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Four-year Experience of Intravenous and Endovascular Treatment in Acute Ischemic Stroke: A Single Center Study
(GALENOS PUBL HOUSE, 2022-01-01) Ozdemir, Zeynep; Dindar, Gulsah Zorgor; Aksoy, Sena; Acar, Erkan; Selcuk, Hakan; Kara, Batuhan; Soysal, Aysun
Objective: Acute ischemic stroke (AIS) is a major cause of mortality and morbidity throughout the world. Intravenous thrombolysis (IVT) and endovasculary treatments (EVT) are recomended currently in eligible patients admitted within the therapeutic window. In this study, the data of AIS patients who were treated with intravenous and EVT methods in Istanbul Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital between 2017-2020 were evaluated retrospectively. Materials and Methods: Five hundred and ninety patients who received IVT and/or EVT were included in the study. Demographic, clinical, radiological characteristics, risk factors and post-treatment clinical characteristics of these patients were analyzed. Results: Of the 590 patients, 324 (54.9\%) underwent IVT, 164 (27.8\%) EVT and 102 (17.3\%) combined IVT+EVT. The median National Institutes of Health Stroke Scale (NIHSS) scores were 9 (1-21) in the iv tPA group, 13 (3-27) in the EVT group, 12 (4-23) in the combined treatment group at admission In the IVT group, 220 patients had no artery occlusion (67.9\%), M2 segment of the middle cerebral artery (MCA) was found to be the most frequently occluded artery with 32 patients (9.9\%). In the EVT and combined IVT+EVT groups, the M1 segment of the MCA had the highest occlusion rate {[}76 (44.2\%), 49 (45\%), respectively]. Asymptomatic hemorrhage rate was higher in the EVT group than the other groups. Symptomatic hemorrhage rate was lower in the IVT group compared to the other groups. A total of 182 (56.2\%), 67 (39\%) and 53 (48.6\%) patients in the IVT, EVT and combined IVT+EVT groups had good outcome, respectively. Conclusion: Acute stroke treatment has been proven to significantly reduce the serious burden of stroke on patients, caregivers and society. For this reason, the societal awareness of the importance of urgent admission to emergency departmentsand the number and capacity of centers that provide AIS treatments should be increased.
Melatonin Related Acneiform Lesions: A Case Report and Potential Mechanism
(AVES, 2021-01-01) Sancak, Baris; Ozdemir, Zeynep; Ozcan, Ozan; Acar, Erkan
Melatonin (MLT) is a hormone secreted by the pineal gland according to the circadian rhythm, which is generated by the suprachiasmatic nucleus. The sleep-promoting effect of exogenous MLT is used to treat steep disorders. The most common side effects reported are headache, somnolence, palpitations, and abdominal pain. Some studies showed dermatological side effects with the use of exogenous MLT, but did not list the specific symptoms. In this article, we describe a case of facial acne occurring after the use of MLT, which is generally known to have protective and healing effects on the skin, and the potential mechanism of this surprising side effect.
Determination of Anxiety, Health Anxiety and Somatosensory Amplification Levels in Individuals with Benign Paroxysmal Positional Vertigo
(AVES, 2019-01-01) Ozdilek, Alper; Dikmen, Pinar Yalinay; Acar, Erkan; Aksoy, Elif Ayanoglu; Korkut, Nazim
OBJECTIVES: Psychiatric cornorbidities may intensify peripheral vertigo and increase the number of repositioning maneuvers required. This study was designed to examine the relationship between benign paroxysmal positional vertigo (BPPV) and anxiety and assess its association with somatic amplification and health anxiety. MATERIALS and METHODS: Sixty patients with BPPV (43 women, 17 men
The Diagnostic and Prognostic Value of Magnetic Resonance Imaging for Evaluating Atypical Inflammatory Demyelinating Lesions
(TURKISH NEUROLOGICAL SOC, 2021-01-01) Ozdemir, Zeynep; Acar, Erkan; Soysal, Aysun
Objective: The diagnosis of patients with atypical demiyelinating lesions has always been challenging, sometimes leading to a biopsy. Recent literature has radiologically classified atypical inflammatory demyelinating lesions as ring-like, Balo-like, infiltrative, megacystic, and unclassified lesions. In this study, we aimed to assess the demographics and clinical and radiologic findings in patients with atypical lesions. Materials and Methods: The records of 320 patients with demyelinating disorders were retrospectively assessed using iMed database. Patients with atypical lesions and whose magnetic resonance imaging evaluations were included. Clinical and radiologic findings were evaluated and lesions were classified according to the recommended criteria. Results: Twenty-seven patients (16 females) were included and the mean age was 34.26 +/- 6.12 (range: 26-49) years. Fourteeen patients had ring-like, three had Balo-like, three had megacystic, five had infiltrative, and two patients had unclassified lesions. Diffusion restriction was observed in contrast-enhancing sites in ring-like lesions, heterogeneously in infiltrative lesions and also peripherally in Balo-like lesions. Two patients with infiltrative lesions had additional lesions on follow-up and had to undergo biopsy. Two patients died despite aggressive treatment. Two patients with Balo-like lesions were evaluated as having acute disseminated encephalomyelitis and did not have further relapses. Seventeen patients from the study group converted to multiple sclerosis (MS) on follow-up. Conclusion: Differential diagnosis of atypical inflammatory demyelinating lesions is not always easy, the prognosis is not different from MS lesions. Mostly, ringlike lesions seem to convert to MS with recurrent relapses

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