Post stroke late onset Non-convulsive status epilepticus: analysis of 9 cases

INTRODUCTION: Non-convulsive status epilepticus is a condition that needs timely diagnosis and treatment with insignificant clinical features and high risk of misdiagnosis. We aimed to reveal late onset NCSE in patients with stroke where stroke plays a role in the etiology. METHODS: We conducted a retrospective analysis of patients who presented to our outpatient stroke clinic between January 2013 to January 2016. A week after the stroke, patients were defined as late onset NCSE. A total of 9 patients were included. Demographic properties, stroke etiology, imaging modality, EEG findings, stroke severity according to NIHSS score, functional disability, modified Rankin Scale were recorded for all patients. RESULTS: A total of 9 patients were included. The mean age of the study population was 70,5± 9,6 years. There were 8 (88,9%) females, and 1 male. Eight of nine patients had middle cerebral artery, 1 patient had posterior cerebral artery infarct. While 5 patients had cardioembolic stroke, 4 patients had cryptogenic stroke. DISCUSSION AND CONCLUSION: The late onset NCSE after ischemic stroke is not a rare entity. NCSE should be kept in the differential diagnosis of apathy patients with older age and large stroke

Predictors of Symptomatic Hemorrhage After Endovascular Treatment for Anterior Circulation Occlusions: Turkish Endovascular Stroke Registry

We evaluated the predictive factors of symptomatic intracranial hemorrhage (SICH) in endovascular treatment of stroke. We included 975 ischemic stroke patients with anterior circulation occlusion. Patients that had hemorrhage and an increase of >= 4 points in their National Institutes of Health Stroke Scale (NIHSS) after the treatment were considered as SICH. The mean age of patients was 65.2 +/- 13.1 years and 469 (48.1%) were women. The median NIHSS was 16 (13-18) and Alberta Stroke Program Early CT 9 (8-10). In 420 patients (43.1%), modified Rankin Scale was favorable (0-2) and mortality was observed in 234 (24%) patients at the end of the third month. Patients with high diastolic blood pressure (P<.05) had significantly higher SICH. SICH was significantly higher in those with high NIHSS scores (P<.001), high blood glucose (P<.001), and leukocyte count at admission (P<.05). Diabetes mellitus (DM) (OR 1.90; P<.001), NIHSS (OR 1.07; P<.05), adjuvant intra-arterial thrombolytic therapy (IA-rtPA) (OR, 1.60; P<.05), and puncture-recanalization time (OR 1.01; P<.05) were independent factors of SICH. Higher baseline NIHSS score, longer procedure time, multiple thrombectomy maneuvers, administration of IA-rtPA, and the history of DM are independent predictors of SICH in anterior circulation occlusion

İNME KLİNİK PRATİĞİNDE NOAK KULLANIMI:TÜRK BEYİN DAMAR HASTALIKLARI DERNEĞİ UZMAN GÖRÜŞÜ

Non-vitamin K oral antikoagülanların (NOAK) atrial fibrilasyonda inmenin önlenmesi amacıyla on yılı aşan bir süredirbaşarı ile kullanıldığı açıktır. Varfarine göre belirgin derecede az kanamaya yol açmaları ve inmeyi de eşit veya daha fazlaoranda önleyebilmeleri yanı sıra kolay kullanım özellikleri primer proflakside atrial fibrilasyona bağlı inmeyi azaltmakonusunda öne çıkmaktadır. Bunlar aynı zamanda genel inme prevalansının azalması anlamına gelmektedir. Yani AFnedenli inmenin engellenmesi toplum sağlığı için çağdaş bir gereklilik olarak algılanmalıdır. İnme klinik pratiğindekardiyoloji uzmanları ile birlikte bu bağlamda çaba sarf eden nöroloji uzmanları için Türk Beyin Damar HastalıklarıDerneği bu uzman görüşünü hazırladı. Görüşler NOAK grubu ilaçların kullanımında sıkça karşılaşılan sorunlar ve buproblemler için güncel çözüm önerilerini içermektedir.It is clear that nonvitamin K oral anticoagulants (NOACs) have been used successfully for more than ten years to preventstroke in atrial fibrillation. In addition to the fact that they cause significantly less bleeding compared to warfarin and canprevent stroke equally or more, their easy-to-use features stand out in reducing stroke due to atrial fibrillation in primaryprophylaxis. These also mean a decrease in the overall prevalence of stroke. For sure, prevention of AF-induced strokeshould be perceived as a contemporary requirement for public health. Turkish Society of Cerebrovascular Diseases hasprepared this expert opinion for neurologists who strive for this purpose together with cardiologists in the clinicalpractice of stroke. The article contains frequently encountered problems in the use of NOACs and current solutions forthese problems