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Publication Metadata only The Reynolds Intellectual Assessment Scales: measurement invariance and mean comparison across United States and Iranian children(Springer Nature, 2024) Tabiani Nian, Lida; Mahmoudi, Hojjat; Reynolds, Cecil R.; Dalvand, Sahar; Ebrahimiave, Seyedehmitra; Abdollahpour Ranjbar, Hamed; Graduate School of Social Sciences and HumanitiesObjectiveExploring the influence of culture on neuropsychological testing presents a complex challenge for researchers. Recently, RIAS-2 has garnered interest in cross-cultural studies. However, there remains a gap in understanding how Asian cultures, particularly in the Middle East, affect the outcomes of this test. This study aims to investigate the invariance and comparative performance of Iranian and U.S. children on the RIAS-2, shedding light on this aspect of the puzzle.MethodThe current study conducted a comparative analysis involving Iranian and U.S. children. A total of 178 Iranian children were chosen through cluster sampling from Tehran and completed the Reynolds Intellectual Assessment Scales (RIAS-2) test. The U.S. sample was carefully matched with the Iranian group and made available to the researchers for analysis.FindingsIn this study, we initially examined a single-factor model encompassing all subtests across both groups. However, the SPS subtest was excluded from this model. Subsequently, we employed index scores, revealing that only two indexes, CIX and SPI, maintained invariance across the two cultural groups. Notably, in both models, U.S. participants exhibited higher average scores compared to their Iranian counterparts. Additionally, the ANOVA test, serving as a supplementary measure, yielded nearly identical results regarding the average score discrepancy.ResultsThe findings of this study underscored the suitability of CIX and SPI scores as reliable indicators for cross-cultural investigations. Furthermore, in the following, some cultural factors affecting the difference in IQ scores between the U.S. and Iranian groups were discussed.Publication Metadata only Reliability and validity of the Turkish version of the 39-item parkinson disease questionnaire(Literatura Medica, 2023) Dereli, Elif Elçin; Kayapınar Aylak, Emine Eda; Bilge, Tuba Kayapınar; Çakmak, Özgür Öztop; Ertan, Fatoş Sibel; Taşkıran, Özden Özyemişçi; ; School of Medicine; Koç University HospitalBackground and purpose - This study aims to investigate the validity and reliability of the Turkish Version of the 39-item Parkinson Disease Questionnaire. Methods - A total of 100 patients with Parkinson's disease who were admitted to the outpatient neurology clinic in Koc University and Istanbul University were enrolled. 39-item Parkinson Disease Questionnaire, Parkinson Disease Quality of Life Questionnaire, Unified Parkinson's Disease Rating Scale, Hoehn-Yahr Scale, and Short Form Health Survey-36 were administered to all participants. 39-item Parkinson Disease Questionnaire was repeated 2 weeks later. Results - The internal consistency coefficient of the 39-item Parkinson Disease Questionnaire was 0.957. Test-retest correlation ranged between r = 0.693-0.979. Reliability of Turkish version of the 39-item Parkinson Disease Questionnaire was found to be very high with the exclusion of one item (30(th) item). The scale was found to be consistent over time and correlated positively with Hoehn-Yahr Scale, and negatively with Unified Parkinson's Disease Rating Scale, Parkinson Disease Quality of Life Questionnaire, and Short Form Health Survey-36. Conclusion - Turkish version of the 39-item Parkinson Disease Questionnaire, with the exclusion of the 30th item can be used reliably in assessing the quality of life of Parkinson's patients.Publication Metadata only Clinical results