexisting neurological deficits. His preoperative Modified Rankin Score was 5, and improved postoperatively to 3 at three and six months, and to 2 at one year. The video can be found here: .
    Neurosurgical FOCUS 07/2015; 39(VideoSuppl1):V13. DOI:10.3171/2015.7.FocusVid.14620 · 2.11 Impact Factor
  • Ulaş Cikla · Tevfik Yilmaz · Yiping Li · Mustafa K Başkaya
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    ABSTRACT: Giant distal anterior cerebral artery aneurysms are rare. Their treatment is most challenging, due to the complexities of the aneurysm neck and branches involved, as well as their relatively deep locations. Various strategies can be used in the treatment of these complex aneurysms, including endovascular coiling, flow-diverting stents, surgical trapping, microsurgical clip reconstruction, and a wide spectrum of bypass techniques.
    Neurosurgery 06/2015; 11 Suppl 3. DOI:10.1227/NEU.0000000000000834 · 3.62 Impact Factor
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    ABSTRACT: Intracranial pseudoaneurysms (IP) represent about 1% of all patients presenting with an intracranial aneurysm. In true intracranial aneurysms, the intima, internal elastic lamina, and media are disrupted, but the adventitia is intact. In pseudoaneurysms, there is disruption of all three layers of the arterial wall, thus resulting in higher rates of re-hemorrhage and thrombus formation. Patients with IP commonly present with subarachnoid hemorrhage or thromboembolic complications. Until now, no specific guidelines have been established for the ideal treatment of pseudoaneurysms. Although IP have higher rates of morbidity and mortality compared to true intracranial aneurysms, surgical treatment can prevent catastrophic hemorrhagic and thrombotic complications. Despite recent advances in endovascular techniques that allow safe approaches to complicated intracranial vascular pathologies, vascular trapping and bypass remains the definitive and safe treatment for IP. Based on our experience and related literature, we consider the latter treatment in experienced hands as an effective and decisive treatment modality to prevent the devastating complications of IP. In this article, we discuss the surgical management of iatrogenic intracranial internal carotid artery pseudoaneurysms by trapping, and extracranial-intracranial bypass through a case illustration in which the technique is demonstrated via a video presentation.
    Turkish neurosurgery 05/2015; 25(2):305-9. DOI:10.5137/1019-5149.JTN.13039-14.1 · 0.58 Impact Factor
  • Joshgun Mammadov · Yiping Li · Ulas Cikla · Rewais Hanna · Mustafa K. Başkaya
    05/2015; 37(9):1-5. DOI:10.1097/01.CNE.0000471804.05826.04
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    ABSTRACT: The role of postoperative radiation (RT) in atypical meningioma remains controversial. We report a retrospective review of outcomes and prognostic factor analysis in 158 patients treated between 2000 and 2010, and extensively review the literature. Following resection, 23 patients received immediate RT, whereas 135 did not. Median progression-free survival (PFS) with and without RT was 59 (range 43-86) and 88 (range 64-123) months. For Simpson grade (G) 1-3 resection, with and without RT, median PFS was 48 (2-80) versus 96 (88-123) months and for Simpson G4, it was 59 (6-86) versus 47 (15-104) months (P = 0.4). The rate of 5-year overall survival (OS) with and without RT was 89% and 83%, respectively. On univariate analysis, Simpson G4 (HR 3.2, P = 0.0006) and brain invasion (HR 2.2, P = 0.03) were significantly associated with progression, whereas age >60 years (HR 9.7, P = 0.002), mitoses >5 per 10 high-power field (0.2, P = 0.0056), and Simpson G4 (HR 2.4, P = 0.07) were associated with higher risk of death. We summarized 22 additional reports, which provide very divergent results regarding the benefit of RT. In our series, adjuvant RT is surprisingly associated with worse PFS and OS, and this is more likely to be due to selection bias of referring tumors with more aggressive characteristics such as elevated Ki-67 and brain invasion for adjuvant RT, rather than a direct causal effect of adjuvant RT. Although there is a trend toward improved PFS with adjuvant RT after subtotal resection, no improvement was noted in OS. Multivariate analysis did not yield statistical significance for any of the factors including Simpson grades of resection, adjuvant RT, or six pathological defining features. The relatively divergent results in the literature are most likely explained by patient selection variability; therefore, randomized trials to adequately address this question are clearly necessary.
