Browsing by Author "Ozturk, Vesile"

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    Anti-N-Methyl-D-Aspartate Receptor Encephalitis During Pregnancy: A Case Report
    (2019) Keskin, Ahmet O.; Tanburoglu, Anil; Idiman, Egemen; Ozturk, Vesile; https://orcid.org/0000-0002-2942-323X; https://orcid.org/0000-0001-9627-3502; 30788880; AAJ-2044-2021; AAK-1876-2021
    Following a generalized tonic-clonic seizure, a previously healthy 27-year-old pregnant woman (18-week pregnancy) was admitted to our emergency department. She experienced lethargy, forgetfulness and persecutory hallucinations the day before hospitalization. Cerebrospinal fluid examination revealed moderate pleocytosis, and abdominal ultrasonography did not detect neoplasia. Orofacial dyskinesia, catatonia and central hypoventilation gradually developed despite medical intervention to ameliorate the symptoms. At 32 weeks of pregnancy, vaginal bleeding and hypotension occurred. Further, owing to septic shock due to fetal demise, the patient died. N-methyl-d-aspartate antibody test results obtained after the patient's death were positive (2++). Currently, no consensus exists on the appropriate treatment and follow-up for pregnant women with anti-N-methyl-d-aspartate receptor encephalitis; however, immunomodulators and teratoma resection may be helpful. Second line immunotherapy (rituximab, cyclophosphamide) and teratoma resection may be necessary in pregnant patients with high N-methyl-d-aspartate receptor antibody titers and inadequate response to first-line treatment.
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    Comparison of conventional and modern methods in determining ischemic stroke etiology by general and stroke neurologists
    (2019) Kunt, Refik; Kutluk, Mustafa Kursad; Tiftikcioglu, Bedile Irem; Afsar, Nazire; Erdemoglu, Ali Kemal; Gedizlioglu, Muhtesem; Ozturk, Vesile; 0000-0002-4573-3844; 30764594; I-7963-2019
    Background/aim: This study aimed to investigate the consistency between stroke and general neurologists in subtype assignment using the Trial of ORG-10172 in Acute Stroke Treatment (TOAST) and Causative Classification of Stroke (CCS) systems. Materials and methods: Fifty consecutive acute ischemic stroke patients admitted to the stroke unit were recruited. Patients were classified by two stroke and two general neurologists, each from different medical centers, according to TOAST followed by the CCS. Each neurologist was assessed for consistency and compliance in pairs. Concordance among all four neurologists was investigated and evaluated using the kappa (kappa) value. Results: The kappa (kappa) value of diagnostic compliance between stroke neurologists was 0.61 (95% CI: 0.45-0.77) for TOAST and 0.78 (95% CI: 0.62-0.94) for CSS-5. The kappa (kappa) value was 0.64 (95% CI: 0.48-0.80) for TOAST and 0.75 (95% CI: 0.60-0.91) for CCS-5 for general neurologists. Compliance was moderate [kappa: 0.59 (95% CI: 0.52-0.65)] for TOAST and was strong [kappa: 0.75 (95% CI: 0.68-0.81)] for CCS-5 for all 4 neurologists. 'Cardioembolism' (91.04%) had the highest compliance in both systems. The frequency of the group with 'undetermined etiologies' was less in the CCS (26%) compared to TOAST. Conclusion: The CCS system improved compliance in both stroke and general neurologists compared with TOAST. This suggests that the automatic, evidence-based, easily reproducible CCS system was superior to the TOAST system.