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    Acute Onset Myositis Associated with Brucellosis, Quite a Rare Diagnosis
    (Japan Soc Internal Medicine, 2008) Celik, Aygul Dogan; Celik, Yahya; Yulugkural, Zerrin; Balci, Kemal; Utku, Ufuk
    Brucellosis is a zoonosis that is transmissible to humans. It is a disease with multi-systemic involvement caused by the genus Brucella. Neurological complications, including meningitis, meningo-encephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess and meningo-vascular syndromes, are rarely encountered. We present a patient presenting with acute onset myositis. This kind of presentation has not previously been reported in the English language literature. We conclude that the diagnosis of neuro-brucellosis should be considered in patients presenting with muscle weakness.
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    Akut inmelerde erken başvuruyu etkileyen faktörler
    (1998) Aydın, Nurgül; Avcı, Aynur Yılmaz; Yılmaz, Hakan; Erdoğan, M. Sarper; Çalıyurt, Okan; Utku, Ufuk
    inmelerde erken başvuru, tıbbi tedavi ve prognozu etkileyen en önemli parametrelerden biridir. Bu çalışmada Edirne merkez ve yakın çevresinden kliniğimize başvuran olgular arasında başvuru süresini etkileyen medikal, patofizyolojik ve demografik özellikler değerlendirildi. Yaş ortalaması 65.95±11.93 olan 100 akut inmeli olgu (K=55, E=45) çalışmaya dahil edildi. Olgular başvuru saatlerine göre, 6 saatten önce gelenler ve daha sonra olmak üzere, 2 gruba ayrıldı. Gruplar erken başvuru üzerine etki eden eğitim, ekonomik durum, medeni hal, geçmişte inme ya da TlA öyküsü, bilinç bozukluğunun derecesi, Rankin Skoru, inme türü ve lateralizasyonu, eşlik edebilen baş ağrısı, afazi, ihmal , BT bulguları açısından karşılaştırıldığında, özellikle bilinç bozukluğu ve BT'de hemorajinin varlığının erken başvuru ile ilişkili olduğu saptandı
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    Akut isoniazid intoksikasyonu: Olgu sunumu
    (2000) Menteş, Erdoğan Fatma; Sönmez, Ümit; Utku, Ufuk
    Akut isoniazid (INH) intoksikasyonu, epileptik nöbetler, koma ve metabolik asiden, triadı ile karakterime bir klinik tablodur. Özellikle yeterli öykü alınamadığı durumlarda, bu tablo ensefalit, meningoensefalit veya ensefalopati ile karışabilmektedir. Bu makalede ateş yüksekliği, bilinç kaybı ve status epileptikus tablosu ile prezante olan ve bu klinik bulguların etiolojisinde daha sonra INH intoksikasyonu saptanan, 19 yaşındaki olgu dolayısıyla, INH intoksikasyonun klinik ve laboratuvar bulguları ve ayırıcı tanı olasılıkları literatür bilgileri ışığında tartışılmıştır.
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    Akut strokta serum nöron spesifik enolaz değerlerinin prognoz ile ilişkisi
    (2001) Avcı, Aynur Yılmaz; Yüksel, Mahmut; Aydın, Nurgül; Erdoğan, M. Sarper; Çiftçi, Şükran; Utku, Ufuk
    Akut strokta, nöronal hasarı ve fonksiyonel prognozu belirlemek için yapılan noninvazif tetkiklerden biri de serum Nöron Spesifik Enolaze (NSE) değerlerinin ölçümüdür. Bu çalışmada, serebrovasküler hastalığı olan 30 olgu (15'i iskemik ve 15'i hemorajik vaka) ve benzer yaş ve cinsiyete sahip 15 kontrol hastası çalışılmıştır. NSE seviyeleri akut fazda (ilk 48±12 saat) ölçülmüştür ve lezyon tipi, lokalizasyonu, Glaskow Koma Skalasının (GKS) başlangıç skoru, ilk kan glukoz değerleri, yaş ve onuncu gündeki Rankin Skoru belirlenmiştir. Sonuçta serum NSE düzeyleri, iskemik ve hemorajik stroklu gruplarda, kontrol grubuna göre daha yüksek bulunmuştur. Fakat sonuçlar istatistiksel olarak anlamlı değildi. Karşılaştırılan değerler arasında NSE düzeyleri başlangıç GKS'leri düşük olan grupta anlamlı derecede daha yüksek bulunmuştur (p = 0.04, p<0.05).