    Journal of cancer research and therapeutics 04/2015; 11(1):59-66. DOI:10.4103/0973-1482.148708 · 0.79 Impact Factor
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    Tevfik Yilmaz · Ulas Cikla · Alice Kirst · Mustafa K Baskaya
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    ABSTRACT: Klippel-Trenaunay-Weber syndrome (KTWS) is a rare syndrome in which patients usually present with cutaneous hemangiomas, venous varicosities, and bone and soft tissue hypertrophy of the affected limb. Intracranial lesions in patients with KTWS are extremely rare, and are generally reported as single cases in the literature. We describe a rare case, where a patient with KTWS was found with a hemorrhagic grade IV astrocytoma. Although central nervous system abnormalities such as intracranial aneurysms and cerebral and spinal cord cavernomas have been described in patients with KTWS, to the best of our knowledge, this is the first report of an association between glioblastoma multiforme (grade IV astrocytoma) and KTWS in the English-language medical literature. A 61-year-old white Caucasian man with a history of KTWS presented with seizures. Left upper and lower extremity hypertrophy, left foot, leg and ear gigantism and left-sided abdominal capillary hemangiomas were noted in the physical examination. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) were obtained, showing a heterogeneous lesion in the cingulate gyrus, with peripheral and central areas of T1 hyperintensity and layering T2 hypointensity consistent with a hemorrhage. A right parasagittal frontal craniotomy was performed with an interhemispheric approach. We had difficulty controlling the bleeding with bipolar electrocautery during surgery and finally were able to stop the bleeding using surgicel and gelfoam. Postoperative cranial CT and MRI scans showed intraparenchymal hemorrhage centered within the medial right frontal lobe. There was no increase in hematoma size in consecutive CT scans. Co-occurrence of vascular abnormalities with KWTS should be taken into consideration to avoid perilous preoperative and postoperative complications.
    Journal of Medical Case Reports 04/2015; 9(1):83. DOI:10.1186/s13256-015-0555-2
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    ABSTRACT: The ventromedial prefrontal cortex (vmPFC) plays a key role in modulating emotional responses, yet the precise neural mechanisms underlying this function remain unclear. vmPFC interacts with a number of subcortical structures involved in affective processing, including the amygdala, hypothalamus, periaqueductal gray, ventral striatum, and bed nucleus of stria terminalis (BNST). While a previous study of non-human primates shows that vmPFC lesions reduce BNST activity and anxious behavior, no such causal evidence exists in humans. In this study, we used a novel application of magnetic resonance imaging (MRI) in neurosurgical patients with focal, bilateral vmPFC damage to determine whether vmPFC is indeed critical for modulating BNST function in humans. Relative to neurologically healthy subjects, who exhibited robust rest-state functional connectivity between vmPFC and BNST, the vmPFC lesion patients had significantly lower resting-state perfusion of the right BNST. No such perfusion differences were observed for the amygdala, striatum, hypothalamus, or periaqueductal gray. This study thus provides unique data on the relationship between vmPFC and BNST, suggesting that vmPFC serves to promote BNST activity in humans. This finding is relevant for neural circuitry models of mood and anxiety disorders.
