Akinetic Mutism Case Following Stroke

Ischemic strokes less common in the area of the anterior cerebral artery infarcts and bilateral occurrence is extremely rare. 86-year-old female patient, admitted to our emergency department with complaints of sudden loss of strength in both arms and legs and inability to speak. Case diagnosed as akinetic mutism due to bilateral anterior cerebral artery infarction presented because it is rare

Acute Pancreatitis Case Presented with Epileptic Seizure

Acute pancreatitis, defined as the acute non-bacte¬rial inflammatory condition of the pancreas. A 53-year-old woman was admitted to our emergency service after a first episode of generalized tonic-clonic seizure. There was no past medical history. The initial laboratory findings showed a low serum calcium level (5.8 mg/dL normal value 8.8-10.2 mg/dL). High Amylase-802 U/L, Lipase-489 U/L levels. CT abdomen showed pancreatic edema and inflammation suggestive of acute pancreatitis. This case report demonstrates a rare but important differential diagnosis in generalised tonic-clonic seizures of adult onse

Chronic Subdural Hematoma Associated with Acute Biphenotypic Leukemia: Case Report

Spontaneous chronic subdural hematoma associated with neoplasm is a rare disorder. A rare case of chronic subdural hematoma associated with acute biphenotypic leukemia presented here. A 78-year-old woman who diagnosed as acute biphenotypic leukemia by hematology was complicated with a large chronic subdural hematoma. She presented to our emergency medicine service of hospital with left-sided weakness. Her non-contrast brain computerized tomography scan showed a non-traumatic right-sided, large, chronic subdural hematoma. She was treated with urgent hematoma evacuation by neurosurgery and had no neurological deficits after that operation. The case highlights the importance of paying attention to acute biphenotypic leukemia patients for important complications such as subdural hematomas

Basilar artery aneurysm case presented with neck pain

Neck pain related with disorders of the brain and neck vascular structures is not rare but importance was attached to a condition that is often overlooked. Tension as a sudden onset, radiating to the nape, the neck pain becomes unbearable and within seconds the raging 51-year-old female patient with aneurysm at the distal end of basilar artery was found. Case, the only sign of neck pain with unruptured basilar artery aneurysm is presented in terms of raising awareness on the subject

Posterior Revers�Bl L�Koensefalopati Sendromu (Pres) �Nun Farkl� Klinik Ve G�R�Nt�Leme ÖZellikleri

Posterior reversible leukoencephalopathy syndrome (PRES) is classically characterized by headache, confusion, seizure, visual loss, and imaging findings of bilateral cortical and subcortical vasogenic edema in the posterior circulation area. We present three cases of PRES with different clinical and/or imaging features. They were associated with pregnancy. First case was a typical PRES, second case’s lesions were predominantly in the anterior circulation area of the brain, and third case was hemorrhagic PRES. Different clinical and/or radiological features can be seen in cases with PRES.Posterior reversıbl lökoensefalopati sendromu (PRES); tipik olarak baş ağrısı, konfüzyon, nöbet, görme kaybı ve görüntüleme bulgusu olarak posterior dolaşım alanlarında bilateral kortikal ve subkortikal vazojenik ödemle karakterizedir. Biz farklı klinik ve/veya görüntüleme özellikleri olan üç PRES olgusu sunuyoruz. Tümü gebelikle ilişkilidir. Birinci olgu tipik PRES, ikinci olgunun lezyonları beyin anterior dolaşım alanlarında belirgindi ve üçüncü olgu hemorajik PRES’ti. PRES’li olgularda farklı klinik ve/veya radyolojik özellikler görülebilir

Evaluation of Cerebral Blood Flow Alterations and Acute Neuronal Damage due to Water-Pipe Smoking

