Person: GÖKÇAL, ELİF
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Publication Metadata only Assessment of Cerebral Vasomotor Reactivity in Patients With Primary Open-angle Glaucoma and Ocular Hypertension Using the Breath-Holding Index(2021-02-01T00:00:00Z) Arslan, Gurcan D.; Olgun, Ali; Ozcan, Delil; GÖKÇAL, ELİF; Guven, Dilek; ASİL, Talip; GÖKÇAL, ELİF; ASİL, TALIPPrecis: Patients with ocular hypertension (OHT) do not show impaired cerebral vasodilation responses to hypercapnia but patients with primary open-angle glaucoma (POAG) do. Impaired vasoreactivity in patients with POAG may have neuronal or vascular origins and increase stroke risk.Publication Metadata only . Kronik migrende ak madde lezyonları orta serebral arter ortalama akım hızları ve vasküler reaktivite ile ilişkili midir?(2017-11-30) USLU, FERDA; GÖKÇAL, ELİF; ŞENGÜL, YILDIZHAN; KARAKAYALI, ZEHRA CEMRE; UZUN, MUSTAFA; ASIL, TALİP; GÖKÇAL, ELİF; ŞENGÜL, YILDIZHAN; KARAKAYALI, ZEHRA CEMRE; USLU, FERDA; ASİL, TALIPPublication Open Access Motor and Non-Motor Symptoms in Parkinson-s Disease: Effects on Quality of Life.(2017-06-01) GÖKÇAL, ELİF; GÜR, VE; SELVITOP, R; Babacan, Yildiz; ASIL, TALİP; GÖKÇAL, ELİF; BABACAN YILDIZ, GÜLSEN; ASİL, TALIPIntroduction: This study aimed to evaluate motor and non-motor symptoms in idiopathic Parkinson's disease (IPD) patients and to determine the self-reported influence of all existing symptoms on their quality of life (QoL). Methods: The sociodemographic and clinical characteristics, medical treatments, and Modified Hoehn and Yahr (mH&Y) scores of IPD patients without cognitive impairment were recorded. A survey questioning different motor and non-motor symptoms was administered to the patients. The patients were asked to rate their symptoms by number from the greatest influence to the least influence on their QoL. Subjects were divided into two groups: those suffering from IPD for ≤5 years (Group 1) and those suffering from IPD for >5 years (Group 2). These groups were compared in terms of sociodemographic and clinical characteristics, existing symptoms, and influences of these symptoms on their QoL. Results: There were 63 patients in Group 1 and 37 patients in Group 2. No statistically significant differences were detected between the groups with respect to sociodemographic characteristics or mH&Y scores. The most common motor symptoms in both of these groups were tremor and bradykinesia; meanwhile, the non-motor symptoms most frequently encountered in these groups were pain-cramps, constipation, and excessive daytime sleepiness (EDS). Again, while the symptoms that most greatly disturbed QoL in all patients were reported to be tremor and bradykinesia, the most disturbing non-motor symptom was frequent voiding/incontinence, which was a less common symptom. Pain-cramp, constipation, and EDS, which were the most frequent non-motor symptoms, were the symptoms that least disturbed QoL. Conclusion: It is widely accepted that motor symptoms determine QoL in IPD. However, non-motor symptoms are seen during all phases of the disease. The impact of non-motor symptoms on the QoL of IPD patients remains substantial. Therefore, in addition to the well-known motor symptoms, non-motor symptoms, which may be overlooked during physical examination yet may profoundly impact QoL, should be questioned and treated appropriately to improve QoL in PD patients as much as possible.Publication Open Access Lambert-Eaton Myasthenic Syndrome with A Twenty-Three-Year Delay in Diagnosis(2017-06-01) Gokcal, ELİF; Gürsoy, AZİZE ESRA; Asil, TALİP; Ertas, Mustafa; GÖKÇAL, ELİF; GÜRSOY, AZIZE ESRA; ASİL, TALIPLambert-Eaton myasthenic syndrome (LEMS) is a rare neuromuscular junction disorder resulting from the development of auto-antibodies against voltage-gated calcium channels (VGCCs) in pre-synaptic terminals (1). It has tumoral and non-tumoral forms; the former is associated with small cell lung cancer. Clinically, it is characterized by proximal weakness, autonomic symptoms, and loss/reduction of deep tendon reflexes (2). Muscular weakness, frequently occurring in the lower extremities, almost always begins symmetrically in the proximal muscles, progressing to involve the distal muscles over time (3). It may be confused with myopathic disorders due to the presence of symmetrical muscular weakness involving the proximal muscles. Herein we present the case of a non-tumoral LEMS patient who was diagnosed as having myopathy due to weakness that started in the legs nearly 23 years ago. Written consent was taken from the patientPublication Metadata only ETIOLOGICAL CLASSIFICATION OF ISCHEMIC STROKE IN YOUNG PATIENTS: A COMPARATIVE STUDY OF TOAST, CCS AND ASCO(2016-10-01) GOKCAL, ELİF; NIFTALIYEV, E.; Asil, TALİP; GÖKÇAL, ELİF; ASİL, TALIPPublication Metadata only PROLONGED HYPOTENSION AFTER CAROTID ARTERY STENTING: INCIDENCE, PREDICTORS AND CONSEQUENCES(2016-10-01) GOKCAL, ELİF; NIFTALIYEV, E.; DENIZ, C.; ERGELEN, M.; GUZEL, VİLDAN; GOKTEKIN, O.; Asil, TALİP; GÖKÇAL, ELİF; DENİZ, ÇİĞDEM; GÜZEL, VİLDAN; ASİL, TALIPPublication Metadata only Risk Factors, Etiological Classification, Topographical Location, and Outcome in Medullary Infarctions(2017-07-01T00:00:00Z) GÖKÇAL, ELİF; Baran, Gode; Niftaliyev, Elvin; GÜZEL, Vildan; ASİL, Talip; GÖKÇAL, ELİF; GÜZEL, VİLDAN; ASİL, TALIPAn understanding of the etiological mechanisms is important for therapeutic decisions and prognostic evaluation of patients with ischemic stroke. The object of this study was to evaluate the risk factors, etiological subtypes, and topography of lesion in patients with medullary infarctions (MIs). Besides, we also investigated early neurological deterioration, new vascular events, and functional outcome of all patients at 3-month follow-up. We analyzed our database consisting of patients who were diagnosed with acute MI and who were admitted within 24 hours of onset. Etiological classification of stroke was made on the basis of the Trial of Org 1972 in Acute Stroke Treatment criteria. All of the infarctions were grouped into anteromedial, anterolateral, lateral, and posterior arterial territories and also categorized into those involving the upper, middle, or lower medulla oblongata. Early neurological deterioration, major vascular events within the first 3 months of follow-up and modified Rankin Score at 3 months were reviewed. A total of 65 patients with medullary infarctions were reviewed. Involved arterial territories differed according to the etiological classification. Large artery atherosclerosis was the most common etiological subtype; however, small vessel disease was the most common subtype in medial MIs. The lesions involving the anteromedial territory were common in the upper medullary region, whereas the lesions involving the posterior and lateral territories were common in the lower medulla oblangata. Recurrent stroke was seen in the posterior and lateral territories; however, early progression and poor functional outcome were mostly seen in lesions involving the anteromedial territories.Publication Open Access Multiple Spontaneous Intracranial-Extracranial Arterial Dissections in a Patient with Osteogenesis Imperfecta(2017-01-01T00:00:00Z) KOLUKISA, MEHMET; GÖKÇAL, ELİF; GÜRSOY, Azize Esra; DENİZ, ÇİĞDEM; ARALAŞMAK, Ayşe; ASİL, Talip; KOLUKISA, MEHMET; GÖKÇAL, ELİF; GÜRSOY, AZIZE ESRA; DENİZ, ÇİĞDEM; ARALAŞMAK, AYŞE; ASİL, TALIPA 40-year-old male with osteogenesis imperfecta (OI) was admitted to the hospital with an acute right monoparesis. Diffusion-weighted MRI showed infarction in the territory of the left anterior cerebral artery (ACA) and in the left posterior cerebral artery (PCA). In his vascular