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DEPARTMENT OF NEUROSURGERY
PROF. DR. MUSTAFA BOZBUĞA, MD, PhD
CENTER of NEUROSCIENCES
 Neurosurgery
 Neurology
 Neuroanesthesiology and Intensive Care Unit
 Neuroradiology
 Neurop...
DEPARTMENT OF NEUROSURGERY
• GENERAL MICRONEUROSURGERY
 Neuro-oncologic operations,
 Skull base surgery operations,
 Ce...
FACULTY of
MEDICINE
İstanbul Faculty of Medicine, University of İstanbul
1977 - 1983
NEUROSURGERY
RESIDENCY
TRAINING
Depar...
INTERNATIONAL TRAINING
“Clinical and Microneurosurgical Training”
in the Department of Neurosurgery of Zürich University H...
Neuro-oncology - Case 1
• G.Ç., 38-year-old female patient,
• GCS:13
• Headache for 5 years (progressive)
• Gait disturban...
• Combined left transsylvian, anterior temporal,
suboccipital retrosigmoid and transpetrosal-
presigmoid approach
• Total ...
POSTOPERATIVE IMAGING
• Post-operative 5-day lumbar drainage
• Left facial paresis, partially improved
• Right hemiparesis (4/5), resolved
• Pat...
Neuro-oncology - Case 2
• M.M.T. 14-year-old girl
• Right-sided severe headache -1 year
• VI. nerve paresis
• Diplopia
• B...
• Right extended frontotemporosphenoidal
craniotomy
+ Right orbitozygomatic osteotomy
+ Drilling of the greater sphenoid w...
• Pathologic diagnosis: Chordoma
Neuro-oncology - Case 3
• N. K.,33-year-old female patient
• Headache,
• Right-sided hearing loss-6 months
• V1,V2 hypoest...
Cranial MRI: Right cerebellopontin intensely
enhancing giant extraaxial mass lesion,
suggesting a meningioma…
• Right suboccipital retrosigmoid approach
• Total tumor resection
• Postoperative period without any problem.
• Pathology: Transitional meningioma
• Follow-up 5 years,
• Late MRI: No recurrence of the tumor
Neuro-oncology - Case 4
• A. Ö., 76-year-old man,
• Headache, protrusion on his parietal region
• Neurologically intact.
Preop Cranial CT
SURGERY
• Right occipital craniectomy,
• Total resection of the tumor + Cranioplasty
Postop Cranial CT
Postop Cranial MRI
Pathology: Meningioma
Normal postoperative period
without any deficit/complication.
Neuro-oncology - Case 5
• 72-year-old female patient
• Headache
• Cerebellar tests impaired on the left
SURGERY
• Left retrosigmoid approach
• Total tumor resection
• Normal neurological examination,
without any deficit/complication
• Histopathology: Transitional meningioma
• Follow-up ...
Neuro-oncology - Case 6
• 35-year-old-male,
• Progressive
headache and
loss of vision for
three months.
 Acuityofvisionisimpressedmarkedly,
 Anosmia (+),…
- Bifrontal craniotomy, subfrontal approach,
- Total resection of the tumor,
- Partial improvement in vision postoperative...
Cerebro-vascular - Case 1
• HP: 53 year-old-female patient,
• Acute, severe headache
• GCS 14, Neurodeficit (-) (WFNS grad...
SURGERY
• Left suboccipital retrosigmoid approach
• Aneurysm clipped,
• The patient recovered well.
POSTOP MRA
POSTOP DSA
Cerebro-vascular - Case 2
• 56-year-old-man,
• Headache (chronic-progressive, for about one-year)
• Neurologically intact
...
SURGERY
• Left pterional trans-sylvian approach
• AComA Aneurysm clipped
• Discharged without any
deficit/complication.
Cerebro-vascular - Case 3
• ST: 43-year-old-female patient
• Headache (acute, severe, for the last a few hours)
• GKS 13 (...
SURGERY
• Right pterional trans-sylvian approach
• Proksimal ICA Aneurysm clipped
Cerebro-vascular - Case 4
DÖ: 59-year-old-male patient,
• Acute, severe headache
• GCS 14 (WFNS grade 2)
• Fisher grade 4
SURGERY
• Left pterional trans-sylvian approach
• AcomA Aneurysm clipped without any
problem,
• The patient recovered well.
Cerebro-vascular - Case 5
• S.Ç.: 32-year-old-female
• Acute severe headache, N&V
• Loss of consciousness,
• Focal neurolo...
SURGERY
• Left frontoparietal large craniotomy
• Total resection of the AVM
• The patient recovered well.
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
some pati̇ents dr. m bozbuğa - neurosurgery
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some pati̇ents dr. m bozbuğa - neurosurgery

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some pati̇ents dr. m bozbuğa - neurosurgery

