1
|
Celik B, Bilik O, Koçbilek ZD, Damar HT, Öz D, Denizmen Z. Validity and reliability of the Turkish version of the Informant Assessment of Geriatric Delirium Scale. Ideggyogy Sz 2024; 77:111-119. [PMID: 38591926 DOI: 10.18071/isz.77.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Background and purpose Delirium is a common complication developing in elderly patients. Therefore, it is important to diagnose delirium earlier. Family caregivers play an active role in early diagnosis of delirium and build a bridge between health professionals and patients. The purpose of this research was to achieve the validity and reliability of the Turkish version of the Informant Assessment of Geriatric Delirium Scale (I-AGeD). . Methods This is a methodological study. The sample comprised 125 caregivers accepting to participate in the study and offering care to older patients with hip fracture aged ≥60 years. Data were gathered preoperatively and on postoperative days 0, 1 and 2. After achieving the linguistic and content validity of the scale, the known-groups comparison was used to achieve its construct validity. The ROC curve analysis was made to determine the sensitivity and specificity of the scale. Item-total correlations, item analysis based on the difference between the upper 27% and lower 27%, Kuder–Richardson 20 (KR-20) coefficient and parallel forms reliability with the NEECHAM Confusion Scale were adapted to assess discriminant indices of the items in the I-AGeD. . Results The item-total correlation coefficients of the scale ranged from 0.54 to 0.89 and KR-20 coefficient ranged from 0.09 to 0.91 depending on the measurement times. According to the ROC curve analysis, the sensitivity and specificity of the scale were ≥ 91% and ≥ 96% respectively. The parallel forms reliability analysis showed a highly significant, strong negative relation at each measurement between the I-AGeD and the NEECHAM Confusion Scale. . Conclusion The I-AGeD is valid and reliable to diagnose delirium in older Turkish patients in perioperative processes. .
Collapse
Affiliation(s)
- Buket Celik
- Surgical Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey
| | - Ozlem Bilik
- Surgical Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey
| | | | - Hale Turhan Damar
- Elderly Care Department, Vocational School of Health Services, Izmir Democracy University Izmir, Turkey
| | - Didem Öz
- Dokuz Eylül University Hospital, Department of Neurology, Izmir, Turkey
| | - Zeynep Denizmen
- Dokuz Eylül University Hospital, Department of Neurology, Izmir, Turkey
| |
Collapse
|
2
|
Yener G, Öz D. Innovations in Neurophysiology and Their Use in Neuropsychiatry. Noro Psikiyatr Ars 2022; 59:S67-S74. [PMID: 36578987 PMCID: PMC9767126 DOI: 10.29399/npa.28234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/31/2022] [Indexed: 12/31/2022] Open
Abstract
Many structural and functional tests are used to explore the nature of neurodevelopmental and neurodegenerative diseases. Cognitive involvement has become more and more remarkable in many neurological and psychiatric diseases. This condition evoked a paradigm shift, and today disorders are addressed from a neuroscientific perspective, including silent symptoms. The spatial resolution of structural studies is lacking and is combined with the unique temporal resolution of EEG methods. In our current clinical practice, EEG does not have definitive diagnostic value in psychiatric disorders, but it helps to make a correct diagnosis by excluding other neurological diseases. However, the use of EEG for research purposes is promising in both groups. In this review; there is up-to-date information on the use of electrophysiological examinations in neurological diseases, especially Alzheimer's disease, Parkinson's disease, Frontotemporal dementia, and psychiatric disorders such as schizophrenia, mood disorders, attention deficit and hyperactivity disorder, and obsessive-compulsive disorder, to define the point we have reached in our journey to understand these disorders.
