Assessment of the severity of unconsciousness in patients with impaired consciousness, prediction of mortality and prognosis are currently the most studied subjects in intensive care. The aim of this study was to investigate the usefulness of the Full Outline of UnResponsiveness (FOUR) score in intensive care unit patients with stroke and the associations of FOUR score with the clinical outcome and with other coma scales (Glasgow [GCS] and Acute Physiology and Chronic Health Evaluation II). One hundred acute stroke patients (44 male, 56 female), who were followed in a neurology intensive care unit, were included in this prospective study. The mean age of the patients was 70.49±12.42 years. Lesion types were determined as haemorrhagic in 30 and ischaemic in 70 patients. FOUR scores on the day of admission and the first, third and 10th days of patients who died within 15 days were lower when compared to scores of patients who survived (P=0.005, P=0.000, P=0.000 and P=0.000 respectively). Receiver operating characteristic curve analysis showed significant trending with both FOUR score and GCS for prognosis; the area under curve ranged from 0.675 (95% confidence interval 0.565 to 0.786) when measurements had been made on day 3 to 0.922 (95% confidence interval 0.867 to 0.977) and 0.981 (95% confidence interval 0.947 to 1.015) for day 10. We suggest that FOUR score is a useful scale for evaluation of acute stroke patients in the intensive care unit as a homogeneous group, with respect to the outcome estimation.

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The anterior system is primarily responsible for the clinical picture in a patient that presents with clinical aphasia. However, recent reports have shown that injuries to posterior structures, the cerebellum in particular, may have a role in language processing. Herein, we will look first at the linguistic role of the cerebellum in light of the literature, then of the thalamus and some described clinical syndromes, and finally, specific syndromes resulting from occipital lobe lesions, all of which are supported by the posterior vascular system. The human brain is such a complex organization that in addition to the thalamus and occipital cortex, we can see the involvement of the cerebellum in high cognitive functions. Posterior system strokes may lead to clinical findings of cognitive deficits, including neurolinguistic components. Determining these defects in stroke patients may precipitate changes in current management strategies.

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Hale Z. Batur Çağlayan ve Fahrettin Ege bu çalışmaya eşit katkıda bulunmuşlardır ve birinci yazarlığı paylaşmaktadırlar.Objective: In Turkey, a national program is governed by National Board of Medical Specialties (BMS), Commision of Syllabus Creation and Standardization to improve and standardize residency training. In the present study, we aimed to assess neurology residency training programs and working conditions in Turkey based on a national survey among residents. Materials and Methods: All neurology residents were invited to complete a 39-question survey via e-mail, which contained a link to the online questionnaire form. Data on the residents' working conditions, education and research activities were collected. Results: Out of 450 neurology residents, 136 (30.2%) completed the survey. Hundred nineteen (88%) of these residents reported working >8 h per day and 116 (85%) reported they were on night duty >3 d per month. Overall, 82% of the residents were not satisfied with the educational program in their department. Half of the residents reported that their institution did not have a structured education program. Eventhough, 70% reported that they contributed to clinical or basic research conducted at their clinics only 35% of them noted that they received sufficient academic supervision. Finally, 126 (94%) of the residents reported that the pay-for-performance healthcare system negatively affected their training. Conclusion:The main reasons of dissatisfaction with neurology training in Turkey seem to be the insufficiency in educational programing, nonstandardized working hours and the pay-for-performance healthcare system. The present findings can help standardize and improve neurology training program founded by National Board of Medical Specialties (BMS).