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An Arachnoidal Cystoperitoneal Shunt Catheter Which Protruded Via Anus and Caused Subdural Empyema After Colonic Perforation: A Rare Complication
(Aves, 2009) Akcora, Bulent; Serarslan, Yurdal; Eris, Ozge; Cavus, Gokhan; Urfali, Boren; Akdemir, Gokhan
Ventriculoperitoneal (VP) and cystoperitoneal (CP) shunt insertion are common surgical treatment methods for hydrocephalus which allow the drainage of cerebrospinal fluid (CSF) into the peritoneal cavity. Although these procedures are safe and effective, they may lead to various intraabdominal complications including colonic perforation. Shunt related colonic perforations have high mortality and morbidity rate because of peritonitis and/or retrograde intracranial infections. We presented here a child who developed hemiparesis due to subdural abscess after colonic perforation.
Bilateral carpal and tarsal tunnel syndrome in the same patient : A case report
(2008) Serarslan, Yurdal; Kalacı, Aydıner; Akdemir, Gökhan; Yanat, Ahmet Nedim
Klinik muayene ve elektrofizyolojik çalışmalarla tanı konmuş, iki taraflı ciddi tarsal tünel sendromlu ve iki taraflı ciddi karpal tünel sendromlu, nadir bir vaka sunuyoruz. Kompresyon nöropatisi, özellikle iki taraflı veya multipl olduğunda sistemik bir hastalığa sekonder olabilir. Literatürde, bugüne kadar, aynı hastada iki taraflı tarsal tünel sendromu ve iki taraflı karpal tünel sendromu, sadece bir kaç vakada bildirilmiştir.
Bilateral carpal and tarsal tunnel syndrome in the same patient: A case report
(Journal Neurological Sciences, 2008) Serarslan, Yurdal; Kalacı, Aydıner; Akdemir, Goekhan; Yanat, Ahmet Nedim
We report, an unique case with co-existing bilateral severe tarsal tunnel syndrome (TTS) and bilateral severe carpal tunnel syndrome (CTS), which were diagnosed by clinical examination and electrophysiological studies. Compression neuropathy, especially when bilateral or multiple may be secondary to a systemic disease. To date, bilateral carpal and tarsal tunnel syndromes in the same patient have been reported only a few cases in the literature.
CAFFEIC ACID PHENETHYL ESTER DECREASES THE LEVEL OF S-100B PROTEIN AFTER MIDDLE CEREBRAL AFTER OCCLUSION IN RABBITS
(Univ Karachi, 2009) Serarslan, Yurdal; Bal, Ramazan; Altug, Muhammed Enes; Kontas, Tuenay; Melek, Ismet Murat
Effects of caffeic acid phenethyl ester (CAPE) on the serum S-100B levels were studied as an index for brain damage after permanent middle cerebral artery (MCA) occlusion in rabbits. Twenty rabbits were divided into four groups (n=5): control, sham, non-treatment and CAPE. The right MCA was occluded using a microsurgical procedure with bipolar coagulation and was then transected in non-treatment and CAPE groups. The rabbits in the sham group underwent a surgical procedure but the MCA was not occluded. No surgery was performed in the control group. CAPE was administered after MCA occlusion at the dose of 10 mu g/kg, once a day intraperitoneally for 7 days in the CAPE group. Serum S-100B levels were determined on days 1, 2, 4 and 7. Serum S-100B level was significantly increased following permanent MCA occlusion. Posttreatment of CAPE significantly reduced the serum S-100B level. This study demonstrated that CAPE is capable of attenuating increased serum S-100B level induced by MCA occlusion in rabbits. CAPE may be useful as a neuroprotective agent.
Caffeic acid phenethyl ester decreases the level of S-100B protein after middle cerebral after occlusion in rabbits
(2009) Serarslan, Yurdal; Bal, Ramazan; Altu?, Muhammed Enes; Kontaş, Tünay; Melek, Ismet Murat
Effects of caffeic acid phenethyl ester (CAPE) on the serum S-100B levels were studied as an index for brain damage after permanent middle cerebral artery (MCA) occlusion in rabbits. Twenty rabbits were divided into four groups (n=5): control, sham, non-treatment and CAPE. The right MCA was occluded using a microsurgical procedure with bipolar coagulation and was then transected in non-treatment and CAPE groups. The rabbits in the sham group underwent a surgical procedure but the MCA was not occluded. No surgery was performed in the control group. CAPE was administered after MCA occlusion at the dose of 10?g/kg, once a day intraperitoneally for 7 days in the CAPE group. Serum S-100B levels were determined on days 1, 2, 4 and 7. Serum S-100B level was significantly increased following permanent MCA occlusion. Posttreatment of CAPE significantly reduced the serum S-100B level. This study demonstrated that CAPE is capable of attenuating increased serum S-100B level induced by MCA occlusion in rabbits. CAPE may be useful as a neuroprotective agent.