of anterior odontoid screw fixation for type II odontoid fractures(Turkish Neurosurgical Society, 2014) Keskin, Fatih; Gomleksiz, Cengiz; Sasani, Mehdi; Oktenoglu, Tunc; Suzer, Tuncer; Özer, Ali Fahir; Faculty Member; School of Medicine; 1022AIM: In this study, 31 patients with a diagnosis of Type II odontoid fractures were reported. All patients were treated with anterior transodontoid screw fixation and clinical outcomes were reported. MATERIAL and METHODS: In this study, the retrospective clinical analysis of 31 patients with traumatic type II odontoid fractures who were treated through anterior transodontoid fixation in Neurosurgery Department at VKV American Hospital between 1998 and 2012 was performed. The age, sex, cause of injury, diagnosis time, neurological examination before and after surgery, follow-up period were evaluated. The neurological status of patients was classified according to the Frankel scale. RESULTS: In 4 patients, 2 transodontoid screws were inserted. The mean hospital stay was 3.35 days. Posterior occipito-cervical fusion was done in 1 patient due to the lack of fusion in the first operation. No vascular injury, screw malposition, infection, neurologic deterioration, or complications were observed during the peroperative and postoperative stage. The mean postoperative follow-up period was 36 months after surgery. Radiological imaging of patients were performed at the early and late postoperative stage. CONCLUSION: We found satisfying fusion rates and better patient comfort during the postoperative period. We think that stabilization and fusion through a transodontoid screw is a minimal invasive method.AMAÇ: Çalışmada, Tip II odontoid fraktürü tanısı alan 31 olgu bildirilmiştir. Olguların hepsi anterior transodontoid vida fiksasyonu ile tedavi edilmiş ve klinik sonuçları bildirilmiştir. YÖNTEM ve GEREÇLER: Çalışma, VKV Amerikan Hastanesi Nöroşirürji Bölümü’nde 1998-2012 yılları arasında travmatik tip II odontoid kırığı nedeniyle anterior transodontoid fiksasyon ile cerrahi tedavi uygulanan 31 hastanın retrospektif klinik analizleri yapılmıştır. Tüm olguların yaş, cinsiyet, travma nedeni, teşhis zamanı, cerrahi girişim öncesi ve sonrasında nörolojik muayeneleri, takip süresi değerlendirilmiştir. Olguların nörolojik durumları Frankel skalasına göre sınıflandırılmıştır. BULGULAR: Dört hastaya 2 adet transodontoid vidası yerleştirildi. Hastanede kalış süresi ortalama 3,35 gün idi. 1 hastada postop takibinde füzyon oluşmaması nedeniyle ikinci bir operasyon ile posteriordan oksipitoservikal füzyon yapıldı. İşlem sırasında ve sonrasında damar yaralanması, vida malpozisyonu, enfeksiyon, nörolojik bozulma gibi komplikasyonlar izlenmedi. Hastalar ameliyat sonrasında ortalama 36 ay takip edildi. Hastaların erken ve geç dönemde radyolojik görüntülemeleri yapıldı. SONUÇ: Postoperatif dönemde hastaların takiplerinde tatmin edici füzyon oranı ve hasta konforunun daha iyi olduğunu saptadık. Tip II odontoid kırıklarının cerrahi tedavisinde minimal invaziv yöntem olan transodontoid vida ile fiksasyonun yüksek avantajlarından dolayı ilk seçenek olabileceğini düşünüyoruz.Publication Metadata only Basilar artery occlusion management: an international survey of middle versus high-income countries(Sage, 2022) Drumm, Brian; Herning, Ana; Klein, Piers; Raymond, Jean; Abdalkader, Mohamad; Huo, Xiaochuan; Chen, Yimin; Siegler, James E.; Peacock, Meabh; Schonewille, Wouter J.; Liu, Xinfeng; Hu, Wei; Ji, Xunming; Li, Chuanhui; Alemseged, Fana; Liu, Liping; Nagel, Simon; Strbian, Daniel; Rebello, Leticia C.; Yaghi, Shadi; Qureshi, Muhammad M.; Fischer, Urs; Tsivgoulis, Georgios; Kaesmacher, Johannes; Yamagami, Hiroshi; Puetz, Volker; Sylaja, Pn; Marto, Joao Pedro; Sacco, Simona; Kristoffersen, Espen Saxhaug; Demeestere, Jelle; Conforto, Adriana