Collapse
Affiliation(s)
- Görsev Yener
- İzmir University of Economics, Faculty of Medicine, Department of Neurology, İzmir, Turkey,İzmir Biomedicine and Genom Center, İzmir, Turkey,Dokuz Eylül University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey
| | - Didem Öz
- Dokuz Eylül University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey,Dokuz Eylül University Hospital, Department of Neurology, İzmir, Turkey,Dokuz Eylül University, Medical Science Faculty, Neuroscience Department, İzmir, Turkey,Global Brain Health Institute, San Francisco, USA,Correspondence Address: Didem Öz, Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, 15 Temmuz Sağlık ve Sanat Yerleşkesi, İnciraltı 35340, İzmir, Turkey • E-mail:
| |
Collapse
|
3
|
Fide E, Yerlikaya D, Öz D, Öztura İ, Yener G. Normalized Theta but Increased Gamma Activity after Acetylcholinesterase Inhibitor Treatment in Alzheimer's Disease: Preliminary qEEG Study. Clin EEG Neurosci 2022; 54:305-315. [PMID: 35957592 DOI: 10.1177/15500594221120723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Acetylcholinesterase inhibitors (AChE-I) are the core treatment of mild to severe Alzheimer's disease (AD). However, the efficacy of AChE-I treatment on electroencephalography (EEG) and cognition remains unclear. We aimed to investigate the EEG power and coherence changes, in addition to neuropsychological performance, following a one-year treatment. Nine de-novo AD patients and demographically-matched healthy controls (HC) were included. After baseline assessments, all AD participants started cholinergic therapy. We found that baseline and follow-up gamma power analyzes were similar between groups. Yet, within the AD group after AChE-I intake, individuals with AD displayed higher gamma power compared to their baselines (P < .039). Also, baseline gamma coherence analysis showed lower values in the AD than in HC (P < .048), while these differences disappeared with increased gamma values of AD patients at the follow-up. Within the AD group after AChE-I intake, individuals with AD displayed higher theta and alpha coherence compared to their baselines (all, P < .039). These increased results within the AD group may result from a subclinical epileptiform activity. Even though AChE-I is associated with lower mortality, our results showed a significant effect on EEG power yet can increase the subclinical epileptiform activity. It is essential to be conscious of the seizure risk that treatment may cause.
Collapse
Affiliation(s)
- Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, 37508Dokuz Eylül University, Izmir, Turkey
| | - Deniz Yerlikaya
- Department of Neurosciences, Institute of Health Sciences, 37508Dokuz Eylül University, Izmir, Turkey
| | - Didem Öz
- Department of Neurosciences, Institute of Health Sciences, 37508Dokuz Eylül University, Izmir, Turkey.,Department of Neurology, 37508Dokuz Eylül University Medical School, Izmir, Turkey.,Global Brain Health Institute, 8785University of California San Francisco, San Francisco, CA, USA.,Brain Dynamics Multidisciplinary Research Center, 37508Dokuz Eylül University, Izmir, Turkey
| | - İbrahim Öztura
- Department of Neurosciences, Institute of Health Sciences, 37508Dokuz Eylül University, Izmir, Turkey.,Department of Neurology, 37508Dokuz Eylül University Medical School, Izmir, Turkey.,Brain Dynamics Multidisciplinary Research Center, 37508Dokuz Eylül University, Izmir, Turkey
| | - Görsev Yener
- Brain Dynamics Multidisciplinary Research Center, 37508Dokuz Eylül University, Izmir, Turkey.,Faculty of Medicine, 605730Izmir University of Economics, Izmir, Turkey.,Izmir Biomedicine and Genome Center, Izmir, Turkey
| |
Collapse
|
4
|
Öz D, Yıldırım Z, Kıyı İ, Özbek Y, Kulaç İ, Erkol G, Tihan T, Gürvit İH, Yener G. Senior Moments Are Never-ending Times When You Are Old (Are They?): First Step of Turquoise Project. Noro Psikiyatr Ars 2022; 59:S10-S16. [PMID: 36578986 PMCID: PMC9767131 DOI: 10.29399/npa.28152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/19/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction The number of dementia patients in Turkey is increasing, as well as all over the world. However, we do not know how much society knows about dementia. The aim of this study is to evaluate people's concept of dementia, their awareness of dementia research and treatment, whether dementia and forgetfulness are considered normal in old age, and whether having dementia is associated with a lack of mental abilities. Methods A Dementia Awareness Questionnaire was created in the form of a self-report questionnaire, consisting of 20 questions and using a five-point Likert-type answering method in order to question participants' information about dementia. In addition, we asked for demographic information such as age, gender, occupation, education level of the participants, as well as whether they have had relatives diagnosed with a neurodegenerative disease. The surveys were administered online. Results A total of 1551 participants from 53 cities were included in the study. Approximately half of the participants did not know the definition of dementia, 20.9% thought that dementia and Alzheimer's disease were the same; 50.4% considered forgetfulness, and 55.2% considered dementia as a natural consequence of aging. While 34.5% of the participants thought that dementia patients could be dangerous, 10.3% thought they could not continue living as a part of society. While 38.5% of healthcare professionals do not know the definition of dementia, 18.5% of them say that dementia and Alzheimer's disease are the same, 58.5% think that dementia patients are not fit to make their own decisions, 40.6% believe that dementia patients have criminal liability. 15.8% of healthcare professionals thought that dementia is only seen in elderly people; 21.4% thought that dementia, and 49.2% thought that forgetfulness was a result of normal aging. Conclusion Our study confirms that dementia is still an unknown concept in society and among healthcare professionals. It is widely believed that forgetfulness and dementia are part of normal aging, and there is no cure for dementia. This study, which we have done in order to understand the level of dementia awareness in Turkish society, reveals the necessity for research on dementia and studies on how to increase dementia awareness.
