Background: We aimed to evaluate the optic nerve and optic nerve sheath diameter of patients with idiopathic normal pressure hydrocephalus with magnetic resonance imaging and to compare with the normal population. Methods: Magnetic resonance images and clinical records of the patients were retrospectively evaluated between 01.01.2015 and 01.01.2020. Twenty one patients in the normal pressure hydrocephalus group and 47 patients in the control group were included. Measurements were performed from the images obtained by creating multiplanar reconstructions from thin-slice Fast Spin Echo T2-weighted images. Measurements were made of optic nerve from the 3 mm posterior to the optic globe, on the plane which is oriented perpendicular to the nerve. Results: There was no difference between the two groups in terms of optic nerve diameters. Optic nerve sheath diameters are significantly higher in the normal pressure hydrocephalus group (p<0.0001). Conclusion: Morphological analysis of the optic nerve sheath complex which contains cerebrospinal fluid will contribute to the diagnosis and understanding chronic effects of normal pressure hydrocephalus, a disease in which changes in brain compliance and cerebrospinal fluid absorption are suspected in its etiology.
{"title":"Evaluation of optic nerve sheath complex by magnetic resonance imaging in patients with idiopathic normal pressure hydrocephalus","authors":"Y. Yılmazsoy, Adnan Ozdemir, Serdar Arslan","doi":"10.54029/2023dsx","DOIUrl":"https://doi.org/10.54029/2023dsx","url":null,"abstract":"Background: We aimed to evaluate the optic nerve and optic nerve sheath diameter of patients with idiopathic normal pressure hydrocephalus with magnetic resonance imaging and to compare with the normal population.\u0000Methods: Magnetic resonance images and clinical records of the patients were retrospectively evaluated between 01.01.2015 and 01.01.2020. Twenty one patients in the normal pressure hydrocephalus group and 47 patients in the control group were included. Measurements were performed from the images obtained by creating multiplanar reconstructions from thin-slice Fast Spin Echo T2-weighted images. Measurements were made of optic nerve from the 3 mm posterior to the optic globe, on the plane which is oriented perpendicular to the nerve.\u0000Results: There was no difference between the two groups in terms of optic nerve diameters. Optic nerve sheath diameters are significantly higher in the normal pressure hydrocephalus group (p<0.0001).\u0000Conclusion: Morphological analysis of the optic nerve sheath complex which contains cerebrospinal fluid will contribute to the diagnosis and understanding chronic effects of normal pressure hydrocephalus, a disease in which changes in brain compliance and cerebrospinal fluid absorption are suspected in its etiology.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41518432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients. Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was performed to identify the polymorphism at ITGA-4 gene promoter region. Results: The 3061 AA and AG genotypes were present in both groups (responders and non-responders to natalizumab treatment) with the lack of the wild form GG genotype. The AG genotype was significantly present in the non-responders’ group and appeared to have a significant impact on the responsiveness to natalizumab by increasing the propensity of being non-responder with a positive correlation (Phi-coefficient of 0.294) on the contrary of AA genotype. Conclusion: The +3061 (G.A) missense mutation is related to the response to natalizumab in multiple sclerosis patients with the AG genotype, thereby increasing the likelihood of non-response significantly.
