Background: Brain imaging in stroke aims at the detection of the relevant ischemic tissue pathology. Cranial computed tomography (CT) is frequently used in patients with transient ischemic attack (TIA) but no data is available on how it directly compares to magnetic resonance imaging (MRI). Methods: We compared detection of acute ischemic lesions on CT and MRI in 215 consecutive TIA patients who underwent brain imaging with either CT (n = 161) or MRI (n = 54). An MRI was performed within 24 h in all patients who had CT initially. Results: An initial assessment with CT revealed no acute pathology in 154 (95.7%) and possible acute infarction in 7 (4.3%) patients. The acute infarct on CT was confirmed by diffusion-weighted imaging (DWI) in only 2 cases (28.6%). DWI detected an acute infarct in 50 of the 154 patients with normal baseline CT (32.5%). Among 54 patients without baseline CT, DWI showed acute ischemic lesions in 19 (35.2%). The ischemic lesions had a median volume of 0.87 cm³ (range: 0.08–15.61), and the lesion pattern provided clues to the underlying etiology in 13.7%. Conclusion: Acute MRI is advantageous over CT to confirm the probable ischemic nature and to identify the etiology in TIA patients.

This study aimed to determine the relationship between serum vitamin B level and tension-type headache. The study groups consisted of 75 patients (40 females, 35 males) with headache and a control group of 49 healthy children (25 females, 24 males). Serum vitamin B level < 200 pg/ml was defined as deficient, and < 160 pg/ml as severely deficient. The serum vitamin B level was measured by the electrochemiluminescence (ECLIA) method. The serum vitamin B levels in the headache and control groups were 273.01 ± 76.77 and 316.22 ± 74.53 pg/ml, with the difference determined as statistically significant (p = 0.003). In the case group, 18/75 patients (24%) had a serum vitamin B12 level below the normal of 200 pg/ml, and in the control group 4/49 (8%) patients were also below the normal range (p = 0.021). The serum vitamin B level in the children with tension-type headache was significantly lower than that in the control group. From the results of the study, it was concluded that there may be an association between vitamin B level and tension-type headache. However, further clinical studies are needed.

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The mean serum IL-6 and oxidative stress levels in refractory epilepsy patients were higher and the serum adiponectin level was lower than the healthy control group. These findings may be associated with an increased risk of seizures, atherosclerosis and cardiovascular disease in refractory epilepsy patients.

PurposeThe aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique.MethodsA retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaraş¸ Sütçü Imam University Medical Faculty. The patients were examined in respect of demographic features and aortic arch anatomic structure characteristics. All demographic characteristics, DSA, carotid, and vertebral artery stent results were recorded.ResultsThe patients comprised 60.1% males and 39.9% females with a mean age of 58.25 years. Type 2 aortic arch was found in 175 (60.7%) patients, Type 2 aortic arch in 99 (34.3%) patients, and Type 3 aortic arch in 14 (4.8%) patients. The right carotid artery stenosis rate was found to be higher in patients with Type 2 aortic arch (P=0.013). When the patients were evaluated according to the presence of a bovine arch, there was no significant difference in terms of age, carotid, and vertebral artery lesions (P>0.05).ConclusionThe aortic arch and its branching properties were not found to have a direct effect on increased risk of cerebrovascular disease or stenting rates. This study can be considered to raise awareness for new studies to demonstrate the effect of aortic arch anatomic differences on cerebrovascular diseases.

Hirayama disease (HD) is a rare motor neuron disorder that involves a single upper extremity. It is clinically characterized by weakness and atrophy of the muscles of the hand and forearm. This article presents a 19-year-old woman who visited the orthopedics outpatient clinic with weakness and atrophy in her right hand and was clinically diagnosed with advanced stage carpal tunnel syndrome and scheduled for surgical intervention; she was later diagnosed with HD by an electrophysiological study. As a result, it has been found that a careful electrophysiological study and neurological examination can be used to diagnose HD. In this way, advanced stage carpal tunnel syndrome will be ruled out and patients will be spared from an unnecessary surgical operation.

Amaç: Elektrokonvulsif terapi (EKT), beyin dokusunun kontrollü olarak elektrik akımı ile uyarılması sonucu jeneralize konvulsiyonlar oluşturulması esasına dayalı bir psikiyatrik tedavi yöntemidir. En yaygın kullanım alanı ilaç tedavisine cevap vermeyen depresyon olguları olmakla beraber mani, katatoni, affektif bozukluklarla seyreden şizofreni, parkinson hastalığı ve nöroleptik malign sendrom (NMS) gibi birçok hastalığın tedavisinde de etkilidir. EKT öncesi tam kan sayımı rutin olarak bakılsa da, EKT için herhangi bir hematolojik kontrendikasyon bulunmamaktadır. Bu yaptığımız çalışmanın amacı EKT tedavisinin hemogram parametreleri üzerindeki etkisini incelemektir. Yöntemler: Bu çalışmaya Harran Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı Kliniği'nde yatan ve EKT uygulanan 30 hasta alınmıştır. Hastaların tedavi öncesi ve sonrası hemogram parametreleri kaydedilmiştir. Bulgular: Çalışmaya dahil edilen 25 hastanın, 19 tanesi (%76) kadın, 6 tanesi (%24) erkektir. Hastaların yaşları 16 ile 56 arasında değişmekte olup; yaş ortalaması 33,12±12,06 olarak saptanmıştır. Ortalama EKT sayısı 9,04±3,12 olarak değerlendirildi. EKT öncesi ve sonrası karşılaştırılan hemogram parametrelerinin istatistiksel analiz sonuçlarına göre, RBC (eritrosit hücrelerinin sayısı) ve MCH (eritrosit hücrelerindeki ortalama hemoglobin miktarı) değerlerinde anlamlı değişiklik saptanmıştır. RBC ortalama değerinde 4,90'dan 4,68'e düşüş gözükmektedir (p=0,018). MCH ortalama değerinde ise 27,37'den 27,85' yükseliş tespit edilmiştir (p=0,036). Diğer hemogram parametrelerindeki değişiklikler ise istatistiksel açıdan önem arz etmemektedir. Sonuç: EKT, yan etkisi oldukça az, etkili, güvenli ve kolayca uygulanabilir bir tedavi yöntemidir. Bu çalışma EKT'nin birçok hemogram parametresi üzerinde anlamlı bir istatistiksel değişiklik yapmadığını göstermektedir. Çalışmamızda anlamlı değişiklik gösteren 2 parametre (RBC ve MCH) bulunmuştur. EKT'nin kırmızı kan hücrelerinde ve hemoglobin miktarlarında nasıl bir değişiklik yaptığı ile ilgili net verilere ulaşmak için, daha fazla sayıda çalışma yapılmasına ihtiyaç vardır.

The aim of this study was to investigate the effects of sodium valproate (SV) and carbamazepine (CBZ) on neuromuscular transmission using single-fibre electromyography (SFEMG) in patients with epilepsy. We performed SFEMG during the voluntary contraction of extensor digitorum communis muscle. 30 epileptic patients taking SV, 25 epileptic patients taking CBZ, and 25 age-matched healthy volunteers were included in the study. Mean jitter values (MCD) of subjects taking SV and CBZ were compared with normal controls. MCD values of subjects taking SV and CBZ were statistically significantly higher than those of control group. Review of the correlation between disease duration and MCD values of patients showed that MCD values were increased with the prolonged use of drugs, and thus, indicated a positive relationship between these two parameters. These results suggest that both SV and CBZ reduce neuromuscular transmission in patients without a neuromuscular junction disease.