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Öğe ABSANS NÖBET İLE BAŞVURAN DYKE DAVİDOFF MASSON SENDROMU OLGUSU(2015) Türkel, Yakup; Alpua, Murat; Adıgüzel, Ahmet; Habipoğlu, Yasin; Dağ, ErselDyke Davidoff Mason Sendromu(DDMS) serebral hemiatrofinin mevcut olduğu hemiparezi ve rekürren epileptik nöbetlerle karakterize bir sendromdur. Biz de absans nöbetlerle prezente olan kranyal MR'ında hemisferik atrofinin mevcut olduğu tipik bir DDMS olgusu sunmak istedik. Olgunun çekilen elektroensefalografisinde jeneralize 3 Hz diken dalga deşarjları izlendi. Hastanın takibinde uygun antiepileptik tedavi ile nöbetleri kontrol altına alındıÖğe Akut Serebrovasküler Olaylı Hastalarda Serum S100B Protein Düzeylerinin Lezyonun Tipi, Büyüklüğü ve Lokalizasyonu ile İlişkisi(Kırıkkale Üniversitesi, 2016) Alpua, Murat; Bakır, Fatih; Öztekin, Neşe; Ak, FikriBu çalışmanın amacı akut inmeli hastalarda serum S100B seviyeleri ile lezyonun tipi ve büyüklüğü arasındaki ilişkiyi tespit etmektir. Akut serebrovasküler olay geçiren 62 hasta çalışmaya dahil edildi.26 sağlıklı kontrol grubu olarak belirlendi. Örnekler hastaların hastaneye başvurusundan 24 saat içerisinde alındı. Hastalar kranyal bilgisayarlı tomografi ve manyetik rezonans tetkikleri kullanılarak lezyonların tipine göre iskemik ve hemorajik inme gruplarına ayrıldılar. İskemik grup Bamford sınıflamasına göre total anterior sirkülasyon enfarktları (TACI), kısmi anterior sirkülasyon enfarktları (PACI) ve posterior sirkülasyon enfarktları (POCI) gruplarına olmak üzere 3 gruba ayrıldılar. Çalışmamızda iskemik ve hemorajik gruplar arasında S100B değerleri açısından istatistiksel olarak anlamlı fark saptanmadı. Ancak kontrol gruplarına kıyasla iskemik ve hemorajik gruplarda yerleşim yeri ve lezyon büyüklüğü açısından istatistiksel olarak anlamlı derecede fark saptandı.Çalışmamızın sonuçları S100B seviyelerinin iskemik ve hemorajik inme sonrası beyin hasarının belirteci olarak kullanılabileceğini göstermiştir ancak mutlak bir karar için bu konuda daha çok çalışmanın yapılması gerekmektedir.Öğe Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut OrkunObjective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.Öğe Apelin-13: A Promising Biomarker for Multiple Sclerosis?(Wolters Kluwer Medknow Publications, 2018) Alpua, Murat; Turkel, Yakup; Dag, Ersel; Kisa, UclerObjectives: Recent studies have shown that Apelin 13 may have a neuroprotective property. Therefore it can be used as a biomarker for multiple sclerosis. Our purpose to assess serum apelin-13 levels in adult patients with multiple sclerosis and healthy controls. Patients and Methods: Subjects consisted of 42 relapsing remitting multiple sclerosis patients and 41 controls. Demographic characteristics including age, gender, duration of disease and Expanded Disability Symptom Scale (EDSS) were recorded. In serum samples obtained from the patients and controls, serum apelin-13 levels were measured with Enzyme Linked Immunosorbent Assay (ELISA) method. Results: Serum apelin-13 levels were significantly higher in the patients groups than the healthy controls (P = 0.003). Pearson analysis did not show any significant correlation between EDSS, disease duration and apelin-13 levels. Conclusion: The results of our study have been showed statistically significant higher levels of serum apelin-13 in multiple sclerosis patients compared to controls. Further studies with larger patients populations and healthy controls should be done to clarify to use serum apelin levels as a biomarker for multiple sclerosis.Öğe Attention deficit and hyperactivity symptoms in adult migraine patients(2019) Alpua, Murat; Say, Bahar; Yavuz, Esra Turgut; Ergün, Ufuk; Buturak, Şadiye VisalAim: To screen the symptoms of attention deficit and hyperactivity disorder in adult migraine patients.Material and Methods: Our study included 102 migraine patients and 93 sex- and age-matched healthy volunteers. Gender, age, levelof education and duration of disease were recorded. We used the adult attention deficit/hyperactivity disorder self-report scale toevaluate the symptoms of adult attention deficit / hyperactivity disorder. In addition, the short form-36 and the hospital anxiety anddepression scale were applied to the patients and the healthy controls.Results: The mean scores