Caffeic acid phenethyl ester protects rabbit brains against permanent focal ischemia by antioxidant action: A biochemical and planimetric study
(Elsevier, 2008) Altug, Muhammed Enes; Serarslan, Yurdal; Bal, Ramazan; Kontas, Tuenay; Ekici, Fatih; Melek, Ismet M.; Aslan, Hueseyin
The present study was conducted to investigate whether caffeic acid phenethyl ester (CAPE), an active component of propolis extract, has a protective effect on brain injury after focal permanent cerebral ischemia, and to determine the possible antioxidant mechanisms. Cerebral infarction in adult male New Zealand rabbits was induced by microsurgical procedures producing right focal permanent middle cerebral artery occlusion (pMCAO). CAPE was administered to the treatment group after pMCAO at a dose of 10 mu mol kg(-1) once a day intraperitoneally for 7 days. Neurological deficits were evaluated, using a modified six-point scale. Spectrophotometric assay was used to determine the contents of malondialdehyde (MDA), glutathione (GSH), catalase (CAT), nitric oxide (NO) and xanthine oxidase (XO). In the ipsilateral hemisphere, the infarct volume of the brain was assessed in brain slices stained with heamatoxylen and eosin. The results showed that treatment with CAPE significantly reduced the percentage of infarction in the ipsilateral hemisphere compared with the ischemia group. CAPE treatment significantly attenuated the elevation of plasma MDA, CAT and XO content (p < 0.05), whereas it significantly increased the levels of plasma GSH and NO (p < 0.05). Therefore, subacute CAPE administration plays a protective role in focal pMCAO due to attenuation of lipid peroxidation and its antioxidant activity. All of these findings suggest that CAPE provides neuroprotection against cerebral ischemia injury through its antioxidant action. (C) 2008 Elsevier B.V. All rights reserved.
Calcified chronic subdural hematoma
(2012) Aras, Mustafa; Altaş, Murat; Yilmaz, Atilla; Serarslan, Yurdal; Urfali, Boran; Yilmaz, Nebi
Calcified subdural hematoma is a rarely seen event. It may develop secondary to previous trauma or inappropriate surgical procedures. Due to the not well understood etiology, there are variations in the treatment choices. We present a 27-year old male patient with calcified chronic subdural hematoma. He was operated on following an motorcycle accident in another hospital 5 years ago. He was admitted to our hospital complaining about seizure, headache and dizziness. Neuroradiological examination revealed a calcified chronic subdural hematoma was detected on the right hemisphere. The patient was hospitalized and put on anti-epileptic and analgesic drugs. Any surgical treatment was not applied. In cases with calcified chronic subdural hematoma, the decision of surgical operation should be decided after a carefully and meticulously investigation. It should be avoided any profitless and likely harmful surgical procedures. The clinical observation may be appropriate in the determination of treatment approaches. © 2012 OMU.
Change in the dimensions of the lumbar area muscles after surgery: MRI analysis
(Kare Yayıncılık, 2020) Duman, Fatma; Serarslan, Yurdal; Öztürk, Fatma; Yücekaya, Bircan; Atçı, Nesrin
Objective: This study aims to assess the change in the dimensions of the lumbar muscles in patients with chronic lower back pain using Magnetic Resonance Imaging (MRI) and to determine pre/post effects of surgery. Methods: We enrolled 28 individuals (13F/15M; age: 45.39±11.56 years) whose L2-S1 muscle measurements were obtained using MRI, before and at follow-up 6-12 months after surgery. The control group comprising 37 individuals (18F/19M; age: 34.41±10.72 years) who had no lumbar pathology but for whom retrospective archive images were available. In the axial MRI analysis, the cross-sections of m.multifidus, mm.erector spinae and m.psoas major on both sides were measured with the 'closed polygon' technique. Results: The L2-3 and L4-5 levels of the m.multifidus on the right side, the L2-3, L4-5 and L5-S1 levels of the m.multifidus and the L5-S1 levels of the mm. erector spinae on the left side cross-sectional areas were significantly lower than the control group (p<0.05). The right-side m.multifidus and the left-side mm.erector spinae sectional areas were significantly lower than the pre-surgery values at the L5-S1 levels (p<0.05). Conclusion: This study demonstrated that chronic lower back pain causes atrophy in the lumbar muscles and established the existence and continuity of atrophy after surgery.