    Cortex 03/2015; 64. DOI:10.1016/j.cortex.2014.11.013 · 5.13 Impact Factor
  • Kutluay Uluc · Ulas Cikla · Christopher Baggott · Mustafa Baskaya
    Journal of Neurological Surgery, Part B: Skull Base 02/2015; 76(S 01). DOI:10.1055/s-0035-1546670 · 0.72 Impact Factor
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    ABSTRACT: The angioarchitectural features of an arteriovenous malformation (AVM) provide key information regarding natural history and treatment planning. Because of rapid filling and vascular overlap, two-dimensional (2D) and three-dimensional (3D) digital subtraction angiography (DSA) are often suboptimal for evaluation of these features. We have developed an algorithm that derives a series of fully time-resolved 3D DSA volumes (four-dimensional (4D) DSA) at up to 30 frames/s from a conventional 3D DSA. The temporal/spatial resolution of 4D reconstructions is significantly higher than that provided by current MR angiography and CT angiography techniques. 4D reconstruction allows viewing of an AVM from any angle at any time during its opacification. This feasibility study investigated the potential of 4D DSA to improve the ability to analyze angioarchitectural features compared with conventional 2D and 3D DSA. 2D, 3D, and 4D DSA reconstructions of angiographic studies of six AVMs were evaluated by three cerebrovascular neurosurgeons and one interventional neuroradiologist. These observers evaluated the ability of each modality to visualize the angioarchitectural features of the AVMs. They also compared the information provided using the combination of 2D and 3D DSA with that provided by a 4D DSA reconstruction. By consensus, 4D DSA provided the best ability to visualize the internal features of the AVM including intranidal aneurysms, fistulae, venous obstructions, and sequence of filling and draining. 2D and 3D images in comparison were limited because of overlap of the vasculature. In this small series, 4D DSA provided better ability to visualize the angioarchitecture of an AVM than conventional methods. Further experience is required to determine the ultimate utility of this technique. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Journal of Neurointerventional Surgery 01/2015; DOI:10.1136/neurintsurg-2014-011534 · 2.77 Impact Factor
  • Ulas Cikla · Kutluay Uluc · Mustafa K Baskaya
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    ABSTRACT: Thrombosed giant intracranial aneurysms usually present with symptoms and signs from their mass effect. Although multiple treatment options are available, direct clip reconstruction with thromboendarterectomy remains the gold standard. Here we present a 66-year-old man with seizure, aphasia and hemiparesis. Work-up revealed a giant partially thrombosed aneurysm of the internal carotid artery bifurcation with surrounding vasogenic edema. He underwent clip reconstruction of the aneurysm via a cranio-orbital approach. Although we prepared for bypass with the radial artery and/or the superficial temporal artery, we were able to clip-reconstruct the aneurysm without bypass. The patient improved upon his pre-morbid state after surgery and made an excellent recovery. The video can be found here: .
    Neurosurgical FOCUS 01/2015; 38(VideoSuppl1):Video20. DOI:10.3171/2015.V1.FOCUS14618 · 2.11 Impact Factor
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    ABSTRACT: Background and Study Aim To enhance the visualization of the intracranial vasculature of cadavers under gross examination with a combination of imaging modalities. Material and Methods A total of 20 cadaver heads were used to test two different perfusion techniques. First, fixed cadaver heads were perfused with water; second, fresh cadavers were perfused with saline and 10% formalin. Subsequently, brains were removed and fixed. The compounds used were silicone rubber, silicone rubber mixed with powdered barium sulfate, and silicone rubber mixed with tantalum dioxide prepared by the first perfusion technique and gelatin mixed with liquid barium prepared with the second technique. Conventional X-ray imaging, computed tomography (CT), dynamic computed tomography (dCT), and postprocessing three-dimensional (3D) images were used to evaluate all the heads. Results Gelatinized barium was better visualized when compared with tantalum dioxide in conventional X-ray images. The blood vessels injected with either tantalum dioxide or gelatinized barium demonstrated a higher enhancement than the surrounding soft tissues with CT or dCT. The quality of the 3D reconstruction of the intracranial vasculature was significantly better in the CT images obtained from the gelatinized barium group. Conclusions Radiologic examinations of the heads injected with gelatinized barium facilitates the 3D understanding of cerebrovascular anatomy as an important tool for neuroanatomy training.
