Person: ASİL, TALIP
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Publication Open Access Spontaneous intracranial hypotension presenting with coma: a case report and literature review(2015-07-01T00:00:00Z) Celik, Yahya; Tekatas, Aslan; Albayram, Sait; Gunduz, Aysegul; Asil, TALİP; Unlu, Ercument; Ozlece Kose, Hatice; ASİL, TALIPSpontaneous intracranial hypotension is characterized by orthostatic headache in the absence of a history of head trauma or lumbar puncture, and diagnosis is confirmed by a specific cerebrospinal fluid pressure and neuroimaging findings. It rarely presents with coma. A 62-year-old man presented with progressive cognitive decline of 2 to 4 weeks- duration. He was diagnosed with spontaneous intracranial hypotension according to cerebrospinal fluid pressure and neuroimaging findings, and treated conservatively.Publication Open Access Combined Use of Invatec Mo.Ma Proximal Protection Device and Solitaire AB Retrievable Stent for Tandem Occlusions in a Patient With Acute Ischemic Stroke(2013-10-01) TASAL, Abdurrahman; Asil, TALİP; GOKTEKIN, Omer; ASİL, TALIPRecanalization of tandem vascular occlusions in the setting of an acute stroke is problematic. Here we report a successful treatment of an acute ischemic stroke with tandem cervical internal carotid artery and middle cerebral artery occlusions. A 56-year-old woman presented with acute left-sided hemiplegia. Diffusion magnetic resonance imaging showed an acute infarction in the right frontal and parietal lobes. We planned to perform rescue endovascular treatment after fibrinolytic therapy failed. Stent-assisted carotid angioplasty with proximal embolic protection device was followed by stent-based mechanical thrombectomy of the proximal middle cerebral artery occlusion. Her neurological condition improved after the procedure with National Institutes of Health Stroke Scale of 3 points. The combination of proximal embolic protection device and retrievable Solitaire stent could be a feasible and safe treatment strategy in acute ischemic stroke patients with extra- and intracranial tandem occlusions.Publication Open Access Splinting is effective for night-only symptomatic carpal tunnel syndrome patients(2015-04-01) HALAC, Gulistan; DEMIR, Saliha; Yucel, HÜLYA; NIFTALIYEV, Elvin; KOCAMAN, Gulsen; DURUYEN, Humeyra; KENDIRLI, Tansel; Asil, TALİP; YÜCEL, HÜLYA; ASİL, TALIP[Purpose] Carpal tunnel syndrome is the most common entrapment neuropathy of the median nerve. Splinting is one of the most used conservative treatment methods for carpal tunnel syndrome. The aim of this study was to show the effectiveness of splinting in carpal tunnel syndrome patients who were divided into two groups according to their level of symptoms. [Subjects and Methods] A total of 40 carpal tunnel syndrome patients were divided into 2 groups based on having symptoms only at night or during the day were included in this study. These two groups were compared at the end of a 3-months splinting therapy in terms of improvement of severity of symptoms, functional capacity, pain level, and electrophysiological findings. [Results] Pain levels of both groups were similar at baseline. After splinting, pain levels of night-only symptomatic patients were lower than those of sustained symptomatic ones. No differences were found in symptom severity, functional capacity, and the electrophysiological findings in either group after the splinting. [Conclusion] The results of this study show that splinting alone may be sufficient to decrease the pain for night-only symptomatic patients. Combined therapy methods may be needed for sustained symptomatic patientsPublication Open Access Presence of Status Epilepticus with Ebstein Barr Virus Encephalitis(2018-04-01T00:00:00Z) DENİZ, ÇİĞDEM; ASİL, Talip; BOLUKÇU, SİBEL; Zengin, S. Ulgen; DENİZ, ÇİĞDEM; ASİL, TALIP; BOLUKÇU, SİBELNeurological involvement, mostly in the form of meningoencephalitis or encephalitis, represents the leading cause of death in patients with infectious mononucleosis (EF). Central nervous system involvement usually occurs after the first 1 to 3 weeks of disease, although patients presenting with neurological signs and symptoms have been rarely reported. In this case presentation, our aim was to examine the association between acute Ebstein barr virus (EBV) infection and refractory myoclonic convulsions in a patient presenting with myodonic status.Publication Open Access Endovascular Therapy of Acute Ischemic Stroke by Interventional Cardiologists: National Initial Experience(2013-10-29) TASAL, Abdurrahman; Bacaksiz, AHMET; VATANKULU, Mehmet Akif; SONMEZ, Osman; TURFAN, Murat; ERDOGAN, Ercan; KARADELI, Hasan Huseyin; Kolukisa, MEHMET; KUL, Seref; ALTINTAS, Ozge; Asil, TALİP; GOKTEKIN, Omer; BACAKSIZ, AHMET; KOLUKISA, MEHMET; ASİL, TALIPObjectives: We report our initial experience with thrombectomy devices in patients with acute ischemic stroke. Study design: Demographic, clinical, and angiographic findings of 19 consecutive patients (7 females and 12 males; mean age 61.4±12.5 years) with acute ischemic stroke were evaluated retrospectively. Results: The mean initial National Institutes of Health Stroke Scale (NIHSS) score was 19.5±5.6. Middle cerebral artery was the occluded artery in all of the patients (proximal occlusion in 11, distal in 8 and tandem occlusions in 7 patients). Successful revascularization was achieved in 16 patients (84%). The mean NIHSS score was 8.4±8.2 at 24 hours after the procedure, and 60% of patients showed a modified Rankin scale score of ≤2 at 90 days. New occlusion by migrated emboli was observed in 2 (11%) cases. None of the patients had experienced post-procedural symptomatic intracerebral hemorrhage; 3 patients died during the three-month follow-up. In all patients, thrombectomy was performed with retrievable Solitaire AB stent system. Conclusion: This single-center experience with mechanical thrombectomy devices