Rapid Recovery of Visual Acuity after Lumboperitoneal Shunt Operation in Malignant Idiopathic Intracranial Hypertension

Background. Idiopathic intracranial hypertension can cause rapid deterioration of visual acuity in some severe cases, and these cases are usually thought to have “malignant” form of this disease. Case. In this paper, we report on a 16-year-old girl who is a typical example for malignant idiopathic intracranial hypertension with a rapid recovery of visual acuity after lumboperitoneal shunt operation. Observations and Conclusions. Malignant form of idiopathic intracranial hypertension must be kept in mind in selected patients to avoid irreversible visual loss

Olanzapine treatment in choreoathetosis due to bilateral striopallidodentate calcinosis

Bilateral Idiopathic Striopallidodentate Calcinosis (BISPDCs) refers to idiopathic calcification of the basal ganglia and secondary striato-dentate calcinosis. Its definition comprises numerous metabolic abnormalities including disturbances of calcium and phosphorous metabolism. In this article, a case with BISPDCs secondary to hypoparathyroidism who presented with generalized choreoathetosis has been reported. A daily dose of 2.5 mg of olanzapine has been initiated and increased gradually up to doses 10 mg/daily. In six weeks time, the patient was almost free from choreoathetosis. Thus, olanzapine may be a good choice at the symptomatic treatment of choreoathetosis due to BISPDCs

Cognitive insight in Alzheimer's disease

Background/rationale: We investigated the cognitive insight profile of patients with Alzheimer's disease (AD) using the Beck Cognitive Insight Scale (BCIS). Methods: This study involved 30 patients with probable AD and 15 healthy participants (ie, the controls). All individuals completed the BCIS, the Hamilton Rating Scale for Depression (HAMD), and the Hospital Anxiety and Depression Scale (HADS). Results: Mean scores of the HADS-depression subscale, HAMD, BCIS-self-reflectiveness (BCIS-R), and BCIS-self-certainty (BCIS-C) subscales were significantly different between the patients and the controls. However, there was no significant difference in BCIS reflectiveness-certainty index scores between the patients and the control groups. Regression analyses showed a moderately positive correlation between hallucinations and BCIS-C scores. Conclusion: This study is the first to investigate cognitive insight in patients with probable AD. The BCIS-R and BCIS-C scores were significantly lower in patients than in control group. © The Author(s) 2012

Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms.Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis.Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio >= 2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug.Conclusion: NoroTekTR revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF