New Indices from Polysomnographic Measures for the Severity of Obstructive Sleep Apnea Syndrome -A Different Look at Obstructive Sleep Apnea Syndrome

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent abnormal respiratory events during sleep and causes oxidative stress which is reported as a major pathogenic mechanism for the development of various cardiovascular disorders. For the diagnosis and management of treatment, disease-related symptoms and the Apnea-Hypopnea Index (AHI) measured from polysomnographic (PSG) recordings are taken together. However, AHI do not sufficiently represent the total hypoxic load, and other indices related to apnea frequency, apnea duration, and desaturation degree should be investigated

Isolated unilateral hypoglossal nerve palsy due to schwannoma

As benign nerve sheat tumors, schwannomas are located mostly in the head and neck region, but rarely originate from the hypoglossal nerve. A woman aged 53 years presented with non-progressive dysarthria and unilateral tongue atrophy, which she had had for 2 years. Neurologic examination revealed left-sided, isolated hypoglossal nerve palsy. Chronic axonal neuropathy of the left hypoglossal nerve was seen in electromyographic (EMG) study. With cranial magnetic resonance MR) imaging, a mass lesion in the left cerebellomedullary cistern was detected. A biopsy was not possible due to its critical location. Due to the non-progressive clinical course and radiologic features of the mass, it was consiered as schwannoma. Six-monthly follow-up with MR imaging and EMG was performed three times, and there was no change in the findings. We aimed to provide clinical, radiologic and electrophysiologic findings of isolated unilateral hypoglossal nerve palsy due to schwannoma

Clinical and radiological findings in cervicocranial artery dissection

INTRODUCTION: Cervicocranial artery dissections account for 25% of ischaemic strokes in young adults. Numerous risk factors that can damage the structure of the vessel walls have been identified. Dissections can present with various forms of stroke, and are diagnosed using magnetic resonance angiography or digital subtraction angiography. In our study, we aimed to evaluate the clinical and radiological characteristics of cervicocranial artery dissections. METHODS: We retrospectively analysed 45 patients, twenty-nine (64%) males and 16 (36%) females, pre-diagnosed with dissection in the Angiography Unit of the Bakirkoy Mazhar Osman State Training and Research Hospital for Psychiatric and Neurological Diseases. The mean age of females and males was 35 and 39 years, respectively. RESULTS: Forty-one (91%) patients presented with transient ischaemic attack and/or ischaemic stroke. Isolated 12th nerve paralysis was found in one patient, and headache was the only symptom in another. Digital subtraction angiography was performed in all the patients, and bilateral dissection was detected in six patients. From the angiography results, three different types of vessel pathologies were detected: 1) long-segment irregularities (65%), 2) tapering occlusion (35%) and 3) pseudoaneurysm (16%). Radiological follow-up was done for 19 (42%) patients; eight of them completely recovered showing normal imaging findings. DISCUSSION AND CONCLUSION: Dissection can present with a broad clinical spectrum, and it should be suspected in cases with unusual neck movement and mild-to-severe trauma. Digital subtraction angiography is still the best modality for the diagnosis of dissection