Introduction and importance Covid-19 is an important disease that still occupies our agenda, and as time passes, we have been observing its extrapulmonary manifestations. In this study, we presented a case of spontaneous thoracolumbar epidural hematoma, which we could not attribute to any cause other than Covid-19. Case presentation We presented a 55-year-old female patient whose etiology could not be found to be compatible with the literature. In the formation of this disease, we did not have any positive findings except for Covid-19, which she had 20 days ago. The patient had no history of anticoagulant or antiaggregant drug use. He had no history of trauma and no signs. Hematological tests were normal. We evacuated the hematoma in the T12-L1 vertebral canal after laminectomy and the pathology result was compatible with hematoma. Clinical discussion Although spontaneous spinal epidural hematoma is rare, many factors are blamed for its etiology. Many extrapulmonary complications of Covid-19 stand out in the literature. The fact that the patient had Covid-19 did not affect the neurosurgical approach, but we think that it is useful to examine the complaints of patients with Covid-19 more systematically. Conclusion Spontaneous spinal epidural hematomas are rare. Making the correct diagnosis often takes time and is difficult. Decompression surgery is at the forefront as a treatment option. However, conservative treatment can be performed in suitable patients. As we saw in this case, we should consider Covid-19 among the etiological causes.

Peritoneal fluid is the product of ultrafiltration activity of the peritoneum. 1 In healthy individuals, visceral and parietal layers of the peritoneum are flushed with a small volume of peritoneal fluid, typically 5-20 mL or up to 100 ml at most. 1,2 Ascites is the abnormal accumulation of peritoneal fluid secondary to the imbalance between peritoneal secretion and absorption functions. 2 Cirrhosis is the most common cause of pediatric ascites. However, non-cirrhotic factors should be reviewed in patients with ascites and good functioning livers. Here, we present a patient referred to our hospital with a symptom that accelerated the diagnosis and treatment of an intracranial tumor; resistant ascites. Case Report A 3.5-year-old Sudanese boy was admitted to our Neurosurgery Intensive Care Unit for the management of his intracranial tumor. He was consulted with the Department of Pediatric Gastroenterology due to his history of intractable ascites for the last 4 months. According to his brief medical report from Sudan, he was in a good state of health until he was 2 years old. He presented to a local hospital in Sudan 18 months ago with complaints of

AIM:To discuss four different materials that are frequently used in cranioplasty, and to reveal their advantages and disadvantages. MATERIAL and METHODS:We retrospectively reviewed 85 of our cranioplasty surgeries between 2016 and 2019. Reconstruction surgeries were excluded from our study due to craniofacial trauma. RESULTS:Of the materials used in cranioplasty, 33 are autologous bone, 32 are methyl-methacrylate, 12 are porous polyethylene, and 8 are titanium mesh. Complications developed in 16 patients. Of these, 10 are infection, 3 are flap collapse, 2 are wound healing disorders, and 1 is reactive effusion complications due to the used material. The highest complication rate was 21.9% in cranioplasty with methyl-methacrylate. No major complications were observed in cranioplasty with titanium mesh. CONCLUSION:Cranioplasty, which are among the surgeries with high complications in neurosurgery, maintain their importance today. As technology is developed and cost problems are resolved, cranioplasty takes its place among the safer and standard neurosurgical operations.

AIM:To investigate the effect of alpha lipoic acid on cerebrospinal fluid (CSF) osmolarity and brain tissue water ratio in a rabbit model of traumatic brain injury. MATERIAL and METHODS:Using a previously established model of traumatic brain injury using liquid nitrogen, 36 New Zealand rabbits were randomized into six groups (three treatment groups, a no trauma/no treatment group, a trauma/no treatment group, and a no trauma/treatment group). The treatment groups were administered intravenous alpha lipoic acid at different times of the experiment. Cerebrospinal fluid was obtained 96 hours after injury/treatment via cisterna magna puncture; glucose, blood urea nitrogen, and sodium levels were measured and osmolarity was calculated. Brain tissue water ratio was determined using wet and dry brain weights. The therapeutic effect of alpha lipoic acid was evaluated by comparing cerebrospinal fluid osmolarity and brain tissue water ratio between study groups. RESULTS:Based on cerebrospinal fluid osmolarity values, alpha lipoic acid treatment effectiveness was greatest in the group that received 3 doses after trauma. CONCLUSION:Alpha lipoic acid is effictive in the treatment of brain edema after experimental traumatic brain injury.

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