Clinical and Demographic Characteristics of Patients Who Were Treated with Kyphoplasty Due to Osteoporotic Fracture
(Galenos Yayincilik, 2017) Yilmaz, Atilla; Yildizgoren, Mustafa Turgut; Oral, Sukru; Serarslan, Yurdal
Objective: The aim of this study is to determine the demographic and clinical characteristics of patients who underwent kyphoplasty due to osteoporotic fractures. Materials and Methods: This retrospective study included 55 patients who underwent kyphoplasty due to osteoporotic fracture between the years 2011 and 2014. The patients divided into two groups according to their ages (under/over 65 years), and divided into three groups according to fracture regions (T10 and above; between T11-L1; L2 and under). Thus the age and gender distributions of the patients were made. Resting pain scores of all patients were determined by using visual analog scale (VAS) and daily life activities by Oswetry Disability Index (ODI) before and in the first month of treatment. Results: Seventeen of the all patients were male (30.9%) and 38 were female (69.1%), with a mean age of 69.9 +/- 8.7 years (between 50-88 ages). 90% of the patients older than 65 years had fracture in T11 and below. In 45.5% of all patients, the fracture was in the T11-L1 (thoracolomber junction) region. Resting VAS and ODI scores significantly improved from 8.7 +/- 1.5 to 2.1 +/- 1.2 and 44.7 +/- 7.2 to 15.4 +/- 3.5 respectively in the first month after kyphoplasty (p<0.05). Kyphoplasty material extravasated to the disc space in 7 (12.7%) patients and in 4 (7.3%) patients to cerebrospinal fluid. Conclusion: Osteoporotic fractures affect patients over 65 years of age and are frequently occur in the thoracolumbar junction and lower vertebras. Kyphoplasty is a minimally invasive treatment option to relieve pain and to improve functional status.
The co-occurrence of Chiari type 1 malformation with syringomyelia and total situs inversus
(Int Scientific Literature, Inc, 2007) Serarslan, Yurdal; Melek, Ismet M.; Duman, Taskin; Eraslan, Turali; Akdemir, Goekhan; Yalcin, Fatih
Background: Total situs inversus (TSI) is a rare congenital anomaly that often occurs concomitantly with other disorders. TSI is the complete left-to-right inversion of the thoracic and abdominal organs. It develops due to an abnormal rotation of the cardiac tube during embryogenesis, the mechanism of which is of unknown mechanism. Syringomyelia (SM) is an uncommon disease of the spinal cord and is known as the occurrence of a cystic space in the middle of the spinal cord. SM occurs due to spinal cord injury, a primary tumor of the spinal cord, or an extramedullary lesion at the foramen magnum such as a Chiari type I malformation (CMI). In the literature there has been reported association of CMI and SM (CMI/SM) with known genetic syndromes. Case Report: We report a 33-year-old female with CMI/SM coexisting with TSI. Our patient presented with pain in the neck, arm, and upper back. She had no trsuma history. There was dysesthesia in the cervical-2 dermatomes. Radiological tools revealed that CMI/SM with TSI accompanied by no other abnormality. Conclusions: It can be suggested that the existence of this case indicates that genetic factors rnay influence the pathogenesis of some CMI/SM cases.
Delayed Seizure With Intracranial Sewing Needles
(Lippincott Williams & Wilkins, 2013) Aras, Mustafa; Altas, Murat; Serarslan, Yurdal; Davran, Ramazan; Bayarogullari, Hanifi; Cagli, Sedat
Penetrating head injuries are the main cause of intracranial foreign bodies. They can lead to complaints such as headaches and seizures at a later period. We report the case of a patient with sewing needles inserted within the parietal lobe. The primary complaint of the patient was epileptic seizures. The patient was treated with antiepileptic drugs. Surgical intervention was not considered. The removal of intracranial needles is still controversial in the literature. In our case, needles were not removed because the epileptic seizures were successfully treated with antiepileptic medication.
