ISSN: 2413-9122 Volume 1 No. 1 March 2016 The Offcal Journal of the Azerbajan Medcal Assocaton AMAJ Azerbaıjan Medıcal Assocıatıon Journal www.amaj.az MD Publshng AMAJ Azerbaıjan Medıcal Assocıatıon Journal Official Journal of Azerbaijan Medical Association Volume 1 • No. 1 • March 2016 Radiology Psychiatry Case Report Case Report Multicystic Perivascular Spaces Mimicking Cystic Risperidone-Induced Hiccups in an Adolescent Neoplasm of Brain Ikram Rustamov · Hatice Gunes · Burak Dogangun - 19 Elnur Mehdi · Alpay Alkan · Ayse Aralasmak - 1 Plastic, Reconstructive and Aesthetic Surgery Cardiovascular Surgery Case Report Original article Reconstruction of Pharyngeal Defect with Our Initial Results of Off-pump Coronary Artery Prelaminated Pectoralis Major Pedicled Flap Bypass Grafting Ilyas Akhundzada · Araz Aliyev · Tural Huseynov · Rauf Islamjan Sharipov · Rustam Yarbekov · Abdulla Kerimov - 4 Ismatov · Sanjar Omonov · Takhir Vakhidov · Nabijon Yuldashev · Ravshanbek Kurbanov - 22 Cardiology Review article İnterventional Radiology Technical Review On Phrenic Nerve Stimulation Case Report During Biventricular Pacing – How To Avoid And Splenic Artery Pseudoaneurysm – Unusual Pediatric How To Treat? Case Farid Aliyev · Elnur İsayev · Fuad Samedov · Rufat Aghakishi Yahyayev - 27 Zeynalov - 8 Obstetrics & Gynecology Forensic Medicine Case Report Original Research Acute Renal Insufficiency Caused by Total Uterine Fatal Mushroom Poisoning in Syrian Refugees Prolapse: A Case Report and Review of the Literature Semih Petekkaya, Turgay Börk, Nüsret Ayaz, Cihan Turab Janbakhishov - 11 Göktürk, Emine Şamdancı, Osman Celbiş - 30 Otorhinolaryngology Case Report Fibrous Dysplasia of the Temporal Bone Presenting with Vertigo Yusif Hajiyev - 14 General Surgery DOI For information about DOIs and to resolve them, please visit Case Report www.doi.org First Living Donor Liver Transplantation For Congenital Hepatic Fibrosis In Azerbaijan The Cover Ruslan Mamedov · Nuru Bayramov - 16 Graphic artwork inspired from “Glass Pane” in Shirvanshahs Palace, Baku, Azerbaijan by Elnur Mehdi, MD. www.amaj.az AMAJ Azerbaıjan Medıcal Assocıatıon Journal Official Journal of Azerbaijan Medical Association Volume 1 • No. 1 • March 2016 Editor in Chief Editorial Board International Advisory Committee Nariman Safarli, MD Aghakishi Yahyayev, MD, PhD Abass Alavi, MD, PhD, DSc Baku, Azerbaijan Philadelphia, PA, USA Associate Editors Ali Quliyev, MD, PhD Alessandro Giamberti, MD, PhD Baku, Azerbaijan Milan, Italy Elnur Mehdi, MD Jamal Musayev, MD Anar Aliyev, MD, PhD Andrey Kehayov, MD, PhD, DSc Baku, Azerbaijan Sofia, Bulgaria Nadir Zeynalov MD, PhD Nigar Sadiyeva, MD Elnur Farajov, MD, PhD Ayaz Aghayev, MD, PhD Baku, Azerbaijan Cambridge, MA, USA Assistant Editors Erkin Rahimov, MD, PhD Bülent Gürler, MD, PhD Baku, Azerbaijan Istanbul, Turkey Rauf Karimov, MD, PhD Lana Yusufova, MD Ferid Aliyev, MD, PhD Ercan Kocakoç, MD, PhD Baku, Azerbaijan Istanbul, Turkey Narmina Aliyeva, MD Saida Talibova, MD Ikram Rustamov, MD, PhD Faik Orucoglu, MD, PhD Baku, Azerbaijan Istanbul, Turkey Ilyas Akhund-zada, MD, PhD Fidan Israfilbayli, MD, PhD Call for papers Baku, Azerbaijan Birmingham, UK Azerbaijan Medical Association invites Islam Magalov MD, PhD, DSc Gia Loblanidze, MD, PhD, DSc authors to submit their papers to Azerbai- Baku, Azerbaijan Tbilisi, Georgia jan Medical Association Journal - AMAJ. 