Browsing by Author "Ayas, Zeynep Ozozen"

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Alteratıon of Mean Platelet Volume in The Pathogenesıs of Acute Ischemıc Stroke: Cause or Consequence?
(2018) Ayas, Zeynep Ozozen; Can, Ufuk; https://orcid.org/0000-0001-8689-417X; 29465900; AAJ-2999-2021
Introduction - Platelets have a crucial role on vascular disease which are involved in pathogenesis of ischemic stroke. Platelet size is measured as mean platelet volume (MPV) and is a marker of platelet activity. Platelets contain more dense granules as the size increases and produce more serotonin and tromboglobulin (p-TO) than small platelets. In this study, the alteration of MPV values were investigated in patients with acute stroke, who had MPV values before stroke, during acute ischemic stroke and 7 days after the stroke. The relationship between this alteration and risk factors, etiology and localization of ischemic stroke were also investigated. Methods - Sixty-seven patients with clinically and radiologically established diagnoses of ischemic stroke were enrolled into the study and stroke etiology was classified by modified Trial of Org 10 172 in Acute Stroke Treatment (TOAST) classification and, modified Bamford classification was used for localization and stroke risk factors were also evaluated. The platelet counts and MPV values from patient files in patients who had values before stroke (at examination for another diseases), within 24 hours of symptom onset and after 7 further days were analysed. Results - MPV values increased after stroke (10.59 +/- 2.26) compared with acute stroke values (9.84 +/- 1.64) and the values before stroke (9.59 +/- 1.72) (p<0.0001); this alteration of MPV values occured 7 days after stroke (p<0.016). There was a positive correlation between age and MPV values during acute stroke (r=0.270; p<0.05). Patients with atrial fibrillation had higher alteration in the time of MPV compared with patients without atrial fibrillation (p>0.006). We assessed for gender, men (n=38) had a higher alteration in the time of MPV compared with women (n=29) (p=0.013). Conclusion - Although there was no alteration of platelet counts, MPV values were increased 7 days after stroke in patients with acute ischemic stroke.
Cerebral Sinus Venous Thrombosis: Evaluation of Nineteen Patients
(2018) Ocal, Ruhsen Oncel; Ayas, Zeynep Ozozen; Boluk, Ayhan
Objective: Cerebral sinus venous thrombosis (CSVT) is a disease that can be seen in all age groups with various clinical findings and usually a good prognosis. In this study, evaluation of the complaints on admission, the possible risk factors, localization, findings and treatment approaches, and discussion of these findings with comparison to the literature were aimed. Materials and Methods: The demographic, clinical, laboratory and the radiological characteristics of 19 patients with diagnosed with CSVT and followed at the Sakarya University Training and Research Hospital Clinic of Neurology. Results: Nineteen patients (15 female, 4 male) with the diagnosis of CSVT were included. The mean age of the patients was determined as 31.3 +/- 11.2. Headache was determined to be the first symptom on admission in 17 patients. Nauseavomiting (n=10), blurred vision (n=4) and epileptic seizures (n=3) had accompanied headache. Altered state of consciousness (n=2), papilledema (n=4), dysarthria (n=1), and cerebellar disorder (n=1) were determined. Two of the patients were pregnant and 6 patients were in the postpartum period. CSVT due to infection was determined in 2 patients. No reason for etiological investigation was found in 4 of the cases. In 11 patients, more than one etiology were detected. Two patients had been diagnosed with Behcet's disease. MTHFR A1298Cgene heterozygous mutation was most detected. Fourteen patients were determined to have a single sinus venous thrombosis and 5 patients had more than one sinus venous thrombosis on magnetic resonance venography. Six patients had venous infarction. Conclusion: Pregnancy and postpartum period are significant risk factors for CSVT. The association of more than one reason in the etiological investigations of patients despite the presence of one significant risk factor has been emphasized.