of attention deficit hyperactivity disorder were significantly higher in migraine patients compared to thecontrol group. There was no significant relationship between the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scalescores and the duration of the disease. There was a negative correlation between the SF-36 health questionnaire scores and theAdult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. There was a positive correlation between the MigraineDisability Assessment scores, the number of migraine attacks and the Adult Attention Deficit and Hyperactivity Disorder Self-ReportScale scores.Conclusion: Attention-deficit and hyperactivity symptoms can develop in adult migraine patients and cause psychosocial morbidityand poor quality of life.Öğe Attention deficit/hyperactivity disorder in adults with multiple sclerosis(Sage Publications Ltd, 2016) Alpua, Murat; Turkel, Yakup; Güneş, Nalan; Oğuztürk, Ömer; Dağ, Ersel; Yoldaş, Tahir K.…Öğe Atypical eclampsia and postpartum status epilepticus(African Field Epidemiology Network-Afenet, 2015) Dag, Zeynep Ozcan; Isik, Yuksel; Turkel, Yakup; Alpua, Murat; Simsek, YavuzPreeclampsia is an entity that may present from 20th week of gestation up to 48 hours postpartum and is associated with hypertension and proteinuria. Eclampsia is emergence of convulsions pre-eclampsia in pregnant women with signs and symptoms. Recent studies showed that in some women, preeclampsia and even eclampsia may occur without hypertension or proteinuria. Here, we present a case of 26 years old women who had an uneventful pregnancy until 30 weeks' of gestation. She had only proteinuria in laboratory tests and was diagnosed as status epilepticus in early postpartum period. Preeclampsia and eclampsia is related with serious fetal and maternal morbidity and mortality and may present with atypical course. The awareness of atypical cases of preeclampsia enhances early diagnosis and management which are critical to avoid feto-maternal complications.Öğe Autonomic dysfunction in patients with essential tremor(Springer-Verlag Italia Srl, 2017) Habipoglu, Yasin; Alpua, Murat; Bilkay, Cemil; Turkel, Yakup; Dag, ErselThe aim of this study was to evaluate the autonomic function in patients with essential tremor (ET). Thirty-one adult patients with ET and 26 healthy controls were enrolled in the study. The electrophysiological evaluations of the autonomic nervous system function were performed by sympathetic skin response (SSR) and R-R interval variation (RRIV) tests. The mean latency of SSR in ET patients was significantly delayed compared with the controls (P = 0.01). The mean amplitude of sympathetic skin response was significantly lower in ET patients in comparison to the controls (P = 0.001). No differences were found in mean RRIV values in both group subjects. Sympathetic dysfunction may occur in patients with ET. This may be easily demonstrated by SSR tests.Öğe Autonomic dysfunction in patients with polycystic ovary syndrome(Elsevier Taiwan, 2015) Dag, Zeynep Özcan; Alpua, Murat; Turkel, Yakup; Işık, YükselObjective: To assess the autonomic system in patients with polycystic ovary syndrome (PCOS). Materials and methods: Thirty-seven adult patients with PCOS and 33 healthy controls were enrolled in the study. The electrophysiological assessments of the autonomic nervous system function were performed using sympathetic skin response and R-R interval variation tests. Results: The mean latency of sympathetic skin response in PCOS patients was significantly delayed compared with the controls (p = 0.001). The mean amplitude of sympathetic skin response was significantly lower in comparison with the controls (p = 0.01). Mean R-R interval variation during deep breathing was also significantly delayed (p = 0.04). Conclusion: There are parasympathetic dysfunction and sympathetic dysfunction in patients with PCOS. This may be easily demonstrated with sympathetic skin response and R-R interval variation tests. Copyright (C) 2015, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.