目的:本研究的目的是评估整合素α-4亚基(ITGA-4)基因第24外显子+3061 (G b> A, rs1143676)错义突变与伊拉克多发性硬化症患者对natalizumab的反应之间的可能关联。方法:59例多发性硬化症患者(男16例，女43例;平均年龄32岁;在2022年3月至8月期间，接受natalizumab至少连续12个月的年龄范围为15至52岁的患者参与了这项研究。样本根据对natalizumab治疗的反应分为两组(反应者和无反应者)。对提取的脱氧核糖核酸进行聚合酶链反应和Sanger测序，鉴定ITGA-4基因启动子区多态性。结果:3061 AA和AG基因型均存在于两组(对那他珠单抗治疗有反应和无反应)，缺乏野生型GG基因型。AG基因型在无应答组中显著存在，与AA基因型相反，AG基因型通过增加无应答倾向而显著影响对natalizumab的应答性(phi系数为0.294)。结论:+3061 (G.A)错义突变与AG基因型多发性硬化症患者对natalizumab的应答相关，从而显著增加无应答的可能性。
{"title":"Integrin alpha-4 gene polymorphism in relation to natalizumab response in multiple sclerosis patients","authors":"F. Ahmed, S. Ali, Gheyath Abd Ali Al-Gawwam","doi":"10.54029/2023afn","DOIUrl":"https://doi.org/10.54029/2023afn","url":null,"abstract":"Objectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients.\u0000Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was performed to identify the polymorphism at ITGA-4 gene promoter region.\u0000Results: The 3061 AA and AG genotypes were present in both groups (responders and non-responders to natalizumab treatment) with the lack of the wild form GG genotype. The AG genotype was significantly present in the non-responders’ group and appeared to have a significant impact on the responsiveness to natalizumab by increasing the propensity of being non-responder with a positive correlation (Phi-coefficient of 0.294) on the contrary of AA genotype.\u0000Conclusion: The +3061 (G.A) missense mutation is related to the response to natalizumab in multiple sclerosis patients with the AG genotype, thereby increasing the likelihood of non-response significantly.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70666701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savaş Karpuz, Ramazan Yılmaz, Emine Akdere, A. Küçük, Havva Cop, H. Yılmaz
Background: Both primary and secondary headaches have been associated with cognitive dysfunction and depression. Objective: This study aims to investigate the effects of cervicogenic headache on cognitive function, quality of life and mood. Methods: This single-center, cross-sectional comparative study includes 30 patients diagnosed with cervicogenic headache by a neurologist and 30 healthy controls. The pain level of the participants was evaluated with the Visual Analog Scale (VAS), their mood with the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale, their quality of life with the Short Form-36 (SF-36), and their cognitive status by a psychologist with the Standard Mini Mental Test (SMMT) and Montreal Cognitive Assessment Scale (MoCA). Results: All MoCA domains except for orientation and the SMMT scores were significantly lower in the cervicogenic headache group compared to the control group (p< 0,05). In addition, scores for the pain catastrophizing scale and selected SF-36 sub-parameters (physical function, physical role difficulty, social functionality, pain and general health perception) were significantly lower in the cervicogenic headache group (p< 0,05). The Beck Depression Inventory score was significantly higher in patients with cervicogenic headache than in the control group (p=0.018). Conclusion: Patients with cervicogenic headache exhibit worse cognitive performance during their headache. Additionally, compared to healthy controls, they had higher rates of depression and pain catastrophizing as well as a lower quality of life.
{"title":"Frequency of cognitive dysfunction in individuals with cervicogenic headache","authors":"Savaş Karpuz, Ramazan Yılmaz, Emine Akdere, A. Küçük, Havva Cop, H. Yılmaz","doi":"10.54029/2023rzc","DOIUrl":"https://doi.org/10.54029/2023rzc","url":null,"abstract":"Background: Both primary and secondary headaches have been associated with cognitive dysfunction and depression. Objective: This study aims to investigate the effects of cervicogenic headache on cognitive function, quality of life and mood.\u0000Methods: This single-center, cross-sectional comparative study includes 30 patients diagnosed with cervicogenic headache by a neurologist and 30 healthy controls. The pain level of the participants was evaluated with the Visual Analog Scale (VAS), their mood with the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale, their quality of life with the Short Form-36 (SF-36), and their cognitive status by a psychologist with the Standard Mini Mental Test (SMMT) and Montreal Cognitive Assessment Scale (MoCA).\u0000Results: All MoCA domains except for orientation and the SMMT scores were significantly lower in the cervicogenic headache group compared to the control group (p< 0,05). In addition, scores for the pain catastrophizing scale and selected SF-36 sub-parameters (physical function, physical role difficulty, social functionality, pain and general health perception) were significantly lower in the cervicogenic headache group (p< 0,05). The Beck Depression Inventory score was significantly higher in patients with cervicogenic headache than in the control group (p=0.018).\u0000Conclusion: Patients with cervicogenic headache exhibit worse cognitive performance during their headache. Additionally, compared to healthy controls, they had higher rates of depression and pain catastrophizing as well as a lower quality of life.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70666797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aslihan Taskiran-Sag, Pinar Guleryuz Kizil, D. Yuce, E. Eroğlu