    Journal of Neurological Surgery, Part B: Skull Base 12/2014; 75(6):435-444. DOI:10.1055/s-0034-1386653 · 0.72 Impact Factor
  • Ulaş Ckla · Christopher Baggott · Azam Ahmed · David B. Niemann · Mustafa K. Başkaya
    12/2014; 36(26):1-8. DOI:10.1097/01.CNE.0000461918.00578.e4
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    Ulaş Cıkla · Alireza Sadighi · Andrew Bauer · Mustafa K Başkaya
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    ABSTRACT: Objective To illustrate a unique instance of Ehlers-Danlos syndrome type VIII (EDS VIII) with blood blister–like aneurysm of the middle cerebral artery. Design This is a single patient case report. Setting University of Wisconsin-Madison Hospital. Participants A 42-year-old woman with diagnosis of EDS VIII presented with a sudden onset severe headache and altered mental status. She was diagnosed with Hunt and Hess grade IV subarachnoid hemorrhage. Angiography demonstrated a blood blister–like aneurysm of the left middle cerebral artery. After an unsuccessful coiling attempt in another facility, the patient was operated on with the intention to perform extracranial to intracranial bypass and trapping of the diseased segment of the artery. Results The patient's neurologic condition remained poor after surgery. On postoperative day 2, her neurologic examination unchanged, and care was withdrawn per the family's request. Conclusions Individuals with EDS VIII may be at risk for catastrophic vascular events.
    Journal of Neurological Surgery 12/2014; 75(2):e210-e213. DOI:10.1055/s-0034-1387185 · 0.49 Impact Factor
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    ABSTRACT: The aim of this study was to analyze the topographical anatomy of the dorsal spinal cord (SC) in relation to the posterior median septum (PMS). This included the course and variations in the PMS, and its relationship to and distance from other dorsal spinal landmarks. Microsurgical anatomy of the PMS was examined in 12 formalin-fixed adult cadaveric SCs. Surface landmarks such as the dorsal root entry zone (DREZ), the denticulate ligament, the architecture of the leptomeninges and pial vascular distribution were noted. The PMS was examined histologically in all spinal segments. The PMS extended most deeply at spinal segments C7 and S4. This was statistically significant for all spinal segments except C5. The PMS was shallowest at segments T4 and T6, where it was statistically significantly thinner than at any other segment. In 80% of the SCs, small blood vessels were identified that traveled in a rostrocaudal direction in the PMS. The longest distance between the PMS and the DREZ was at the C1–C4 vertebral levels and the shortest distance was at the S5 level. Prevention of deficits following a dorsal midline neurosurgical approach to deep-seated SC lesions requires careful identification of the midline of the cord. The PMS and septum define the midline on the dorsum of the SC and their accurate identification is essential for a safe midline surgical approach. In this anatomical study, we describe the surface anatomy of the dorsal SC and its relationship with the PMS, which can be used to determine a safe entry zone into the SC. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.
    Clinical Anatomy 12/2014; 28(1). DOI:10.1002/ca.22490 · 1.33 Impact Factor
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    ABSTRACT: Non-aneurysmal spontaneous subarachnoid hemorrhage is characterized by an accumulation of a limited amount of subarachnoid hemorrhage, predominantly around the midbrain, and a lack of blood in the brain parenchyma or ventricular system. It represents 5% of all spontaneous subarachnoid hemorrhage cases. In spite of extensive investigation, understanding of the mechanisms leading to perimesencephalic non-aneurysmal subarachnoid hemorrhage remains incompletely defined. A growing body of evidence has supported a familial predisposition for non-aneurysmal spontaneous subarachnoid hemorrhage. A 39-year-old Caucasian man presented with sudden onset headache associated with diplopia. His computed tomography scan revealed perimesencephalic subarachnoid hemorrhage. A cerebral angiogram showed no apparent source of bleeding. He was treated conservatively and discharged after 1 week without any neurological deficits. The older brother of the first case, a 44-year-old Caucasian man, presented 1.5 years later with acute onset of headache and his computed tomography scan also showed perimesencephalic non-aneurysmal subarachnoid hemorrhage. He was discharged home with normal neurological examination 1 week later. Follow-up angiograms did not reveal any source of bleeding in either patient. We report the cases of two siblings with perimesencephalic non-aneurysmal subarachnoid hemorrhage, which may further suggest a familial predisposition of non-aneurysmal spontaneous subarachnoid hemorrhage and may also point out the possible higher risk of perimesencephalic non-aneurysmal subarachnoid hemorrhage in the first-degree relatives of patients with perimesencephalic non-aneurysmal subarachnoid hemorrhage.
