Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Agildere, Ahmet MuhtesemSubject: search.filters.subject.MRI

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    Predisposing Factors in Posterior Circulation Infarcts: A Vascular Morphological Assessment
    (2015) Coban, Gokcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem; 0000-0002-4010-2883; 0000-0002-9057-722X; 0000-0003-4223-7017; 25666230; P-7533-2014; ABI-3856-2020; AAB-5802-2020
    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.
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    Recurrent Childhood PRES
    (2015) Donmez, Fuldem Yildirim; Agildere, Ahmet Muhtesem; 0000-0003-4502-106X; 0000-0003-4223-7017; 25894844; AAE-5528-2021; AAB-5802-2020
    The purpose of the study was to review the recurrent posterior reversible encephalopathy syndrome (PRES) and emphasize the possibility of repeated attacks on the basis of particular clinical situations. 32 children, diagnosed with PRES were included in our study. The recurrent cases were determined; their radiological features such as involved localizations and clinical information such as presenting symptoms, underlying diseases and clinical prognosis are retrospectively assessed. Of the 32 children (8 months to 18 years old; mean age 11), four of the patients had recurrent episodes of PRES. They had different underlying diseases. One had Chediak-Higashi syndrome, one had ALL, one had chronic renal disease on hemodialysis and one was a renal transplant recipient. Three of the children recovered with no residual neurological deficits, one of them passed away due to multiorgan failure. Three of them had high blood pressures at the time of either one or both PRES, and the renal transplant recipient had also high blood levels of Tacrolimus. Recurrent PRES is encountered most commonly because of repeated increasing blood pressures due to various underlying diseases, immune system disorders or side effects of the treatments.