Background & Objective: It is unknown whether occult neurological damage exists in mild COVID-19 patients. Obtaining direct histopathological evidence is difficult and often inappropriate. Radiological tools provide important clues regarding this issue. We aimed to investigate any overt or subtle changes in brain magnetic resonance (MR) scans of patients who recovered from non-severe COVID-19 at subacute stage. Methods: Cortical thicknesses/areas were measured in the olfactory bulb (OB), gyri recti, amygdalae, hippocampi, entorhinal cortices, perirhinal cortices, insulae, and substantia nigrae (SN) and compared with controls. Gross findings have also been reported. We assessed the correlations between radiological and clinical parameters. Results: Twenty percent of the patients had abnormal MR scans (mild ventriculomegaly, a hyperintense lesion, a lacune and hydrocephalus) although their relevance to COVID-19 was unknown. We found increased cortical thickness in bilateral OB, left entorhinal cortex, right perirhinal cortex, bilateral insulae, and bilateral gyri recti (p<0.05 for all). Right OB was thinner in patients with anosmia (p=0.015) and ageusia (p=0.004). Left perirhinal cortex and left gyrus rectus were thicker in patients with vertigo (p=0.040; p=0.032 respectively). Sleep disturbance was associated to increased thickness in left perirhinal cortex (p=0.033). Patients with brain fog had smaller SN bilaterally (right p=0.028 and left p=0.011). Patients with anxiety symptoms after COVID-19 had increased right hippocampal area(p=0.023). Neutrophil-to-lymphocyte ratio was correlated to the thickness of right perirhinal cortex (r=-0.57, p=0.02) while CRP, time since COVID-19 and age were not. Conclusion: These changes in limbic areas, insula and SN necessitate close monitoring of patients for autonomic complications, and secondary neurodegenerative processes.
{"title":"Grey matter analysis in non-severe COVID-19 points out limbic-related cortex and substantia nigra","authors":"Aslihan Taskiran-Sag, Pinar Guleryuz Kizil, D. Yuce, E. Eroğlu","doi":"10.54029/2023usk","DOIUrl":"https://doi.org/10.54029/2023usk","url":null,"abstract":"Background & Objective: It is unknown whether occult neurological damage exists in mild COVID-19 patients. Obtaining direct histopathological evidence is difficult and often inappropriate. Radiological tools provide important clues regarding this issue. We aimed to investigate any overt or subtle changes in brain magnetic resonance (MR) scans of patients who recovered from non-severe COVID-19 at subacute stage.\u0000Methods: Cortical thicknesses/areas were measured in the olfactory bulb (OB), gyri recti, amygdalae, hippocampi, entorhinal cortices, perirhinal cortices, insulae, and substantia nigrae (SN) and compared with controls. Gross findings have also been reported. We assessed the correlations between radiological and clinical parameters.\u0000Results: Twenty percent of the patients had abnormal MR scans (mild ventriculomegaly, a hyperintense lesion, a lacune and hydrocephalus) although their relevance to COVID-19 was unknown. We found increased cortical thickness in bilateral OB, left entorhinal cortex, right perirhinal cortex, bilateral insulae, and bilateral gyri recti (p<0.05 for all). Right OB was thinner in patients with anosmia (p=0.015) and ageusia (p=0.004). Left perirhinal cortex and left gyrus rectus were thicker in patients with vertigo (p=0.040; p=0.032 respectively). Sleep disturbance was associated to increased thickness in left perirhinal cortex (p=0.033). Patients with brain fog had smaller SN bilaterally (right p=0.028 and left p=0.011). Patients with anxiety symptoms after COVID-19 had increased right hippocampal area(p=0.023). Neutrophil-to-lymphocyte ratio was correlated to the thickness of right perirhinal cortex (r=-0.57, p=0.02) while CRP, time since COVID-19 and age were not.\u0000Conclusion: These changes in limbic areas, insula and SN necessitate close monitoring of patients for autonomic complications, and secondary neurodegenerative processes.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49541670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Compression of the occipital nerves can cause occipital headache. Several potential compression points have been identified along their course. One of these points is the hitherto undescribed instance of exostoses of anatomic structures of the occipital bone. A 34-year-old man with a prominent external occipital tuberance and superior nuchal lines complained of headache in the area of distribution of the greater occipital nerve with tenderness near the bony protrusion on palpation. A 44-year old woman experienced stabbing pain in the lateral orbital region with pressure on the ossified insertion of the ipsilateral trapezius muscle near the external occipital protuberance. Local nerve block achieved temporary relief of pain. Exostosis of the external occipital protuberance and superior nuchal lines may impinge on the greater and third occipital nerves. The characteristics of the pain in our cases differ in some aspects from those of occipital neuralgia.