demonstrated that high success rates can be achieved by experienced interventional cardiologists in equipped cath labs throughout the country.Publication Open Access Higher minor hemoglobin A2 levels in multiple sclerosis patients correlate with lesser disease severity(2016-01-01) Ozcan, Muhammed Emin; INCE, Bahri; KARADELI, Hasan Huseyin; GEDIKBASI, Asuman; Asil, TALİP; Altinoz, Meric A.; ASİL, TALIPObjective: To define whether minor adult hemoglobin A2 (HbA2, α2δ2) exerts any protective activity in multiple sclerosis (MS). Methods: HbA2 levels were measured in 146 MS patients with high performance liquid chromatography and association with MS Severity Scores (MSSS) were determined. HbA2 associations with blood count parameters were also studied using blood counts evaluated on the same day of high performance liquid chromatography sampling. Routine biochemical parameters were also determined to rule out elusively influential factors, such as anemia and thyroid disorders. Results: HbA2 levels negatively correlated with MSSS (Spearman correlation, R: -0.186, P=0.025). Exclusion of confounding factors with a generalized linear model revealed an even stronger negative correlation between HbA2 and MSSS (P<0.001). HbA2 positively correlated with red blood cells (RBCs) (R=0.350, P<0.001) and in turn, RBCs negatively correlated with MSSS (R=-0.180, P=0.031). Average HbA2 levels were highest among patients treated with interferon β1a. Conclusion: RBC fragility is increased in MS, and recent data suggest that circulating free Hb contributes to neural injury in MS. HbA2 and its oxidative denaturation product hemichrome A2 enhance RBC membrane stability to a greater extent than do major HbA or hemichrome A. Reductions in ischemic cerebrovascular vascular events are reported in β-thalassemia carriers and HbA2 levels are considerably higher in this population. Episodic declines of cerebral blood flow were shown in bipolar disorder, and we have recently shown a protective role of HbA2 against postpartum episodes in females with bipolar disorder. HbA2's erythroprotective functions may reduce free Hb and long-term neural injury in MS.Publication Open Access One-year follow-up in patients with brainstem infarction due to large-artery atherothrombosis(2015-01-01) Kolukisa, MEHMET; GUELTEKIN, Tugce Ozdemir; BARAN, Gozde Eryigit; Aralasmak, AYŞE; KOCAMAN, Guelsen; GUERSOY, Azize Esra; Asil, TALİP; KOLUKISA, MEHMET; ARALAŞMAK, AYŞE; GÜRSOY, AZIZE ESRA; ASİL, TALIPBackground: Posterior circulation infarction accounts for approximately 25% of the ischemic strokes. A number of different conditions may be associated with the development of brainstem infarction. Prognosis and recurrence rate of brainstem infarction due to large-artery atherothrombosis is still controversial. Methods: A total of 826 patients with ischemic stroke were admitted to our clinic during a 15-month period. Patients with clinical and radiological evidence of brainstem infarction were comprehensively assessed with appropriate vascular imaging modalities and for cardiological causes. Subjects with an established diagnosis of large-artery atherothrombosis were followed up for 1 year in terms of prognosis and recurrence rates. Results: Of the 101 patients with an established brainstem infarction, the diagnostic work-up indicated the presence of large-artery atherothrombosis as the causative factor in 53. A recurrent stroke was detected in the posterior circulation within the first 3 months in 5.8% and within 1 year in 9.8% of these individuals. The 1-year mortality rate was 11.7%. All patients with recurrent stroke had intracranial vascular narrowing at baseline. Conclusion: Our findings demonstrate a particularly high rate of recurrence and mortality at 1 year among patients who have a brainstem infarction due to intracranial arterial stenosis. Keywords: posterior circulation, intracranial arteries, extracranial arteries, stroke, vertebral artery, basilar arteryPublication Open Access Ulnar nerve entrapment neuropathy at the elbow: relationship between the electrophysiological findings and neuropathic pain(2015-07-01) HALAC, Gulistan; Topaloglu, Pinar; DEMIR, Saliha; CIKRIKCIOGLU, Mehmet Ali; KARADELI, Hasan Huseyin; OZCAN, Muhammet Emin; Asil, TALİP; ASİL, TALIP[Purpose] Ulnar nerve neuropathies are the second most commonly seen entrapment neuropathies of the upper extremities after carpal tunnel syndrome. In this study, we aimed to evaluate pain among ulnar neuropathy patients by the Leeds assessment of neuropathic symptoms and signs pain scale and determine if it correlated with the severity of electrophysiologicalfindings. [Subjects and Methods] We studied 34 patients with clinical and electrophysiological ulnar nerve neuropathies at the elbow. After diagnosis of ulnar neuropathy at the elbow, all patients underwent the Turkish version of the Leeds assessment of neuropathic symptoms and signs pain scale. [Results] The ulnar entrapment neuropathy at the elbow was classified as class-2, class-3, class-4, and class-5 (Padua Distal Ulnar Neuropathy classification) for 15, 14, 4, and 1 patient, respectively. No patient included in class-1 was detected. According to Leeds assessment of neuropathic symptoms and signs pain scale, 24 patients scored under 12 points. The number of patients who achieved more than 12 points was 10. Groups were compared by using the χ(2) test, and no difference was detected. There was no correlation between the Leeds assessment of neuropathic symptoms and signs pain scale and electromyographic findings. [Conclusion] We found that the severity of electrophysiologic findings of ulnar nerve entrapment at the elbow did not differ between neuropathic and non-neuropathic groups as assessed by the Leeds assessment of neuropathic symptoms and signs pain scale.Publication 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 patient
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