The Dowling-Orlando technique in a giant primary cerebral hydatid cyst: a case report
(Via Medica, 2010) Altas, Murat; Serarslan, Yurdal; Davran, Ramazan; Evirgen, Omer; Aras, Mustafa; Yilmaz, Nebi
Hydatid cyst disease is a parasitic illness that is rarely located in the brain. We present a case of a 26-year-old female who complained of headache, nausea, and vomiting. The diagnosis was intracranial hydatid cyst disease and was confirmed with radiological and serological tests. Neurological examination revealed papilloedema and left-sided pyramidal signs. She was operated on using the Dowling-Orlando technique. The cyst was removed without rupture, and therapy was completed with albendazole for a period of four weeks. In this article, we discuss the application of the Dowling-Orlando technique, microsurgery, the Valsalva manoeuvre and the positioning of the patient such that gravity could facilitate surgical removal of a giant cerebral hydatid cyst.
The effect of subthalamic nucleus - Deep brain stimulation and different stimulation frequencies on cerebral hemodynamics in Parkinson's disease: A transcranial doppler study
(Elsevier, 2020) Koban, Orkun; Yildizgoren, Mustafa Turgut; Aras, Mustafa; Oral, Sukru; Uyanik, Sadik Ahmet; Serarslan, Yurdal; Okuyucu, Esra Emine
Objectives: To investigate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) and to compare low-frequency versus high-frequency STN-DBS on hemodynamic parameters of the middle cerebral artery between patients with advanced Parkinson's disease and age-sex matched healthy controls. Patients and Methods: Eighteen patients with advanced Parkinson's disease (PD) with bilateral STN-DBS and 18 control subjects underwent Transcranial Doppler Ultrasound (TCDU) were included in the study. The hemodynamic parameters including blood flow velocity (FV), pulsatility index (PI) and, resistance index (RI) of the right middle cerebral artery (MCA) were measured and compared during the phases using TCDU. The first DBS-off, the second low-frequency DBS of 60 Hz, and the third high-frequency DBS of 130 Hz were compared. Results: PD patients had significantly higher MCA-PI values compared with controls (0.99 +/- 0.27 vs. 0.82 +/- 0.14) (p = 0.031). Also, the MCA-PI values were higher in the low-frequency DBS (0.94 +/- 0.14) and high-frequency DBS (0.93 +/- 0.16) than in the controls (0.82 +/- 0.14) (p = 0.022 and p = 0.041, respectively). There were no significant differences of FV and RI values among the DBS-on, DBS-off and, controls. The RI values were higher in the PD patients than in the controls, although these were not statistically significant. Also, PI values of the MCA decrease in different frequencies (60 Hz or 130 Hz). Conclusion: The results of this study showed that MCA-PI values are higher in advanced PD compared with controls. These indices indicate that MCA resistances and impedances are increased in advanced PD. Low- or high-frequency DBS treatment have beneficial effect to reduce high PI in advanced PD patients.
Giant calvarial meningioma which obliterated superior sagittal sinus: Case report
(2012) Altaş, Murat; Aras, Mustafa; Bayaro?ullari, Hanifi; Karcio?lu, Murat; Serarslan, Yurdal; Yilmaz, Nebi
Interosseous meningioma, defined as meningiomas confined to the skull with no epidural or subcutaneous component, is a rarely encountered example of the primary meningiomas. It is usually a benign tumour and takes origin from arachnoids cap cells. Several etiological hypotheses have been asserted for interosseous meningiomas up to the present. The literature pointed out that the symptoms of the patients with meningiomas might vary. The findings of osteolysis and hyperostosis might also be seen by X-Ray radiograph imaging. Our case was a male and 21 years old. He admitted the polyclinics of neurosurgery with the complaint of convulsion. Intracranial component of the meningioma was measured as 90 × 42 mm in MRI. Imaging indicated that this was a giant calvarium meningioma which diffusely skirted along to suture lines and obliterated superior sagittal sinus in a wide area. Clinical and radiological properties of the tumour were evaluated, and the responsible mechanisms from its pathogenesis are discussed in the light of the literature. © 2012 OMU.
