Samet Dinc

Background: Confocal laser endomicroscopy (CLE) enables real-time microscopic assessment of tissue during brain tumor surgery and has been investigated as an adjunct to intraoperative diagnosis and fluorescence-guided resection. Previous reviews have largely focused on the technical characteristics and clinical applications of CLE. This study aimed to provide a quantitative overview of the development of the field, its collaborative structure, intellectual foundations, and major research themes. Methods: The Web of Science Core Collection was searched on May 30, 2026. After title and abstract screening, 114 publications from 2010 to 2026 were included. Bibliographic data were analyzed using VOSviewer version 1.6.20. Co-authorship, citation, co-citation, author-keyword co-occurrence, and bibliographic coupling analyses were performed. Publications with zero citations were additionally examined according to publication year, document type, and research topic. Results: The 114 publications received 1801 citations and had a dataset H-index of 25. Publication output increased after 2018 and reached its highest annual level in 2024. The United States, Germany, and Italy were the leading contributing countries, while Mark C. Preul, Jennifer M. Eschbacher, and Evgenii Belykh were among the leading contributors. The main thematic core included CLE, brain tumors, fluorescein sodium, glioma, and fluorescence-guided surgery, with recent work extending toward telepathology and artificial intelligence-assisted image interpretation. Thirty-two publications (28.1%) were uncited; 16 (50.0%) were meeting abstracts, and 19 (59.4%) were published between 2024 and 2026. Conclusion: CLE research in brain tumor surgery has expanded since 2010, with published studies increasingly addressing potential clinical applications, telepathology, and computer-assisted image interpretation rather than demonstrating established adoption in routine clinical practice. Uncited publications included both publication types with lower citation visibility and recent studies with limited time to accumulate citations. These bibliometric patterns should not be interpreted as evidence of the clinical effectiveness of CLE. Further multicenter studies using standardized imaging and interpretation protocols and clinically relevant outcomes are needed to clarify the role of CLE in routine neurosurgical practice.

Chiari malformation (CM) is a congenital condition characterized by herniating cerebellar tonsils (HCTs) into the spinal canal. Although mostly managed through posterior decompression surgery, there is a lack of consensus about the need for surgery in asymptomatic patients or those with mild clinical findings. This study aimed to evaluate cerebrospinal fluid (CSF) flow parameters in patients with CM type 1 (CM-1) and compare them with posterior cranial fossa (PCF) morphometric measurements to use these measurements for predicting disease progression. Retrospective analysis. Department of Neurosurgery, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Health Sciences University Participants: Adult patients (n = 95; mean age = 40.8 ± 13.8 years; 76 females) diagnosed with CM-1 between January 2017 and October 2018. Symptoms at presentation, CSF flow score, PCF morphometric measurements—measured using brain and spinal cord magnetic resonance imaging and computed tomography. Coughing headache, presence of additional pathology (syringomyelia), PCF volume and height, Boogard's angle, foramen magnum surface area, HCT length, and HCT surface area (HCTSA) were significant factors affecting CSF flow. Further, multivariate regression analysis revealed that the HCT length and HCTSA, the presence of additional pathology, and Boogard's angle were independent predictors of CSF flow scores. The morphometric measures, HCT length, HCTSA, and Boogard's angle, and the presence of additional pathology are important predictive factors for reduced CSF flow at the craniovertebral junction in patients with CM-1. These factors can help clinicians predict the disease's clinical progression and plan surgical treatment.

Objective: We aimed to retrospectively evaluate and examine pediatric head trauma cases according to PECARN in the light of their neurological and clinical conditions. We wanted to contribute to the detection of TBI with minimum CT imaging rates in order to avoid radiation-related carcinogenesis. Method: 108 pediatric patients who were admitted to the emergency department due to minor head trauma and were admitted to the neurosurgery clinic were evaluated retrospectively. Result: During follow-up, 9 patients required intensive care and 5 patients underwent neurosurgical surgery. The most common trauma etiology was falling from one's own level with 53.7%. The most common tomography pathology was non-displaced fracture. According to the evaluations made in accordance with the PECARN algorithm, CT was recommended in 18 cases (16.7%); CT was not recommended for 32 cases. Conclusion: The clinician's goal is to quickly and accurately diagnose clinically significant TBI while avoiding unnecessary CT imaging to protect against the adverse effects of radiation. We recommend using the PECARN algorithm for this purpose.