Öğe BİR ORTA ANADOLU ÖRNEĞİ OLARAK KIRIKKALE ÜNİVERSİTESİ TIP FAKÜLTESİ NÖROLOJİ KLİNİK VERİLERİ(2019) Say, Bahar; Ergun, Ufuk; Yardımcı, İlknur; Alpua, MuratAmaç: Nörolojik hastalıklar, görülme oranlarındaki artış,özürlülük ve sağlık giderlerindeki payı nedeniyle önemli biryere sahiptir. Bu çalışma, orta Anadolu örneği olarakKırıkkale Üniversitesi Tıp Fakültesi Hastanesi Nörolojikliniğinde gördüğümüz nörolojik hastalıklar spektrumunu veoranlarını belirlemek amacıyla planlanmıştır.Gereç ve Yöntem: Bu retrospektif çalışmada, Ağustos2016- Ağustos 2018 tarihleri arasında nöroloji kliniğindeyatırılan hastaların dosyaları incelendi. Dosyalar ve tanıkodları doktor tarafından düzenlenmiş olup, InternationalClassification of Diseases kodlamasına göre olan ana tanı,demografik özellikler dikkate alındı.Bulgular: Toplam 805 (422 kadın, 383 erkek) hasta dosyasıtarandı Servisteki hasta sayısı 712, yoğun bakımdaki ise93’di. Kadın hastalardan 50’si (%10.7), erkek hastalardan43‘ü (%10) yoğun bakımda takip edildi. Yaş dağılımında 70yaş üzeri hasta sayısı fazlaydı. Tanılara göre 413 (%51.3)serebrovasküler hastalık, 119 (%14.7) epilepsi, 62 (%7.7)senkop, 60 (%7.4) başdönmesi, 51 (%6.3) baş ağrısı diğersendromlar, 44 (%5.4) multipl skleroz, 17 (%2.1)enflamatuar polinöropatiler, diğeri, 11 (%1.3) Parkinson, 7(%0.8) Miyastenia Gravis, 7 (%0.8) bunama, 5 (%0.6)normal basınçlı hidrosefali, 4 (%0.4) Guillian BarreSendromu (GBS), 3 (%0.3) motor nöron hastalığı, 1 (%0.1)Lambert Eaton sendromu ve 1 (0.1) Herpes virüs ensefalitigörüldü.Sonuç: Bu çalışma da örneklem sayısı az olsa da ortaAnadolu’da başkentin yanı başındaki bir üniversitehastanesinin iki yıllık klinik verileri analiz edildi. Bulgularliteratür ile uyumlu olup en sık serebrovasküler hastalık,sonra epilepsi izlendi. Hastaların çoğunluğu 70 yaş üzeriydi.Ayrıca solunum kasları tutulumu ile tehlike yaratabilecekMiyastenia Gravis ve GBS olguları dikkat çekiciydi.Öğe Comorbid fibromyalgia in migraine patients: clinical significance and impact on daily life(Taylor & Francis Ltd, 2019) Onder, Halil; Hamamci, Mehmet; Alpua, Murat; Ulusoy, Ersin KasimObjective: Herein, we aimed to investigate the impact of FM in migraine patients and the specific features and discriminations of this group of migraineurs with FM according to patients without FM. Methods: 102 consecutive migraine patients among 18-50 years old who accepted to involve in the study were included. All patients were asked to complete the following self-report questionnaires for the assessment of pain-related disability, migraine-related disability, anxiety, depression, sleep disturbance and quality of life. All statistical analyses were performed using the SPSS statistics 20 program. Results: 92% of the patients were diagnosed with episodic migraine, whereas 8% of them was diagnosed with chronic migraine (CM). Comorbid FM which was detected to present in 30.3% of the patients. FM was more frequent in CM patients and in migraine patients with aura. The analyses comparing FM (+) and FM (-) migraineurs revealed that headache frequency, migraine disease duration, headache impact test, MIDAS scores were significantly higher in FM (+) migraineurs. Furthermore, the vitality and role-emotional domains of the SF-36 resulted in worse scores in the group of FM (+) migraineurs. Conclusion: The results of our study may suggest the presence of FM as a clinical sign of a more severe migraine. However, the long-term prospective studies including these group of patients are needed to understand the prognostic impact and importance of the comorbid FM in migraine.Öğe Cranial Magnetic Resonance Imaging Findings of Bonzai Abuse: A Case Report(2016) Burulday, Veysel; Koç, Ural; Tan, Sinan; İnal, Mikail; Alpua, MuratSentetik kannabinoidler (SK) Avrupa da Spice, ABD de K2, diğer taraftan Türkiye de Bonzai ismiyle popülerleş- mişlerdir. Çağımızın tehlikesi Bonzai, komplikasyonları ve nöroradyolojik bulguları literatürde çok bilinmeyen, son zamanlarda Türkiye de popüler olan bir bitkisel kaynaklı sentetik kannabinoid ilaçtır. Bunun sonucu olarak Bon- zai veya Bonzai ilişkili komplikasyonlar konusunda rad- yoloğun nöroradyolojik olarak farkında olması önemlidir. Biz bu olgu sunumunda, bilgisayarlı tomografide iskemi ile ilişkili olabilecek hipodens alanları olan, diğer taraf- tan magnetik rezonans görüntülemesinde T2 ağırlıklı ve FLAIR sekanslarda vazojenik ödemle uyumlu olduğu dü- şünülen Bonzai suistimali olgusunun kranial görüntüleme bulgularını sunduk. Ek olarak FLAIR görüntülemede kor- pus kallozumda sinyal artışı ve kanama odakları izlendi.