Collapse
Affiliation(s)
- Didem Öz
- Dokuz Eylul University, Faculty of Medicine, Department of Neurology, İzmir, Turkey,Global Brain Health Institute, University of California San Francisco, United States,Dokuz Eylul University, Department of Neurosciences, İzmir, Turkey,Dokuz Eylul University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey,Correspondence Address: Didem Öz,Dokuz Eylül Üniversitesi, Nöroloji Anabilim Dalı, 15 Temmuz Sağlık ve Sanat Yerleşkesi, İnciraltı 35340, İzmir, Turkey • E-mail:
| | - Zerrin Yıldırım
- İstanbul University, Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, İstanbul, Turkey,University of Health Sciences, Bagcilar Training and Research Hospital, Department of Neurology, İstanbul, Turkey
| | - İlayda Kıyı
- Dokuz Eylul University, Department of Neurosciences, İzmir, Turkey,Dokuz Eylul University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey
| | - Yağmur Özbek
- Dokuz Eylul University, Department of Neurosciences, İzmir, Turkey,Dokuz Eylul University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey
| | - İbrahim Kulaç
- Koç University, Faculty of Medicine, Department of Pathology, İstanbul, Turkey
| | - Gökhan Erkol
- Koç University, Faculty of Medicine, Department of Neurology, İstanbul, Turkey
| | - Tarık Tihan
- Koç University, Faculty of Medicine, Department of Pathology, İstanbul, Turkey,University of California, Department of Pathology, Division of Neuropathology, San Francisco, CA. United States
| | - İbrahim Hakan Gürvit
- İstanbul University, Istanbul Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, İstanbul, Turkey
| | - Görsev Yener
- İzmir University of Economics, Faculty of Medicine, İzmir, Turkey,İzmir Biomedicine and Genome Center, İzmir, Turkey,Dokuz Eylul University Brain Dynamics Multidisciplinary Research Center, İzmir, Turkey
| |
Collapse
|
5
|
Brugulat-Serrat A, Chen Y, Demnitz N, Ashour A, Adrion E, Ilinca S, Kinchin I, Almirall-Sanchez A, Öz D, Karanja W, Pintado M, Rogers N, Browning A, Petkuté I, Lawlor B. Roadmap for change in sex and gender inequities in brain health: A global perspective. Int J Geriatr Psychiatry 2022; 37. [PMID: 35393642 DOI: 10.1002/gps.5710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anna Brugulat-Serrat
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Yaohua Chen
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- University.Lille, Inserm UMR-S1172, Lille Neurosciences & Cognition, Degenerative and Vascular Cognitive Disorders, CHU Lille, LiCEND, Lille, France
- Department of Geriatrics, CHU Lille, Lille, France
| | - Naiara Demnitz
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hvidovre Hospital, Hvidovre, Denmark
| | - Aya Ashour
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Emily Adrion
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Global Health Policy Unit, University of Edinburgh, Scotland, UK
| | - Stefania Ilinca
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- European Centre for Social Welfare Policy and Research, Vienna, Austria
- World Health Organization Regional Office for Europe, Copenhagen, Europe
| | - Irina Kinchin
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- University of Technology Sydney, Ultimo, Sydney, New South Wales, Australia
| | | | - Didem Öz
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Dokuz Eylul University Hospital, İzmir, Turkey
| | - Wambui Karanja
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Maritza Pintado
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Cognitive impairment diagnostic unit and dementia prevention, Peruvian Institute of Neurosciences, Lima, Peru
- Research Department, Peruvian Institute of Neurosciences, Lima, Peru
| | - Nicole Rogers
