Browsing by Author "Candan, Selman"
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Publication Demonstration of cephaloceles in patients with rhinorrhea: Single centre experience of intrathecal gadolinium enhanced MR cisternography(Briefland, 2020-01-01) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Yılmazlar, Selçuk; Hakyemez, Bahattin; BİLGİN, CEM; CANDAN, SELMAN; YILMAZLAR, SELÇUK; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; HHS-7433-2022; AAH-5070-2021; AAI-2318-2021; GVS-7682-2022Background: MR cisternography has the crucial role for diagnosis of cerebrospinal fluid (CSF) leakage in patients with rhinorrhea and otorrhea. Trauma is the major cause of rhinorrhea. Cephalocele is diagnosed in some rhinorrhea patients.Objectives: To evaluate the CSF leakage in patients with rhinorrhea and assess the frequency of cephalocele in the etiology of rhinorrhea.Patients and Methods: Intrathecal gadolinium enhanced MR cisternography and nonenhanced CT of paranasal sinus images of patients with suspected CSF rhinorrhea between October 2012 and September 2018 were evaluated retrospectively. Twenty-one patients with the diagnosis of contrast leakage causing rhinorrhea were included in the study. All patients had intrathecal gadolinium enhanced MR cisternography. Three dimensional (3D)-T1 weighted and 3D-fluid attenuated inversion recovery (FLAIR) head MRI was obtained after administration of 1 ml intrathecal gadoterate meglumine after half, 3, and 8 hours. Locations of contrast leakage and etiologies were analyzed.Results: Patient group consisted of 21 patients with persistent or intermittent rhinorrhea. CT imaging showed bone defect in all patients. Intrathecal gadolinium enhanced MR cisternography revealed CSF leakage (10 ethmoid, 10 sphenoid, and 1 frontal). Cephalocele was detected in 10 of 21 patients.Conclusion: MR cisternography with intrathecal gadolinium enhancement is an effective and safe imaging modality compared to other techniques used for diagnosis of CSF leakage. Accurate localization of CSF fistula and demonstration of herniating content from cranial bone defect is feasible with this technique.Item Nörogirişimsel işlemlerde transradial yaklaşım(Bursa Uludağ Üniversitesi, 2021) Candan, Selman; Nas, Ömer Fatih; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.Çalışmamızın amacı kardiyolojik girişimsel işlemlerde rutin olarak kullanılan transradial yaklaşımın diagnostik ve tedaviye yönelik nörogirişimsel işlemlerdeki etkinliğini göstermektir. 30 hastada toplam 33 transradial giriş denemesi yapıldı, hastalardan 3 tanesine ikişer adet transradial işlem gerçekleştirildi. Bu 30 hastadan 20’si erkek (%67), 10’u (%33) kadındı. 33 işlemden 2 tanesinde giriş yeri transfemoral olarak değiştirildi (İşlem Başarısı 31/33= %94). Bu hastalardan birinde Allen testi negatif, Barbeau testi tip C paterninde olduğu için işlem transfemoral yolla gerçekleştirildi. Diğerinde ise giriş yapıldıktan sonra radial arterde tortiozite izlendi ve kateter radial arterden brakial artere ilerletilemedi. Olguların 18’inde (%58) diagnostik anjiografi işlemi, 8’inde (%25,8) karotid arter stentleme, 2’sinde (%6,5) vertebral arter stentleme, 2’sinde (%6,5) anevrizma koilleme işlemi, 1’inde (%3,2) anevrizmaya akım çevirici yerleştirme işlemi yapıldı. İşlemin başlangıcından işlem bitene geçen kadar süre ortalama 32,1±26,9 (minimum 5, maksimum 124) dakikaydı. 3 hastada komplikasyon izlendi. Komplikasyonlar sırasıyla hipotansiyon, sağ gözde görme kaybı ve radial arter spazmıydı. Sonuç olarak nörogirişimsel işlemlerde transradial girişim güvenli ve uygulanabilir bir yöntemdir. Her türlü nörogirişimsel işlemde tercih edilebilir ve vertebral arterlerle ilgili işlemlerde özellikle kolaylık sağlamaktadır.Publication Post-traumatic occipital intradiploic encephalocele(Elsevier Science, 2019-05-22) Kandemirli, Sedat Giray; Candan, Selman; Bilgin, Cem; Kandemirli, Sedat Giray; CANDAN, SELMAN; BİLGİN, CEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3976-4062; HHS-7433-2022; GVS-7682-2022; A-1409-2017BACKGROUND: Brain parenchyma herniation through a disrupted inner table into an enlarged diploic cavity with an intact outer table is described as intradiploic encephalocele. Intradiploic encephaloceles share common morphologic characteristics with expanding skull fractures and intradiploic arachnoid cysts. Herein, we describe a case of traumatic occipital intradiploic encephalocele.CASE DESCRIPTION: Cranial computed tomography of an 11-year-old boy revealed erosion of the inner table of the left side of occipital bone and expansion of the cranial diploe by a soft-tissue density with a gyral pattern. His medical history was positive for head trauma at the age of 3 years to the same region. Magnetic resonance imaging showed herniation of left occipital parenchyma with cystic encephalomalacic changes into the diploe.CONCLUSIONS: Intradiploic encephaloceles have different features compared with the classic encephalocele and can be considered as a variant of expanding skull fracture and intradiploic arachnoid cyst.Publication Right- versus left-sided approach for transhepatic tunneled catheter placement: Is there a difference?