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    Altıncı kranial sinir paralizisine neden olan bir herpes zoster oftalmikus olgusu
    (2008) Utku, Ufuk; Balcı, Kemal; Özbek, Bahar
    Bilimsel zemin: Herpes zoster oftalmikus enfeksiyonları tüm zoster enfeksiyonlarının %25 kadarını oluşturur. Bununla birlikte herpes zoster enfeksiyonları ile birlikte ekstraoküler bakış paralizisi oldukça nadir bildirilmiştir. AMAÇ: Bu yazıda, herpes zoster oftalmikus enfeksiyonu ile birlikte altıncı kranial sinir paralizisi gelişen bir olgu sunulmuştur. OLGU: Altmış yaşında bir bayan hasta sol retroorbital ağrı, konjuktival konjesyon, alın ve burnun sol yarısında döküntü ve altıncı kranial sinir paralizisi ile başvurmuştur. SONUÇ: Herpes zoster virüs enfeksiyonu ekstraoküler bakış paralizisinin bir nedeni olarak göz önünde bulundurulmalıdır ve erken tedavi ile bu tür komplikasyonların gelişimi önlenebilir.
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    Antihistaminik kullanımı ile tetiklenen tekrarlayıcı baş ağrısı ve reversible serebral vazokonstriksiyon sendromu
    (2017) Güler, Sibel; Utku, Ufuk; Çelebı, Canan
    Reversibl serebral vazokonstriksiyon sendromu (RSVS), Call-Fleming sendromu olarak da bilinen, genellikle 20-40 yaşlarında ve kadınlarda görülen, nörolojik defisitlere neden olabilen gök gürültüsü baş ağrısının nadir nedenlerinden biridir. RSVS nedeni muhtemelen serebral vasküler tonustaki geçici disregülasyonun neden olduğu multifokal arteriyal konstriksiyon ve dilatasyondur. Altmış üç yaşında kadın hasta başının sol tarafında belirgin, ani gelişen, tekrarlayıcı baş ağrısı şikayeti ile başvurdu. Fizik ve nörolojik muayenesi normaldi. Kraniyal manyetik rezonans görüntüleme (MRG) anjiyo incelemelerinde MCA ve PCA'da belirgin olmak üzere damarların distallerinde belirgin vazokonstriksiyon saptandı. Ayırıcı tanıda ilk olarak düşünülen primer SSS anjitisi kranial MRG'de parankim lezyonu ve beyin omurilik sıvısında (BOS) protein artışı olmaması nedeniyle dışlandı. Deksametazon sodyum fosfat 4 mg/ml (4 mg/gün) ve nimodipin 90 mg/gün tedavisi başlandı. Nimodipin dozu kademeli olarak 120 mg/gün'e çıkarıldı. Ek olarak, antihistaminik ajanların kesilmesi ile baş ağrısı belirgin olarak geriledi. RSVS sendromunun vurgulanması gereken en önemli özelliğinin benzer klinik prezentasyon gösteren subaraknoid kanama veya primer santral sinir sistemi (SSS) anjitisinden farklı olarak klinik bulgularının reversibl olmasıdır. Klinik bulgular çoğunlukla düzelmekle birlikte, kalıcı nörolojik defisitler de olabileceği göz önünde bulundurulmalıdır
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    Bilateral basal ganglionic lesions due to transdermal methanol intoxication
    (Elsevier Sci Ltd, 2009) Karaduman, Fatih; Asil, Talip; Balci, Kemal; Temizoz, Osman; Unlu, Ercument; Yilmaz, Arif; Utku, Ufuk
    Methanol is a clear, colorless, and highly toxic liquid with a similar smell and taste to ethanol, and is found in many commercial products such as solvents and cleaning fluids. Severe methanol intoxication occurs after suicidal or accidental oral ingestion of solvents. A few patients with methanol intoxication via the transdermal route have been reported. We present a 47-year-old woman with acute transdermal methanol intoxication admitted to the emergency department with weakness, blurred vision, bilateral areactive mydriasis, and deterioration of consciousness. (C) 2009 Elsevier Ltd. All rights reserved.