B.; Meyer, Lukas; Kaiser, Daniel P. O.; Reiff, Tilman; Romoli, Michele; Diana, Francesco; Lobotesis, Kyriakos; Roi, Dylan; Masoud, Hesham E.; Ma, Alice; Mohammaden, Mahmoud H.; Doheim, Mohamed F.; Zhu, Yuyou; Sang, Hongfei; Sun, Dapeng; Ton, Mai Duy; Raynald; Li, Fengli; Lapergue, Bertrand; Hanning, Uta; Yang, Qingwu; Lee, Jin Soo; Thomalla, Gotz; Yang, Pengfei; Liu, Jianmin; Campbell, Bruce C., V; Chen, Hui-Sheng; Zaidat, Osama O.; Qiu, Zhongming; Nogueira, Raul G.; Miao, Zhongrong; Nguyen, Thanh N.; Banerjee, Soma; N/A; Aydın, Kubilay; Doctor; N/A; Koç University Hospital; N/ABackground and Purpose: Two early basilar artery occlusion (BAO) randomized controlled trials (RCTs) did not establish the superiority of endovascular thrombectomy (EVT) over medical management. Yet many providers continued to recommend EVT. The goal of the present article is to compare physicians' diagnostic and management strategies of BAO among middle-income and high-income countries (MICs and HICs, respectively). Methods: We conducted an international survey from January to March 2022 regarding management strategies in acute BAO, to examine clinical and imaging parameters influencing clinician management of patients with BAO. We compared responses between physicians from HIC and MIC. Results: Among the 1245 respondents from 73 countries, 799 (64.2%) were from HIC, with the remaining 393 (31.6%) from MIC. Most respondents perceived that EVT was superior to medical management for acute BAO, but more so in respondents from HIC (98.0% vs. 94.2%, p < 0.01). MIC respondents were more likely to believe further RCTs were warranted (91.6% vs. 74.0%, p < 0.01) and were more likely to find it acceptable to enroll any patient who met a trial's criteria in the standard medical treatment arm (58.8% vs. 38.5%, p < 0.01). Conclusions: In an area where clinical equipoise was called into question despite the lack of RCT evidence, we found that respondents from MIC were more likely to express willingness to enroll patients with BAO in an RCT than their HIC counterparts.Publication Metadata only Gamma knife radiosurgery for hemorrhagic brainstem cavernomas(Turkish Neurosurgical Soc, 2019) Üçüncü Kefeli, Ayşegül; Şengöz, Meriç; N/A; Peker, Selçuk; Faculty Member; School of Medicine; Koc University Hospital; 11480AIM: To assess treatment results of gamma knife radiosurgery (GKRS) for hemorrhagic brainstem cavernous malformations (BSCMs). MATERIAL and METHODS: A retrospective review of patients with hemorrhagic BSCMs, who were treated at the Acibadem Kozyatagi Hospital GKRS unit from May 2007 to October 2015 was performed. RESULTS: In total, 82 patients were identified. All patients had experienced at least one hemorrhagic event (range 1-3), and all of them presented with radiological evidence of hemorrhage. The median target volume was 0.3 ml, and the median marginal radiation dose was 12 Gy. The mean durations before and after surgery were 25.5 (range 1-204) months, and 50.3 (range 13-113) months, respectively. Pre-treatment hemorrhage rates were calculated from the date of first hemorrhage to the date of radiosurgery. There were 97 bleeds over 174.4 patient-years during the observation period, with an annual hemorrhage rate of 55.7%. If the first bleed is excluded, the annual hemorrhage rate was 8.6%. Only three patients demonstrated re-bleeding, which occurred at 3, 12 and 79 months after radiosurgery. Over a total follow up time of 344 patient-years the annual re-bleeding rate was therefore 0.87%, indicating that the risk of BSCM hemorrhage was significantly decreased by radiosurgery. CONCLUSION: GKRS was a safe and effective treatment for symptomatic low volume BSCMs when a low marginal dose is used. A randomized controlled trial is needed that compares GKRS to observation if we want to establish the