    Journal of Medical Case Reports 11/2014; 8(1):380. DOI:10.1186/1752-1947-8-380
  • Ulaş Cıkla · Christopher Baggott · Mustafa K Başkaya
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    ABSTRACT: Background Blood blister-like aneurysms (BBAs) pose a significant challenge to neurosurgeons and neuro-interventionalists. These fragile broad-based aneurysms have a propensity to rupture with minimal manipulation during surgical or endovascular explorations because, unlike saccular aneurysms, they lack all layers of the arterial wall. Aneurysm trapping with extracranial-intracranial (EC-IC) bypass is a safe and durable treatment for BBAs. Methods We describe our technique and the guiding principles for surgical bypass and trapping of BBAs of the supraclinoid internal carotid artery (ICA). Conclusions Treatment of BBAs of the supraclinoid ICA remains difficult. Aneurysm trapping with EC-IC bypass treats BBAs definitively by eliminating the diseased segment of the ICA. We have found the technique and principles described here to be safe and durable in our hands.
    Acta Neurochirurgica 09/2014; 156(11). DOI:10.1007/s00701-014-2212-8 · 1.77 Impact Factor
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    Ulas Cikla · Chiristopher Baggott · Mustafa K. Baskaya
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    ABSTRACT: In adolescents and young adults, ependymomas are the most common intramedullary tumors in the spinal cord.These tumors arise from ependymal cell lining the ventricles and spinal canal. The clinical presentation of intramedullary ependymomas are variable and nonspecific. They usually present with diffuse back or neck pain as a chief complaint. Upper and lower motor neuron deficits, numbness which typically progresses from distal to proximal, are other common symptoms. Gross total resection of ependymomas can achieve long-term tumor control with preservation of function. Here we present a 29-year old man who presented with progressive weakness of the left leg, bowel and bladder incontinence. During surgery, somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) were used and we achieved gross total resection while preserving the spinal cord. The patient made excellent recovery and all of his preoperative deficitis improved completely. He returned to work on postoperative 2-month.
    Turkish neurosurgery 09/2014; 24(5):763-764. DOI:10.5137/1019-5149.JTN.12603-14.0 · 0.58 Impact Factor

Publication Stats

2k Citations
386.53 Total Impact Points


  • 1997–2015
    • University of Wisconsin–Madison
      • Department of Neurological Surgery
      Madison, Wisconsin, United States
    • University of Wisconsin - Stout
      Menominee, Wisconsin, United States
  • 2008
    • St. Mary's Hospital (WI, USA)
      Madison, Wisconsin, United States
  • 2004–2007
    • University of Miami
      • • Department of Medicine
      • • Lois Pope LIFE Center
      كورال غيبلز، فلوريدا, Florida, United States
  • 2003–2006
    • University of Miami Miller School of Medicine
      • Department of Neurological Surgery
      Miami, Florida, United States
  • 2000–2003
    • Louisiana State University Health Sciences Center Shreveport
      • Department of Neurosurgery
      Shreveport, Louisiana, United States
  • 1998–2000
    • Louisiana State University in Shreveport
      Shreveport, Louisiana, United States
  • 1995–1996
    • University of Kentucky
      • Department of Surgery
      Lexington, Kentucky, United States
  • 1992–1996
    • Ankara University
      • • Department of Neurosurgery
      • • Faculty of Medicine
      Engüri, Ankara, Turkey