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    A case of cerebral venous thrombosis accompanying with intracranial hypotension: Headache that changing character
    (Kare Publ, 2013) Guler, Sibel; Deniz, Cigdem; Utku, Ufuk; Kehaya, Sezgin
    Spontaneous intracranial hypotension was first described by Schalternbarn. Severe complications like cerebral venous thrombosis and subdural hemorrhage are seldomly seen. A 40-year-old man was examined for weakness of right arm started 9 months earlier and aggravated in last 3 months. He was undergo a lumbar punction because of a demyelinating plaque at C2 level in MRI. After 10 days of lumbar punction he experienced a generalised tonic clonic seizure. At cranial MRI and venography thrombosed superior sagittal and right transverse sinus and image of pachymeningitis, caused by intracranial hypotension were observed. Coincidence of these two situations together was seldomly found at literature. Thrombosis can both effect the sinuses and cortical veins. Spontaneous intracranial hypotension is a risk factor for CVT, but at only 2% CVT is seen as a complication. We think that our case can add addition to literature by having this coincidence.
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    A Case with Symmetrical Intracranial Calcifications and Systemic Lupus Erythematosus Presenting with Optic Neuropathy
    (Turkish Neurological Soc, 2012) Guler, Sibel; Donmez, Salim; Utku, Ufuk; Yavuz, Selcuk
    53 years old female patient presented with sudden loss of sight of her right eye. The patient's neurological examination revealed a decrease in visual acuity (2/20) in her right eye. Her optical disc was hyperemic with edema. The patient's brain CT scans showed symmetrical calcifications in cerebellar peduncles, cerebral hemispheres, putamens and thalamus bilateraly. Laboratory examinations showed positive ANA, positive anti-DNA antibodies and lymphopenia leading to the diagnosis of systemic lupus erythematosus (SLE). We report this case with SLE because of the rare comorbity of optic neuropathy with bilateral calcifacitions.
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    Cerebral infarction due to traumatic carotid artery dissection
    (Turkish Assoc Trauma Emergency Surgery, 2008) Kilincer, Cumhur; Tiryaki, Mehmet; Celik, Yahya; Turgut, Nilda; Balci, Kemal; Utku, Ufuk; Cobanglu, Sebahattin
    With the advent of improved neuroradiological methods, it has been determined that frequency of traumatic carotid artery dissections is higher than previously observed. Since delayed neurological deficits may develop in some asymptomatic undiagnosed cases, it is essential to consider the possibility of the carotid artery dissection and evaluate it properly in suspicious cases. In this article, a case of internal carotid artery dissection and subsequent cerebral infarction following a motor vehicle accident is presented. Pathogenesis, clinical features, diagnostic method choices and treatments in this rare but severe condition are discussed in light of the relevant literature in order to convey current knowledge.
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    Cerebral sinus thrombosis in patients with inflammatory bowel disease: A case report
    (Baishideng Publishing Group Inc, 2005) Umit, Hasan; Asil, Talip; Celik, Yahya; Tezel, Ahmet; Dokmeci, Gulbin; Tuncbilek, Nermin; Utku, Ufuk
    Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcerative colitis, who spontaneously developed intracranial sinus thrombosis that was treated with low molecular weight heparin. Literature was searched to assess the frequency and characteristics of cerebral sinus thrombosis in IBD and the role of certain etiopathological factors in such thrombotic patients. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.
