Physician-anatomists of Italy in Sanizade Mehmed Ataullah Efendi's work Mir'at al-abdan (Mirror of bodies).

Sanizade Mehmed Ataullah Efendi was a pioneer in the history of Turkish medical education with his work Hamse-i Sanizade (Five Works of Sanizade). The first of these works, Mir'at al-abdan fi tasrih-i a'dai'l-insan (Mirror of the bodies in the dissection of the members of the human body), concerns anatomy and was written in 1816. Sanizade's Mir'at al-abdan is an important milestone in the teaching of anatomy in the Ottoman Empire and was also the first book on anatomy both written in a modern manner and printed in the Ottoman Empire. This paper is based on investigation of a printed copy of Mir'at al-Abdan in the library of the History of Medicine and Ethics Department, Ankara University Faculty of Medicine. The main text and explanations were transliterated into the contemporary Turkish alphabet. The names of European physicians and their eponyms in the main text and in the explanations of illustrations were identified and evaluated. The names of European masters of anatomy in Sanizade are mentioned either in the text or in plate explanations. These names and plates indicate well-known physicians and masters of anatomy whose works were examined and quoted by Sanizade. The references in Sanizade's book and presented in this study relate to Italian physician-anatomists such as Bartolomeo Eustachi, Gabriele Fallopio, Costanzo Varolio and to others, such as Andreas Vesalius and Adriaan van den Spiegel, who were also Padua-educated but not Italian.

A Study on the Sources of Chief Physician Kãtib-zãde Mehmed Refî' Efendi's Risãla 'Illat Mathãna: Did Kãtib-zãde Actually Use the Works of European Authors as Sources?

OBJECTIVES: The aim of this study was to identify the Eastern and Western authors and physicians quoted by Kãtib-zãde Mehmed Refî' Efendi (died 1769), the chief physician of the Ottoman Empire, in his work Risãla 'illat mathãna. The study also aimed to determine whether Kãtib-zãde Mehmed Refî' Efendi benefited from the views of the physicians that he mentioned in his treatise and, if so, from which works he benefited. MATERIALS AND METHODS: In this study, a copy of Kãtib-zãde Mehmed Refî' Efendi's Risãla 'i rãbi' fî al-mathãna, with the registration number T 3796/4 in the Turkish manuscripts section of the Istanbul University Rare Books Library, was examined. Eastern and Western physicians mentioned by Kãtib-zãde Mehmed Refî' Efendi in this work were first identified; then, a literature search was conducted regarding these authors and their works. RESULTS: In his Risãla 'illat mathãna, Kãtib-zãde Mehmed Refî' Efendi mentions the names of eminent Eastern physicians and quotes from their works. For example, he mentions Ibn Sînã (980-1037) and his work al-Qãnun fî al-Tibb, Najîb al-dîn al-Samarqandî (died 1222) and his work al-Asbãb wa l-'alãmãt, and Ibn Mãsawayh (died 857). He also mentions the names of Western physicians and their works. For example, he mentions Lazarus Riverius (1589-1655), Ioannes Fernelius (1497-1558), Petrus Forestus (1521-1597), and Amatus Lusitanus (1511-1568). CONCLUSIONS: Regarding sources, Kãtib-zãde Mehmed Refî' Efendi refers to The Canon of Medicine and a commentary on al-Asbãb wa l-'alamãt written by al-Kirmãnî in his work. His main Western source was Lazarus Riverius's Praxis Medica. More specifically, he draws on the section of Praxis Medica titled "Dysuria seu ardoris urine curatio." Kãtib-zãde Mehmed Refî' also refers to other Western physicians, including Ioannes Fernelius, Petrus Forestus, and Amatus Lusitanus. These physicians are actually the physicians mentioned and quoted in the section of Lazarus Riverius' work mentioned above.

What Does the Most Celebrated and Pioneer Ottoman Physician, Sanizade Mehmed Ataullah Efendi, Say on Anatomy, Physiology, Diseases, and Surgery of the Urinary System? A Glance at Hamse-i Sanizade or Kanun-i Sanizade.

