This retrospective analysis of patients aims to show the blood levels of preoperative inflammatory markers in patients with glioblastoma and brain metastasis and to provide the diagnostic accuracy of the neutrophil–lymphocyte (NLR), lymphocyte–monocyte (LMR), and platelet–lymphocyte (PLR) ratios between the 2 groups of patients. The retrospective reviews of the neutrophil, lymphocyte, monocyte, and platelet counts were analyzed in 80 patients with newly diagnosed glioblastoma and 70 patients with brain metastasis. The NLR, LMR, and PLR were calculated in each group. The differences in all the parameters were compared between the 2 groups. Although the neutrophil, monocyte, and platelet counts were higher and the lymphocyte count was lower in patients with metastasis, the difference was not significant. A significantly higher PLR (P = .004) and a lower LMR (P = .01) were found in patients with brain metastasis. Although both PLR and LMR had diagnostic accuracy in differentiating glioblastoma from brain metastasis, LMR showed the highest diagnostic accuracy. NLR showed no diagnostic accuracy. Systemic inflammation is more severe in glioblastoma than in brain metastasis, and LMR is more sensitive and/or specific than PLR in differentiating glioblastoma from brain metastasis. Therefore, LMR (less likely PLR) can be used as an index for differentiating between glioblastoma and brain metastasis before surgery.

AIM: To analyze preoperative inflammatory markers including neutrophil, lymphocyte and platelet counts and neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios in a group of patients with different brain pathologies and healthy controls. MATERIAL and METHODS: Above mentioned preoperative inflammatory markers were analyzed in a total of 140 patients included 39 with temporal lobe epilepsy, 37 with glioblastoma multiforme, 32 with grade-I meningioma and 32 with intracranial metastasis. Healthy controls included 30 subjects. The levels were compared between each patient group and between patients and controls. RESULTS: Significant higher neutrophil, platelet counts, NLR and PLR were found in glioma, meningioma and metastasis patients compared to epilepsy (p<0.05). On the other hand lymphocyte counts were significantly lower than epilepsy (p120.78 was suggestive of metastasis rather than GBM. CONCLUSION: Preoperative inflammatory markers increase in different brain pathologies and metastasis show striking changes. PLR can have diagnostic value in differentiating metastasis from GBM.

Temporal lobe epilepsy is the most common form of focal epilepsy, and surgical treatment has been proven to be an effective and safe management. Despite its safety, it is important to know that some complications and/or even death can be seen after surgery. Neurosurgeons should be able to precisely inform epilepsy surgery candidates about the possible unwanted/unexpected conditions after surgery. Fifty-three patients who underwent anterior temporal lobe resection due to temporal lobe epilepsy by a single surgeon were investigated retrospectively regarding postoperative surgical and neurological complications. Overall complication rate was found to be 19%, surgical complications comprised 13.2% whereas neurological complications were 5.8%. Three patients underwent a second surgery whereas the rest had medical treatment or recovered spontaneously. Fortunately persistent complication rate was found to be 0%, and there was no mortality. Anterior temporal lobe resection is a safe and very effective surgical modality for the treatment of temporal lobe epilepsy. However, unexpected complications may be possible in this modern era and a surgeon should trust in him/herself not in modern equipments.

Background/aim: To assess the efficacy of postoperative antibiotics on postoperative infection in clean supratentorial craniotomies. Material and methods: This study is a prospective, randomized, single-blind, and placebo-controlled clinical trial that included consecutive patients who underwent clean supratentorial craniotomy between November 2017 and September 2020 and evaluated the effectiveness of postoperative antibiotic prophylaxis on postoperative infection. Results: A total of 80 patients were included and the whole group was divided into two groups. Group A included patients who received antibiotic prophylaxis and group B who did not receive antibiotic prophylaxis after surgery. Each group included the same number of patients (40 patients in each). Two patients showed postoperative infection, and both were in group B. No significant difference was found regarding postoperative infection between the two groups (p = 0.15). The rate of postoperative infection was found to be 2.5% in the whole group (2 cases out of 80) and it was 5% in group B (2 cases out of 40). Conclusions: Our results showed that antibiotic prophylaxis after a clean supratentorial craniotomy has no effect on the prevention of postoperative infection and we do not suggest using antibiotic prophylaxis after clean supratentorial neurosurgery.

Aim: Evaluation of whether there is a significant relationship between chronic low back pain and spinal sagittal alignment. Methods: This prospective, controlled study was conducted between April 2023 and September 2023, among patients aged 18–50, who complained of chronic low back pain and a healthy control (HC) group. In addition to the participant's demographic information, sagittal vertical axis (SVA), thoracic kyphosis (TK), and lumbar lordosis (LL) values on the lateral whole-spine radiograph and degenerations on the lumbar vertebra MRI were compared. VAS and ODI scores of the patients were also included in the statistical evaluation. Results: A total of 64 participants (44 patients, 20 controls) were included in the study. There was no significant difference in age, gender, body mass index (BMI). SVA significantly increased in the patient group (p < 0.001), but not LL and TK. In a linear discriminant analysis (LDA), SVA discriminates 100% of the two groups. No significant correlation was observed between VAS and ODI scores and the patient's age, gender, BMI, and spinal parameters. Conclusion: SVA is a crucial parameter of spinal balance, and as shown in this study, deviations from normal SVA appear to be a significant contributor to low back pain. We recommend an easy-to-implement and cost-effective method for assessing SVA in evaluating and treating patients with chronic low back pain.