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    Changing cerebral blood flow velocity by transcranial Doppler during head up tilt in patients with diabetes mellitus
    (Elsevier, 2007) Asil, Talip; Utku, Ufuk; Balci, Kemal; Uzunca, Ilkay
    Objective: Diabetes mellitus is an independent risk factor for poor prognosis in patients with ischemic stroke. It is known that diabetes mellitus directly affects cerebral vasculature as a secondary, long-term complication of cerebral circulation, and causes cerebral blood flow abnormalities. The abnormalities of cerebral autoregulation also poorly affects the prognosis of ischemic stroke. In this study, we aimed to show the cerebral autoregulation with transcranial Doppler (TCD) ultrasound in diabetic patients with autonomic nervous system abnormalities, determined with electrophysiological studies. Material and method: Twenty healthy controls and 39 patients, who had at least 2 years of diabetes mellitus, were evaluated (age ranges: 42-75 years). The patients were divided into two groups according to sympathetic skin response and R-R interval variation studies: (1) patients with autonomic neuropathy; (2) patients without autonomic neuropathy. Blood flow velocities were measured during supine position and after the patients were raised upright position on head up tilt table. Arterial blood pressures and heart rates were also evaluated. Results: Mean blood flow velocities of diabetic patients with autonomic neuropathy were found more decreased at 90 s after the patients were raised upright position. Discussion: Autonomic neuropathy due to diabetes mellitus affects cerebral autoregulation, and by this way cerebral perfusion loses protection against hemodynamical changes. (c) 2006 Elsevier B.V. All rights reserved.
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    Clinical and Radiological Features in CADASIL and NOTCH3-Negative Patients: A Multicenter Study from Turkey
    (Karger, 2014) Ince, Birsen; Benbir, Gulcin; Siva, Aksel; Saip, Sabahattin; Utku, Ufuk; Celik, Yahya; Necioglu-Orken, Dilek
    Background: The diversity of clinical presentation and neuroimaging findings of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) from different regions of the world has not yet been studied in depth. Here we investigated the variability of clinical, radiological and genetic data of 48 patients analyzed for NOTCH3 mutation in Turkey. Methods: Clinical evaluation was made according to a preformed questionnaire. Cranial neuroimaging findings were determined on the basis of T1, T2, FLAIR and proton-density magnetic resonance scans. For genetic analysis, polymerase chain reaction was performed with primers flanking exons 2-6 and 11 of NOTCH3 gene. Results:Twenty-five patients (52.1%) were diagnosed as CADASIL with NOTCH3 mutation, while 23 patients (47.9%) had no mutation (NOTCH3-negative patients). The mean age and age at stroke onset were lower in male CADASIL patients (p < 0.03). A family history of migraine (p = 0.012), stroke (p < 0.001), recurrent strokes (p = 0.020) and dementia (p = 0.012) was more common in CADASIL patients. Temporal pole involvement was more common in CADASIL patients (p = 0.004). Conclusion: It is of clinical importance to identify the heterogeneity of CADASIL from different countries due to a low correlation of clinical and radiological data with respect to NOTCH3 mutation. (C) 2014 S. Karger AG, Basel
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    A comparison of risk factors and prognosis between intra and extracranial acute atherosclerotic stroke in the Turkish population: a prospective study
    (Taylor & Francis Ltd, 2016) Keheya, Sezgin; Tekatas, Aslan; Aynaci, Ozer; Utku, Ufuk; Solmaz, Volkan
    Background: The aim of this study was to compare the differences in risk factors and prognosis between acute stroke caused by definitive intracranial atherosclerosis (ICAS) or extracranial atherosclerosis (ECAS) in the Turkish population. Methods: This study was prospectively designed in a single centre and conducted with patients who were hospitalised due to acute ischaemic stroke. Inclusion criteria were the diagnosis of atherosclerotic ischaemic stroke, defined as more than 50% stenosis or occlusion in the arterial structure supplying the ischaemic area, having excluded other possible causes. Results: Information on 58 ICAS and 57 ECAS stroke patients was collected in a 13-month period. The ECAS patients had male gender predominance (p = 0.003). Ageing, stroke history and hyperlipidaemia were related with stroke severity in ECAS, and gender was associated with severity in ICAS. Hypertension and being female were related with poor prognosis in ICAS (p = 0.081 vs. 0.087). Congestive heart failure (p = 0.002) was associated with poor prognosis and alcohol with a favourable outcome (p = 0.087) in ECAS. Stroke severity was related with poor prognosis in both groups (p < 0.001). Conclusions: The prevalence of risk factors differs between ICAS and ECAS, and their influence differs for stroke severity and prognosis.
