In recent years, the use of three-dimensional imaging and modeling methods has become increasingly frequent, replacing two-dimensional studies. Three-dimensional images, which are widely used in medicine, provide surgical facilities, especially in neurosurgical practice. Surgery for epilepsy, cranioplasty, vascular and intracranial lesions could be shaped based on threedimensional images. The main purpose of cranioplasty is to replace bone tissue loss due to previous surgery or trauma to protect brain tissue. For this purpose, autologous grafts could be used as well as materials such as polymethylmethacrylate. In this study, a PLA mold was produced using a three-dimensional printer for the patient who was planned for cranioplasty and cranioplasty was performed with PMMA. The perioperative observation of the patient revealed that the mold was fully seated. The patient was satisfied cosmetically in the follow-up. With the advancement of technology, the use of three-dimensional printers in neurosurgery practice will further increase, individual treatment methods will be developed and better results will be obtained with less cost and complication rates.

Objective: To compare three different surgical techniques for chronic subdural hematoma (CSDH), one of the most common neurosurgical diseases increasingly affecting the elderly, and for which there is no standard treatment currently. Material and Methods: We included 28 patients diagnosed with CSDH and retrospectively analysed their data. The surgical techniques were compared to subgroups of the burr-hole craniostomy technique. Results: The mean age of included patients was 72.71 ± 10.81 years, and the male/female ratio was 2/5. Preoperative subdural hematoma volume was 113.63 ± 40.74 cc, and the Hounsfield unit value was 33.66 ± 8.67 HU. The mean operative time was 60.89 ± 20.04 min, and the mean hospital stay was 6.17 ± 2.56 days. Detectable radiologic complete recovery was 42.69 ± 17.46 days. Conclusion: All surgery subgroups experienced successful outcomes during long-term follow-up. The irrigation technique demonstrated no superiority to the other two techniques and the complication rate was significantly lower with the endoscopic technique

Aim:The annual incidence of chronic subdural hematoma is 2-4/100000 in geriatric population. We aimed to investigate relationship between potentially inappropriate medication usage according to Beers 2019 criteria, fall and Charlson comorbidity index in geriatric patients diagnosed with chronic subdural hematoma. Materials and Methods: We retrospectively collected medical records of 69 geriatric patients diagnosed with chronic subdural hematoma and hospitalized for the last 5 years in neurosurgery department of Izmir Katip Çelebi University Hospital with the permission of local ethical committee of medical faculty. Data was recorded and analyzed with appropriate method by using SPSS v18. Results: Mean age was 78.43 ± 7.51 years, mean Charlson comorbidity index was 5.87 ± 2.97. Falling events were responsible for 59 (85.5%) out of 69 chronic subdural hematoma cases. Potentially inappropriate medication usage according to Beers 2019 criteria was found in 20 (29%) patients. Inappropriate medications belonged to cardiovascular system (14.5%) class and antiplatelet/anticoagulant (14.5%) class mostly. When group was divided into two groups as patients who used potentially inappropriate medication or not, Charlson comorbidity index was found to be higher in the first group. (p <0.05) When group was divided into two groups as patients who fall or not, no correlation was found in Charlson comorbidity index, dementia prevalence, hospitalization duration, number of medications, potentially inappropriate medication, cerebrovascular infarct and hemiplegia prevalence between these groups (p >0.05). Charlson comorbidity index and number of medications showed significant correlation (p = 0.001). Conclusion:We could not reach a significant correlation between fall, Charlson comorbidity index and potentially inappropriate medication usage in our retrospective study. Small study population size, unreliable medical records and relatively healthy characteristics of population may contribute to crossing results.

Aim: Open-door cervical laminoplasty is the standard surgical option for patients with multipl levels cervical myelopathy. In this surgical technique, while linear laminectomy is performed on one side of the lamina, bone is drilled to form a hinge on the opposite side. Hinge fractures may occur on the other side while lifting the linear laminectomy side. Our study aimed to examine possible risk factors for preventing these fractures. Materials and Methods: The patients' files, radiological images, and laboratory results who underwent cervical laminoplasty between 2013-2018 were retrospectively analyzed. Results: A total of 78 patients, 54 males and 24 females, were included in the study. The mean age of the patients was 57.8±11.6 years. The mean modified Japanese Orthopedic Association (JOA) cervical myelopathy scores of the patients before the operation were 16.2±2.1. When the preoperative blood Ca values were examined, the mean value was 9.3±0.5 mg/dl. The mean Pavlov ratio of the patients was 0.7±0.2. Laminas were opened from the right side in 26 cases and from the left side in 52 cases. A total of 304 laminae were opened. In post-operative control cervical CTs, 42 patients had lamina hinge fractures, and the number of patients without hinge fracture was 36. There were 89 fractures in total at the lamina level. When post-operative cervical tomography images were examined, the mean opening angle (OA) of the laminas was 30.6±8.9 degrees. The opening angle of the lamina was determined to affect the hinge fracture significantly. While OA was 32.3±9 degrees in patients with lamina hinge fracture, it was found to be 28.7±8.3 in patients without fractures (p <0.05). Conclusion:During open-door cervical laminoplasty, the excessive opening angle of the lamina increases the possibility of hinge fractures. Pre-operative necessary measurements will reduce the risk of hinge fractures during surgery. This evaluation will reduce the risk of complications during the operation and increase patient comfort in the post-operative period.