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ABSTRACTresponsible for the development of SDHs (2,7). The causative factors for SDHs include previous trauma, coagulopathies, intracranial hypotension, chronic alcoholism, vascular malformations, and intracranial masses (1). According to the time of development, SDHs that develop within the first 3 days are classified as acute SDHs, those that develop within 4-20 days are classified as sub-acute SDHs, and those that develop after 21 days are classified as chronic SDHs (CSDHs) (14). CSDHs reflect the organization of the █ INTRODUCTION I ntracranial subdural hematomas (SDHs) are hemorrhages that develop between the dura mater and the arachnoid mater and are likely to be associated with high mortality and morbidity. They are divided into three types as acute, sub-acute, and chronic, according to the time of development (7). Rupture of the parasagittal bridging veins, which course along the subdural distance, is classically shown as the factor AIM: To evaluate microcirculatory changes in neighboring parenchyma as a result of pressure due to chronic subdural hematoma (CSDH) in early and late periods after hematoma drainage. MATERIAL and METHODS:The subject group consisted of 25 patients who underwent CSDH drainage. Brain diffusion and perfusion magnetic resonance images (MRIs) were obtained preoperatively, and at 48 hours (early period) and 2 months (late period) postoperatively. Measurements were performed on 1 cm 2 regions of interest (ROI) in the neighboring parenchymal tissue. RESULTS: CONCLUSION:The fact that there was an increase in diffusion values from early to late postoperative periods, compared with the preoperative period, indicates that the beneficial effects of surgery increase over time. Brain perfusion was found to be slightly decreased in early postoperative period. Following CSDH drainage, neurological deteriorations are observed in some patients in the early postoperative periods; a slight impairment in perfusion may account for this. However, during the late postoperative period, perfusion was seen to recover prominently.

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Purpose We investigated the coexistence of newly diagnosed acromegaly with primary empty sella (ES), which is considered to be a rare association, and the impact of ES on the laboratory, radiological and prognostic status of acromegaly. Methods Acromegaly patients diagnosed and followed-up between 2012–2021 were included. Empty sella was defined as the pituitary gland and adenoma filling less than 50% of the sella turcica on preoperative T1 magnetic resonance imaging (MRI). Results 102 acromegalic patients (45 male, 57 female, 45.5 ± 12.8 (range: 20–70 years) were included and data of a median 3 years (range: 0.5-9 years) were presented. Empty sella was detected in 19 (18.6%) patients and 4 had complete and 15 had partial ES. Although not significant, adenoma size and residual adenoma on MRI on postoperative 3rd month, and disease remission at last control were lower in acromegaly with ES than in acromegaly without ES, while the rate of female gender and remission on postoperative 3rd month were higher. While preoperative serum prolactin and nadir GH responses to OGTT were significantly lower in patients with ES, there was no difference in terms of other pituitary hormones among both groups. Conclusion The present study revealed the coexistence of newly diagnosed acromegaly with primary ES at a rate of nearly 20% which is more frequent than expected and this association is not rare. The presence of ES was not associated with any preoperative/postoperative pituitary hormone levels and remission status, except lower preoperative prolactin and nadir GH responses to OGTT.