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    Decompression craniotomy
    (Amer Assoc Neurological Surgeons, 2007) Kilincer, Cumhur; Asil, Talip; Utku, Ufuk; Balci, Kemal; Hamacioglu, Mustafa Kemal
    Object. Middle cerebral artery infarction often occurs at a younger age than other strokes and is associated with significant rates of mortality and morbidity. After a period of pessimism regarding decompressive hemicraniectomy in the management of acute stroke, the method has reemerged in the past decade. The present study was undertaken to assess the immediate and long-term outcome of this intervention and to help better define the selection criteria for surgery. Methods. The authors conducted a nonrandomized prospective study using decompressive hemicraniectomy with duraplasty in patients at various stages of clinical deterioration due to a space-occupying middle cerebral artery infarct. Patients were assessed at 6 and 12 months postinfarction by using functional scales. Subjective reconsideration was assessed using a questionnaire. Twenty-six patients were included in the study. The mean age was 48.4 +/- 11.2 years, and the mean preoperative Glasgow Coma Scale score was 9.9 +/- 3.2. The median time from ictus to surgery was 54 hours (range 13-288 hours). The rate of survival at 1 year postsurgery was 73%. Among survivors, 33.3% were independent (Barthel Index [BI] > 95) and 55.6% were partially dependent (BI 60-95) at 1 year postsurgery, with 72% attaining the ability to walk independently by 1 year postsurgery. No patient remained in a vegetative state. The 1-year BI score was inversely related to patient age(r = -0.47, p = 0.048). Conclusions. Survival after decompressive hemicraniectomy was better than previously reported using medical management alone. A vegetative state was avoided and functional independence was possible, especially in younger patients. Increasing age was a statistically significant predictor of disability and long-term functional dependence.
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    Deep cerebral vein thrombosis associated with iron deficiency anaemia in adults
    (Elsevier Sci Ltd, 2007) Balci, Kemal; Utku, Ufuk; Asil, Talip; Buyukkoyuncu, Nilufer
    Cerebral venous thrombosis (CVT) is rare and has a wide spectrum of symptoms, therefore it is difficult to diagnose. Thrombosis of the deep cerebral veins occurs very rarely: it has been reported that approximately 6% of patients with CVT have deep CVT, and the prognosis for patients with this condition is poor. CVT has been reported in association with dehydration, a hypercoagulable state, mastoiditis, tumour invasion of a venous sinus, use of oral contraceptives, pregnancy, puerperium, head trauma, vasculitis, and intracranial and systemic infections. However, in the literature, there are few reported cases of CVT in association with iron deficiency anaemia, especially in adults. We present here two patients with bilateral thalamic and basal ganglionic lesions due to thrombosis of the deep cerebral veins. Both of our patients had severe hypochromic microcytic anaemia due to iron deficiency, and both had a good prognosis after 2 months. (c) 2006 Elsevier Ltd. All rights reserved.