Öğe Detecting pain severity with full cup test in painful diabetic peripheral neuropathy(2020) Say, Bahar; Ergün, Ufuk; Yıldız, Ayşe; Alpua, Murat; Arıkan, Şenay Durmaz; Turgal, EbruObjectives: The aim of this study was to test the utility and validity of the full cup test (FCT) to assess the severity of pain in subjects with painful diabetic peripheral neuropathy (PDPN). Methods: Subjects with diabetic PDPN were enrolled for this prospective, cross-sectional study. Other causes of PDPN and subjects with cognitive impairment were excluded. The diagnosis of neuropathic pain was made using the results of a physical examination and the Douleur Neuropathique 4 questionnaire. Pain severity was assessed with a FCT and a visual analog scale (VAS) administered before and after treatment. The correlation of FCT with VAS was evaluated to examine validity. Results: A total of 43 (33 female, 10 male) subjects were included. The mean age was 61.9±8.25 years and the mean disease duration was 13.02±7.6 years. Type I diabetes mellitus (DM) was present in 2 (4.7%) subjects and Type II DM in 41 (95.3%) subjects. The mean glycated hemoglobin level was 8.9±1.9 mmol/mol. When the mean VAS and FCT scores were analyzed, the results were 6.7±2.05 and 66.35±23.2, respectively, pretreatment and 4.6±2.2 and 41.36±23.5 posttreatment, which were both statistically significant (p<0.001, p<0.001). The mean control period was 23.4 days (min–max: 15-30 days). The VAS and FCT scores in pretreatment and posttreatment demonstrated a high positive correlation (rs =0.86, p<0.001; rs =0.843, p<0.001). Conclusion: The FCT can be useful to detect pain severity in PDPN.Öğe Electroencephalography (EEG) and Syncope: A Retrospective Study(2020) Say, Bahar; Yıldız, Ayşe; Alpua, Murat; Ergun, UfukObjectives: Electroencephalography (EEG) is one of the most vital tools in neurology practice. It is used for the diagnosis and differential diagnosis of several clinical conditions. One of them is syncope. In this study, it was planned that a retrospective evaluation of EEGs performed due to syncope in our laboratory and determine the rate of abnormal EEGs. Methods: EEG recordings performed due to syncope were reviewed over a two-years period in this study. The EEG findings were classified as normal and abnormal. The abnormal EEG findings were classified into focal epileptiform discharge, generalized epileptiform discharge, focal slowing and generalized slowing subgroups and analyzed. Results: The results of 298 EEGs were analyzed, which involved 174 (58.3%) female and 124 (41.6%) male subjects, with a mean age of 38.84±17.83 (min-max: 17–90) years. Among subjects with syncope, 90.6% of the EEGs were normal and 9.4% showed abnormal findings. The most common abnormal finding was focal epileptiform discharge (5.03%). Generalized epileptiform discharge was observed in three (1%), focal slowing in seven (2.3%) and generalized slowing in two (0.6%) subjects. Among the EEG results with no abnormal findings, 38 (12.7%) had sleep-deprived EEG and six (2.1%) were found to have focal epileptiform discharge. A total of 113 (37.9%) subjects had electrocardiogram recording and results were normal. Conclusion: The rate of abnormal findings in EEGs performed due to syncope is low. EEG may be helpful in some selected subjects with syncope referred to the laboratory with a good history and neurological examination. EEG may be repeated if necessaryÖğe Endothelial and Autonomic Functions in Patients with Migraine(OXFORD UNIV PRESS, 2020) Dogru, Mehmet Tolga; Dilekoz, Ergin; Alpua, Murat; Eroglu, Oguz; Kandemir, Hilseyin; Alp, Caglar; Bolay, HayrunnisaObjective It has been shown that patients with migraine have endothelial dysfunction. Migraine patients with aura, especially, have more clinical manifestations of autonomic nervous system dysfunction. We aimed to evaluate the endothelial and autonomic functions in migraine patients during both migraine headache attack and headache-free periods. Design This was a cross-sectional, randomized study. Subjects and Methods A total of 130 participants (67 male and 63 female patients, minimum age = 19 years, maximum age = 71 years, mean age = 38.812.2years) were enrolled into the study. For the statistical evaluation of data, we