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    Acute ischemic stroke patient with cardiac involvement of light chain amyloidosis
    (2020) Demir, Esra; Bektas, Hesna; Kursun, Oguzhan
    Light chain amyloidosis is one of the clonal plasma cell disorders characterized by the accumulation of misfolded light chain in tissues and organs. It may affect many organs and tissues like kidney, heart, nervous system, intestinal systems. Symptoms may mimic several diseases. The natural history of the disease, involvement of other organs and treatment options vary significantly based on the origin of the protein. In amyloid light-chain (AL) amyloidosis, amyloid protein is derived from immunoglobulin light chains and most often involves the kidneys and the heart. Cardiac amyloidosis is important in terms of causing intracardiac thrombus and increases the risk of thromboembolic complications as stroke. We discussed a 55-year-old patient with known cardiac involvement of systemic amyloidosis who presented to an emergency department with loss of consciousness and progressive leftsided weakness and had the diagnosis of acute ischemic stroke.
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    A Multicenter Study of 1144 Patients with Cerebral Venous Thrombosis: The VENOST Study
    (Elsevier, 2017) Duman, Taskin; Uluduz, Derya; Midi, Ipek; Bektas, Hesna; Kablan, Yuksel; Goksel, Basak K.; Milanlioglu, Aysel
    Background: Based on a number of small observational studies, cerebral venous sinus thrombosis has diverse clinical and imaging features, risk factors, and variable outcome. In a large, multicenter cerebral venous thrombosis (VENOST) study, we sought to more precisely characterize the clinical characteristics of Caucasian patients. Methods: All data for the VENOST study were collected between the years 2000 and 2015 from the clinical follow-up files. Clinical and radiological characteristics, risk factors, and outcomes were compared in terms of age and sex distribution. Results: Among 1144 patients 68% were women, and in older age group (>50 years) male patients were more prevalent (16.6% versus 27.8%). The most frequent symptoms were headache (89.4%) and visual field defects (28.9%) in men, and headache (86.1%) and epileptic seizures (26.8%) in women. Gynecological factors comprised the largest group in women, in particular puerperium (18.3%). Prothrombotic conditions (26.4%), mainly methylenetetrahydrofolate reductase mutation (6.3%) and Factor V Leiden mutation (5.1%), were the most common etiologies in both genders. 8.1% of patients had infection-associated and 5.2% had malignancy-related etiology that was significantly higher in men and older age group. Parenchymal involvement constitutively hemorrhagic infarcts, malignancy, and older age was associated with higher Rankin score. Epileptic seizures had no effect on prognosis. Conclusions: Clinical and radiological findings were consistent with previous larger studies but predisposing factors were different with a higher incidence of puerperium. Oral contraceptive use was not a prevalent risk factor in our cohort. Malignancy, older age, and hemorrhagic infarcts had worse outcome. (c) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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    THE ULTRASONOGRAPHIC EVALUATION OF HEMODYNAMIC CHANGES IN PATIENTS WITH DIABETIC POLYNEUROPATHY AFTER TARSAL TUNNEL DECOMPRESSION
    (Wiley, 2015) Tekin, Fatih; Agladioglu, Kadir; Surmeli, Mehmet; Ceran, Candemir; Bektas, Hesna; Falcioglu, Mehmet Cagatay; Yildirim, Ismail Okan
    Background: Nerve decompression procedures have shown to have promising roles in patients with diabetic polyneuropathy. It is known that not only nerves but also arteries pass through the same compressed anatomical tunnels. The aim of the study is to reveal whether the surgical decompression procedures have a positive effect on hemodynamic and morphological parameters of the arterial structures passing through these anatomic tunnels. Methods: Twenty-seven patients who underwent posterior and anterior tarsal tunnel release procedures were retrospectively scanned for preoperative and 3 months postoperative arterial Doppler ultrasound imaging. The preoperative and third month postoperative measurements were compared for flow pattern of artery, flow lumen diameter, pulsatility index (PI), resistance index (RI), and flow volumes by evaluating the hemodynamic and morphological parameters of dorsalis pedis (DPA) and tibialis posterior arteries (TPA). Results: For TPA, mean PI values were 5.76 +/- 2.78 preoperatively, 7.17 +/- 3.08 postoperatively. Mean RI values were 0.94 +/- 0.04 preoperatively and 0.89 +/- 0.05 postoperatively. For DPA, mean PI values were 5.06 +/- 2.14 preoperatively and 6.35 +/- 2.31 postoperatively. Mean RI values were 0.93 +/- 0.05 preoperatively and 0.86 +/- 0.06 postoperatively. When the results are analyzed for both of the arteries, PI values were significantly increased; RI values were significantly decreased when the preoperative measurements were compared with the postoperative measurements (P<0.05). Conclusion: According to these results, it can be suggested that the nerve release procedures have a positive effect on the hemodynamic and morphological parameters of the arteries as they pass through the anatomical tunnels as well as its positive effects on the neurological functions of the entrapped nerves. (C) 2015 Wiley Periodicals, Inc.