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    Bilateral Occipital Condyle Fracture with Clivus Fracture: Case Re port
    (Emergency Medicine Physicians Assoc Turkey, 2025) Ozkal, Birol
    Occipital condyle and clivus fractures caused by trauma are rare injuries that are difficult to diagnose. Only a few publications have reported cases involving both fractures. With the widespread use of high-resolution computed tomography in recent years, the diagnosis of these fractures has become more feasible; however, their clinical presentation and treatment approach remain uncertain for clinicians. The concurrent occurrence of occipital condyle and clivus fractures has recently been incorporated in to the Anderson and Montesano classification system for occipital condyle fractures. In this paper, we aim to discuss the clinical presentation and treatment strategies of a 39-year-old female patient who was brought to our hospital with bilateral occipital condyle and transverse clivus fractures following a pedestrian traffic accident, in light of the existing literature.
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    Idiopathic Syringomyelia: Diagnostic Value of Cranial Morphometric Parameters
    (Mdpi, 2025) Ozkal, Birol; Ozcelik, Hakan
    Background: Identifying the etiological factors of syringomyelia, which can cause progressive neurological deficits in the spinal cord, is critically important for both diagnosis and treatment. This study aimed to assess the cranial morphometric features of patients with idiopathic syringomyelia by conducting comparative analyses with individuals diagnosed with Chiari Type I, Chiari Type I accompanied by syringomyelia, and healthy controls, in order to elucidate the potential structural contributors to the pathogenesis of idiopathic syringomyelia. Methods: In this retrospective and comparative study, a total of 172 patients diagnosed with Chiari Type I and/or syringomyelia between 2016 and 2024, along with 156 radiologically normal individuals, were included. The participants were categorized into four groups: healthy controls, Chiari Type I, Chiari Type I with syringomyelia, and idiopathic syringomyelia (defined as syringomyelia without an identifiable cause). Midline sagittal T1-weighted MR images were used to obtain quantitative measurements of the posterior fossa, cerebellum, intracranial area, and foramen magnum. All measurements were stratified and statistically analyzed by sex. Results: In cases with idiopathic syringomyelia, both the posterior fossa area and the cerebellum/posterior fossa ratio differed significantly from those of healthy controls. In male patients, the foramen magnum diameter was significantly larger in the Chiari + syringomyelia group compared with the idiopathic group. A significant correlation was found between the degree of tonsillar descent and selected morphometric parameters in female subjects, whereas no such correlation was observed in males. Both Chiari groups exhibited significantly smaller posterior fossa dimensions compared with the healthy and idiopathic groups, indicating greater neural crowding. Additionally, in Chiari Type I patients, increasing degrees of tonsillar descent were associated with a decreased incidence of syringomyelia. Conclusions: Anatomical variations such as a reduced posterior fossa area or altered foramen magnum diameter may contribute to the pathogenesis of idiopathic syringomyelia. Cranial morphometric analysis appears to offer diagnostic value in these cases. Further prospective, multicenter studies incorporating advanced neuroimaging modalities, particularly those assessing cerebrospinal fluid dynamics, are warranted to better understand the mechanisms underlying syringomyelia of unknown etiology.
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    Morphometric evaluation of superficial anastomatic veins of the brain using venous MR angiography
    (Springer France, 2025) Ozkal, Birol; Candan, Busra; Top, Esra; Yasin, Muge
    PurposeThis study aimed to perform a morphometric analysis of the main superficial anastomotic veins of the brain the vein of Trolard (VT), vein of Labb & eacute; (VL), and superficial Sylvian vein (SSV) using magnetic resonance venography (MRV), and to compare the findings with the literature to assess clinical and surgical implications.MethodsMRV scans of 154 individuals (105 females, 49 males; mean age: 42.12 +/- 16.39 years) obtained between 2020 and 2024 were retrospectively analyzed. The presence, length, midpoint diameter, course, drainage pattern, dominance, and interconnections of the VT, VL, and SSV were evaluated bilaterally. Statistical analyses included chi-square, independent t-test, Mann-Whitney U, Pearson correlation, and Holm-Bonferroni correction.ResultsVT was the most prevalent vein, observed in 88.3% of right and 76.6% of left hemispheres, most often located in the postcentral region. VL was present in 74.0% (right) and 66.9% (left), draining mainly into the transverse sinus. SSV was identified in 74.3% (right) and 63.6% (left). Significant associations were found between right VL and SSV (p = 0.0003) and between left VT and right SSV (p = 0.0385, not significant after correction). VT predominated in the right hemisphere and VL in the left. No correlation was found between age and morphometric parameters.ConclusionSuperficial cerebral veins exhibit marked anatomical variability. Understanding their course and drainage is essential for neurosurgical planning, particularly in lateral and trans-Sylvian approaches. This study provides updated morphometric data to help minimize venous injury and support future anatomical and surgical research.