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At 12.5 dpc, they showed less testicular development in the form of sex cords, with fewer gonocytes and somatic cells. At 17.5 dpc, they presented greater interstitial space, fewer spermatogonial, sustentacular Sertoli, peritubular and interstitial Leydig cells. At 6 weeks postnatal, they presented fewer spermatogonia, pachytene spermatocytes, elongated spermatids, sustentacular Sertoli and interstitial Leydig cells, with statistically significant differences. In conclusion, prenatal exposure to VPA causes histopathological alterations in the offspring of mice in testicular development, from the embryonic stage to 6 weeks postnatal.Intermediate-grade meningeal melanocytomas (IGM) are rarely reported tumors and has not been reported in childhood yet. They are spaculated to have more agressive clinical behavior and their best management options has not been defined. Here we report a 19 months old child being the first case in English literature having IGM. Pre-operative diagnosis was confusing since patient history was unclear and radiological features resembled a growing skull fracture or a subtype of congenital parietal bone agenesis. An area of 5x7 cm dura was found to be dark grey and black in colour and excised but the operation was complicated with brain edema and swelling, and a second operation for reconstruction and dural repair was needed. Of the 16 patients reported in adults, 14 showed a high recurrence rate without adjuvan radiotherapy, and 2 did not showed recurrence with adjuvan radiotherapy. Our patient did not have adjuvan radiotherapy since he was just 19 months old at the time his diagnosis and did not show recurrence until now at 24 months of follow-up. Close monitoring with radiological imaging is of paramount importance.

Epilepsy surgery is an effective treatment in patients suffering from refractory epilepsy. In this study, the aim is to discuss seizure outcomes of patients, who had had invasive EEG monitorization (IEM), following their epilepsy surgery at our centre.

Forty-seven patients suffering from refractory epilepsy and who were evaluated by invasive EEG were included in this retrospective study at Istanbul Faculty of Medicine from 2003 to 2017. We examined the Video EEG and invasive EEG monitorization, cranial MRI, SPECT, PET and neuropsychological tests of all patients. Moreover, postoperative seizure outcome results were evaluated according to Engel classification. The factors affecting seizure outcome were discussed.

Twenty-six of the patients were female (55.3%), 21 were male (44.7). The average age were 32.0 (±12.4). Forty-three patients had surgery and the average age of these patients was 26,6 (±11,15). 38.3% of the patients had hippocampal sclerosis (HS), 23.4% had focal cortical dysplasia (FCD), 8.5% het of epilepsy and ages at surgery were lower than other groups; but the difference was not statistically significant (p 0.05). We argue that IEM is an essential examination for favorable outcome for the determination of epileptogenic zone and/or the proximity of the functional structures.

Mitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes (MELAS) syndrome is a rare but one of the most common maternally inherited multisystem disorder. Although patients with MELAS present a variable clinical profile, stroke-like lesions have been detected in 90% of cases, with stroke being the first presenting symptom in 25% of cases. However, cases of local brain edema requiring decompressive craniectomy has not been reported.

A 12-year-old male patient was admitted to our pediatric intensive care unit with altered mental status, seizures, and vision loss. The patient was stuporous and presented neck stiffness. Complete blood count, serum electrolytes, biochemistry (including lactate level), acute phase reactants, and repeated blood gas analysis were unremarkable. Brain magnetic resonance imaging (MRI) revealed an edematous stroke-like lesion in the right occipital lobe accompanied by brain swelling. Intravenous ceftriaxone, acyclovir, intravenous immunoglobulin (IVIG), andomy.

If the diagnosis and treatment are delayed, MELAS syndrome can cause serious brain edema, which may ultimately require decompressive craniectomy.

Brain metastasis in pediatric neuroblastoma is uncommon and with poor prognosis. This study was aimed to analyze the prognostic factors and treatment outcomes of neuroblastoma patients with brain metastasis.

The medical records of 7 patients with brain metastasis among 120 neuroblastoma patients treated with radiotherapy between June 2002 and December 2018 at our department were collected retrospectively. Survival time and prognostic factors were evaluated.

The prevalence of brain metastasis was 7/120 (5.8%). The median age was 35 months (25-64). Three (43%) patients had single brain metastasis. Two (29%) patients with solitary metastases underwent gross total resection and 1 (14%) patient with two lesions underwent subtotal resection for brain metastasis. All patients received chemotherapy and radiotherapy. The median time interval between the initial diagnosis and the brain metastasis was 14 months (0-28 months) in all patients; 12 months (0-28 months) in deceased patients and 23 months (19-26 months) in patients who were still alive at the time of this analysis (p=0.245). The median overall survival time after the treatment of brain metastasis was 14 months (7-22 months). GNE781 Five patients died from progressive disease and 2 patients who had gross total resection were alive for 164 and 187 months, respectively. While the 5-year overall survival rate was 67% in patients with isolated brain metastasis, the 5-year overall survival rate was 0% in the presence of other metastases (p = 0.221).