OBJECTIVES: Hamse-i Sanizade (Khamse Shani-zade) is the most important work of Sanizade Mehmed Ataullah Efendi (1769 or 1771-1826), an Ottoman kadi (qadi), physician, historian, polymath, and polyglot, about medicine and consists of 5 books. The first book, Mir'at al-ebdan fi teshrih a'da' al-insan, is on anatomy. The second book, Usul al-tabi'a, deals with physiology, while the third, Mi'yar al-etibba, mentions diseases and their treatments. These books were published together in Istanbul in 1820. A fourth book, Qanun al-cerrahin, published in Cairo after his death in 1828, discusses surgical treatments of diseases. A fifth book, Mizan al-edviye, is a pharmacopeia. In this study, we examined the information about urinary system anatomy, physiology, diseases, and their medical and surgical treatments in Hamse-i Sanizade. MATERIALS AND METHODS: We examined the first 3 books and the fourth book. The relevant passages were translated into English after being transliterated into the contemporary Turkish alphabet. RESULTS: In the first book, kidney anatomy is discussed under the heading "fi teshrih al-kula" and bladder anatomy under "fi teshrih al-methane." In the second book, the formation and excretion of urine are explained in different headings. In the third book, kidney inflammation and its treatment are discussed, with kidney and bladder stones and their medical treatments explained in detail. Finally, the types and treatments of urinary retention are discussed, with types, causes, symptoms, prognosis, and surgical treatments of bladder stones written in detail. CONCLUSIONS: In the Ottoman Empire, Hamse-i Sanizade is regarded as one of the first gateways to the West in the field of medicine. It was instrumental in modernizing Ottoman-Turkish medicine and contains and reflects the state-of-the-art knowledge of the time regarding the anatomy, physiology, diseases, and medical and surgical treatments of the urinary system.

On the Surgical Treatments Related to Nephrological Issues in 'Ali b. al'Abbas al-Majusi's (Haly Abbas) Kamil al-Sina'a al-Tibbiyya (The Perfect Book of the Art of Medicine).

OBJECTIVES: In this study, we translate from Arabic into English the chapters on surgical treatments related to nephrological issues in the ninth article of the second part of Haly Abbas' Kamil al-Sina'a al-Tibbiyya. Our aim was to contribute to the medical history literature, to compare these chapters with the relevant chapters in Paul of Aegina's Epitome, and to discuss findings in light of the related literature. MATERIALS AND METHODS: We examined the Cairo, Bulaq, copy of Kamil al-Sina'a al-Tibbiyya (printed in Arabic) and the manuscripts that are in the Istanbul University Rare Works Library, Yale University Library, and Süleymaniye Manuscript Library. We translated the chapters from Arabic to English. Translated chapters were then compared with the relevant chapters of Paul of Aegina's Epitome and discussed in light of the related literature. RESULTS: Surgical treatments in nephrological issues are provided in Chapter 45 (On urination with a catheter) and Chapter 46 (On removing a stone from the bladder) of the ninth article of the second volume of Kamil al-Sina'a al-Tibbiyya. The same topics are covered in Section 59 (On catheterism and injection of the bladder) and Section 60 (On calculus) of Paul of Aegina's sixth book in the second volume. The information provided by Haly Abbas on these subjects was remarkably similar to the information provided by Paul of Aegina. CONCLUSIONS: It is considered that Haly Abbas benefited from Paul of Aegina's knowledge of the causes of the bladder obstruction, the catheter to remove the accumulated urine, the catheter application technique, and all applications and treatments for stone removal.

Urinary System Problems in al-Rãzî's Book, Man lã yahduruhu al-tabîb: Practical Advice for Those Who Cannot Access Physicians and Medical Recourses.

OBJECTIVES: Abu Bakr Muhammad ibn Zakariyyã al-Rãzî is a historical physician who made theoretical and practical contributions to medicine. The aim of al-Rãzî's book, Man lã yahduruhu al-tabîb, is to provide a valuable benefit to the general public. The book was written for people who do not have access to physicians, critical medical manuscripts, and medications. Our study aimed to add to the literature and discuss the issues concerning urinary tract problems in al-Rãzî's Man lã yahduruhu al-tabîb. MATERIALS AND METHODS: The sections of al-Rãzî's Man lã yahduruhu al-tabîb dealing with the urinary system were discussed and translated from Arabic to English. RESULTS: Urinary system problems are discussed in al-Rãzî's book under the headings of "Pains in the kidneys and bladder (nephritis and cystitis) and stones in the kidneys," "Hematuria," "Pyuria and painful micturition/dysuria," "Prescription for medicine on this subject," and "Drug for the difficulty of passing urine/strangury." The relevant sections mention drugs and approach to be used, particularly in the face of problems, rather than theoretical explanations. Changes in practice and treatment have been suggested in various symptomatic situations. CONCLUSIONS: Rather than theoretical and etiological explanations for urinary problems, al-Rãzî provides accessible and applicable practical drugs and approaches for the general public, which can be considered suitable for the purpose mentioned in al-Rãzî's introduction to the book.

Personal Experiences of Chief Physician Emir çelebi on Kidney and Bladder Diseases: A Brief Review in Anmudhaj al-Tibb.

OBJECTIVES: The aim of this study is to review the kidney and bladder disease sections in Emir çelebi's book called Anmudhaj al-Tibb by presenting and discussing his own experiences with these issues. MATERIALS AND METHODS: A copy of Anmudhaj al-Tibb registered in Istanbul Süleymaniye Manuscript Library, Mihrisah Sultan Collection, no. 342/1, and a printed copy of al-Mujaz fi al-Tibb in Arabic, as well as a copy of the Turkish translation of this work by Sururi registered in Ankara National Library, A1437, were examined. We examined the findings in light of the literature. RESULTS AND CONCLUSION: We discovered that the sections on kidney and bladder diseases in Emir çelebi's Anmudhaj al-Tibb are actually Turkish translations of relevant sections of Ibn al-Nafis's al-Mujaz fi al-Tibb. In some of these chapters, Emir çelebi has added his own observations and experiences, whereas, in others, he has included quotations from physicians such as Ibn Masawayh and Abu Bakr Muhammad ibn Zakariyya al-Razi. One of the most intriguing findings was the drug Yad-Allah, which Emir çelebi claimed was very effective in reducing the kidney stone of the Grand Admiral of the Ottoman Navy Receb Pasha. According to Emir çelebi, Galen and Aflinus [?] both praised this medicine in their own works. However, it has been discovered that Yad-Allah, as described in the literature, is a drug defined by Philagrius.

On Kidney and Bladder Diseases in Nuzhat al-adhhan fi islah al-abdan by Physician Dawud b. 'Umar al-Antaki.

OBJECTIVES: Dawud b. 'Umar al-Antaki, known as the Avicenna of his time, was an Ottoman physician and scholar who wrote medical texts in Arabic in the 16th century. He was taught by an Iranian medical scholar, Muhammad Sharif, in the fields of logic, physical sciences, Greek, and medicine. After leaving Antioch, he traveled to Lebanon and then to Damascus, where he began writing his work, Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. Dawud b. 'Umar al-Antaki settled in Egypt, where he taught at the Zahiriyya Madrasa and practiced medicine before dying in Mecca in 1599. Here, we examined al-Antaki's writings on kidney and bladder diseases in his work Nuzhat al-adhhan fi islah al-abdan. MATERIALS AND METHODS: We translated sections on kidney and bladder diseases into English and compared Ilter Uzel's copy of Nuzhat al-adhhan fi islah al-abdan with a printed copy. We compared the relevant sections of Nuzhat al-adhhan fi islah al-abdan with the relevant sections of other important works of al-Antaki, al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija, and Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. The similarities and differences between these works were revealed. RESULTS: Kidney and bladder diseases are briefly discussed in Nuzhat al-adhhan fi islah al-abdan under the headings "amrad al-kula wa l-mathana," "al-hisa," and "harqan al-bawl wa taqtiruhu." CONCLUSIONS: Issues concerning kidney and bladder diseases are addressed more briefly in Nuzhat al-adhhan fi islah al-abdan than in al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija. Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab consists solely of kidney and bladder stones. When these works are combined, the information in them complements each other.

Ibn Zuhr (Avenzoar) on Head Wounds in Kitab al-Taysir (Liber Teisir).

OBJECTIVE: To present and evaluate the section concerning head wounds in Kitab al-Taysir (Liber Teisir) by Ibn Zuhr (Avenzoar). METHODS: In this study, 4 different versions of Avenzoar's work were analyzed. The first 2 versions are in Arabic and titled Kitab al-Taysir fi al-Mudawat wa al-Tadbir; one was edited by Michel Khouri and printed in Damascus in 1983, and the other was edited by Muhammad b. 'Abd Allah al-Rudani and printed in Rabat in 1991. The third and fourth versions are in Latin; one was translated by Paravicius, edited by Hieronymus Surianus, and printed in Venice in 1530, and the other was a manuscript in Bibliothèque interuniversitaire de santé, MS 5119 in Paris and was translated by John of Capua. RESULTS: The titles of the sections are "Wounds due to iron objects" and "Wounds due to stones" in Arabic and "On head injuries from external factors such as blow" and "On head wounds from iron or stone or wood" in Latin. The chapter written by Avenzoar on head wounds is divided into 2 parts. First, he explained the treatment, and subsequently he described his views and related experiences. CONCLUSIONS: The information provided by Avenzoar on head injuries technically reflects the medical and surgical comprehension of his era. In the section that is the focus of this study, he first provided technical information related to head injuries and then offered his opinions on the controversial and problematic issues in treatment such as phlebotomy. This study revealed that Avenzoar approached the subject differently than his predecessors.

