Yazar "Asil, Talip" seçeneğine göre listele
Listeleniyor 1 - 20 / 30
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Ani işitme kayıpları hastaların transkraniyal doppler ultrasonografi ile değelendirilmesi(2006) Asil, Talip; Karasalihoğlu, Ahmet R.; Yağız, Rcep; Uzun, Cem; Taş, Abdullah; Şan, HaldunAmaç: Vasküler patolojiyi belirleme açısından, ani işitme kayıplı olguların değerlendirilmesinde transkraniyal Doppler ultrasonografinin yeri araştırıldı. Hastalar ve Yöntemler: Ani işitme kaybı tanısı konmuş 13 hasta (11 erkek, 2 kadın; ort. yaş 46.6±17.7; dağılım 18-66) çalışmaya alındı. Kronik otitis media, diğer orta kulak hastalıkları ve kulak ameliyatı öyküsü olan hastalar çalışma dışı bırakıldı. Bütün hastalara saf ses odyometri, impedans odyometrisi, transient evoked otoakustik emisyon, işitsel beyin sapı yanıtları ve transkraniyal Doppler ultrasonografi yapıldı. Kontrol grubu, kulak hastalığı, gürültülü yerde çalışma ve ototoksik ilaç kullanma öyküsü olmayan, otoskopik ve odyometrik değerlendirmede patoloji saptanmayan, hasta grubuyla yaş ve cinsiyet bakımından farklılık bulunmayan sağlıklı 19 bireyden (12 erkek, 7 kadın; ort. yaş 46.8±6.9; dağılım 33-58) oluşturuldu. Bulgular: Ani işitme kayıplı olguların hasta tarafta vertebral arter ortalama akım hızı ve sistolik akım hızı ortalamaları sağlam tarafa göre istatistiksel olarak anlamlı derecede düşük, pulsatil indeks ortalaması ise yüksek bulundu. Çalışma grubunda, baziler arter ortalama akım hızı kontrol grubuna göre düşük bulundu. Sonuç: Transkraniyal Doppler ultrasonografi ani işitme kayıplı olgularda vertebral ve baziler arter sistemindeki vasküler etkilenmeyi değerlendirme amacıyla kullanılabilir.Öğe Beyin damar hastalığı sonrası gelişen epileptik nöbetler(2006) Karaçayır, Semra Şengün; Balcı, Kemal; Asil, Talip; Çelik, YahyaAmaç: Beyin damar hastalığı geçiren hastalarda epileptik nöbet sıklığı araştırıldı. Hastalar ve Yöntemler: Üç yıllık bir sürede beyin damar hastalığı ile başvuran 1273 hastanın verileri retrospektif olarak değerlendirildi. Çalışmaya beyin damar hastalığı sonrası epileptik nöbet geçiren 160 hasta (130 iskemik, 30 hemorajik) alındı. İnme risk faktörleri ile nöbet gelişimi arasındaki ilişki, nöbet tipleri, elektroensefalografi bulguları, nöbetlerin zamansal dağılımı, lezyon tipi ve lokalizasyonu değerlendirildi. Aynı dönemde kliniğimizde takip edilen beyin damar hastalığı olan 640 hasta da kontrol grubu olarak alındı. Bulgular: Üç yıl boyunca takip edilen beyin damar hastalarının ortalama bir aylık takip süresinde nöbet geçirme oranı %12.6 bulundu. Multivaryant analizle, iskemik beyin damar hastalığı olanlarda kortikal tutulum, enfeksiyon ve metabolik bozukluk varlığı; kanayıcı beyin damar hastalığı olanlarda ise kortikal lezyon ve enfeksiyon nöbet gelişimi için bağımsız risk faktörleri olarak saptandı. Total anterior sirkülasyon infarktı olan hastalarda nöbet gelişimi istatistiksel olarak anlamlı derecede yüksek bulundu. Sonuç: Kortikal lezyonlu ve anterior sirkülasyon lezyonlu hastalarda nöbet gelişim oranı daha yüksek bulundu ve nöbet geçiren hastaların mortalitesi yüksekti. Ayrıca beyin damar hastalığı sonrası gelişen nöbetlerin çoğu jeneralize tonik klonik tipteydi.Öğe 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, UfukMethanol 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.Öğe 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, UfukInflammatory 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.Öğe 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, IlkayObjective: 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.Öğe Combined Antithrombotic Treatment With Aspirin and Clopidogrel for Patients With Capsular Warning Syndrome A Case Report(Lippincott Williams & Wilkins, 2012) Asil, Talip; Ir, Nasif; Karaduman, Fatih; Cagli, Bekir; Tuncel, SedatCapsular warning syndrome is characterized by recurrent transient ischemic attacks and is caused by microthrombosis or hypoperfusion of small-sized vessels. The pathophysiological basis of this syndrome is not well understood and currently a consensus has not been reached on its optimal treatment. In this study, we present 2 cases with favorable clinical outcomes after combined antithrombotic treatment with loading doses of clopidogrel and aspirin.Öğe Decompression craniotomy(Amer Assoc Neurological Surgeons, 2007) Kilincer, Cumhur; Asil, Talip; Utku, Ufuk; Balci, Kemal; Hamacioglu, Mustafa KemalObject. 