{"title":"Can exostoses of the external occipital protuberance and superior nuchal lines cause headache? A report of two cases","authors":"S. Bahadır","doi":"10.54029/2023jwm","DOIUrl":"https://doi.org/10.54029/2023jwm","url":null,"abstract":"Compression of the occipital nerves can cause occipital headache. Several potential compression points have been identified along their course. One of these points is the hitherto undescribed instance of exostoses of anatomic structures of the occipital bone. A 34-year-old man with a prominent external occipital tuberance and superior nuchal lines complained of headache in the area of distribution of the greater occipital nerve with tenderness near the bony protrusion on palpation. A 44-year old woman experienced stabbing pain in the lateral orbital region with pressure on the ossified insertion of the ipsilateral trapezius muscle near the external occipital protuberance. Local nerve block achieved temporary relief of pain. Exostosis of the external occipital protuberance and superior nuchal lines may impinge on the greater and third occipital nerves. The characteristics of the pain in our cases differ in some aspects from those of occipital neuralgia.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"31 1-2","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41291561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gözde Öngün, F. Eren, Cihat Özgüncü, G. Özdemir, Aydin Talip Yildogan, Ö. F. Çiçek, Ş. Öztürk
Background & Objectives: Symptomatic carotid artery stenosis (SCAS) is one of the most important causes of ischemic stroke. We aimed to investigate the relationship between hematological and inflammatory parameters in patients with SCAS and controls. Method: Patients who underwent digital subtraction angiography for SCAS were evaluated retrospectively. Patients with carotid stenosis greater than 50% who had a stroke in the last six months were included in the study. Clinical and sociodemographic characteristics, stent characteristics, filter use, balloon dilatation status, arch type, presence of contralateral occlusion, and complication status were recorded. Hemogram was evaluated using fluorescence flow cytometry. Data were analyzed among patients with SCAS, ischemic stroke patients without stenosis and healthy control group. Results: SCAS was higher in patients with advanced age, male, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, and a history of stroke as compared to healthy individuals (p<0.001). Smoking and atrial fibrillation were higher in group without carotid stenosis and who had ischemic stroke (p<0.001). Hemoglobin and hematocrit values were higher in healthy control group (p=0.001). Red blood cell distribution width (RDW) and platelet/lymphocyte ratio (PLR) were higher in SCAS patients (p<0.001); Neutrophil and neutrophil/lymphocyte ratio (NLR) was higher in the group with stroke and without stenosis (p <0.001). There was no relationship between blood parameters and procedure technical features and complications (p> 0.05). Conclusion: Hematologic parameters like PLR, NLR and RDW level are correlated with SCAS. PLR, NLR and RDW value can be an inexpensive and useful biomarker for predicting SCAS.