true efficacy of this treatment.Publication Metadata only A multidisciplinary clinical approach to facioscapulohumeral muscular dystrophy orthopedic surgery in facioscapulohumeral dystrophy(Literatura Medica, 2018) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Çakmak, Özgür Öztop; Eren, İlker; Aslanger, Ayça Dilruba; Günerbüyük, Caner; Kayserili, Hülya; Oflazer, Piraye; Şar, Cüneyt; Demirhan, Mehmet; Özdemir, Yasemin Gürsoy; Faculty Member; Faculty Member; Doctor; Teaching Faculty; Faculty Member; Faculty Member; Doctor; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koc University Hospital; 107818; 168021; N/A; 380939; 7945; N/A; N/A; 9882; 170592Background - Impaired shoulder function is the most disabling problem for daily life of Fascioscapulohumeral muscular dystrophy (FSHD) patients. Scapulothoracic arthrodesis can give a high impact to the functionality of patients. Here we report our experience with scapulothoracic arthrodesis and spinal stenosis surgery in FSHD patients. Patients and methods - 32 FSHD patients were collected between 2015-2016. Demographical and clinical features were documented. All the patients were neurologically examined. The Medical Research Council (MRC) and the FSHD evaluation scale was used to assess muscle involvement(1). Scapulothoracic arthrodesis and spinal stenosis surgeries were performed in eligible patients. Results - There were 16 male and 16 female (mean age 34.4 years; range 12-73) patients. 6 shoulders of 4 patients aged between 2132 years underwent scapulothoracic arthrodesis (two bilateral, one left and one right sided). Only one 63 years old female patient with severe hyperlordosis had spinal fusion surgery. All of the patients undergoing these corrective surgeries have better functionality in daily life, as well as superior shoulder elevation. Conclusion - Until the emergence and clinical use of novel therapeutics, surgical interventions are indicated in carefully selected patients with FSHD to improve arm movements, the posture and the quality of life of patients in general. Scapulothorosic arthrodesis is a management with good clinical results and patient satisfaction. In selected cases other corrective orthopedic surgeries like spinal fusion may also be considered.Publication Metadata only Hormonal and radiologic outcomes after gamma knife radiosurgery for nonfunctioning pituitary adenomas(Taylor & Francis Ltd) Kara, Mujdat; Yilmaz, Meltem; Sengoz, Meric; N/A; Peker, Selçuk; Faculty Member; School of Medicine; Koç University Hospital; 11480Background Gamma knife radiosurgery (GKRS) is an established treatment option for residual and recurrent nonfunctioning pituitary adenoma (NFPA). This investigation assessed hormonal and radiologic outcomes after adjuvant and primary GKRS for NFPAs. Methods This retrospective study included 252 patients with NFPA who underwent GKRS at a single center between 2005 and 2016. GKRS was performed as adjuvant procedure in 216 (85.8%) patients and as primary procedure in 36 (14.2%) patients. Characteristics of these two groups were compared. Results Mean age was comparable between adjuvant and primary GKRS groups (48.3 +/- 12.6 vs. 52.2 +/- 13.2 years, respectively, p > 0.05). Adjuvant GKRS and primary GKRS groups were similar in terms of the mean prescribed radiation dose and tumor volume (15.1 +/- 2.7 vs. 15.3 +/- 1.9 Gy and 4.2 +/- 3.6 vs. 3.1 +/- 2.5 cm(3), respectively, p > 0.05 for both). The rate of endocrine deficiency during 5-year follow-up showed similar trend in adjuvant and primary GKRS groups (3.7%, 8.7%, and 14.8% vs. 5.6%, 13.9%, and 27.8% at first, third, and fifth year time points, respectively). Tumor control rates were also similar (98.6%, 96.3%, and 93% vs. 100%, 97.3%, and 94.5% at first, third, and fifth year time points, respectively). In