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Öğe Cluster-like headache associated with vertebrobasilar dolichoectasia(Turkish Society of Cerebrovascular Diseases, 2014) Kaplan Y.; Kamişli O.; Altinayar S.Vertebrobasilar dolichoectasia (VBD) is characterized by marked elongation, dilatation, and tortuosity of the vertebral and basilar arteries. The etiology of VBD is unknown. VBD can be asymptomatic or associated with clinical manifestations, such as posterior circulation stroke, intracranial bleeding, cranial nerve disorders, brainstem compression, and obstructive hydrocephalus. However, cluster-like headache (CLH) associated with VBD has not been reported in the literature. We report a case of CLH considered as a possible manifestation of VBD. Copyright © 2012 TBDHD.Öğe Epileptic seizures in patients with a posterior circulation infarct(Turkish Society of Cerebrovascular Diseases, 2014) Kaplan Y.; Kamişli Ö.; Kamişli S.; Özcan C.OBJECTIVE: The aim of this study was to investigate the frequency of seizures and the clinical features of patients with seizures related to a posterior circulation infarct (POCI). MATERIAL and METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2011 and January 2012. The patients' database information was retrospectively analyzed. Fifty-five patients with a POCI were included in the study. We reviewed all patients with epileptic seizures related to a POCI. Age, gender, recurrent stroke, risk factors, etiology, radiographic localization, the seizure type and onset time, and the electroencephalographic findings of patients were evaluated. We excluded all patients who had precipitating conditions during seizures such as taking drugs, acid-base disturbances, electrolyte imbalance, and history of epilepsy. RESULTS: Seizures were observed in four patients (3 male, 1 female) with a POCI related epileptic seizures (7.2%). The etiology of strokes was cardiac-embolic in 3 patients and vertebral artery dissection in 1 patient. Seizures occurred in 2 patients as presenting finding, in 1 patient within 7 days, and 1 patient within 28 days. Primary generalized tonic-clonic seizures occurred in 3 patients and simple partial seizures with secondary generalization in 1 patient. Three patients had cerebellum infarction at the left hemisphere. One patient had lateral medullary infarction at the right side. The electroencephalographic findings of patients were normal. CONCLUSION: Studies involving patients with seizures related to a POCI are novel and few in number. Three patients with seizure had cerebellum infarction. The cerebellum in these patients may contribute via different mechanisms over seizure activity.Öğe The evaluation of serum uric acid levels in the ischemic stroke subtypes(Turkish Society of Cerebrovascular Diseases, 2013) Kamişli Ö.; Gönüllü S.; Kamişli S.; Kaplan Y.; Özcan C.OBJECTIVE: Uric acid is a water-soluble antioxidant which is the end-product of purine metabolism. Several studies indicated that high levels of serum uric acid increased the risk of cerebrovascular events and some of them reported poor prognosis with increased serum uric acid levels in stroke patients. Our aim was to analyse serum uric acid levels in the early phase of ischemic stroke and determine whether increased levels of uric acid are associated with ischemic stroke subtypes. MATERIAL and METHODS: 237 patients with ischemic stroke admitted to the study between January 2011 and December 2011. Ischemic stroke subtypes were classified according to Bamford classification. Patients admitted in the the beginning of the first 24 hour of disease were included the study. We compare the serum uric acid levels between stroke subgroups and controls. RESULTS: We found increased serum uric acid levels in all stroke patients but the most increased levels were in the posterior circulation infarct group. However this elevation was not statistically significant. CONCLUSION: Future researches should be focus on the pathogenetic mechanism of hyperuricemia as well as examining the role in stroke subtypes especially posterior circulation infarcts.Öğe Mortality-related factors in ischemic stroke patients 80 years of age and older(Turkish Society of Cerebrovascular Diseases, 2014) Kaplan Y.; Kamişli Ö.; Kamişli S.; Özcan C.OBJECTIVE: The aim of this study was to investigate mortality-related factors in ischemic stroke patients 80 years of age and older. MATERIAL and METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2010 and January 2012. The patients' database information was retrospectively analyzed. One hundred and ten patients aged older than 80 years with ischemic stroke were included in the study. The patients were divided into two groups based on survival. Age, gender, recurrent stroke, risk factors, clinical syndrome, etiology, radiographic localization, duration of hospitalization, and presence of systemic complications were accepted as mortality-related prognostic factors. The groups were compared according to these prognostic factors. RESULTS: In the clinical follow-up, 58 (52.7%) patients died; 65.5% died of neurological causes, and 31% died of systemic complications. No significant differences existed between the two groups in age, gender, risk factors, recurrent stroke, or etiology. The frequency of total anterior circulation infarct syndrome was much higher in deceased than living patients (50% and 36.5% respectively;p<0.05). Deceased patients had a statistically significantly higher incidence of total MCA infarct and systemic complications than did living patients (p<0.05). CONCLUSION: To date, many variables that affect the early and late prognosis in stroke patients have been reported. Many of these factors cannot be changed, such as oldest age. It is important to determine the changeable and non-changeable factors related to disability and death in the oldest age groups. Starting appropriate treatment and care initiatives as soon as possible is also very necessary in the oldest stroke patients.Öğe The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis(Turkish Society of Cerebrovascular Diseases, 2012) Kamişli S.; Kami?sli Ö.; Gön?ul?lu S.; Kaplan Y.; Özcan C.OBJECTIVE: Venous stasis, genetic and acquired factors and also inflamation are important in the formation and re- canalisation of cerebral venous thrombosis. In this study we aimed to investigate important indicators such as total white blood cell, neutrophil and lymphocyte counts and also neutrophil/lymphocyte ratio in the early phase of cerebral venous thrombosis. MATERIAL and METHODS: Thirty-five patients with evidence of CVT were included in this study. CVT patients were divided into two subgroups based on the presence or absence of parenchymal lesion. Count of blood cells (CBC) were compared with healthy control objects. RESULTS: Leukocyte and neutrophil counts and neutrophil / lymphocyte ratio were significantly higher in the CVT group who has parenchymal lesions than the control group in the early phase of CVT. CCONCLUSION: There may be a relationship between inflammation and the level of severity of illness in CVT patients on admission. This relationship may be guiding the determination of treatment and prognosis.