{"title":"The association between symptomatic carotid stenosis and hematological parameters","authors":"Gözde Öngün, F. Eren, Cihat Özgüncü, G. Özdemir, Aydin Talip Yildogan, Ö. F. Çiçek, Ş. Öztürk","doi":"10.54029/2023ane","DOIUrl":"https://doi.org/10.54029/2023ane","url":null,"abstract":"Background & Objectives: Symptomatic carotid artery stenosis (SCAS) is one of the most important causes of ischemic stroke. We aimed to investigate the relationship between hematological and inflammatory parameters in patients with SCAS and controls.\u0000Method: Patients who underwent digital subtraction angiography for SCAS were evaluated retrospectively. Patients with carotid stenosis greater than 50% who had a stroke in the last six months were included in the study. Clinical and sociodemographic characteristics, stent characteristics, filter use, balloon dilatation status, arch type, presence of contralateral occlusion, and complication status were recorded. Hemogram was evaluated using fluorescence flow cytometry. Data were analyzed among patients with SCAS, ischemic stroke patients without stenosis and healthy control group.\u0000Results: SCAS was higher in patients with advanced age, male, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, and a history of stroke as compared to healthy individuals (p<0.001). Smoking and atrial fibrillation were higher in group without carotid stenosis and who had ischemic stroke (p<0.001). Hemoglobin and hematocrit values were higher in healthy control group (p=0.001). Red blood cell distribution width (RDW) and platelet/lymphocyte ratio (PLR) were higher in SCAS patients (p<0.001); Neutrophil and neutrophil/lymphocyte ratio (NLR) was higher in the group with stroke and without stenosis (p <0.001). There was no relationship between blood parameters and procedure technical features and complications (p> 0.05).\u0000Conclusion: Hematologic parameters like PLR, NLR and RDW level are correlated with SCAS. PLR, NLR and RDW value can be an inexpensive and useful biomarker for predicting SCAS.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44003873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limin Li, C. Y. Fong, W. Lim, J. C. Foo, R. R. Azman, N. Bahuri, K. Mun
Gliomatosis cerebri (GC) is a rare extensively infiltrating growth pattern of diffuse glioma with wide clinical heterogeneity, often mimicking other disorders. GC usually affects the white matter and involvement predominantly of the deep gray matter at onset is uncommon. We describe a teenager who presented with bi-thalamic and left hippocampal-parahippocampal lesions at first presentation with a 1-month history of right-sided motor hemiparesis and hemiataxia. Over a 1-year period the lesion spread to the bi-temporal, right insular cortex, and bi-frontal cerebral hemisphere associated with multiple cranial palsies and progressive dementia. Histological examination revealed a high- grade anaplastic astrocytoma consistent with GC. Our case widens the phenotypic spectrum of GC. Clinicians need to consider GC in children with lesions in the deep gray matter in combination with pyramidal, cranial nerve palsies and extrapyramidal signs.
{"title":"Paediatric gliomatosis cerebri presenting with deep gray matter lesions","authors":"Limin Li, C. Y. Fong, W. Lim, J. C. Foo, R. R. Azman, N. Bahuri, K. Mun","doi":"10.54029/2023hjd","DOIUrl":"https://doi.org/10.54029/2023hjd","url":null,"abstract":"Gliomatosis cerebri (GC) is a rare extensively infiltrating growth pattern of diffuse glioma with wide clinical heterogeneity, often mimicking other disorders. GC usually affects the white matter and involvement predominantly of the deep gray matter at onset is uncommon. We describe a teenager who presented with bi-thalamic and left hippocampal-parahippocampal lesions at first presentation with a 1-month history of right-sided motor hemiparesis and hemiataxia. Over a 1-year period the lesion spread to the bi-temporal, right insular cortex, and bi-frontal cerebral hemisphere associated with multiple cranial palsies and progressive dementia. Histological examination revealed a high- grade anaplastic astrocytoma consistent with GC. Our case widens the phenotypic spectrum of GC. Clinicians need to consider GC in children with lesions in the deep gray matter in combination with pyramidal, cranial nerve palsies and extrapyramidal signs.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48969358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leyla Ramazanoğlu, I. Aslan, Ahmet Gunkan, Yilmaz Onal, M. Velioglu, O. M. Topçuoğlu, E. Gozke
Background & Objective: Data about outcomes of endovascular treatment (EVT) in basilar artery occlusion (BAO) are limited. The aim of this study is to evaluate the predictors of functional outcome and to investigate the benefit of bridging intravenous thrombolysis (IVT) and the impact of first-pass effect (FPE) on prognosis. Methods: A total of 57 consecutive BAO patients who received EVT at our tertiary stroke center between January 2018 and March 2021 were retrospectively analyzed. The primary outcome was to evaluate excellent prognosis (mRS 0-1) and mortality (mRS 6) at day 90. The secondary outcome was to define the benefit of bridging IVT and the impact of FPE on prognosis. The safety outcome was symptomatic intracranial hemorrhage (sICH). National Institutes of Health Stroke Scale (NIHSS) at admission and at 24 hours, collateral scores, successful recanalization, asymptomatic ICH, embolization, malignant infarction and decompression were also evaluated. Results: The mean age of the patients was 64.1 ± 14.5 years. Male-to-female ratio was 1.7. Hypertension (HT) was the most common risk factor. Bridging IVT was performed in nine patients (15.8%). The FPE rate was 56.1%. NIHSS scores at admission and at 24 hours were found to be statistically significant predictors of prognosis (P=0.023 and P<0.001, respectively). Bridging IVT, FPE, successful recanalization and collateral status did not significantly predict outcome. Conclusion: Lower NIHSS scores at admission and at 24 hours were significantly associated with excellent prognosis. NIHSS scores at admission and at 24 hours were significantly higher in mortality group. sICH did not predict mortality.