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    Early Clinical Signs, Lesion Localization, and Prognostic Factors in Unilateral Symptomatic Internal Carotid Artery Occlusion
    (Elsevier Science Bv, 2014) Guler, Sibel; Utku, Ufuk; Aynaci, Ozer
    Background: The aim of this study was to assess infarct localization, clinical signs, and prognostic factors in cases with unilateral symptomatic total internal carotid occlusion. Methods: In total, 101 patients who had a diagnosis of symptomatic unilateral carotid occlusion in the Department of Neurology, Trakya University Faculty of Medicine, between January 2008 and May 2012, were included in this study. The relationship between infarct localizations and prognosis of patients was evaluated by cranial magnetic resonance imaging (MRI) and diffusion-weighted MRI. The condition of ipsilateral middle cerebral artery (MCA) and posterior communicating arteries (PCoAs) was assessed by cranial and cervical magnetic resonance angiography besides opposite carotid. Patients were evaluated by modified Rankin Scale in terms of prognosis at discharge and after 3 months. Furthermore, they were evaluated in terms of risk factors, such as cigarette and alcohol use, presence of temporary ischemic attack and stroke history, hypertension, diabetes mellitus, coronary artery disease, previous myocardial infarction, hyperlipidemia, and peripheral vascular disease. Results: Territorial infarct was commonly seen as acute ischemic stroke pattern especially in cases with a poor MCA circulation and insufficient collateral circulation. Development of territorial stroke, occlusion of MCA, and nonvisualization of PCoA were found to be associated with poor prognosis. Conclusions: In unilateral symptomatic intracranial carotid artery occlusion, poor prognosis and high mortality-associated territorial stroke pattern is frequently observed. Besides, presence of severe stenosis or occlusion and absence of collateral circulation in MCA are associated with poor prognosis.
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    The Effect of Admission Blood Pressure on the Prognosis of Patients with Intracerebral Hemorrhage That Occurred during Treatment with Aspirin, Warfarin, or No Drugs
    (Informa Healthcare, 2012) Balci, Kemal; Utku, Ufuk; Asil, Talip; Celik, Yahya; Tekinaslan, Ilkay; Ir, Nasif; Unlu, Ercument
    Background. Hypertension is the most important modifiable risk factor for intracerebral hemorrhage (ICH), but blood pressure (BP) management during the acute phase of ICH is still controversial. Approximately one-fourth of ICHs occur during treatment with warfarin or aspirin. Aim. This study was designed to determine the effect of admission BP on the early prognosis of ICH patients by dividing them into three groups (warfarin, aspirin, and no drugs). Methods. Three hundred and sixty-nine patients with supratentorial ICH were divided into three groups according to medication. Each group was evaluated in terms of prognosis and the risk for mortality based on the modified Rankin Scale (mRS) score at discharge (good prognosis: mRS <= 3; poor prognosis: mRS > 3). The effect of admission BP on prognosis was evaluated for each group. Results. The inhospital mortality rate was 72% for ICH patients treated with warfarin, 41.6% for ICH patients treated with aspirin, and 35% for ICH patients treated with no drugs. Admission mean arterial blood pressure (MABP) values were higher in patients with poor prognosis compared with patients with good prognosis for the aspirin (P = .002) and no-drug (P = .001) groups, but not in the warfarin (P = .067) group. Conclusion. A high MABP at admission was found to be an independent predictor of poor prognosis for ICH patients treated with aspirin or with no drugs, but not for ICH patients treated with warfarin.