Clear cell hydroadenocarcinoma is a very rare sweat gland tumor. It has an aggressive course and has a high recurrence rate. Wide excision is the first option in the treatment of this tumor with a high rate of metastasis. Subsequent radiotherapy and chemotherapy are still controversial. In this case, we presented a patient who was operated on and presented with a lipoma-like appearance on the scalp. The pathology result of the patient was Clear cell hidradenocarcinoma. We emphasized that in operations performed with the preliminary diagnosis of lipoma on the scalp, this diagnosis should be included among the preliminary diagnoses and resection should be performed as widely as possible.

Objective: SARS-CoV-2 is a pandemic that still causes high mortality and morbidity in our world. We observed and wanted to examine the high mortality and morbidity rates of SARS-CoV-2 due to lung and other organ involvement, and even more mortality in the presence of accompanying intracranial events.Methods: This study is a single-center retrospective cohort study. Patients who applied to Afyonkarahisar State Hospital between June 2020 and June 2021, who were evaluated as SARS-CoV-2 in their current state and who were found to have an intracranial hemorrhage, were evaluated.Results: Of the 13 patients in our cohort, 7 (54%) had comorbidities such as hypertension, diabetes mellitus, and chronic renal failure. The intraparenchymal hematoma was observed in 5 patients, chronic subdural hematoma in 2 patients, acute subdural hematoma in 1 patient, and subarachnoid hemorrhage in 4 patients. Decompressive craniectomy and hematoma evacuation were performed on 5 patients in our study. Nine of the patients included in our study died as a result of their follow-up and treatment in the intensive care unit, and the mortality rate was 69%.Conclusion: Intracranial hemorrhages may occur rarely in patients with SARS-CoV-2 infection, and it is observed that intracerebral hemorrhages, which are already quite mortal, are more mortal. In addition, COVID-19 infection is thought to be a risk factor for intracranial hemorrhages.

Cervical spondylotic myelopathy (CSM) develops as a result of compression of the spinal cord in the cervical region. Early diagnosis and surgical treatment can limit the progression of symptoms. Various surgical approaches and strategies have been described in the literature. This study aims to evaluate the clinical and radiological results of open-door laminoplasty for the treatment of CSM. In this study, we retrospectively analyzed the patients who underwent expansive open-door laminoplasty secured with titanium miniplates. Thirty-four patients with CSM who were followed up postoperatively for more than 12 months were included in the study.The modified Japanese Orthopedic Association(mJOA) score was used to assess the degree of myelopathy.We evaluated cervical sagittal alignment with C2-C7 Cobb angle, the ambulatory status with the Nurick grade, and measured postoperative neck pain with the Visual Analogue Scale(VAS). The mean mJOA score was 11(range 6-15) preoperatively, and 13.5 (range 9-16) postoperatively with an average 55% recovery rate (range 0-75)(p <0.001).The mean Nurick grade was 2(range 1-3) preoperatively and 1 (range 0-3) postoperatively (p <0.001).The median cervical lordoticangle increased from 7.5° preoperatively to 12.5° postoperatively (p = 0.044).K-line (+) patients' mean mJOA scores significantly increased from 10.8 ±1.7 to 13.3±1.7postoperatively (p <0.001).The mean preoperative VAS reducedfrom 2.66±1.4 to 1.59±1.4 postoperatively (p <0.001). Open-door laminoplasty technique is an effective surgical procedure that can be used safely to treat cervical spondylotic myelopathy.Our findings suggest that it can limit the progression of symptoms and alter the poor prognosis in CSM.