classified the participants of the study as follows: group 1: headache (+) aura (+); group 2: headache (+) aura (-); group 3: headache (-) aura (+); group 4: headache (-) aura (-). Noninvasive evaluation of endothelial function was performed by flow-mediated dilation (FMD) and pulse wave analysis methods. Heart rate variability measurements were used for noninvasive evaluation of autonomic functions. Results Group 1 had a higher FMD ratio than the control group, group 3, or group 4 (P<0.001, P<0.001, and P=0.003, respectively). Group 4 had lower FMD ratio levels than the other migraine groups and or the control group (P<0.001). Group 3 had the highest high-frequency (HF) power levels among all migraine groups (P<0.001). Group 2 had higher low-frequency/HF ratio values than other migraineurs (P<0.001). Conclusions We concluded that endothelial dysfunction and headache are closely related. Additionally, higher parasympathetic tonus might be associated with the presence of aura.Öğe The evaluation of temperament and quality of life in patients with polycystic ovary syndrome(Taylor & Francis Ltd, 2017) Dag, Zeynep Ozcan; Alpua, Murat; Isik, Yuksel; Buturak, S. Visal; Tulmac, Ozlem B.; Turkel, YakupAims: To evaluate the temperament and quality of life (QoL) of patients with PCOS. Materials and methods: Fifty-three adult patients with PCOS and 38 healthy controls were enrolled in the study. Demographic characteristics including age, education and body mass index (BMI) were recorded. Affective temperaments were assessed by the temperament evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A) scale. The general health-related quality of life (HRQoL) instrument used in this study was short Form 36. Hospital anxiety and depression scale (HADS) were also performed. Results: The patients with PCOS had significantly higher rates of depressive, anxious and hyperthymic scores compared to controls. The PCOS patients had significantly lower mean SF-36 health summary scores. Conclusions: TEMPS-A seems to be an easy and reliable test to evaluate temperament in PCOS patients.Öğe Evaluation of the Optic Nerve by Strain and Shear Wave Elastography in Patients With Migraine(Wiley, 2019) Sahan, Mehmet Hamdi; Dogan, Adil; Inal, Mikail; Alpua, Murat; Asal, NeseObjectives To investigate the optic nerve's elastic properties using shear wave and strain elastography in patients with migraine compared to healthy individuals. Methods The migraine group consisted of 30 patients (16 with visual auras and 14 without auras) who had previously had a diagnosis of migraine. These were age and sex matched with healthy participants to form the control group. The findings from shear wave and strain elastography in the groups were compared. The elastographic examination was performed with a 6-15-MHz multifrequency linear array transducer. Results The evaluation involved 30 patients with migraine (3 male and 27 female), whose mean age +/- SD was 34.63 +/- 10 years, and 30 healthy participants (3 males, 27 females), whose mean age was 36.4 +/- 10.5 years. In strain elasticity patterns, a statistically insignificant hardening of the optic nerve in the patients with migraine was observed (P = .052). Analysis of the shear wave elastic modulus values (9.8 +/- 3.34 and 12.3 +/- 5.25 kPa; P = .03) revealed that differences between the healthy participants and patients with migraine were statistically significant. The results for elasticity patterns and the shear modulus suggested that the differences between migraines with and without visual auras were insignificant (P > .05). A positive correlation was discovered between the duration of the disease and the shear modulus in the patients with migraine (r = 0.496; P < .01). Conclusions Histopathologic changes in the optic nerve may be seen in patients with migraine due to possible fibrotic changes. Elastographic techniques can be useful diagnostic tools for investigating these changes.