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.Öğe Deep cerebral vein thrombosis associated with iron deficiency anaemia in adults(Elsevier Sci Ltd, 2007) Balci, Kemal; Utku, Ufuk; Asil, Talip; Buyukkoyuncu, NiluferCerebral 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.Öğe Does Cervical Radiculopathy Have an Effect on Peripheral Nerve Conduction Studies? An Electrophysiological Evaluation(Karger, 2011) Balci, Kemal; Asil, Talip; Tekinaslan, Ilkay; Ir, NasifBackground: Peripheral nerve neuropathies are more common in patients with cervical radiculopathy (CR) and a proximal lesion along an axon might predispose that nerve to injury at distal sites. To evaluate this hypothesis, the frequency of median nerve neuropathy at the wrist and the frequency of ulnar nerve neuropathy at the elbow were investigated in 80 patients with one-sided CR. Methods: The symptomatic and asymptomatic extremities were compared for the electrophysiological parameters of ulnar and median nerve conduction studies. The patients were divided into three diagnostic subgroups (C5/C6 radiculopathy, C7 radiculopathy and C8/Th1 radiculopathy), and ulnar nerve conduction studies were compared between symptomatic and asymptomatic extremities in each subgroup. Results: Although, the median and ulnar nerves are mainly derived from C8/Th1 roots, we did not observe an increased frequency of ulnar nerve involvement at the elbow (3.7% in symptomatic, 2.5% in asymptomatic extremities) while increased median nerve involvement was present at the wrist (27.5% in symptomatic, 12.5% in asymptomatic extremities). Conclusion: The electrophysiological data and the frequency of ulnar and median nerve neuropathy did not support an etiological association between CR and distal neuropathy. Significance: the association between CR and peripheral neuropathy is associational rather than causative. Copyright (C) 2011 S. Karger AG, BaselÖğe 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, ErcumentBackground. 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.Öğe Erdheim-Chester Disease Presented with Bilateral Carotid Artery Occlusion: Case Report(Turkish Neurological Soc, 2010) Celik, Yahya; Balci, Kemal; Asil, Talip; Tuzun, Erdem; Hamamcioglu, Mustafa Kemal; Temizoz, Osman; Albayram, SaitErdheim-Chester disease is a rare, non-Langerhans form of systemic histiocytosis of unknown etiology. The disease affects multiple organ systems, including musculoskeletal, cardiac, pulmonary, gastrointestinal, and central nervous systems, producing protean manifestations. Neurological manifestations are less frequent. We present a 44-year-old patient with Erdheim-Chester disease who had bilateral carotid artery occlusion and cavernous sinus infiltration.Öğe Evaluation and follow-up of cognitive functions in patients with minor stroke and transient ischemic attack(Dove Medical Press Ltd, 2016) Deniz, Cigdem; Celik, Yahya; Gultekin, Tugce Ozdemir; Baran, Gozde Eryigit; Deniz, Cagla; Asil, TalipBackground and purpose: We aimed to examine the incidence of cognitive impairment among patients with stroke, the associated risk factors, progression of the cognitive impairment, and the association between the localization of the lesion(s) as detected by magnetic resonance imaging and the affected areas of cognitive function. Methods: A total of 40 patients over 18 years of age enduring a transient ischemic stroke or minor stroke within the past 3 months who had a minimum life expectancy of 1 year were included in this study. Same number, age-, and sex-matched individuals were included as controls. Patients were inquired on the presence of risk factors for stroke. A series of neuropsychological test batteries were administered in patient and control subjects for assessing cognitive functions. These tests were readministered at 6 and 12 months of follow-up to assess the progression of cognitive functions. Results: In this study among the patients with stroke, a significant impairment was seen in multiple cognitive functional tests following ischemic stroke as compared to control groups. The most common risk factors for stroke included hypertension (72.5%), hyperlipidemia, and cigarette smoking. The number of cognitive domains with an impairment was highest ( in four cognitive tests) among those with coronary artery disease and atrial fibrillation, followed by those who had a > 50% stenosis in Doppler (three cognitive tests). These findings suggest that the frequency of risk factors associated with stroke does not correlate with the frequency of risk factors associated with cognitive dysfunction. The stroke localizations were classified among the patients with stroke and reviewed in accordance with cognitive impairment. Conclusion: Neuropsychological tests, clinical findings, and imaging studies should be used to document the poststroke cognitive dysfunction.