imaging, occlusion of the left vertebral artery (VA) starting from V2 segment was consistent with dissection and pseudoaneurysm in the right ACA. We presented this case because of the presence of spontaneous and simultaneous occurrence of both intracranial and extracranial arterial dissections in OI.Publication Metadata only Progressive deficit in isolated pontine infarction: the association with etiological subtype, lesion topography and outcome(2017-09-01T00:00:00Z) GÖKÇAL, ELİF; Niftaliyev, Elvin; Baran, Gozde; DENİZ, ÇİĞDEM; ASİL, Talip; GÖKÇAL, ELİF; BARAN, GÖZDE; DENİZ, ÇİĞDEM; ASİL, TALIPIt is important to predict progressive deficit (PD) in isolated pontine infarction, a relatively common problem of clinical stroke practice. Traditionally, lacunar infarctions are known with their progressive course. However, few studies have analyzed the branch atheromatous disease subtype as a subtype of lacunar infarction, separately. There are also conflicting results regarding the relationship with the topography of lesion and PD. In this study, we classified etiological subtypes and lesion topography in isolated pontine infarction and aimed to investigate the association of etiological subtypes, lesion topography and clinical outcome with PD. We analyzed demographics, laboratory parameters, and risk factors of 120 patients having isolated pontine infarction and admitted within 24 h retrospectively. PD was defined as an increase in the National Institutes of Health Stroke scale >= 2 units in 5 days after onset. Patients were classified as following: large artery disease (LAA), basilar artery branch disease (BABD) and small vessel disease (SVD). Upper, middle and lower pontine infarcts were identified longitudinally. Functional outcome at 3 months was determined according to modified Rankin scores. Of 120 patients, 41.7% of the patients were classified as BABD, 30.8% as SVD and 27.5% as LAA. 23 patients (19.2%) exhibited PD. PD was significantly more frequent in patient with BABD (p 0.006). PD was numerically higher in patients with lower pontine infarction. PD was associated with BABD and poor functional outcome. It is important to discriminate the BABD neuroradiologically from other stroke subtypes to predict PD which is associated with poor functional outcome in patients with isolated pontine infarctions.Publication Open Access A CADASIL Case Presenting with Progressive Bulbar Palsy Caused by Acute Simultaneous Multiple Subcortical Infarcts(2019-04-01T00:00:00Z) GÖKÇAL, ELİF; KOLUKISA, MEHMET; Mustafayev, Nihat; ASİL, Talip; GÖKÇAL, ELİF; KOLUKISA, MEHMET; ASİL, TALIPCerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an adult-onset inherited small vessel disease of the brain caused by NOTCH3 mutations. Clinical characteristics of CADASIL include recurrent infarctions, migraine with aura, mood disturbances and cognitive impairment. We report a 35 year-old migraine-free patient with unusual presentation with acute simultaneous multiple subcortical infarctions causing progressive bulbar palsy as the initial manifestation. Hepresented with slurred speech progressing to anarthria and bilateral palsy of lower motor cranial nerves within 24 hour. Initial acute subcortical infarcts enlarged and new infarcts developed in bilateral hemispheres. There was diffuse leukoencephalopathy involving temporal horns and the patient had positive familiy history of migraine and young stroke. CADASIL was diagnosed genetically when NOTCH3 mutationwas shown. The patient improved after treatment with liquid hydration and antiplatelet agent. We experienced with the patient that CADASIL may present with unusual progressive manifestations and bilateral simultaneous infarctions. Irrespective of clinical presentation, patients with leukoencephalopathy and positive familiy history should be tested for NOTCH3 mutation.