Two different approaches regarding hydrocephalus treatment in the Islamic World during the Middle Ages.

AIM: This study aimed to present the sections allocated to hydrocephalus in the works of Ibn Hubal al-Baghdadi and Ibn al-Quff, to include them and determine their position in the history of medicine by discussing relevant literature. MATERIAL AND METHODS: A printed copy and a manuscript in Istanbul Süleymaniye Manuscript Library, Fatih Collection, nr. 3632 of Ibn Hubal's Kitab al-Mukhtarat fi al-Tibb, and a facsimile of a printed copy and a manuscript in Istanbul University Rare Works Library, Arabic Manuscripts, A 4749 of Ibn al-Quff's Kitab al-'Umda fi Sina'a al-Jiraha, were used. The chapters on hydrocephalus in both works have been translated to English and obtained knowledge was determined based on relevant literature. RESULTS: Hydrocephalus was discussed under the title "On swellings and water occurring outside the skull and on the 'utash of the child and on water collection in the skull" in the third volume of Ibn Hubal's work and "The sixth chapter on the treatment of water which collects in the heads of children" in the 19th article of Ibn al-Quff's work. Ibn Hubal's and Ibn al-Quff's knowledge and approach to hydrocephalus match the knowledge and approaches of their predecessors. Compared with Ibn Hubal, Ibn al-Quff provided more systematic and detailed information on hydrocephalus. CONCLUSIONS: Like other writers of the Islamic world in the medieval times, Ibn Hubal and Ibn al-Quff accept definitions and classifications of hydrocephalus by Greco-Roman writers.

A Study on Head Wounds in Kitab al-'Umda fi Sina'a al-Jiraha by Ibn al-Quff.

The aim of this study is to investigate the knowledge on head wounds contained in the Kitab al-'Umda fi Sina'a al-Jiraha, written by Ibn al-Quff in the thirteenth century. This study was based on a copy of the Kitab al-'Umda fi Sina'a al-Jiraha, printed in 2 volumes in Da'ira al-Ma'arif al-Uthmaniyya in Hyderabad in 1356/1937-38 and reprinted by the Institute for the History of Arabic-Islamic Science at the Johann Wolfgang Goethe University. This printed copy was compared with the manuscript of Istanbul University Rare Works Library, Arabic Manuscripts, A 4749. Relevant chapters were translated from Arabic to English, after which they were thoroughly examined. Obtained knowledge is presented in the Results section and is compared in the Discussion section with other reports of this subject. The first chapter classified head wounds into 6 types: the first 3 types are conservatively treated and the remaining 3 types are surgically treated. This chapter also presents information on how to proceed when there is a head wound-related hemorrhage, which medications should be used, and which are the adequate treatment protocols. The second chapter discusses the symptoms and signs that follow head blow and fall injuries. The characteristics and noteworthy circumstances of skull fractures as well as the surgical treatment methods are included in the fifteenth chapter, which is concluded with surgery-related complications. The present study shows that Ibn al-Quff benefited from his predecessors' knowledge and made some considerable contributions to this subject.

What does Al-Qanun Fi Al-Tibb (the Canon of Medicine) say on head injuries?

A historical approach could help in the detection of some viewpoints that cannot be paid attention to or signified by a purely medical one. In this text, the important points of Ibn Sina's (Avicenna) treatise on head injuries have been introduced in light of neurosurgery. The most detailed chapter regarding head injuries in Canon, under the title of "Fracture of the Skull," presents rather detailed knowledge concerning skull fractures and their surgical treatments in the eleventh century and the medical paradigm of that era. Ibn Sina provided extremely systematic knowledge on head traumas along with both his observations and experiences and citations from the writings of the ancient physicians, Galen and Paul of Aegina. Regarding the treatment of skull fractures, Ibn Sina is a real successor of Galen and Paul of Aegina.