Isolated brain metastasis and gross total resection of the brain metastasis seems to be favorable prognostic factors. Patients with solitary brain metastasis should be consulted for brain surgery.

Isolated brain metastasis and gross total resection of the brain metastasis seems to be favorable prognostic factors. Patients with solitary brain metastasis should be consulted for brain surgery.

To compare external ventricular drain-related infection (EVD-RI) rates of two Academic Medical Centers in Turkey and the US in order to determine the key factors.

We performed an observational retrospective cohort study to compare the EVD-RI rates between two hospitals (Hospital T in Turkey; Hospital A in US). We analyzed data gathered from 736 patients (Hospital T, n=237; Hospital A, n=499), in a total of 736 EVD cases which occurred between January 1, 2013 and December 31, 2018. Electronic records of hospitals were searched according to the procedure code "external ventricular drain". The study protocol was approved by the audit and clinical governance committees of both participating hospitals.

EVD-RI rates in Hospital T, for a total of 3227 catheter days, was 18.3 per 1000 days and in Hospital A, for a total of 7010 catheter days, was or 4.0 per 1000 days.The prolonged use of EVD catheter, length of stay, and frequency of number of cerebrospinal fluid sampling were associated with EVD-RI in both hosCerebrospinal fluid culture of Hospital A was dominant for gram positive 32.6% and gram negative 46.1% rods, whereas for Hospital T, gram positive 39.0% and gram negative 33.9% rods were the main microorganisms for the EVD-RI.There was a correlation, between the duration of antibiotic use and EVD-RI in Hospital T.The nursing care facilities of the hospitals were significantly different. EVD-RI mortality found to be 10.7% versus 2.8% in Hospital A and Hospital T (p 0.05 Conclusion In both institutions, the EVD-RI was associated with EVD characteristics rather than patients\' personal characteristics. Early drain removal and patient discharge should be goals whenever medically appropriate.

Schwannomas are the most common benign tumors of the peripheral nerve. Surgery is indicated in patients with progressively increasing tumor volume, pain, paresthesia, and progressively worsening neurological deficits.

This article presents the case of a 32-year-old female patient with schwannoma. The patient had swelling on the anterior aspect of her right foot for a year. Her pain increased over the past 2 months, and a positive Tinel sign was present over the swelling. Magnetic resonance imaging revealed a large schwannoma mass in the deep peroneal nerve. The patient's large schwannoma was completely excised along with its capsule.

Schwannomas are benign tumors of the peripheral nerves that rarely exhibit malignant transformation. Treatment is considered to be curative if complete resection is achieved.

Schwannomas are benign tumors of the peripheral nerves that rarely exhibit malignant transformation. Treatment is considered to be curative if complete resection is achieved.

Cerebral cavernous malformations (CCM) are the second most common type of vascular malformations and also regarded as highly epileptogenic lesions if they involve the cortex. We present one of the largest retrospective cavernoma related epilepsy (CRE) studies which include divergent supratentorial locations operated and followed up at least 2 years. We also investigated the factors affecting the seizure outcome.

This study includes 56 patients with drug-responsive (40) and drug-resistant (16) CRE who underwent resective surgery. Age at seizure onset, age at surgery, gender, duration of epilepsy, seizure frequencies/type before and after treatment, EEG and brain MRI findings, prescribed AEDs, preoperative and post-operative neurological status, histopathological diagnosis, post-operative seizure outcomes and surgical information were documented.

The average follow-up period was 69.6 months (range 24-216 months). The seizure outcome was assessed according to Engel's classification at the last follow-up. Engel class I was achieved in 53 patients (95%); there was one patient at class II and two patients at class III. All patients in the drug-responsive group were at Engel class I after the surgery, while all patients at Engel classes II and III were in the drug-resistant patient group. This clearly shows that there were better outcomes in DRP group (p 0.01). Neither the locations of cavernomas nor the duration of epilepsy had any impact on seizure outcome (p 0.05).

An earlier surgical intervention may prevent the patients from becoming drug-resistant such that their chances of being seizure free after surgery increase.

An earlier surgical intervention may prevent the patients from becoming drug-resistant such that their chances of being seizure free after surgery increase.

Midbrain tremor is a rare and complex condition of the upper extremities, comprising a combination of resting, postural and kinetic tremors. Midbrain tremor is usually seen in the pathologies of the thalamus, upper brainstem and cerebellum. In midbrain tremor cases resistant to medical treatment, ventralis intermedius nucleus thalamotomy, dual-lesion or single-target stimulation have been applied with different success rates.

In this report, we present the case of a 21-year-old female with midbrain tremor involving atypical features, treated using a pedinculopontine nucleus lesion. Different targets for the treatment of midbrain tremor using radiofrequency lesion have been reported. In this case, stimulation of the thalamic ventralis intermedius nucleus and subthalamic nucleus produced no satisfactory improvement in tremor frequency and amplitude. A third goal was to obtain a significant response in terms of these outcomes with pedinculopontine nucleus stimulation.

According to the literature, this is the first case of midbrain tremor treated with a pedinculopontine nucleus radiofrequency thermocoagulation lesion.