both groups, tumor volume >5 cm(3) was associated with higher rate of hypopituitarism and tumor progression. Conclusions GKRS was effective both as adjuvant and primary procedure in patients with NFPA. Radiation dose of <= 13.5 Gy was associated with lower tumor control rate and tumor volume >5 cm(3) was associated with higher rates of hypopituitarism and tumor progression.Publication Metadata only Complications of 2-level dynamic stabilization: a correlative clinical and radiological analysis at two-year follow-up on 103 patients(2018) Yılmaz, Atilla; Erbulut, Deniz Ufuk; N/A; Çıplak, Necati Mert; Süzer, Süleyman Tuncer; Şentürk, Salim; Yaman, Onur; Sasani, Mehdi; Öktenoğlu, Bekir Tunç; Özer, Ali Fahir; Doctor; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; N/A; N/A; N/A; N/A; School of Medicine; School of Medicine; School of Medicine; Koc University Hospital; N/A; 221691; N/A; 219524; 219451; 220898; 1022AIM: To investigate the postoperative complications, such as screw loosening, screw breakage and adjacent segment disease (ASD), in patients who underwent surgery with 2-level dynamic stabilization systems. MATERIAL and METHODS: Postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization were retrospectively reviewed. A total of 103 patients with lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at 2-year follow-up. Screw breakage and loosening were evaluated during this duration together with clinical findings. ESULTS: Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were significantly decreased at the four-month evaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. ASD was diagnosed in twelve (8 females, 4 males) of the 103 patients in the follow-up radiological and clinical controls. There were 9 screw breakages and 4 screw loosening cases. The complication rate of 2-level dynamic stabilization was high in this study. CONCLUSION: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are not rare after 2-level dynamic stabilization, unlike the acceptable results with the single-level dynamic system. The most probable explanation is that the instrument system behaves more rigidly with every additional segment.Publication Metadata only Posterior dynamic stabilization for the treatment of patients with lumbar degenerative disc disease: long-term clinical and radiological results(Turkish Neurosurgical Soc, 2013) Canbay, Suat; Aydin, Ahmet Levent; Aktas, Elif; Erten, Serhat Fuat; Basmaci, Mehmet; Sasani, Mehdi; Özer, Ali Fahir; Faculty Member; School of Medicine; 1022AIM: Comparison of long-term preoperative and postoperative clinical and radiological results for patients diagnosed with degenerative disc disease that underwent posterior dynamic stabilization. Lumbar disc degeneration is caused by a variety of factors. Disruptions in the vertebral endplate result in defects in disc nutrition and, thus, disc degeneration. The aims of dynamic stabilization are to unload the disc/facet joints, preserve motion under mechanical load, and restrict abnormal motion in the spinal segment. MATERIAL and METHODS:Twenty-five patients diagnosed with lumbar degenerative disc disease were enrolled.Totally, 25 vertebral segments were subjected to posterior dynamic stabilization. Patients were clinically evaluated in the preoperative and postoperative periods using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS). Segmental movement was evaluated radiologically in the late postoperative period by measuring the segmental angles during flexion and extension. RESULTS: Significant postoperative improvements were observed in the ODI and VAS measurements (P<0.01). During the long postoperative period (averaging 5 years and 2 months), lumbar lordosis angles, intervertebral space ratio and segmental ratio were measured and compared statistically. Adjacent