Background:Although water-pipe smoking is a great public health problem, data regarding the acute and chronic effects and the degree of toxin exposure are limited. While water pipe-related malignancy, pulmonary, infectious, cardiac effects, infertility, and biological effects have been described in a meta-analysis, there are no studies in the literature about its neurologic effects.Aims:To evaluate water pipe-related acute neurological effects and cerebral blood flow through transcranial Doppler ultrasonography and serum S100 calcium binding protein calcium binding protein level measurements.Study Design:Prospective observational study.Methods:Vital signs and baseline carboxyhemoglobin and S100 calcium binding protein levels, cerebral flood changes with transcranial Doppler ultrasound were evaluated and recorded before and after water-pipe smoking.Results:The mean age of the 31 volunteers was 30.61 (±5.67) years, and 24 of them (77.42%) were male. A statistically significant difference was determined in heart rate, oxygen saturation, systolic and diastolic arterial pressure values before and after water-pipe smoking (p<0.001, p=0.035, p=0.009, p=0.021, respectively). Mean carboxyhemoglobin level was 2.68% (±1.68) before, 14.97% (±4.83) after water-pipe smoking (p<0.001). The S100 calcium binding protein level was 25.05 μ/mL (±8.34) at the beginning, 40.71 μ/mL (±14.06) after water-pipe smoking (p<0.001). An increase was determined in peak, and median middle, anterior and posterior cerebral artery blood flow rates, and a decrease was determined in both the pulsatility index and resistivity index values after water-pipe smoking using transcranial Doppler ultrasound.Conclusion:Cerebral vasodilation develops due to the increase in cerebral blood flow rate and the decrease in pulsatility index, resistivity index values, and the elevation in carboxyhemoglobin, S100 calcium binding protein level indicates that water-pipe smoking leads to neuronal damage in the acute period

Bilateral Peroneal Neuropathy after Obesity Surgery

A 33-year-old woman is presented with a bilateral progressive foot drop in three months. Her medical history revealed an obesity surgery seven months ago and she had 65 kgs weight loss in about six months (from 147 kgs to 82 kgs). Bilateral peroneal neuropathy determined at the fibular head on her electromyography study. The case highlights the importance of paying attention to the peroneal neuropathy after massive weight loss. Diet modification and physical therapy should be kept in mind in these patients

Neurobrucellosis

In 5-10% of cases of brucellosis may lead to central nervous system manifestation presenting most often as a meningitis or meningoencephalitis. We report three neurobrucellosis who have different presentation. First patient; a 49-year-old-woman who developed diffuse cerebral white matter lesions as leukoencephalopathy associated with neurobrucellosis, presented with gait disturbance, behavior change and seizure. Second patient; 44-year-old man was admitted to our hospital with a complaint of progressive motor weakness in his bilateral legs for four months and headache for one year. The patient’s symptoms may be explained with myeloradiculopathy and meningoencephalitis but the clinical picture didn’t correlate with imaging findings. Third patient; 23-year-old man was admitted to our hospital with a complaint of transient numbness attacks in his left of face and hand and headache for twenty days. He presented as meningitis which is the most clinical presentation of neurobrucellosis and meningovascular complications. Conclusively, brucellosis is still endemic in Turkey and thus neurobrucellosis should be considered in the unexplained neurological symptoms such as cognitive dysfunction, young transient ischemic attacks, paraparesis and psychiatric symptoms

A case of acute intra-operative atelectasis duringpost upper respiratory tract infection period

Çocuk hastalarda ameliyat öncesi üst solunum yolu enfeksiyonu (ÜSYE) çok sık karşılaşılan bir durum olup ÜSYE geçmiş dahi olsa çocuk hastalarda bronşiyal hiper-reaktivite uzun süre devam edebilmektedir. Geçirilmiş ÜSYE sonrası elektif ameliyatların belli bir süre ertelenmesi gerektiği konusunda herhangi bir görüş birliği bulunmamaktadır. Burada konuya dikkat çekmesi açısından geçirilmiş ÜSYE sonrası gelişen intraoperatif atelektazi olgusu sunulmuştur.Preoperative upper respiratory tract infection (URI) in children is very common; even after relieving URI, bronchial hyper-reactivity may carry on for a long time. There is no consensus about postponing elective surgeries for a period of time soon after the patient is affected by URI. Here, an intraoperative atelectasis event, which occurred after the patient was affected by URI, has been presented to bring attention to this point