The goal of the present study is to investigate the relationship between the degree of cognitive impairment and retinal nerve fiber layer (RNFL) thickness which is measured by the optical coherence tomography (OCT). Thirty-five patients with Alzheimer's disease (AD), 35 patients with mild cognitive impairment (MCI), and 35 healthy volunteers, between the ages of 60-87, who were examined in the neurology outpatient clinic among 2012-2013 were prospectively involved in our study. Mini mental state examination (MMSE) test, montreal cognitive assessment (MOCA), and also neuropsychological test batteries were used for the neurocognitive evaluation. RNFL thickness was measured by the OCT technique and the differences among groups were studied. The relationship between RNFL thickness and MMSE scores with demographic characteristics was investigated. RNFL thickness was significantly lower in AD and MCI groups compared with the control group (p < 0.01). No significant differences of RNFL were found between the MCI and the AD groups (p > 0.05). Significant correlation was found between MMSE scores and the RNFL values (p < 0.05). Significant thinning in RNFL along with age was detected (p < 0.05). In our study, it is thought that retinal nerve fiber degeneration and central nervous system degeneration may be concurrent according to the thinning of RNFL measured by OCT in AD and MCI groups. RNFL measurement may also be useful for early diagnosis and evaluation of the disease progression. Further studies are needed to optimize the utility of this method as an ocular biomarker in AD.

Montreal Cognitive Assessment (MoCA) is a new cognitive tool developed for screening mild cognitive impairment (MCI). The authors examined validity of MoCA and discriminating power of subtests in a Turkish population comprising of 474 participants (246 healthy controls, 114 subjects with MCI and 114 subjects with dementia). The ANCOVAs showed that age and education had a main effect on MoCA scores. Cut scores were computed according to different education levels. The overall cut-off values for MCI and dementia were found to be lower compared to western studies. MoCA was found to have good internal consistency. The subtests most useful in discriminating MCI from healthy controls were recall, visuospatial and language, while in discriminating dementia from MCI were visuospatial, orientation and attention subtests. The results demonstrated that MoCA is a valid and reliable instrument in screening MCI, and compared with the MMSE, MoCA was proved to have superior sensitivity and specificity in detecting MCI.

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Aspirin resistance occurs in 5-45% of high-risk patients, with various mechanisms proposed for its development. This study aimed to determine the relationships among aspirin resistance, aspirin dosage, type of aspirin and glycoprotein IIIa P1A1/A2 polymorphism in patients with vascular risk factors. Two hundred and eight (75 symptomatic, 133 asymptomatic) patients with vascular risk factors who were using aspirin for primary or secondary prevention were prospectively included. The symptomatic group was further classified into two groups according to aspirin use at the time of stroke. Aspirin resistance was measured by the PFA-100 system (collagen/epinephrine cartridge) and glycoprotein IIIa P1A1/A2 polymorphism was determined by PCR. The overall prevalence of aspirin resistance was 32.2%. The mean age of patients with aspirin resistance was significantly higher than that in those who did not have resistance (P = 0.009). The prevalence of aspirin resistance was similar for the symptomatic and asymptomatic under aspirin therapy groups. The resistance rate was found to be highest with 100 mg enteric-coated preparation use (39.3%). Increasing the aspirin dosage and/or shifting to uncoated preparations caused a change in aspirin sensitivity of 36-60%. Repeated measurements showed development of aspirin resistance in 14% of patients who were sensitive to aspirin in previous measurements. Glycoprotein IIIaP1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke were not significantly related. The effect of aspirin can change by time, dosage and type of preparation used. There are no relationships among glycoprotein IIIa P1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke.

Objectives: Neurologic complications occur frequently after liver transplants. Up to 43% of patients experience severe postsurgical neurologic complications. These complications are significantly associated with longer hospital stay, morbidity, and mortality. The aim of this retrospective study was to evaluate the type and incidence of neurologic complications after liver transplants in adult patients. Materials and Methods:We retrospectively evaluated the medical records of 176 adult patients who had undergone liver transplants between 1995 and 2013. We recorded the demographic data, type of neurologic complications, type, and level of immunosuppressive treatment, and cause of liver failure. Results: Our study sample consisted of 48 deceaseddonor liver transplants and 128 living-donor transplants (n = 176). Fifty-three of the patients (30.1%) were female. The age range of the total sample was 18 to 66 years (mean age, 43.1 ± 13.7 y). As immunosuppressive treatment, most patients received tacrolimus alone (52%) or tacrolimus combined with mycophenolate mofetil (33%). Neurologic complications occurred in 74 of the patients (42%). The most common neurologic complications were diffuse encephalopathy (22.2%) and seizure (14.2%). Other neurologic complications were posterior reversible encephalopathy (1.7%), peripheral neuropathy (1.7%), cerebrovascular disease (1.1%), and central nervous system infection (1.1%). Age, cause of liver failure, and type of transplant were not associated with occurrence of neurologic complications. Conclusions: There was a high incidence of neurologic complications after liver transplants. Diffuse encephalopathy and seizure were common complications. Physicians should be aware of the high risk of neurologic complications after liver transplants. Factors such as immunosuppressive toxicity and metabolic imbalance that predispose patients to neurologic complications after liver transplants should be evaluated immediately, and treatment of postoperative neurologic complications should be initiated as early as possible.

Numerous treatment modalities have been tried with diverse results for pruritus due to notalgia paresthetica (NP). Corticosteroids suppress ectopic neural discharges from injured nerve fibers and also have short‐lived suppressive effect on transmission in normal C‐fibers. Herein, we evaluated the efficacy of intralesional triamcinolone acetonide in the treatment of NP. The medical reports of five patients who had been diagnosed with NP and treated with intralesional triamcinolone acetonide injections were retrospectively evaluated. Triamcinolone acetonide solution was injected intradermally (10 mg/mL; 0.1 mL/cm2) every 3 weeks for a maximum of four treatments. The severity of itch was scored by the patients on a combined numerical and visual analogue scale. After treatment, reduction in itch severity scores varied between 33% and 100%.

A 69-year-old woman presented with sudden onset of diplopia. In neurologic examination left medial rectus palsy without abduction nystagmus was detected. Brain magnetic resonance imaging revealed acute ischemic lesion in mesencephalon on diffusion-weighted images. Sponteneous resolution was observed after 1 month. Medial rectus palsy is a rare presention of acute ischemic stroke and early neuroimaging is important to establish such lesions.

Aim To compare the relationship between white matter hyperintensities (WMH) on brain magnetic resonance imaging and retinal nerve fiber layer (RNFL), choroid, and ganglion cell layer (GCL) thicknesses in migraine patients and healthy subjects. We also assessed the role of cerebral hypoperfusion in the formation of these WMH lesions. Methods We enrolled 35 migraine patients without WMH, 37 migraine patients with WMH, and 37 healthy control subjects examined in the Neurology outpatient clinic of our tertiary center from May to December 2015. RFNL, choroid, and GCL thicknesses were measured by optic coherence tomography. Results There were no differences in the RFNL, choroid, or GCL thicknesses between migraine patients with and without WMH ( p > 0.05). Choroid layer thicknesses were significantly lower in migraine patients compared to control subjects ( p < 0.05), while there were no differences in RFNL and GCL thicknesses ( p > 0.05). Conclusions The 'only cerebral hypoperfusion' theory was insufficient to explain the pathophysiology of WMH lesions in migraine patients. In addition, the thinning of the choroid thicknesses in migraine patients suggests a potential causative role for cerebral hypoperfusion and decreased perfusion pressure of the choroid layer.