Öğe Evaluation of vasomotor reactivity by transcranial Doppler sonography in patients with acute stroke who have symptomatic intracranial and extracranial stenosis(Wiley, 2007) Uzunca, Ilkay; Asil, Talip; Balci, Kemal; Utku, UfukObjective. In patients with large artery disease, determining the cerebral hemodynamic state and following its alterations may be a good marker for predicting long-term outcome. The aim of our study was to compare the changes in vasomotor reactivity (VMR) of patients with symptomatic intracranial and extracranial artery stenosis. We also examined whether VMR after stroke influences the long-term prognosis for these patients. Methods. Forty-one patients were included in the study. To determine the cerebral hemodynamic state, transcranial Doppler ultrasound examinations and acetazolamide tests were performed after acute stroke and repeated after 6 months. We compared the VMR on admission and at 6 months, together with changes in VMR, of the patients with symptomatic intracranial and extracranial artery stenosis. By calculating the Barthel index at 6 months, We examined whether VMR had an effect on an improvement in their quality of life. Results. We observed a significantly higher initial VMR of the ipsilateral hemisphere in patients with intracranial stenosis (22.4 +/- 9.1 versus 13.4 +/- 12.8; P = .013). At 6 months, the VMR obtained from the ipsilateral hemisphere was better in patients with extracranial stenosis than in the patients with intracranial stenosis (P = .01). The ipsilateral VMR measured on admission showed a positive correlation with the Barthel index at 6 months (P = .007; r = 0.434). Conclusions. Our study showed that VMR in patients with acute stroke who have extracranial and intracranial artery stenosis measured by using a transcranial Doppler examination may have value in predicting long-term outcome.Öğe High asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels in migraine patients(Springer-Verlag Italia Srl, 2017) Reyhani, Aylin; Celik, Yahya; Karadag, Hakan; Gunduz, Ozgur; Asil, Talip; Sut, NecdetExperimental and clinical data strongly suggests that nitric oxide (NO) plays a pivotal role in migraine. This is also supported by studies of migraine induced by substances that release NO. NO is synthesized from L-arginine by endothelial NO synthase (NOS). Asymmetric dimethylarginine (ADMA) is the major endogenous competitive inhibitor of NOS. Symmetric dimethylarginine (SDMA) is an inactive stereoisomer of ADMA. It may reduce NO production by competing with arginine for cellular uptake. The aim of this study was to measure the levels of ADMA, SDMA and L-arginine in migraine patients during the interictal period. One hundred migraine patients and 100 healthy volunteers were recruited. The patients were in the interictal period and classified into two groups as having migraine with aura and migraine without aura. Their serum ADMA, SDMA and L-arginine levels were measured by high-performance liquid chromotography (HPLC) method. ADMA, SDMA and L-arginine levels were significantly higher in migraine patients compared to the control group. But there was no difference between the patients with and without aura. These results suggest that NOS inhibitors and L-arginine/NO pathway plays an important role in migraine pathopysiology.Öğe İdyopatik intrakranyal hipertansiyon: Klinik, laboratuvar özellikleri ve prognoz(2006) Büyükkoyuncu, Nilüfer; Balcı, Kemal; Asil, TalipAmaç: Bu çalışmada idyopatik intrakranyal hipertansiyon (İİH) olgularının klinik semptom ve bulguları, demografik özellikleri ve prognozları araştırıldı. Hastalar ve Yöntemler: Modifiye Dandy kriterlerine göre idyopatik intrakranyal hipertansiyon tanısı almış, on yıllık bir süredir izlenen 21 hasta (18 kadın, 3 erkek; ort. yaş 34.9; dağılım 16-50) çalışmaya alındı. Bütün hastaların başvuru yakınmaları, tıbbi öyküleri, hemogram, biyokimya ve görüntüleme incelemeleri, göz dibi bakıları kaydedilerek değerlendirildi. Bulgular: En sık gözlenen yakınma