Mert Sahinoglu

Extramedullary plasmacytoma (EMP) is a rare plasma cell disorder of the soft tissue without systemic involvement like multiple myeloma (MM). It develops outside of the bone marrow. It happens seldom for a plasma cell neoplasm to manifest as an intracranial or cranial tumor, and it is much less common for it to resemble a pituitary adenoma. In patients with sellar area plasmacytomas, headaches, cranial nerve deficits, visual abnormalities, bloody nasal discharge, and discomfort in the eyes and craniofacial regions are common presentations. A biopsy is required to make the diagnosis. For parasellar plasmacytomas to be successfully managed, an accurate diagnosis is essential. Overall, patient survival is very good, although it might be lowered if they go on to develop overt MM. If there is no known history of MM, it is advised to do a thorough workup to identify any underlying MM or to closely monitor any MM development in the future. In this study, we aimed to report a rare case who presented with loss of vision without systemic involvement of MM and whose pituitary biopsy was a plasmacytoma.

Objective This retrospective study evaluates the demographic characteristics, clinical symptoms, laboratory results, treatment approaches, and outcomes of children with complications arising from bacterial sinusitis. Methods Fifty-four pediatric inpatients with sinusitis complications admitted between September 2013 and October 2022 were included in the study. These patients were categorized into two groups: those with preseptal cellulitis (group 1) and those with orbital–intracranial complications (group 2). Results The median age of the patients was 10.8 years, and 61.1% were males. Maxillary sinusitis (n = 40.74%) was the most common type of sinus involvement. Half of the patients exhibited preseptal cellulitis. The median age of our patients with intracranial complications was 13.7 years, while the median age of patients with orbital complications was 8 years. The predominant orbital–intracranial complication was meningitis, which accounted for 41% of the cases. All patients with a subdural abscess (n = 6) presented with frontal sinusitis, while all cases of cavernous sinus thrombosis (n = 3) involved the sphenoidal sinus. Surgical intervention was undertaken in 37% of cases. Streptococcus pneumoniae was the most frequently isolated microorganism. The median duration of hospital stay was 14 days, with a total median treatment duration of 21 days. There were no fatalities, although neurological sequelae were observed in 7.4% of patients (n = 4). Conclusion Preseptal cellulitis and meningitis remain the most common complications of sinusitis in children. Adolescents with sinusitis should be monitored closely for intracranial complications. The prevalence of S. pneumoniae as the most frequently detected pathogen underscores the importance of vaccination.

Aim: Posterior fossa epidural hematoma (PFEDH) in the pediatric age group is a very rare condition and the treatment method is still a matter of debate. The aim of this study is to evaluate the observation results in the management of pediatric patients with PFEDH in our tertiary care hospital and to investigate the importance of the relationship of the hematoma with the cerebral venous sinuses, which has not been investigated before in the literature, in the treatment decision. Materials and Methods: This is a retrospective study conducted at Selcuk University, Faculty of Medicine. All patients (≤ 17 years) diagnosed with PFEDH between January 2010 and May 2022 were included in this study. Demographic data, clinical signs, trauma type and symptoms at presentation, CT findings, type of treatment, and outcomes were collected. CT findings including hematoma thickness, hydrocephalus, presence of fourth ventricular compression, relation with cerebral venous sinuses and other associated brain injuries were evaluated. Results: The patient group consists of two girl and six boy. The most common cause of PFEDH was a fall from a height resulting in a blow to the back of the head in four patients. Vomiting was the most frequent presenting symptom. Four patients had a relation between cerebral venous sinuses and hematoma, and two of these patients underwent surgical treatment Conclusion: In addition to criteria such as hematoma thickness, GCS, hydrocephalus, and compression of the fourth ventricle, we determined that the relationship of hematoma with venous sinuses is a criterion to be evaluated.

Diencephalic syndrome is characterized by excessive weight loss and subcutaneous fatty tissue loss, hyperactivity, euphoria, and hypervigilance observed in early childhood. It usually accompanies space-occupying neoplastic lesions of the hypothalamic–optochiasmatic region. There is an inverse relationship between mass size and weight gain. In this case report, a patient aged 1 year and 2 months with hypothalamic–optochiasmatic glioma was presented. We aimed to draw attention to diencephalic syndrome, which is a rare cause of weight gain and vomiting.

Purpose Arachnoid cysts are usually asymptomatic lesions. However, they can sometimes cause intracranial hypertension, headache, seizures, focal neurological deficits, and bleeding. The most commonly used surgical techniques are microsurgical cyst fenestration/excision/drainage, cyst shunting, and endoscopic procedures. We aimed to investigate the success of different surgical techniques. Methods Between 2000 and 2021, patients with Sylvan fissure arachnoid cysts who received treatment via an endoscopic approach chosen as the first-line treatment in three centers were enrolled. All case notes and radiological studies were evaluated retrospectively. Results The study included 131 (female, n = 28; male, n = 103) patients with a mean age of 87.04 ± 66.76 (range, 0–216) months. Of the patients, 25 had Galassi type II left-sided arachnoid cysts, 33 had Galassi type II right-sided arachnoid cysts, 40 had Galassi type III left-sided arachnoid cysts, and 32 had Galassi type III right-sided arachnoid cysts. No difference was found between patients who underwent single and multiple fenestrations in terms of Galassi type, side, clinical outcome, and cyst size (p > 0.05). On the contrary, the rate of additional surgical intervention was lower in patients with multiple fenestrations than in those with single fenestration (36.10% vs. 5.30%; p < 0.001). Conclusion Endoscopic fenestration of Sylvian fissure arachnoid cysts is a good alternative to open surgery or cystoperitoneal shunting, and the number of fenestrations made during this surgery decreases the need for a second surgical procedure.

Symptomatic Chiari type 1 malformation (CIM) patients may elect to be treated; however, choosing the optimum surgical method remains problematic: posterior fossa decompression with duraplasty (PFDD...