Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050(2021) Suner, Halil İbrahim; Tanburoglu, Anil; Durdag, Emre; Civi, Soner; Gunesli Yetisken, Aylin; Kardes, Ozgur; Andic, Cagatay; Tufan, Kadir; 0000-0002-5957-8611; 0000-0003-2854-941X; 0000-0001-9627-3502; 0000-0001-8581-8685; 33890450; AAJ-5381-2021; P-5895-2018; AAK-1876-2021; AAM-1671-2021Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients < 60 and > 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically.Item Early Treatment of Ruptured Blood Blister-Like Aneurysms of the Internal Carotid Artery With Flow Diverters Using Single Antiplatelet Therapy: A Single-Center Experience With Long-Term Follow-Up(2021) Tanburoglu, Anil; Andic, Cagatay; 0000-0001-9627-3502; 0000-0001-8581-8685; 34630284; AAK-1876-2021; AAM-1671-2021Background and Purpose: Blood Blister-like aneurysms (BBAs) of the internal carotid artery (ICA) are rare entities of cerebral aneurysms. FD use in acutely ruptured aneurysms, timing of treatment and antiplatelet regimen are main debate topics in clinical practice when the treatment decision is flow diversion. The aim of this study is to report the safety and efficacy of a single-center FD treatment for ruptured BBAs in the early phase of SAH using the SAPT regimen. Material and Method: This study involved a retrospective analysis of a prospectively collected database. Records of patients admitted to our clinic and treated by endovascular route on ruptured BBA between January 2013 and December 2020 were reviewed. Ruptured supraclinoid ICA BBAs treated with FD devices with SAPT within 48 h from ictus of SAH are included. BBA of atypical anatomic locations, other endovascular techniques performed, and delayed admissions (> 48 h) were excluded from the study. Demographic, clinical and angiographic features of patients and aneurysms, FD types and numbers, periprocedural complications, immediate and follow-up angiographic and clinical outcomes were recorded. Results: A total of six patients with ruptured BBAs treated via FDs within 48 h and used SAPT were included in the study. The mean age was 41.6 years (range from 34 to 45 years), and four of six patients were female. All patients were treated within 48 h after ictus, and the mean treatment day was 1.33 days. One patient received ticagrelor, and five patients received prasugrel as SAPT for one year after treatment. No procedure-related death and rebleeding were recorded. One (16.7 %) treatment responsive procedure-related complication occurred (transient ischemia). Overall good outcome rate was 83.3%. One patient died due to pneumonia. The immediate control angiograms showed complete occlusions of BBAs in one patient (16.6%). The complete occlusion rate was 100 % for five survivors at the control angiogram. The median follow-up was 49.5 months. Conclusion: This single-center experience suggests that early treatment (< 2 days) within SAH of ruptured BBAs with FDs using SAPT is safe and effective in terms of clinical and radiological long-term outcomes.Item Late recurrence of post-dural puncture headache(2021) Goksel, Basak Karakurum; Tanburoglu, Anil; Karatas, Mehmet; Altinkaya, Naime; 34671953The term post-dural puncture headache (PDPH) refers to a common complication that occurs after accidental dural puncture. One of the diagnostic symptoms of PDPH is a postural headache, which worsens dramatically while sitting or standing and is relieved mostly by lying down. This symptom is caused by a cerebrospinal fluid (CSF) leak, leading to decreased CSF pressure or low CSF volume, which provokes a shift of intracranial contents and traction on pain-sensitive structures in the upright position. PDPH is commonly a self-limited condition and remits spontaneously within 2 weeks, or becomes less severe after surgical intervention to seal the leak with autologous epidural blood patch (EBP). Although recurrence of spontaneous intracranial hypotension following an EBP is not rare, spontaneously late recurrence of PDPH has been rarely reported. The purpose of this paper is to discuss this case with late recurrence of PDPH after 10 months following EBP.Item Examination of IL-1 beta level as an inflammasome marker in Alzheimer's disease(2019) Bulut, Onur; Tanburoglu, Anil; Boluk, Gulsah; Demir, Nurhak; Eren, Erden; Vurgun, Ufuk; Genc, Sermin; Yener, GorsevObjective: Interleukin (IL)-1 beta is believed to be responsible for the neurotoxicity of amyloid plaques in Alzheimer's disease (AD). In the present study, serum levels of IL-1 beta, and correlations with clinical features and neuropsychiatric test results were examined. Methods: Thirty-eight patients with AD and 38 healthy control patients were included in the study. Serum IL-1 beta levels in patients with AD and control were analyzed using enzyme-linked immunosorbent assay method. The Mini-Mental Test Score (MMSE) and Geriatric Depression Scale (GDS) were administered to both the patient and control groups. Furthermore, the clinical dementia rating, detailed neuropsychological test battery, and neuropsychiatric inventory were administered to the AD group. It was determined that the serum IL-1 beta measurements of the patient and control groups were not statistically different, and IL-1 beta measurements in the patient group were not correlated with the MMSE and GDS. Results: The relationship of IL-1 beta measurements in the patient group with other clinical data was not significant. Among the patients' neuropsychological tests, a moderately, significant negative correlation was found only between the clock drawing test and visual learning score and serum IL-1 beta levels. Conclusion: Our study is in agreement with other studies in which no significant difference was found between patients with AD and healthy controls in terms of serum IL-1 beta levels, but the moderately negative correlation obtained with the clock drawing test and visual learning score indicates a weak relation. This result may indicate that stronger relations will be determined in large-scale studies involving larger numbers of patients.