{"title":"The predictors of prognosis in endovascular treatment of basilar artery occlusion","authors":"Leyla Ramazanoğlu, I. Aslan, Ahmet Gunkan, Yilmaz Onal, M. Velioglu, O. M. Topçuoğlu, E. Gozke","doi":"10.54029/2023aea","DOIUrl":"https://doi.org/10.54029/2023aea","url":null,"abstract":"Background & Objective: Data about outcomes of endovascular treatment (EVT) in basilar artery occlusion (BAO) are limited. The aim of this study is to evaluate the predictors of functional outcome and to investigate the benefit of bridging intravenous thrombolysis (IVT) and the impact of first-pass effect (FPE) on prognosis.\u0000Methods: A total of 57 consecutive BAO patients who received EVT at our tertiary stroke center between January 2018 and March 2021 were retrospectively analyzed. The primary outcome was to evaluate excellent prognosis (mRS 0-1) and mortality (mRS 6) at day 90. The secondary outcome was to define the benefit of bridging IVT and the impact of FPE on prognosis. The safety outcome was symptomatic intracranial hemorrhage (sICH). National Institutes of Health Stroke Scale (NIHSS) at admission and at 24 hours, collateral scores, successful recanalization, asymptomatic ICH, embolization, malignant infarction and decompression were also evaluated.\u0000Results: The mean age of the patients was 64.1 ± 14.5 years. Male-to-female ratio was 1.7. Hypertension (HT) was the most common risk factor. Bridging IVT was performed in nine patients (15.8%). The FPE rate was 56.1%. NIHSS scores at admission and at 24 hours were found to be statistically significant predictors of prognosis (P=0.023 and P<0.001, respectively). Bridging IVT, FPE, successful recanalization and collateral status did not significantly predict outcome.\u0000Conclusion: Lower NIHSS scores at admission and at 24 hours were significantly associated with excellent prognosis. NIHSS scores at admission and at 24 hours were significantly higher in mortality group. sICH did not predict mortality.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45511521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Sofia Cotelli, M. Frigerio, Patrizia Civelli, M. Bianchi, F. Manelli, M. Turla
Cholangiocarcinoma is poorly treatable and highly lethal adenocarcinoma of the hepatobiliary system. The incidence of brain metastases was 0.15%, 0.47% and 1.4% in three large case series. Cavernous sinus syndrome (CSS) refers to any disease involving the cavernous sinus. It is characterized by ophthalmoplegia, proptosis, chemosis, but also trigeminal sensory loss and Horner’s syndrome. We report the case of a 56-year-old Caucasian woman evaluated due to partial Horner syndrome, periorbital and retroorbital unilateral moderate-to-severe headache involving the left frontal and temporal areas of about 2 weeks duration.
