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    The effect of intravenous thrombolytic and intraarterial interventional procedures on acute stroke: First-year clinical experience of a stroke center in eastern anatolia
    (2022) Çıplak, Sibel; Adigüzel, Ahmet; Akalın, Yahya
    Treating acute stroke in the early period can lead to reperfusion and minimize the loss of neurological function. In this study, our aim is to analyze the prognosis of our patients who underwent intravenous thrombolytic and/or mechanical interventional treatment in the last one year in our newly opened stroke center and evaluate our clinical experience. A total of 166 patients with a mean age of 68.7±11.3 who underwent intravenous r-tPA ± mechanical thrombectomy in our stroke center were included in the study. The mean time from symptom-to-door was 138.6±48.3 min, and the mean NIHSS score on admission was 10.9±4.1. Intravenous r-tPA was preferred for treatment in 59.6% (99) patients. The mortality rate was 25.3% (42) for all patients. The mortality rate was 15.1% (15/99) for patients receiving intravenous r-tPA, and based on this finding, the mortality risk was found to be significantly higher in patients who did not receive intravenous r-tPA (p < 0.001). The mortality rate was 40% (6/15) for patients undergoing only mechanical thrombectomy (p: 0.145). The mRS score of the patients who received intravenous r-tPA was 3.18 in the first month, whereas the score of the patients who did not receive intravenous r-tPA was 3.74 (p: 0.010). As a result, mortality and sequelae rates have been significantly reduced with the use of thrombolytic therapy and interventional neurovascular procedures. Although our center is newly opened, it shows promise for the upcoming years.
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    THE ROLE AND ASSESSMENT OF SYSTEMIC IMMUNE-INFLAMMATION INDEX AS A NOVEL INFLAMMATORY MARKER IN PERIPHERAL AND CENTRAL FACIAL PARALYSIS
    (Inonu University, 2023) Demir, İsmail; Adigüzel, Ahmet
    Systemic immune-inflammation index (SII) is a novel inflammatory marker and is commonly used in clinical management such as prognosis and response to therapies. In this study, the outcomes and correlations of inflammatory markers in central and peripheral facial paralysis were evaluated. The study was planned retrospectively and cross-sectionally. Totally 133 patients (group 1; 53, group 2; 80) were included in the study. The neutrophil counts were 4.7 ± 1.6 and 3.7 ± 1.6 (p=0.001), and the lymphocyte counts were 2.8 ± 0.8 and 3.3 ± 1 (p=0.007) in groups 1 and 2, respectively. While Neutrophil lymphocyte ratio (NLR) was 1.8 ± 0.9 in patients with central facial paralysis, NLR was analysed as 1.4 ± 1 in patients with peripheral facial paralysis (p=0.001). Systemic immune-inflammation index was determined as 529.5 ± 297.4 in the first group and 408.2 ± 228.1 in the second group (p=0.029). There was a positive correlation between NLR and SII (r:0.787, p<0.001). Peripheral facial paralysis was evaluated according to the H-B scale [(median:3, min-max:2-6)]. In conclusion, an elevated level of inflammatory markers was remarkable in pathologies affecting the central nervous system. NLR and SII values were increased in central facial paralysis. © 2023, Inonu University. All rights reserved.