The case presentation of vertebral and carotid artery stenting at the same session

Stroke is one of the most common causes of mortality and morbidity in the world. It contains many etiological factors. 85% of the stroke is ischemic origin. Carotid and vertebral artery stenosis are risk factors for stroke. Early diagnosis and treatment can prevent recurrence of stroke. Although carotid artery stenting is common in many centers today, vertebral artery stenting is rarely performed. We have demostrated that in our case, carotid and vertebral artery stenting is effective and reliable at the same time

Multipl Kranial Nöropati ile Prezente olan Rinoserebral Mukormikoz Olgusu

Rinoserebral mukormikoz, mukormikozun en sık görülen formu olup, fatal seyreden fulminan bir enfeksiyondur. Sıklıkla immunsüprese ve diabeti olup ketoasidoz gelişen hastalarda görülmektedir. Hastalık primer olarak paranazal sinüslerde olup direk yolla yada damar duvarı invazyonu ile intrakranial yayılım gösterir. Rinoserebral mukormikoz, ateş, pürülan burun akıntısı, baş ağrısı, yüz ağrısı gibi akut sinüzit bulguları ile gelebilir. Mortal seyirli bir hastalık olduğu için diabet tanılı, ketoasidozu olan ve akut sinüzit bulguları gelişen hastalarda mukormikoz tanısının dışlanması önemlidir. Tedavisi zor bir hastalıktır. Tanı ne kadar erken konulup tedaviye ne kadar erken başlanırsa başarı şansı o kadar yükselmektedir. Nekrotik dokunun debritmanı ve yüksek doz amfoterisin B kullanımı tedavinin ana prensibini oluşturmaktadır. Burada multipl kranial nöropatisi gelişerek takipte mukormikoz tanısı alan ve ilk görüntülemelerinde hafif akut sinüzit bulguları olan hasta sunulmuştur. Bu vakada diabetik ketosidozu ve akut sinüziti olan hastalarda mukormikozun ayırıcı tanıda ilk ekarte edilmesi gereken hastalık olması gerektiği vurgulanmak istenmiştir.Rhinocerebral mucormycosis is the most common form of mucormycosis and is a fatal fulminant infection. It is frequently seen in patients with immunosuppression and diabetes who develop ketoacidosis. The disease is primarily located in the paranasal sinuses and shows intracranial spread by direct or vessel wall invasion. Rhinocerebral mucormycosis may present with signs of acute sinusitis such as fever, purulent nasal discharge, headache, and facial pain. It is important to exclude the diagnosis of mucormycosis that is a mortal disease in patients with diabetes, ketoacidosis and acute sinusitis. It is a difficult disease to treat. The earlier the diagnosis is made and the sooner the treatment is started, the higher the chance of success. Debridement of necrotic tissue and the use of high-dose amphotericin B are the main principles of treatment. We present a patient with multiple cranial neuropathies who was diagnosed as mucormycosis at follow-up and had mild acute sinusitis on initial imaging. In this case, it is emphasized that mucormycosis should be the first disease to be ruled out in the differential diagnosis in patients with diabetic ketoacidosis and acute sinusitis

Retrospective Evaluation of Carotid Artery Stenting Experience of a Third Stage Neurology Clinic

INTRODUCTION: In the protection of both primary and secondary ischemic stroke, the effectiveness and reliability of the placement of carotid artery stent (CAS) has been demonstrated. Our aim in this study is to demonstrate the reliability of the CAM procedure performed in the tertiary care neurology clinic and the clinical and radiological to evaluation the two-year results. METHODS: Twenty-seven patients who applied to our hospital between July 2015 and July 2016, were evaluated by our neurology clinic, decided on CAS and stenting were studied (average age 71.6 [58-85]). Patients with symptomatic onset of the carotid artery stenosis over 50% angiographically, asymptomatic and over 70% stenosis in the carotid artery were included. RESULTS: The operation success rate was 96.3% (a thrombus developed in the stent 2 hours after the operation in a single patient). No deaths or myocardial infarction occurred in any of these patients with CAS. No ischemic cerebrovascular event or transient ischemic attack occurred in any of the patients at 6 months follow-up. No restenosis was observed in any of the carotid doppler follow-ups performed in our clinic. DISCUSSION AND CONCLUSION: We believe that carotid artery stent placement performed by neurologists trained in endovascular surgery can be safely performed with low complication and high success rates in symptomatic or asymptomatic patients and that patients will be monitored in a more healthy manner