baş ağrısıydı (%85.7), bunu vizüel semptomlar (%47.6), tinnitus (%19.0) ve bulantı- kusma (%38.1) izliyordu. Hastaların 15'inde (%71.4) papilla ödemi, dördünde (%19.0) optik diskte nazal veya temporal siliklik saptandı, kalan iki hastada (%9.5) fundus muayenesi normaldi. Sekiz hastada (%38.1) beyin ödemi saptandı. Görsel uyandırılmış potansiyel kaydı yapılan 16 hastanı n dördünde (%25) P100 latansında uzama gözlendi. Ortalama sekiz aylık takip süresinin sonunda hastaların baş ağrısı ve vizüel semptomlarında belirgin düzelme oldu. Sonuç: Sonuç olarak, İİH genellikle benign karakterli bir tablodur ancak nadiren kalıcı görme kaybına da neden olabilir. Bu nedenle baş ağrısı, görme ve işitme bozukluğu yakınmalarıyla başvuran genç, kilolu kadın hastalarda İİH tanısı da akılda bulundurulmalıdır.Öğe Intrakranyal ve ekstrakranyal ateroskleroza bağlı iskemik serebrovasküler hastalık (SVH) geçiren hastaların risk faktörleri açısından karşılaştırılması(2004) Kerimoğlu, Mahmut; Uzunca, İlkay; Utku, Ufuk; Asil, TalipAmaç: Bu çalışmanın amacı ekstrakranyal ve intrakranyal ateroskleroza bağlı iskemik SVH geçiren hastaların başlıca risk faktörleri açısından farklılıklarını incelemektir. Hastalar ve Metod: Bu çalışmaya l Mart 2001-28 Şubat 2002 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Nöroloji kliniğine başvuran ve ilk kez iskemik SVH geçiren hastalar arasından Manyetik Rezonans Anjiografi (MRA) ile intrakranyal stenoz saptanan 16 hasta alındı. Hastaların tamamında karotis doppler ile ekstrakranyal ateroskleroz ve ekokardiografi (EKO) ile kardioemboli kaynağı olmadığı gösterildi. Aynı yaş ve cinsiyette karotis doppler veya DSA ile ekstrakranyal ateroskleroz saptanmış, MRA ve Transkranyal Doppler ile intrakranyal stenozu olmadığı gösterilmiş 16 hasta ile başlıca risk faktörleri açısından karşılaştırma yapıldı. Sonuçlar: Çalışmamızda ilk kez SVH geçiren hastalardanintrakranyal stenoz saptanan 16 hastadan 9'unda MCA anadalda, 2'sinde intrakranyal ICA'da ve 4'ünde baziler arterde, birinde ise vertebral arterin intrakranyal parçasında stenoz veya oklüzyon saptandı. Diabetes Mellitus, hipertansiyon, hiperkolesterolemi, ve sigara açısından intrakranyal ve ekstrakranyal aterosklerozlu hastalar arasında anlamlı bir fark bulunamazken iskemik kalp hastalığı (1KH) geçirme oranı ekstrakranyal aterosklerozlu hastalarda istatiksel olarak anlamlı bir şekilde daha yüksekti. Tartışma: intrakranyal stenoz iskemik SVH etyolojisi araştırılırken gözden kaçırılmaması gereken çok da nadir görülmeyen bir durumdur. IKH geçirmiş olmanın servikal ateroskleroz için intraktrakranyal stenoza göre daha belirgin bir risk faktörü olduğu görülmüştür.Öğe Intravenous tPA Administration in Patients With Acute Ischemic Stroke: Edirne Experience(Journal Neurological Sciences, 2011) Asil, Talip; Balci, Kemal; Utku, Ufuk; Ir, NasifObjective: Intravenous (IV) thrombolytic therapy is the only approved effective treatment used in patients with acute ischemic stroke. In this study, we aimed at establishing the clinical outcomes of the IV tissue plasminogen activator (tPA) therapy and the main factors affecting the success rate of the treatment. Patients and Methods: Demographic data, radiological and clinical findings of the patients with acute ischemic stroke who were administered IV tPA therapy in our clinic were recorded. During the first 90 days, symptomatic intracranial hemorrhage and death events were reported. On day 90, patients were divided into two groups; patients with 0-2 MRS scores were deemed to have a good prognosis, while patients with 0-1 MRS score were deemed to have an excellent prognosis. The next step was to analyze the factors which affected disease prognosis. Results: The study included 48 patients with acute ischemic stroke. Patients were administered IV tPA therapy between November 2006 and January 2010. The mean age was 64,8 +/- 12,8 and the mean NIH score was 16,8 +/- 5,2. In addition, the mean ASPECT score was 6,7 +/- 2,5 based on the baseline CT scan. A total of 9 (18%) of the patients died within the first 90 days, including 2 (4%) patients with symptomatic intracranial hemorrhage. On day 90, 11 patients (23%) had an excellent prognosis, whereas 22 (46%) had a good prognosis. In the study, baseline NIH scores and ASPECT scores were associated with a good prognosis. Conclusion: Intravenous tPA therapy is an approved therapeutic modality in patients with acute ischemic patients, which prevents disability, although it does not decrease mortality. Our study results suggesting that IV tPA therapy was an effective treatment in patients with acute ischemic disease were also consistent with previous significant study findings.