Özet: Orta konkadan kaynaklanan dev anjiyomatöz koanal polip: Olgu sunumuKoanal polip (KP) histolojik olarak benign, nazal kavite ile nazofarenks aras› birleflme noktas›na koana yoluyla uzanan, soliter yumuflak doku lezyonu olarak tan›mlan›r. Genellikle maksiller sinüsten köken al›r. Bu olgu sunumunda orta konkan›n alt bölümünden ç›kan ve nazofarenksi tamamen dolduran ola¤and›fl› bir dev anjiyomatöz KP'yi sunmaktay›z. Burnun sol taraf›nda t›kanma, burun ak›nt›s› ve hafif-orta derecede burun kanamas› üzerine 5 y›ll›k öyküsü olan 24 yafl›ndaki erkek hasta klini¤imize baflvurdu. Tan›, paranazal sinüslerin kontrastl› bilgisayarl› tomografi taramas›yla kombine anjiyografiyle desteklendi ve histopatolojik incelemeyle do¤ruland›. Lezyon kombine endoskopik ve transoral yaklafl›mla ç›kart›ld›. Sunumumuzda ayr›ca, anjiyomatöz KP'lerin patogenezini, klinik, radyolojik ve patolojik özelliklerini ve ay›r›c› tan›lar›n› tart›flmaktay›z.Anahtar sözcükler: Epistaksis, nazal polipler, nazal cerrahi prosedür, konka. AbstractChoanal polyps (CPs) can be defined as histologically benign, solitary, soft tissue lesions extending towards the junction between the nasal cavity and the nasopharynx through the choana. They usually originate from the maxillary sinus. In this report, we present an unusual case of a giant angiomatous CP arising from the inferior part of the middle turbinate that completely filled the nasopharynx. A 24-year-old man presented with five-year history of left-sided nasal obstruction, nasal discharge and mildto-moderate epistaxis. The diagnosis was supported by contrastenhanced computed tomography scan of the paranasal sinuses with angiography and confirmed by histopathological examination. The lesion was removed by combined endoscopic and transoral approach. In addition, we discuss the pathogenesis, clinical, radiological and pathological characteristics of angiomatous CPs, and their differential diagnosis.

Although ischemic stroke is one of the most common neurological diseases, ischemic stroke of the hippocampus is rare, the isolated bilateral presentation with clinical signs of severe amnestic syndrome in particular. Timely recognition and modern therapeutic approach could have a favorable impact on the recovery from severe neurological, cognitive deficit. It could be suggested that in patients with the clinical image of acute anterograde amnesia and vascular risk factors the MSCT examination of the brain with computed tomography perfusion and angiography is performed immediately upon hospitalization.

Although, as asymptomatic, they appear in about 10- 12% of the worldwide population, vertebrae hemangiomas are symptomatic in about 0.9-1.2% of all the cases. We showed the case of the symptomatic hemangioma in the 7th thoracic vertebrae in 67 year old patient, that was successfully preoperative embolised. Magnetic resonance imaging (MRI) detected the tumor in the body of 7th vertebrae with mass effect on the anterior aspect of the spinal cord. Multidetector computed tomography (MDCT) imaging describes this tumor as hemangioma that is in the body of the 7th vertebrae and in the both pedicules. We performed selective and supraselective spinal angiography which showed pathological vascularisation of the tumor, and then the tumor was embolised. The control angiography detected the reduction of the tumor blood vessels, as a sign of the successful embolisation. Ten days after embolisation, the patient went through corporectomia of the Th7 and the stabilization of the thoracic spine was performed. Intraoperative blood transfusion in our patient was 930 mL, while expected blood transfusion during the surgical intervention without preoperative embolisation is about 1600 mL. Method of choice in conditions with neurological compressive symptoms caused by vertebral hemangioma is surgery for the decompression of the nerve structures. Embolisation of aggressive vertebral hemangioma is recommended and preoperatively performed for the intraoperative hemorrhage reduction and decreasing of intraoperative complications.

Background/Aim. are rare hypervascular neoplasms. The aim of this study was to present experience in treatment of paragangliomas with preoperative embolization. Methods. This is a retrospective cross-sectional study of 10 patients (7 women and 3 men; median age 55 years) with paragangliomas who were embolized before surgery. Results. Three had tympanicum paragangliomas, two carotid body, three jugulare and two jugulare-tympanicum paragangliomas.During the operation, 9 out of 10 patients didn't have bleeding which would require blood transfusion. One patient received 1130 ml of blood transfusion due to surgical complication. Conclusion.Adequate preoperative selective embolization of paragangliomas is essential in the preoperative preparation of these patients, because this strategy is feasible with low complications rates.

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