Öğe Evaluation of the optic nerve using strain and shear wave elastography in patients with multiple sclerosis and healthy subjects(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2017) Inal, Mikail; Tan, Sinan; Yumusak, M. Erhan; Sahan, Mehmet Hamdi; Alpua, Murat; Ornek, KemalAims: Our aim was to evaluate the elasticity features of the optic nerve using strain (SE) and shear wave elastography (SWE) in multiple sclerosis (MS) patients in comparison with healthy subjects. Material and methods: One hundred and seven optic nerves from 54 MS patients and 118 optic nerves from 59 healthy subjects were examined prospectively by SE and SWE. Optic nerves were divided into three types in accordance to the elasticity designs, as follows: type 1 predominantly blue (hardest tissue); type 2 predominantly blue/green (hard tissue); and type 3 predominantly green (intermediate tissue). Quantitative measurements of optic nerve hardness with SWE were analyzed in kilopascals. Results: Elastographic images from healthy volunteers showed mostly type 3 optic nerves (61.9%); type 2 was also found (38.1%), but type 1 was not observed. Elastographic examination of MS patients showed mostly type 2 optic nerves (88%), while some type 1 (4.6%) and type 3 optic nerves (6.5%) were rarely observed. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p<0.001). Statistically significant differences were observed between patients and healthy volunteers in the analysis of SWE values (10.381 +/- 3.48 kPa and 33.87 +/- 11.64 p< 0.001). The receiver operating characteristic curve analysis was perfect (0.993; 95% confidence interval [CI]=0.971-0.999), and a cut-off value of 18.3 kPa shear had very high sensitivity and specificity for the patient group. No significant differences were observed between patients with and without previous optic neuritis. Conclusion: SE and SWE examination findings concerning the optic nerve in MS patients demonstrated remarkable differences according to the healthy group.Öğe First Admission Neutrophil-Lymphocyte Ratio May Indicate Acute Prognosis of Ischemic Stroke(Rambam Health Care Campus, 2021) Alpua, Murat; Say, Bahar; Yardimci, Ilknur; Ergun, Ufuk; Kisa, Ucler; Ceylan, Ozlem DoganObjectives: Our study aimed to determine the relationship between serum periostin levels, and the neutrophil-lymphocyte ratio (NLR) with ischemic stroke subtypes, clinical stroke scales, and acute prognosis in patients with acute ischemic stroke. Materials and Methods: Forty-two ischemic stroke patients and 39 age- and sex-matched healthy volunteers were included in our study. Demographic characteristics including age and gender were recorded. Blood serum periostin and NLR values were evaluated in the first 24 hours after admission. Serum periostin levels were compared with healthy controls of similar age and sex. Lesion localization was determined by cranial CT or diffusion MRI of the patients. Stroke scales were recorded on days 1 and 7 of hospitalization in the study group. Results: The mean serum periostin levels were higher than in the control group, but no statistically significant difference was found. There was no correlation between serum periostin levels and prognosis of stroke. First admission NLRs were statistically higher than in the control group. The first admission NLRs were positively correlated with the first admission National Institute of Health Stroke Scale score and the day 7 modified Rankin score. Conclusion: Our study is the first study to evaluate both NLR and serum periostin levels in all types of acute ischemic stroke. While our study did not show that first admission serum periostin levels can be used as a biomarker in ischemic stroke, it did indicate that the first admission NLR can be used for acute prognosis of ischemic stroke.Öğe Idiopathic Hypereosinophilic Syndrome as a Rare Cause of Stroke: A Case Report(Turkish Neurological Soc, 2021) Turgut, Esra; Alpua, Murat; Yalcin, Selim; Coskun, Oya; Bilgili, Mirace Yasemin Karadeniz; Acikgoz, Ergin Ayaslioglu; Coskun, OzlemHypereosinophilic syndrome (HES) is a rare hematological disease that causes organ damage by eosinophil infiltration in the tissue with increased eosinophil production in the bone marrow. HES is a rare but important cause of stroke. Central nervous system involvement findings can be serious and life-threatening. Eosinophil values should be examined as the cause of stroke, and hypereosinophilia should be suspected, especially in young patients with no etiology. Reported herein is a case of a 47-year-old female patient who was followed up with the diagnosis of acute cerebrovascular disease due to idiopathic HES.