Öğe Ischemic Stroke in Young Adults Risk Factors, Subtypes, and Prognosis(Lippincott Williams & Wilkins, 2011) Balci, Kemal; Utku, Ufuk; Asil, Talip; Celik, YahyaBackground: Ischemic strokes occurring in patients younger than 47 years is a relatively rare event and accounts for less than 5% of all ischemic strokes in western countries. Objective: The etiologic spectrum in younger patients and older patients differs considerably. Methods: In this hospital case series study, we enrolled 192 patients with ischemic stroke, aged 18 to 47 years, all of whom were submitted to a diagnostic protocol. The risk factors for stroke and the distribution of stroke subtype and prognosis were studied. Modified diagnostic criteria adopted from the Trial of ORG 10172 in Acute Stroke Treatment and the Baltimore-Washington Cooperative Young Stroke Study, were used for etiologic classification. Results: Hypertension was found to be the main risk factor (45%) followed by cigarette smoking (37%), hyperlipidemia (35.4%), diabetes mellitus (17%), and family history of stroke (18%). Hypertension, diabetes mellitus, hypercholesterolemia, and smoking were present either alone or in combination in the majority of our patients. Oral contraceptives were being taken by 25% of the women. The etiology of stroke was as follows: atherothrombosis 26.5%, cardioembolism 20%, nonatherosclerotic vasculopathies 13%, other determined causes 10%, lacunar stroke 6%, migraine 3.6%, and undetermined causes 21%. Conclusions: Hypertension, diabetes mellitus, hypercholesterolemia, and smoking were the most common risk factors in our ischemic stroke patients between 18-47 years of age. Health care programs targeting the prevention and treatment of these factors will reduce the associated morbidity and mortality of stroke among this socioeconomically active age group.Öğe Korpus Kallozum Spleniumunda Postinfeksiyöz GeçiciLezyon: Olgu Sunumu(2014) Güven, Harun Mest; Ünlü, Ercüment; Tuncel, Sedat Alpaslan; Asil, Talip; Çağlı, BekirAcil servise bilinç bulanıklığı, yüksek ateş ve baş ağrısı şikayeti ile başvuran 39 yaşındaki erkek hastanın yapılan kranyal manyetik rezonans görüntüleme (MRG)'sinde korpus kallozum splenium (KKS) kesiminde difüzyon kısıtlaması gösteren fokal lezyon izlendi. Beyin omurilik sıvısı (BOS) analizi ile birlikte hastaya meningoensefalit ön tanısı ile medikal tedavi başlandı. Kliniği hızla düzelme gösteren hastanın bir ay sonra yapılan kontrol kranyal MRG incelemesinde, korpus kallozumdaki lezyonunun tümü ile ortadan kalktığı görüldü. Bulgular KKS'nin postinfeksiyöz geçici lezyonu ile uyumlu olarak değerlendirildi. Bu lokalizasyon ve radyolojik özellikler spesifik olmayıp çeşitli viral ve bakteriyal enfeksiyonlarla ilişkili ensefalit/ensefalopati yada antiepileptik ilaç kullanan epilepsi hastalarında da görülebilmektedir.Öğe Long-Term Prognosis and Factors Influencing Prognosis in 20 Patients With Cerebral Venous Thrombosis: Combined Analysis of 582 Patients(Turkish Neurological Soc, 2006) Balc, Kemal; Utku, Ufuk; Asil, TalipScientific background: Cerebral venous thrombosis (CVT) is a rare disorder with strikingly diverse manifestations that may mimic the clinical features of other neurological conditions. The experience of each neurological center in the diagnosis and management of CVT is known as a few cases each year, and therefore the reported case series could not avoid referral bias. Patients and methods: In this study, we analyzed the correlation between the mortality and the radiological or clinical findings in 20 patients with CVT, and then, we pooled the data from the available previous studies (11 prospective and retrospective studies) and our study and performed a combined analysis of predictors for mortality. Results: Seizure (p=0.018), coma on admission (p=0.012), age (p=0.001), focal deficit (p=0.002), hemorrhagic lesion (p=0.001) were found in association with poor prognosis. In combined analysis, the negative predictive values of all these parameters were found high, but the positive predictive values were found low. Conclusion: Initial clinical features and findings of the patients with sinus venous thrombosis may give information about the prognosis.