The clinico-radiological spectrum of Dyke-Davidoff-Masson syndrome in adults
(2017) Ocal, Ruhsen; Ayas, Zeynep Ozozen; Asil, Kiyasettin; 28733757; V-3553-2017
Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, seizure, contralateral hemiplegia/hemiparesis, and mental retardation. In this study, clinical and radiological investigations of seven patients who were diagnosed with DDMS as adult age were evaluated and discussed. Seven patients (four male, three female) were included. The mean age +/- SD of the patients was 46 +/- 21 years. Clinical presentation of six patients was epileptic seizure. One patient was presented with head trauma due to a fall. Two patients had complex partial seizures, three patients had generalized tonic-clonic seizures (GTC), and one had GTC and myoclonic seizure. Mental retardation was in five patients. A congenital cause was detected in one patient in the etiologic investigation and acquired causes in two patients. In four patients, the etiology was not identified. We observed left-hemisphere involvement in four patients and right-hemisphere involvement in three patients. Brain imaging was performed by CT only in four patients and by MRI only in three patients. All patients were diagnosed with DDMS at adulthood. Atrophy in basal ganglia was detected in five patients, and atrophy in brain stem in four patients. Calvarial thickening was observed in four patients. Three patients had hyperpneumatization in mastoid cells. Sinus hyperpneumatization, including the paranasal and frontal sinuses, was seen in six patients. DDMS can also be diagnosed in adulthood symptomatically (mild-severe) or asymptomatically in adulthood. As a result, DDMS is a syndrome with wide clinical and radiological spectra that can be variably symptomatic at different stages of life.
Comparison of Brain MRI Angiography and Brain MRI Cisternography in Patients with Hemifacial Spasm
(2016) Ocal, Ruhsen; Tunc, Tuba; Ayas, Zeynep Ozozen; Yilmaz, Omer; Inan, Levent Ertugrul; 26908032
The aim of this study was to compare the ability of brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography of showing the neurovascular contiguity of the facial nerve in patients with hemifacial spasm. This study included a total of 35 patients (28 females, 7 males), with an average age of 57.5 +/- 13.8 years, who presented to our outpatient clinic of movement disorders. All patients were prospectively applied brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography, and the results were evaluated by a radiologist who was blind to study protocol. The study included 35 patients, of whom 28 (80 %) were female and 7 (20 %) were male. Brain magnetic resonance imaging angiography demonstrated facial nerve compression of vascular origin in 5 (14.3 %) patients presenting with the clinical presentation of hemifacial spasm. Neurovascular compression of facial nerve was shown by brain magnetic resonance imaging cisternography in 13 (37.1 %) patients. No statistically significant difference was found between brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography techniques in detecting a compressive interaction causing hemifacial spasm between facial nerve and adjacent vascular structures (p > 0.05).
Posterior Reversible Encephalopathy Syndrome as an Initial Manifestation of Systemic Lupus Erythematosus
(2017) Ayas, Zeynep Ozozen; Ocal, Ruhsen Once; Gundogdu, Asli Aksoy; 29870651; V-3553-2017; C-3992-2016
Posterior reversible encephalopathy syndrome (PRES) is a disorder which is diagnosed with its characteristic clinical and radiological findings, typically resolves with treatment. The prevalence of PRES in systemic lupus erythematosus (SLE) patients is not exactly known. A systemic disorder frequently appears as a presenting symptom in SLE. However, in rare cases, the disease starts with a neurological manifestation. Here we report a 35-year-old woman presenting with a headache and blurred vision. She had neurologic symptoms and cerebral lesions on magnetic resonance imaging (MRI) suggesting PRES. The patient was diagnosed with SLE during the etiological investigation of PRES. In this article, we aimed to emphasize that PRES as an initial presentation of SLE.
A Rare Cause of Paresthesia: Hypophosphatemia
(2019) Ayas, Zeynep Ozozen; Ocal, Ruhsen Oncel; Boluk, Ayhan
Phosphate is a structural molecule for cells and also is used as coenzyme or as seconder messenger. Renal or gastrointestinal loss of phosphate, diabetes mellitus, chronic alcoholism, hyperparathyroidism, sepsis, increased glucocorticoid, diuretics and antacids may cause hypophosphatemia. Muscle weakness, paresthesia, confusion, convulsion, tremor and coma are neurological symptoms of hypophosphatemia. Main clinical signs occur due to deterioration oxygen distribution and reduced intracellular adenosine triphosphate. In the treatment of hypophosphatemia identification of underlying causes is important. In this article, a 26-year-old young male patient with paresthesia that is caused by hypophosphatemia due to D vitamin deficiency is reported. Clinicians must be on the alert about phosphate imbalance which is seen more rare than other electrolytes when investigation of patients with paresis and/or paresthesia.