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Reproduction without permis- Baku, Azerbaijan Basel, Switzerland sion is prohibited. Yusif Haciyev, MD, PhD Yves Durandy, MD For futher information please contact: Baku, Azerbaijan Paris, France MD Publishing, Tel: (+99455) 328 1888, email: [email protected] www.amaj.az 1 Case Report DOI: 10.5455/amaj.2016.01.001 Multicystic Perivascular Spaces Mimicking Cystic Neoplasm of Brain Elnur Mehdi, MD Alpay Alkan, MD, PhD* Background: Virchow-Robin (VR) spaces are the fluid-filled perivascular spaces Ayse Aralasmak, MD, PhD* adjacent the brain vessels. The signal intensities of the VR spaces are very similar to those of cerebrospinal fluid (CSF). VR spaces should be distinguished various patho- Nuclear Medicine Department, logic conditions, including lacunar infarctions, cystic periventricular leukomalacia, National Institute of Oncology, cryptococcosis, cystic neoplasms and neuroepithelial cysts. Baku, Azerbaijan Case presentation: 32-year-old female with 6 month history of worsening severe * Radiology Department, headaches. The clinical examination and laboratory findings were congruent with Bazmialem Vakif University, hypothyroidism. MR imaging revealed multiloculated, thin-walled, “soap bubble” like Istanbul, Turkey lesions cystic lesions involving anterior part of left cingulated gyrus. Cystic lesions showed the same signal intensity characterstics with CSF. There was no any mass ef- Correspondence: fect, enhancement, peripheral edema and no restriction in diffusion-weighted imag- Elnur Mehdi, MD es. After 10 month follow-up there was no any change in size or in MRI features. Nuclear Medicine Department, Conclusion: Knowledge of the signal intensity characteristics, locations of VR spac- M. Xiyabani, 137 AZ1012, Baku, Azerbaijan es and absence of any change in follow up prevents unnecessary biopsy. email: [email protected] Phone: (+99450) 331 30 02 Keywords: Virchow-Robin spaces, perivascular spaces, cingulate gyrus, cystic le- sion of brain, neuroepithelial cyst Introduction amination was performed and revealed irchow-Robin (VR) spaces are perivas- multiloculated, clusters of variable-sized, Vcular spaces surrounding the brain ves- thin-walled, “soap bubble” like lesions cystic sels. Although, the signal intensities of the lesions involving anterior part of left cingu- VR spaces are identical to those of CSF, they lated gyrus (figure 1). Cystic lesions showed do not communicate directly subarachnoid the same signal intensity characterstics with space or ventricles. One of the most basic CSF. There was no any mass effect, enhance- roles of the VR spaces is the regulation of ment and peripheral edema, calcification or CNS fluid movement and drainage [1]. haemorrhagia. Diffusion-weighted images VR spaces can be distinguished by it’s showed no restricted diffusion. The patient signal characterictics and location from has a history of traumatic brain injury 20 various pathologic conditions, including la- years before. We decided to follow-up and cunar infarctions, cystic periventricular leu- after 10 month there was no any change in komalacia, cryptococcosis, cystic neoplasms size or in MR imaging features (figure 2). and neuroepithelial cysts. Discussion Case Report Virchow-Robin spaces surround the A 32-year-old female, presented with walls of vessels as they course from the sub- 6 month history of severe headache. The arachnoid space through the brain paren- clinical examination and was laboratory chyma. Dilated VR spaces typically occur findings were congruent with hypothy- in three characteristic locations: Type I VR roidism (fT3=2.16 Pg/ml; fT4=0.33 ng/ spaces found along the lenticulostriate ar- ml; TSH=76.45 µIU/ml;). MR imaging ex- teries entering the basal ganglia; Type II VR www.amaj.az Mehdi et al. AMAJ 2 Perivascular spaces mimicking neoplasm of brain 2016; 1: 1-3 Figure 1. Axial T1-weighted (repetition time - TR:550ms, echo time - TE:10ms, averages:4, flip angle:90°) images(a) shows parasagittal hypointense multicystic lesions in cingulate gyrus that completely suppressed in FLAIR (TR:8000ms, TE:118ms, averages:1, flip angle:150°) images (b). There is no restriction diffusion-weighted (b-value:1000) images (c) and no calcifica- tion or haemorrhage in T2W-Fast Field Echo (TR:757ms, TE:23ms, averages:2,