A Case Of Transient Ischemic Attack Presenting As Hemichroea

Chorea is defined as; involuntary movements of the distal parts of limbs which have arrhythmic, rapid, bouncing or smooth, simple or complex properties. Choreiform movements occur when putamen, globus pallidus and subthalamic nucleus are affected. Chorea can be observed during the course of metabolic and vascular diseases, neurodegenerative or hereditary diseases. Chorea may be a rare symptom of cerebral hypoperfusion. Transient ischemic attack is an event that occurs in short term characterized by a temporary ischemia of brain. A wide variety of symptoms can be seen depending on the localization of cerebral hypoperfusion. Hemichorea is a very rare finding observed during transient ischemic attacks. In this article hemichorea in a case of symptomatic transient ischemic attack is discussed with relevant literature

Pregnancy and facial diplegia: A rare case

Facial paralysis is seen more commonly in the womenduring pregnancy compared to their peers. Facial diplegiais a more common condition than facial paralysis.In etiology, many reasons such as Moebius syndrome,Guillain-Barre syndrome, sarcoidosis, infectious mononucleosis,bilateral temporal bone fractures, Lyme diseaseand multiple sclerosis might be responsible. While facialparalysises are generally observed as idiopathically, asmall part of facial diplegias is idiopathic. Diagnosis of idiopathicfacial diplegia is possible only after an extensiveinvestigation. In this case, clinical follow-up and treatmentof pregnant women diagnosed as idiopathic facial diplegiawas evaluated.Key words: Pregnancy, facial diplegia, prednisolon

RESISTANT CYCLIC VOMITING SYNDROME SUCCESSFULLY RESPONDING TO CHLORPROMAZINE

Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent, stereotypic episodes of nausea, vomiting, and other symptoms, separated by intervals of comparative wellness. These episodes carry on for hours or days. The patient is healthy between the episodes and has no clinical finding. For the treatment of the CVS, antiemetic, antimigraine and sedative medications were used. However, in some cases CVS treatment is very difficult. We report about a young patient, who did not respond to many agents, but was succesfully treated with chlorpomazine

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

Protective Effects of Memantine Induced by Cerebral Ischemia and Reperfusion Injury in Rats

OBJECTIVE: The severity of apoptosis developing after hypoxia-ischemia and reperfusion is an indicator of cerebral injury. In cerebral ischemia, there are many factors initiating the events progressing to cell death. The most common leading cause is excessive increase in intracellular calcium concentration. Ion channels in NMDA receptors cause cell death by increasing Ca+2 entries into the cell. Memantine is non-competitive excitatory amino acid blocker of NMDA receptor. Studies suggesting administration of memantine before and after ischemia decreasing the neural injury have been published. In this study we aimed to examine the memantine could have decreasing effect on neuronal injury resulting with apoptosis especially in penumbra region after ischemia and its effects on antioxidants and oxidants in brain tissues. METHODS: Experimental study was performed in three groups each of them including 7 rats. No procedure was performed in control group and it was used for evaluation of the normal brain tissue. Transient focal cerebral ischemia was performed by clipping the right common carotid arteries of the rats in ischemia and ischemia-drug groups. Ten mg/kg intraperitoneal memantine was administered in ischemia-drug group 30 minutes after ischemia and for 5 days. All of the rats were sacrificed after the experiment. Antioxidant and oxidant levels of the cerebral tissues were measured. Apoptotic cells were determined by immunohistochemically with TUNEL method. RESULTS: When the group administered memantine was compared with ischemia group, it was observed that memantine decreased apoptotic cells in the brain tissue and provided improvement in oxidant levels (p<0.05). CONCLUSION: In conclusion, memantine may be effective in prevention of apopitozis and neuronal injury in cerebral ischemic tissue via decreasing cerebral oxidant formation