{"title":"Cavernous sinus syndrome as the first presenting sign of metastatic cholangiocarcinoma","authors":"Maria Sofia Cotelli, M. Frigerio, Patrizia Civelli, M. Bianchi, F. Manelli, M. Turla","doi":"10.54029/2023drm","DOIUrl":"https://doi.org/10.54029/2023drm","url":null,"abstract":"Cholangiocarcinoma is poorly treatable and highly lethal adenocarcinoma of the hepatobiliary system. The incidence of brain metastases was 0.15%, 0.47% and 1.4% in three large case series. Cavernous sinus syndrome (CSS) refers to any disease involving the cavernous sinus. It is characterized by ophthalmoplegia, proptosis, chemosis, but also trigeminal sensory loss and Horner’s syndrome. We report the case of a 56-year-old Caucasian woman evaluated due to partial Horner syndrome, periorbital and retroorbital unilateral moderate-to-severe headache involving the left frontal and temporal areas of about 2 weeks duration.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48651554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vindya Ranasinghe Ranasinghe, G. Bowatta, I. Gawarammana
Background & Objective: Hyponatremia is a frequently found complication of stroke. However, its impact on stroke outcome is poorly understood. Hence, the purpose of this study was to determine the outcome of strokes in association with hyponatremia. Methods: This was a prospective cohort study conducted at a tertiary referral center in Sri Lanka. The study subjects consisted of 246 patients with confirmed stroke. Patient characteristics, mortality, length of hospital stay and functional outcome by Modified Rankin Scale (MRS) score were assessed to evaluate the effect of hyponatremia (<131mmol/l) on stroke. Early mortality was defined as the total number of deaths occurred by 70 days. The “not favorable” MRS score was defined from 4 to 6. Results: Out of 246 patients, 47 patients (19.1%) developed hyponatremia (95% confidence interval (CI): 14.39, 24.58). The mean day of development of hyponatremia was 1.81days (SD=1.73). Hyponatremia was associated with early mortality (OR=2.08; 95% CI: 1.05, 4.1; P=0.034), increased length of hospital stay (β=2.37; 95% CI: 1.51, 3.23; P= <0.001) and “not favourable” functional outcome at discharge (OR=2.59; 95% CI: 1.33, 5.05; P=0.005). Kaplan Meier survival curve analysis showed better chance of survival in non-hyponatremic group compared to hyponatremic group (P =0.02). Conclusion: Hyponatremia is associated with early mortality, increased length of hospital stay and unfavorable functional outcome at discharge following stroke. Early detection and correction of hyponatremia may improve stroke outcome.
{"title":"Hyponatremia as an early marker of poor outcome of stroke - results of a prospective cohort study","authors":"Vindya Ranasinghe Ranasinghe, G. Bowatta, I. Gawarammana","doi":"10.54029/2023pyf","DOIUrl":"https://doi.org/10.54029/2023pyf","url":null,"abstract":"Background & Objective: Hyponatremia is a frequently found complication of stroke. However, its impact on stroke outcome is poorly understood. Hence, the purpose of this study was to determine the outcome of strokes in association with hyponatremia.\u0000Methods: This was a prospective cohort study conducted at a tertiary referral center in Sri Lanka. The study subjects consisted of 246 patients with confirmed stroke. Patient characteristics, mortality, length of hospital stay and functional outcome by Modified Rankin Scale (MRS) score were assessed to evaluate the effect of hyponatremia (<131mmol/l) on stroke. Early mortality was defined as the total number of deaths occurred by 70 days. The “not favorable” MRS score was defined from 4 to 6.\u0000Results: Out of 246 patients, 47 patients (19.1%) developed hyponatremia (95% confidence interval (CI): 14.39, 24.58). The mean day of development of hyponatremia was 1.81days (SD=1.73). Hyponatremia was associated with early mortality (OR=2.08; 95% CI: 1.05, 4.1; P=0.034), increased length of hospital stay (β=2.37; 95% CI: 1.51, 3.23; P= <0.001) and “not favourable” functional outcome at discharge (OR=2.59; 95% CI: 1.33, 5.05; P=0.005). Kaplan Meier survival curve analysis showed better chance of survival in non-hyponatremic group compared to hyponatremic group (P =0.02).\u0000Conclusion: Hyponatremia is associated with early mortality, increased length of hospital stay and unfavorable functional outcome at discharge following stroke. Early detection and correction of hyponatremia may improve stroke outcome.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48240820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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