İmmünkompetan hastada primer nokardiyal vertebra osteomiyeliti
(2015) Bal, Tayibe; Önlen, Yusuf; Serarslan, Yurdal; Kaya, Mustafa Emrah; Özer, Burçin
Nokardiya türleri, immünsüpresif hastalarda vertebral osteomiyelitin nadir bir sebebidir ve literatürde bildirilmiş az sayıda olgu bulunmaktadır. Nokardiyoz genellikle akciğerlerden orijin alan, beyin gibi diğer organlara yayılma eğiliminde olan kronik bakteriyel bir infeksiyondur. Bu makalede pulmoner tutulumu olmayan, immünkompetan bir primer nokardiyal vertebra osteomiyeliti olgusu sunulmuştur. Olguda bir buçuk yıl önce başlayan bel ağrısı ve spinal hareketlerde kısıtlılık yakınmaları saptanmıştır. L2 vertebra, paraspinal bölge ve psoas kası içerisinde saptanan multiple apseleri cerrahi ve medikal tedaviye rağmen tekrarlamıştır. Operasyon bölgesindeki akıntıdan alınan materyalin kültüründe 3. günde Nocardia spp. izole edilmiştir. Tür tayini yapılamadığından trimetoprim sülfametoksazol, meropenem ve amikasin ile üçlü kombinasyon tedavisi başlanmıştır. Tedavinin 7. gününde operasyon bölgesindeki akıntı kesilmiştir. Hastada apselerin cerrahi drenajı, L2 vertebra korpusu eksizyonu ve uygun medikal tedavi sonrasında kontrol lomber vertebra MR’larında apse görülmemiştir. Bu olgu, tüberküloz ve brusellozun dışlandığı granülomatöz vertebral osteomyelit olgularında Nokardiya türlerinin de olası patojenlerden biri olabileceğini vurgulamak amacıyla paylaşılmıştır.
The importance of proliferative activity and angiogenesis in meningioma and glioma
(Turkish Neurosurgical Society, 2005) Atik, Esin; Serarslan, Yurdal; Bakariş, Sevgi; Savaş, Nazan
OBJECTIVE: The aim of this study was to investigate the usefulness of a mean vascular density (MVD) and proliferative activity labeling index (LI) in gliomas and meningiomas as biological markers in histological grading. MATERIALS AND METHODS: Our study included 18 cases of glioma and 36 cases of meningioma. These cases were graded according to the WHO classification. CD-34 and Ki-67 immunohistochemical methods were used on paraffin-embedded tissues. Distribution of CD-34 and Ki-67 LI values were determined for different histologic grades of gliomas and meningiomas. The results were analyzed with statistical methods. RESULTS: In gliomas, the values of Ki-67 were detected as 3.33±2.50 in grade I, 5.01±2.28 in grade III and 10.33±4.85 in grade IV. The mean values of CD-34 were found as 11.80± 9.71 in grade III glioma and 8.40±5.45 in grade IV glioma. The values of Ki-67 were detected as 4.40±0.40 in atypical, 4.26±4.05 in psammomatous and 3.69±3.24 in meningothelial meningioma. CD-34 expression was 19.60±0.20 in angiomatous meningioma and 6.14±1.91 in malignant meningioma. CONCLUSION: Our results show that Ki-67 LI and angiogenesis can be useful in tumor grading of gliomas. However, the score of angiogenesis and Ki-67 LI adds little information to predict tumor grade in meningiomas, in contrast to gliomas.
Infected colloid cyst
(Springer, 2017) Yilmaz, Atilla; Aras, Mustafa; Serarslan, Yurdal; Kaya, Mustafa Emrah
Introduction Colloid cysts are the most common pathologic lesions of the third ventricle. Although they are histologically benign, they may grow and can cause the hydrocephalus. Case summary A 5-year-old male patient underwent to surgery with the diagnosis of colloid cyst. In operation, after the anterior transcallosal approach, the cyst was punctured by syringe and obviously pus aspirated. Conclusion Colloid cysts mostly remain silent and detected incidentally. Although it is rarely defined, rhinorrhea, hypopituitarism, diabetes insipidus, spasmodic torticollis, drop attack, aseptic meningitis, and coexistence with neurocysticercosis have been reported, but this is the first reported case of an infected colloid cyst.
Investigating the effect of STN-DBS stimulation and different frequency settings on the acoustic-articulatory features of vowels
(Springer-Verlag Italia Srl, 2018) Yilmaz, Atilla; Sarac, Elif Tugba; Aydinli, Fatma Esen; Yildizgoren, Mustafa Turgut; Okuyucu, Emine Esra; Serarslan, Yurdal
Introduction Parkinson's disease (PD) is the second most frequent progressive neuro-degenerative disorder. In addition to motor symptoms, nonmotor symptoms and voice and speech disorders can also develop in 90% of PD patients. The aim of our study was to investigate the effects of DBS and different DBS frequencies on speech acoustics of vowels in PD patients. Methods The study included 16 patients who underwent STN-DBS surgery due to PD. The voice recordings for the vowels including [a], [e], [i], and [o] were performed at frequencies including 230, 130, 90, and 60 Hz and off-stimulation. The voice recordings were gathered and evaluated by the Praat software, and the effects on the first (F1), second (F2), and third formant (F3) frequencies were analyzed. Results A significant difference was found for the F1 value of the vowel [a] at 130 Hz compared to off-stimulation. However, no significant difference was found between the three formant frequencies with regard to the stimulation frequencies and off-stimulation. In addition, though not statistically significant, stimulation at 60 and 230 Hz led to several differences in the formant frequencies of other three vowels. Conclusion Our results indicated that STN-DBS stimulation at 130 Hz had a significant positive effect on articulation of [a] compared to off-stimulation. Although there is not any statistical significant stimulation at 60 and 230 Hz may also have an effect on the articulation of [e], [i], and [o] but this effect needs to be investigated in future studies with higher numbers of participants.