  1. 1. DEPARTMENT OF NEUROSURGERY PROF. DR. MUSTAFA BOZBUĞA, MD, PhD
  2. 2. CENTER of NEUROSCIENCES  Neurosurgery  Neurology  Neuroanesthesiology and Intensive Care Unit  Neuroradiology  Neuropathology  Neurorehabilitation
  3. 3. DEPARTMENT OF NEUROSURGERY • GENERAL MICRONEUROSURGERY  Neuro-oncologic operations,  Skull base surgery operations,  Cerebrovascular cases,  Microvascular decompression operations,  Spinal surgery operations,  Pediatric neurosurgical operations,  ….
  4. 4. FACULTY of MEDICINE İstanbul Faculty of Medicine, University of İstanbul 1977 - 1983 NEUROSURGERY RESIDENCY TRAINING Department of Neurosurgery İstanbul Faculty of Medicine, University of İstanbul 1985 - 1991 ASSOCIATE PROFESSOR in NEUROSURGERY 1999 DOCTORAL DEGREE in ANATOMY (PhD) Department of Anatomy İstanbul Faculty ofMedicine, University of İstanbul 1998 - 2004 PROFESSOR in NEUROSURGERY 2007
  5. 5. INTERNATIONAL TRAINING “Clinical and Microneurosurgical Training” in the Department of Neurosurgery of Zürich University Hospital Prof. Dr. M. Gazi Yaşargil 1988 & 1989 “Fellowship in “Cranial Base Surgery and Microneurosurgery” Department of Neurosurgery of School of Medicine, George Washington University, Washington, DC, USA Prof. Dr. L. N. Sekhar May 1993 – May 1994 “Fellowship in “Cranial Base Surgery and Microneurosurgery” Department of Neurosurgery of School of Medicine Osaka City University, Osaka, Japan Prof. Dr. Akira Hakuba June 1994 – October 1994
  6. 6. Neuro-oncology - Case 1 • G.Ç., 38-year-old female patient, • GCS:13 • Headache for 5 years (progressive) • Gait disturbance • Generalized tonic-clonic seizures for two months • Visual impairment on the left eye • Left V1,V2,V3 hypoesthesia • Left hemiparesis (4/5) • Dysphagia
  7. 7. • Combined left transsylvian, anterior temporal, suboccipital retrosigmoid and transpetrosal- presigmoid approach • Total tumor removal was performed
  8. 8. POSTOPERATIVE IMAGING
  9. 9. • Post-operative 5-day lumbar drainage • Left facial paresis, partially improved • Right hemiparesis (4/5), resolved • Pathology: Meningioma • No residual tumor/recurrence in the long-term follow-up.
  10. 10. Neuro-oncology - Case 2 • M.M.T. 14-year-old girl • Right-sided severe headache -1 year • VI. nerve paresis • Diplopia • Blurred vision • Nausea, vomiting • Bilateral papilloedema
  11. 11. • Right extended frontotemporosphenoidal craniotomy + Right orbitozygomatic osteotomy + Drilling of the greater sphenoid wing,…  Combined transsylvian and anterior temporal approach • Total tumor removal was achieved.
  12. 12. • Pathologic diagnosis: Chordoma
  13. 13. Neuro-oncology - Case 3 • N. K.,33-year-old female patient • Headache, • Right-sided hearing loss-6 months • V1,V2 hypoesthesia • Right facial paresis • Right ataxic gait • Cerebellar tests minimally impaired on the right
  14. 14. Cranial MRI: Right cerebellopontin intensely enhancing giant extraaxial mass lesion, suggesting a meningioma…
  15. 15. • Right suboccipital retrosigmoid approach • Total tumor resection • Postoperative period without any problem.
  16. 16. • Pathology: Transitional meningioma • Follow-up 5 years, • Late MRI: No recurrence of the tumor
  17. 17. Neuro-oncology - Case 4 • A. Ö., 76-year-old man, • Headache, protrusion on his parietal region • Neurologically intact.
  18. 18. Preop Cranial CT
  19. 19. SURGERY • Right occipital craniectomy, • Total resection of the tumor + Cranioplasty
  20. 20. Postop Cranial CT
  21. 21. Postop Cranial MRI
  22. 22. Pathology: Meningioma Normal postoperative period without any deficit/complication.
  23. 23. Neuro-oncology - Case 5 • 72-year-old female patient • Headache • Cerebellar tests impaired on the left
  24. 24. SURGERY • Left retrosigmoid approach • Total tumor resection
  25. 25. • Normal neurological examination, without any deficit/complication • Histopathology: Transitional meningioma • Follow-up three years: No recurrence
  26. 26. Neuro-oncology - Case 6 • 35-year-old-male, • Progressive headache and loss of vision for three months.
  27. 27.  Acuityofvisionisimpressedmarkedly,  Anosmia (+),…
  28. 28. - Bifrontal craniotomy, subfrontal approach, - Total resection of the tumor, - Partial improvement in vision postoperatively, - No complication, - Pathology: Meningoteliamatosis type meningioma.
  29. 29. Cerebro-vascular - Case 1 • HP: 53 year-old-female patient, • Acute, severe headache • GCS 14, Neurodeficit (-) (WFNS grade 2) • Fisher grade 3
  30. 30. SURGERY • Left suboccipital retrosigmoid approach • Aneurysm clipped, • The patient recovered well.
  31. 31. POSTOP MRA
  32. 32. POSTOP DSA
  33. 33. Cerebro-vascular - Case 2 • 56-year-old-man, • Headache (chronic-progressive, for about one-year) • Neurologically intact • Cranial MRI: • pituitary macroadenoma • incidental AComA aneurysm
  34. 34. SURGERY • Left pterional trans-sylvian approach • AComA Aneurysm clipped • Discharged without any deficit/complication.
  35. 35. Cerebro-vascular - Case 3 • ST: 43-year-old-female patient • Headache (acute, severe, for the last a few hours) • GKS 13 (WFNS grade 2) • Fisher grade III
  36. 36. SURGERY • Right pterional trans-sylvian approach • Proksimal ICA Aneurysm clipped
  37. 37. Cerebro-vascular - Case 4 DÖ: 59-year-old-male patient, • Acute, severe headache • GCS 14 (WFNS grade 2) • Fisher grade 4
  38. 38. SURGERY • Left pterional trans-sylvian approach • AcomA Aneurysm clipped without any problem, • The patient recovered well.
  39. 39. Cerebro-vascular - Case 5 • S.Ç.: 32-year-old-female • Acute severe headache, N&V • Loss of consciousness, • Focal neurological deficits: Hemiparesis, disphasia,
  40. 40. SURGERY • Left frontoparietal large craniotomy • Total resection of the AVM • The patient recovered well.

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