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    A Case of Spontaneous Spinal Epidural Hematoma Mimicking Stroke
    (Turkish Neurological Soc, 2014) Koc, Emine Rabia; Acar, Burcu; Ayturk, Zubeyde; Cemil, Duran Berker; Kosehan, Dilek; Ilhan, Atilla
    Spontaneous spinal epidural hematoma is an uncommon cause of acute non-traumatic myelopathy and may present with various clinical phenotypes. It should be included in the differential diagnosis of the patients who have focal neurological findings suggestive of stroke. Therefore, a thorough documentation of patient history is of great importance, since this can reveal symptoms suggestive of a different etiology. Here, we present a case of a 80-year-old female who was admitted with hemiparesis without cortical or cranial neurological abnormalities. She described pre-existing shoulder and neck pain. Diagnosis of epidural hematoma was made by cervical magnetic resonance imaging. Symptoms resolved partially after surgical intervention. Our case illustrates the variation in the clinical presentations of spontaneous spinal epidural hematoma which can be misdiagnosed as stroke. Therefore, in patients with preceding neck, shoulder or interscapular pain and focal neurological deficits, this diagnosis should be included in the differential diagnosis, particularly in the absence of cortical and cranial symptoms.
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    Pharmacomechanical Thrombectomy in the Management of Deep Vein Thrombosis Using the Cleaner Device: An Initial Single-Center Experience
    (Elsevier Science Inc, 2015) Bozkurt, Alper; Kirbas, Ismail; Kosehan, Dilek; Demircelik, Bora; Nazli, Yunus
    Background: Pharmacomechanical thrombectomy (PMT) has appeared as an effective treatment modality for deep venous thrombosis (DVT). The study aimed to assess the efficacy of the Cleaner(TM) thrombectomy device for acute DVT. Methods: Sixteen consecutive patients presenting with extensive iliofemoral and/or femoropopliteal acute DVT and managed at our institution between February 2013 and May 2014 were retrospectively reviewed. The patients underwent PMT with the Cleaner device after insertion of vena caval filters. For underlying stenotic lesions, balloon angioplasty and/or stent placement was performed. Results: PMT with the Cleaner device was successful in 14 patients with complete restoration of flow. No clinical signs of pulmonary thromboembolism was recorded after the procedure. Thrombectomy failed in 2 patients. For the rest of the patients, balloon angioplasty was performed to relieve underlying stenotic lesions. Nine of them underwent additional stenting. Conclusions: Our initial experience suggests that the Cleaner device can be used in acute DVT. However, further studies involving larger patient populations are warranted to determine long-term results.
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    The Value of Preoperative Lesion Dedicated Ultrasound of Breast Cancer before Conserving Surgery for Optimizing Margins
    (Wiley, 2017) Kosehan, Dilek; Dener, Cenap; Akin, Kayihan; Bozkurt, Alper; Bilgic, Ismail; Cakir, Banu
    To investigate the effect of US performed immediately before breast conserving surgery (BCS) by radiologist accompanied by the surgeon. All patients scheduled for BCS in the last year (group 1, n = 46) were evaluated with US immediately before surgery. About 108 patients (group 2) who were treated with BCS before the study were included as the control group. Tumor size and localization, the distances between tumor-skin and tumor-pectoralis muscle fascia were noted. Re-excision rate due to positive margins was significantly lower in group 1. Statistically significant difference was detected in re-excision rates for nonpalpable tumors. Preoperative US is an effective and practical method.