Kafaiçi anevrizmalarda bilgisayarlı tomografik anjiografinin yeri
(2013) Altaş, Murat; Aras, Mustafa; Bayaroğulları, Hanifi; Yılmaz, Atilla; Serarslan, Yurdal; Yılmaz, Nebi; Atcı, Nesrin
Amaç: Serebral anevrizmaların tanısında geçerli olan üç yöntem vardır. Bunlar; manyetik rezonans anjiografi (MRA), dijital substraksiyon anjiografi (DSA) ve 3 boyutlu komputerize tomografi anjiografi (CTA) dir. Biz bu çalışmada CTA’nin avantajlarının ve sınırlarının anlaşılması, DSA ile karşılaştırılarak tedavi metodu konusunda farlılık olup olmamasını inceledik. Yöntem ve Gereç: Mustafa Kemal Üniversitesi, Beyin ve Sinir Cerrahisi Anabilim dalında son 2 yılda, kontrastsız CT tetkikinde, subaraknoid kanama tespit edilen ve bu nedenle takip ve tedavi altına alınan 40 hasta çalışmaya dahil edildi. Bulgular: Çalışmaya dahil edilen 40 olguya, üç gün içinde önce CTA, daha sonra DSA yapıldı. Olguların 10’unda (%25) anevrizma tespit edilemedi. 30 olguda (%75) anevrizma tespit edildi. Anevrizmaların en küçüğü 3x2 mm, en büyüğü 7x11 mm boyutlarında idi. Tartışma: DSA, anevrizmaların tanısında ve değerlendirilmesinde altın standart görüntüleme yöntemi olarak kabul edilmektedir. Ancak DSA zaman alan, pahalı, düşükte olsa komplikasyonlara neden olabilen bir yöntemdir. Sonuç: Bizim çalışmamızın bulguları ışığında, CTA’nin DSA’ya göre bazı dezavantajları olmasına rağmen, anevrizma tanısında DSA kadar efektif bir tanı yöntemidir.
Karpal tünel sendromu
(2008) Serarslan, Yurdal; Melek, İsmet M.; Duman, Taşkın
Karpal tünel sendromu (KTS) en sık rastlanan tuzak nöropatidir. Median sinir, bilek düzeyinde, karpal tünel içerisinde kompresyona uğrar. Bu kompresyon sonucunda, kan-sinir bariyeri yıkılarak ödem, enflamasyon ve çevre yumuşak dokuda fibrozis gelişir. Sonraki evre sinirdeki myelin örtünün yıkımını takip eden akson hasarıdır. Karpal tünel sendromunun çoğu idiopatiktir. Diğer nedenler ise sistemik bozukluklar, lokal faktörler ve aşırı kullanım/çaba gerektiren faktörlerdir. Öykü, fizik muayene ve elektronöromiyografi tanı için gereklidir. Hastalar çoğunlukla radial taraftaki 3.5 parmakta uyuşma, karıncalanma ve ağrıdan yakınır. Tipik olarak hastalar gece uyuşuk bir el ile uyanırlar. Fizik muayenede, median sinir duysal alanında hipoestezi, provokatif testlerin pozitifliği ve tenar kaslarda güçsüzlük ve atrofi görülebilir. Sinir ileti hızı çalışmasındaki tipik bulgu, uzamış latansdır. Konservatif tedavi istirahat, non steroid antienflamatuvar ilaçlar, nötral pozisyon splintleri ve steriod enjeksiyonunu içerir. Cerrahi tedavi endikasyonları, konservatif tedavinin başarısızlığı veya ciddi KTS’dir. KTS, median sinirin bilekte tuzaklanması ile seyreden en sık fokal nöropati ve özellikle kadınlarda önkol ağrısının önde gelen etkenlerinden olması nedeniyle önemlidir.

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