Circumferential total resection of cervical tumors: report of two consecutive cases and technical note.

To date, few studies have addressed the subaxial vertebrectomy technique and related anatomical landmarks in this method. Total spondylectomy is performed via piecemeal resection or en bloc removal in a one-stage procedure associated with stabilizing the spine and preserving neurological status. In this presentation, a circumferential total cervical tumor resection for subaxial cervical spine lesions was described. Two cases of subaxial cervical malignancy, one with primary C3 chondrosarcoma and the other with C4 lung adenosarcoma metastasis, were both treated by the anterior-posterior approach. The lesions could be removed macroscopically totally in both cases. The patients did well after surgery with preserved neurological status and they survived a considerable period without tumor recurrence. Subaxial total tumor resection can be performed safely while preserving vertebral arteries with adequate anatomical knowledge and careful surgical planning, and circumferential vertebrectomy (even intralesional) can provide a long recurrence-free survival period for patients suffering from subaxial spine tumors.

Wounds in the Head from Kitab al-Dhakhira fi 'Ilm al-Tibb by Thabit b. Qurra in the Ninth Century.

OBJECTIVE: Kitab al-Dhakhira fi 'Ilm al-Tibb is one of Thabit b. Qurra's most noteworthy books on medicine in Arabic in the ninth century. This study aims to present and discuss the section subtitled "wounds in the head" in the 24th chapter of Kitab al-Dhakhira considering the information in the literature. MATERIALS AND METHODS: This study is primarily based on a copy of Kitab al-Dhakhira edited by Dr. G. Sobhy and printed in al-Matba'at al-Amiriyya, Cairo in 1928. It is compared with the manuscript, which is in the Sehit Ali Pasa Collection, nr. 2028, in the Süleymaniye Manuscript Library in Istanbul, Turkey. The 24th chapter was first translated into English and then examined. The acquired knowledge from the chapter is discussed in this study by comparing it with that on this subject from the literature regarding the history of medicine. RESULTS: The 24th chapter, entitled "On Wounds and Wounds in the Head and Hemorrhage from Them and from Other Wounds and on Gently Drawing Arrowhead/Spearhead and Thorn," includes a section subtitled "wounds in the head." This section provides information regarding steps to be taken if the head is simply wounded or if there is an accompanying swelling, how to control hemorrhage, which medicines should be used for treatment, and how to bandage wounds in the head, but unfortunately, it specifies no details regarding surgical interventions for such wounds. CONCLUSIONS: Kitab al-Dhakhira presents interesting knowledge regarding wounds in the head, reflecting the medical paradigm of that era.

Did Ibn Zuhr (Avenzoar) Postulate Before Vesalius That Liquid Collects in Ventricles in the Hydrocephalus?

OBJECTIVE: This study aimed to present and evaluate the part of Avenzoar's Liber Teisir that pertains to hydrocephalus. Avenzoar was an Andalusian physician prominent in the history of medicine because of the broadness of his observations and original methods. His most important work is recognized to be the Al-Taysir fi al-Mudawat wa al-Tadbir (On Preventive Regimen and Treatment), and its Latin version, Alteisir scilicet regiminis et medelae, which was in use for centuries in Europe. METHODS: The Arabic (Rabat, Morocco, in 1991) and Latin (Venice, Italy, in 1530) versions of Avenzoar's work were perused, relevant sections were separately translated into English, and both translations were then compared. An English version was prepared and is given in our results. RESULTS: The location of liquid collection was described as the anterior ventricles of the brain and around the brain. CONCLUSIONS: Avenzoar might have noted one of the earliest records on the clinical state called idiopathic adult hydrocephalus and postulated liquid collection in the ventricles of the brain in hydrocephalus before Vesalius.

Giant distal superior cerebellar artery aneurysm: case report and review of the literature.

Aneurysms arising from the distal portion of superior cerebellar artery are infrequently seen. They are usually assumed to result from local arterial wall disruption like proximal supratentorial artery aneurysms. Depending on institutional facilities, these particular aneurysms can be treated either by a microsurgical procedure or interventional radiological technique. In general, surgical clipping has been recommended for these lesions. In this report we describe a 44-year old man who presented with a subarachnoid hemorrhage in the right cerebellopontine angle and was diagnosed with a giant aneurysm arising from the cisternal portion of the right superior cerebellar artery. The patient underwent surgery; microsurgical clipping of the aneurysm through subtemporal craniotomy was performed with no difficulty. We conclude that surgical therapy is suitable for the majority of aneurysms arising from the distal portion of the superior cerebellar artery.