segment disease developed in two patients. Both patients received L5-S1 discectomy. CONCLUSION: Good clinical outcomes were observed in the treatment of lumbar degenerative disc disease with a posterior dynamic system. / AMAÇ: Dejeneratif disk hastalığı tanısı almış ve posterior dinamik stabilizasyon sistemi uygulanmış hastaların uzun dönem preoperatif ve postoperatif klinik ve radyolojik sonuçlarının karşılaştırılması. Lomber dejeneratif disk hastalığına birçok etken sebep olur. Bu etkenler sonuç olarak omurga son plaklarında dejenerasyona ve disk dokusunun beslenmesinin bozulmasına yol açar. Dinamik stabilizasyon sistemleri, omurlar arasındaki hareketi korurken, disk ve faset eklemleri üzerindeki aşırı yüklenmeyi azaltır, aynı zamanda da omurga segmentindeki anormal hareketlenmeyi önler. YÖNTEM ve GEREÇLER: Bu çalışmada, dejeneratif disk hastalığı tanısı konmuş 25 hasta ele alınmıştır. Toplamda 25 omurga segmentine posterior dinamik stabilizasyon uygulanmıştır. Hastalar, preoperatif ve postoperatif dönemde Oswestry Disability Index (ODI) and Vizüel Analog Skala (VAS) ile klinik olarak değerlendirilmiştir. Segmental hareketi değerlendirmek için geç postoperatif dönemde radyolojik olarak fleksiyon ve ekstansiyon grafileri kullanılmıştır. BULGULAR: Postoperatif dönemde ODI ve VAS ölçümlerinde anlamlı düzelmeler kaydedilmiştir (P<0,01). Ameliyatlardan sonraki uzun dönem takiplerinde (ortalama 5 yıl 2 ay), lomber lordoz açısı, intervertebral aralık oranı ve segmental oran ölçülmüş ve istatiksel olarak değerlendirilmiştir. İki hastada postoperatif dönemde komşu segment hastalığı tespit edilmiş ve bu hastalarda L5-S1 diskektomi uygulanmıştır. SONUÇ: Lomber dejeneratif disk hastalığının cerrahi tedavisinde posterior dinamik stabilizasyon sistemi başarılı sonuçlar vermektedir.Publication Metadata only Assessing the connectional anatomy of superior and lateral surgical approaches for medial temporal lobe epilepsy(Elsevier, 2020) Balak, Naci; Baydin, Serhat; Aydin, Ilhan; Kayhan, Ahmet; Evran, Sevket; Kemerdere, Rahsan; Tanriover, Necmettin; N/A; Baran, Oğuz; Faculty Member; School of Medicine; Koç University Hospital; 291138The most common approaches in the treatment of epilepsy, the trans-sylvian selective amygdalohippocampectomy (SAH) and the anterior temporal lobe resection (ATLR) reach the medial temporal lobe through different surgical routes. Our aim was to delineate the white matter (WM) fiber tracts at risk in relation to trans-sylvian SAH and ATLR by defining each fascicle en route to medial temporal lobe dur ing each approach. ATLR and trans-sylvian SAH were performed and related WM tracts en route to medial temporal region were presented in relation to the relevant approaches and surrounding neurovascular structures. The WM tracts most likely to be disrupted during trans-sylvian SAH along the roof of the temporal horn were the UF - and less commonly IFOF - at the layer of the external capsule, anterior commissure, anterior bend of optic radiations, and sublenticular internal capsule. Amygdaloid projections to the claustrum, putamen and globus pallidus, the tail of caudate and the peduncle of the lentiform nucleus were also in close proximity to the resection cavity. Fiber tracts most likely to be impaired during ATLR included the UF, ILF, IFOF, anterior commissure, optic radiations, and, less likely, the vertical ventral segment of the arcuate fascicle. Both ATLR and trans-sylvian SAH carry the risk of injury to WM pathways, which may result in unpredictable functional loss. A detailed 3-D knowledge of the related connectional anatomy will help subside neurocognitive, neuroophtalmologic, neurolinguistic complications of epilepsy surgery, providing an opportunity to tailor the surgery according to patient's unique connectional and functional anatomy.