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    EFFECTS OF CHADS2 SCORE, ECHOCARDIOGRAPHIC AND HAEMATOLOGIC PARAMETERS ON STROKE SEVERITY AND PROGNOSIS IN PATIENTS WITH STROKE DUE TO NONVALVULAR ATRIAL FIBRILLATION
    (Literatura Medica, 2019) Aynaci, Ozer; Tekatas, Asian; Aynaci, Gulden; Kehaya, Sezgin; Utku, Ufuk
    Introduction - The aim of this study is to evaluate utility of CHADS2 score to estimate stroke severity and prognosis in patients with ischemic stroke due to non-valvular atrial fibrillation (AF) in addition to evaluate effects of hematologic and echocardiographic findings on stroke severity and prognosis. Methods - This prospective study included 156 ischemic stroke cases due to non-valvular AF in neurology ward of Trakya University Medical School between March 2013-March 2015. National Institute of Health Stroke (NIHS) score was used to evaluate severity of stroke at admission. Carotid and vertebral Doppler ultrasonography findings, brain computed tomography (CT) and magnetic resonance imaging (MRI) of the cases were evaluated. Left atrial diameter and ejection fraction (EF) values were measured. CHADS2 score was calculated. Modified Rankin Scale was used to rate the degree of dependence. Effects of age and sex of the patients, presence of diabetes mellitus (DM), Congestive Heart Failure (CHF), Cerebrovascular Disease (CVD) and C-reactive protein (CRP) levels on CHADS2, NIHS, and mRS were evaluated. Results - In patients with age >= 75, mean NIHS score was 3.3 points and mean mRS score was 1.02 points higher, than in patient below 75 years of age. Compared with the mild risk group, cases in the high risk group had older age, higher serum D-dimer, fibrinogen and CRP levels and lower EF. A positive relation was detected between stroke severity and Hemorrhagic Transformation (HT), previous CVD history, and presence of CHF. A significant association was found between increased stroke severity and Early Neurological Deterioration (END) development. Older age, higher serum fibrinogen, D-dimer, CRP and lower EF values were associated with poor prognosis. History of CVD and presence of CHF were associated with poor prognosis. END development was found to be associated with poor prognosis. In the high-risk group, 30.3% (n = 33) had END. Among those in the high-risk group according to the CHADS2 score, END development rate was found to be significantly higher than in the moderate risk group (p < 0.05). There was a strong positive correlation between CHADS2 and NIHS scores. mRS score increased with increasing CHADS2 score and there was a strong correlation between them. Effect of stroke severity on prognosis was assessed and a positive correlation was found between NIHS score and mRS value. Discussion - Our study demonstrated the importance of CHADS2 score, haemostatic activation and echocardiographic findings to assess stroke severity and prognosis. Knowing factors which affect stroke severity and prognosis in patients with ischemic stroke may be directive to decide primary prevention and stroke management.
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    Esansiyel trombositemiye bağlı yaygın serebral venöz tromboz
    (2000) Turgut, Nilda; Aydın, Nurgül; Çelik, Yahya; Turgut, Burhan; Demir, Muzaffer; Utku, Ufuk; Vural, Özden
    Serebral venöz tromboz etyolojisinde birçok neden bulunmakla birlikte, hiperkoagulabilite önemli rol oynamaktadır. Bu çalışmada son bir aydır giderek artan başağrısı, bulantı, kusma nedeni ile servisimize yatan, daha önce hiçbir yakınması olmayan 34 yaşındaki bayan hasta bildirilmiştir. Hastanın yapılan nörolojik muayenesinde bilateral grade IV papil ödem mevcut olup, nöroradyolojik inceleme sonucunda yaygın (superior sagittal sinüs, konfluen sinium, her iki transvers ve sigmoid sinüsler) serebral venöz tromboz tespit edilmiştir. Tam kan sayımında Hb 17.1 g/dl, Hct % 48.4, Lökosit 28 500 /mm3 , Plt 674 000 /mm3 bulunması nedeni ile yapılan kemik iliği incelemesinde hastaya esansiyel trombositemi tanısı konmuş olup, antikoagulan tedavi yanısıra ribonükleotid redüktaz inhibitörü de tedaviye eklenmiştir. Literatürde olgumuzda olduğu gibi yaygın serebral venöz tromboz olguları nadiren bildirilmiş olup, bazı hematolojik hastalıkların, endokrin bozuklukların ve anatomik varyasyonların etyolojide yer alabileceği ifade edilmiştir.