An Early Description of Using Oral Route for the Management of Cervical Vertebra Fracture by Ibn al-Quff in the Thirteenth Century.

OBJECTIVE: This study presents information regarding the treatment of fractures and dislocations of the vertebrae, including the use of the oral route for upper cervical fractures, presented in certain chapters of the book titled Kitab al-'Umda fi Sina'a al-Jiraha (Ibn al-Quff, thirteenth century ad). METHODS: A printed copy of the second volume of the book was studied. Chapters 22 ("On treatment of vertebral fractures") and 33 ("On treatment of vertebral dislocation") of the seventeenth treatise of this book were translated from Arabic into English. Each section is presented (in full text) in the Results section of this article. The findings were compared with the relevant literature and discussed to determine whether Ibn al-Quff presented novel information compared with that presented by his predecessors. RESULTS: The writings of Ibn al-Quff regarding vertebral dislocations seem to summarize information derived from his predecessors. Moreover, he modified certain approaches, previously described for vertebral dislocations, and used them for correcting vertebral fractures. Ibn al-Quff introduced the most novel use of a bridlelike instrument for anterior cervical fracture through the oral route. By introducing the device in the mouth, he described a pushing maneuver to the cervical vertebrae from the ventral site and a simultaneous pulling maneuver by cupping on the neck from the dorsal site. CONCLUSIONS: The use of the oral route introduced by Ibn al-Quff may be one of the earliest examples of novel, practical, and advanced treatment for cervical vertebral fracture.

Hydrocephalus and its management in Avicenna's Canon of Medicine.

Hydrocephalus and macrocrania in children have been regarded as amazing disorders throughout the history of medicine. Although the main underlying causes and pathophysiology of hydrocephalus were not understood until the middle of the 18th century, early physicians had made important contributions to this field with their careful observations, management protocols, and anatomical studies. Among these pioneering physicians was Avicenna, widely accepted as an influential and leading scientific figure of the medieval ages. Avicenna was interested in the study of hydrocephalus, and in his principal medical book, the Canon of Medicine, he devoted a large section to this topic. In this paper, a short excerpt concerning hydrocephalus is presented from Avicenna's Canon.

The earliest document regarding the history of cranioplasty from the Ottoman era.

Cranioplasty is one of the significant neurosurgical procedures in which the technical advances and also, by some means, drawbacks are still continuing. According to archeological findings and anthropological studies, the earliest procedures regarding cranioplasty date back to just about the same period claimed for trepanation. Ancient surgeons from different geographical sites and cultures performed both practices with remarkable survival rates. However, despite the length of the thriving past of cranioplasty, the first known written record on the topic dates back to late 16th century Europe. Further study of the Ottoman era documents revealed an intriguing text that was written about the repair of skull defects and that dates from early 16th century. This worthy discovery will add valuable contribution to the history of neurosurgery by drawing the written history of cranioplasty more than 60 years back and the use of organic grafts 160 years back. In the present study, this original text is discussed.

A rare cause of "foot drop": spinal epidural brucella granuloma.

Spinal epidural abscess is rare but serious medical condition which may cause permanent neurological deficits, or even death, if not treated. Staphylococcus aureus is the responsible microorganism in most spinal abscess cases. However, rarely other microorganisms like Brucella may be responsible. Brucellosis, a zoonotic infection endemic in the Mediterranean Region, Middle East; and South and Central America, most frequently involves the reticuloendothelial and musculoskeletal systems. Vertebral involvement is rarely seen; and its differential diagnosis is rather difficult. Spondylodiscitis and rarely spinal abscess or development of a granuloma are the main pathologies. Spinal epidural granulomas due to brucellosis may cause neurologic deficits. In this case presentation, a spinal epidural brucella granuloma causing foot drop is discussed taking other reports into account.

Lumbar radiculopathy due to unilateral facet hypertrophy following lumbar disc hernia operation: a case report.

OBJECTIVE: To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. CASE REPORT: A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. RESULTS AND CONCLUSIONS: Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In addition, it can be speculated that unilateral facet hypertrophy, which may develop after a disc hernia operation, might also be one of the causes of radiculopathy.