(Springer, 2021-04-08) Nas, Ömer F.; Candan, Selman; Öztepe, Muhammed F.; Kandemirli, Sedat G.; Bilgin, Cem; İnecikli, Mehmet F.; Özkaya, Güven; Gökalp, Gökhan; Öngen, Gökhan; Erdoğan, Cüneyt; NAS, ÖMER FATİH; CANDAN, SELMAN; Öztepe, Muhammed F.; İNECİKLİ, MEHMET FATİH; ÖZKAYA, GÜVEN; GÖKALP, GÖKHAN; ÖNGEN, GÖKHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsünde/Biyoistatistik Bilim Dalı.; 0000-0003-0297-846X; 0000-0002-3682-2474; AAK-5124-2020; HHS-7433-2022; GVS-7682-2022; AAG-8561-2021; DLB-1623-2022; IVU-2672-2023; GMO-0473-2022; FQR-8472-2022Objective We aimed to compare the technical difficulties, complications, long-term efficacy, and risks between right- and left-sided approach transhepatic tunneled catheterization. Methods We retrospectively evaluated transhepatic tunneled catheter placement cases in our institution between May 2012 and November 2019. Demographic and procedural parameters were recorded. Statistical tests were used to compare the complication rates of right- and left-sided approach. Furthermore, Cox regression analyses were used to investigate the relationship between functional catheter days and included parameters. Results A total of 83 procedures were performed in 46 patients, with a female to male ratio of 1.88 and a mean age of 55.5 +/- 18.2 years. Indication for catheter placement was chronic renal insufficiency and loss of central venous access through traditional routes in all cases. Median functional catheter durations were 28 days (1-382) and 55.5 days (1-780) for right-sided and left-sided access, respectively. Complication rates were similar for both sides. There was no difference between primary and revision procedures in terms of safety and efficacy outcomes. In univariate Cox regression analysis, gender was the only variable which was found to be statistically significant (HR = 2.014 (1.004-4.038)) for functional catheter days. In multivariate Cox regression model, gender and access side were included which failed to reach statistical significance. Conclusions In our study, both right- and left-sided approaches provided similar safety and efficacy outcomes, suggesting that both techniques can be employed based on physician's preference.Item Spinal cerebrospinal fluid leakage in spontaneous intracranial hypotension: An intrathecal gadolinium enhanced MR-myelography study(Ubiquity Press, 2019-12-25) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Demir, Aylin Bican; Hakyemez, Bahattin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; 0000-0002-3425-0740; HHS-7433-2022; GVS-7682-2022; 57200617643; 57209348454; 18036596400; 6602527239Objectives: In the present study, the authors presented the intrathecal gadolinium enhanced MR-myelography findings of patients with spontaneous intracranial hypotension. Materials and Methods: Intrathecal gadolinium enhanced MR-myelography (Gd-MR-myelography) examina-tions between October 2012 and September 2018 in patients having clinical and radiological findings of spontaneous intracranial hypotension were evaluated retrospectively. Sites and types of contrast leakages in 20 patients who met inclusion criteria were reviewed. All patients had undergone T1-fat suppressed sagittal images of cervical, thoracic and lumbar region after the off label intrathecal injection of 1 ml gadolinium-based contrast agent. Results: Patients (18 female, 2 male) are aged between 23 and 62 years-old (mean age: 41.1). Cerebrospi-nal fluid (CSF) leakages were cervical in 6 patients, thoracic in 5 patients, lumbar in 5 patients. One patient had leakage in multiple levels on both cervical and thoracic region and another patient on both cervical-thoracic and lumbar regions. No patients had adverse effects related to intrathecal injection of gadolinium. Conclusions: Gd-MR-myelography is effective imaging modality to reveal spinal CSF leakages in patients with spontaneous intracranial hypotension.