Hyperglycemia-induced Nonconvulsive Status Epilepticus (NCSE) and Cranial Magnetic Resonance Imaging Results: A Case Presentation

Epileptic seizure occur in up to 25% of cases of, non-ketotic hyperglycemia (NKH). These seizures are the first finding of diabetes mellitus in 50% of the patients. The most common epilepsy is known as epilepsia partialis continua (EPC), Occipital lobe seizures and aphasic seizures may also be seen in these patients. The recovery from seizures can be with the correction of hyperglycemia. The cranial magnetic resonance imaging (MRI) findings of hyperglycemia induced status epilepticus (SE) and/or epileptic seizures have been described; however, their significance and underlying mechanisms have not been understood clearly. Although there is a consensus about the acute treatment of status epilepticus, insufficient information is available about the acute symptomatic SE treatment. Here we described the clinical and the radiological findings of a patient with NKH who was diagnosed with nonconvulsive status epilepticus in the light of the literature

Experience of Intravenous Thrombolytic Treatment in Sanliurfa: A Prospective Study

Objective: Stroke ranks second among the diseases that cause death and third among the causes of disability in Turkey. An average of 1.9 million neurons die every minute due to acute ischemic stroke and therefore ‘time is brain’. Intravenous thrombolytic treatment (ITT) and, if possible, endovascular treatment should be initiated quickly. We aimed to share our ITT experience in Sanliurfa with this study. Materials and Methods: We recorded the clinical and demographic characteristics, risk factors, and three-month follow-up of 21 patients with acute ischemic stroke who were given ITT between June 2015 and July 2017. Results: Of the 21 patients, nine were male and 12 were female, and the mean age was 72.1±11.8 (range, 48-87) years. Large vessel occlusion was found in five (23.8%) patients, cardioembolism in 9 (42.9%), and small vessel occlusion in 2 (9.5%) patients; etiology was not determined in five (23.8%) patients. Atrial fibrillation was found in 38.1%, hypertension in 57.1%, diabetes mellitus in 23.8%, coronary artery disease in 33.3%, hyperlipidemia in 19%, and smoking in 33.3% of the patients.The NIHSS score was 11.7±6.7 (range, 2-24) prior to treatment. The symptom-onset to needle time was 185±55.8 minutes when 19 patients were evaluated. Intracerebral hemorrhage was observed in two (9.5%) patients after treatment. One patient was asymptomatic and the symptomatic patient (4.75%) died despite decompression surgery. Ten patients died and the mortality rate was 47.6% at the end of the three-month follow-up period. The modified Rankin scale score was 0-2 in eight patients (38.1%) and was 0-1 in seven patients (33.3%). ITT was given to seven patients aged ≥80 years, five patients with NIHSS <5, and two patients in whom the treatment window was exceeded, which was non-adherent to the label. Conclusion: ITT is effective and safe. It increases the number of independent living patients. We must strive to perform this treatment all over Turkey and encourage our colleagues

Cerebellar antibodies in post-stroke sera of acute ischemic stroke patients

Background and purpose – Although serum anti-neuronal antibodies are found in acute ischemic stroke (AIS) patients, it is not completely clear whether they are already present before the cerebrovascular event or emerge thereafter. Methods – Sera of 21 consecutive first- ever AIS patients were collected within the first day of AIS (baseline), as well as 1 and 6 months after AIS. Well-characterized and novel anti-neuronal antibodies were investi- gated by cell-based assays, immunoblotting and indirect immunohistochemistry. Results – None of the AIS sera collected at different time points showed well-char- acterized antibodies. In 7 patients, 1- and 6-month sera (but not baseline sera) showed IgG mostly reacting with soma and dendrites of cerebellar Purkinje cells. Antibody-positive patients did not differ in terms of clinical and etiological features. Conclusion – Our results provide evidence for the antibody-triggering action of AIS. Although anti-cerebellar antibodies are not associated with the severity of stroke, they may potentially contribute to chronic post- stroke complications and disability

The role of genetics in stroke risk factors; the discussion of two rare genetic syndroms associated with stroke and review of the literature

Stroke is defined as a focal or at times global neurological impairment of sudden onset, that lasts more than 24 hours or that leads to death. The nonmodifiable risk factors for stroke include age, race, gender and acquired risk factors include smoking, hypertension, diabetes and obesity. Previous studies have shown that these mentioned risk factors might be responsible for approximately 50% of patients presenting stroke. However for the remaining half of the stroke patients no risk factors could be detected and genetics might be responsible for this group. In this manuscript we would like to present 2 cases who were being followed-up with the rare genetic syndromes as Marfan syndrome and Robinow syndrome respectively. These patients presented to our clinic with stroke and no identifiable risk factors other than these genetic syndromes could be detected. By this case-series we would like to further discuss the relationship between genetic syndromes and stroke

The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients.

Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology

The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients

Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology