Browsing by Author "Ocal, Ruhsen Oncel"

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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.
Multiple Thrombotic Gene Mutations in Patients with Cerebral Venous Thrombosis: Three Case Reports and Literature Review
(2015) Ayas, Zeynep Otzon; Ocal, Ruhsen Oncel; Kotan, Dilcan; Boluk, Ayhan
Although cerebral venous thrombosis (CVT) is mostly seen in young adults, it is a disease that affects all age groups, has a broad range of symptoms, and usually carries a good prognosis. Extensive tests and examinations are needed to determine its etiology. Even in the presence of a marked risk factor, genetic thrombotic factors should be systematically investigated. Thrombotic gene mutations are among the most important hereditary causes of coagulation defects. Single gene mutations may be observed, as well as multiple gene mutations can rarely be detected. Here, we report three patients with cerebral venous thrombosis who had multiple gene mutations.
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.