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Departamento de Neurociencia, Universidad de Chile, Santiago, Chile
| | - Anne Browning
- Global Brain Health Institute, University of California, San Francisco, California, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Ieva Petkuté
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- NGO "Socialiniai meno projektai", Vilnius, Lithuania
- Association "Dementia Lithuania", Vilnius, Lithuania
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
6
|
Öz D, Keret O, Özbek Y, Yener G. "Seizure and neurodegeneration": Understanding the nature of seizure in patients with cognitive disorder, A chicken and egg situation. Alzheimers Dement 2021. [DOI: 10.1002/alz.058715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Didem Öz
- GBHI ‐ UCSF San Francisco CA USA
- Dokuz Eylul University Hospital Neurology Department Izmir Turkey
| | - Ophir Keret
- Cognitive Neurology Clinic Rabin Medical Center Beilinson Hospital Petah Tikva Israel
- Global Brain Health Institute University of California San Francisco San Francisco CA USA
- Department of Neurology Rabin Medical Center Beilinson Hospital Petah Tikva Israel
| | | | - Gorsev Yener
- Izmir Biomedicine and Genome Center Izmir Turkey
- International Biomedicine and Genome Institute Izmır Turkey
- Izmir Ekonomi University Izmir Turkey
| |
Collapse
|
7
|
Kunt R, Çınar BP, Yüksel B, Güllüoğlu H, Sayılır İ, Çeliker Uslu S, Özaydın Göksu E, Bülbül NG, Yıldız B, Öz D, Keskin AO, Korucu O, Akpınar ÇK, Solmaz V, Akpınar M, Altunç FZ, Elmas Z, Büyükuysal Ç, Ekici M, Güvendi G. Clinical-epidemiological and radiological characteristics of stroke patients: A multicentre study. Int J Clin Pract 2021; 75:e14963. [PMID: 34626055 DOI: 10.1111/ijcp.14963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/06/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION AND AIM Stroke is the leading cause of disability in adults and the second most common cause of death, at a rate of 11.8% worldwide. The purpose of this study was to examine the aetiological, demographic, and clinical characteristics of patients admitted to hospital because of acute strokes. MATERIALS AND METHODS This multicentre study retrieved information for all patients admitted to hospital because of an acute cerebrovascular event over a six-month period, and sociodemographic, aetiological, and clinical characteristics were recorded. RESULTS A total of 1136 patients, 520 of whom were women (45.7%), with a mean age of 70.3 ± 12.8 years, were included in the study. Of these, 967 were diagnosed with ischaemic stroke (IS) (85.1%), 99 with haemorrhagic stroke (HS) (8.7%), and 70 with transient ischaemic attack (6.1%). The most common risk factor for stroke was hypertension (73%). Carotid disease and hyperlipidaemia rates were higher in patients with HS. Numbers of functionally dependent patients with severe neurological status according to the National Institutes of Health Stroke Scale and modified Rankin scale were significantly higher in the HS group (P < .001). When IS was classified according to the Trial of Org 10172 in Acute Stroke Treatment, small vessel disease emerged as the most common cause (41%). The most common lesion localisations were the parietal lobe (23%) in the IS group and the thalamus (35.3%) in the HS group. Eighty-eight patients (7.7%), 62 (6.4%) in the ischaemic subgroup, and 26 (26.3%) in the haemorrhagic subgroup, died within the first month. CONCLUSION Current and accurate evaluations of stroke aetiology are essential for stroke prevention and treatment planning. This study, shows that no change occurred in the aetiology of stroke and epidemiological characteristics and that accurate identification of modifiable stroke risk factors is still a major goal.
Collapse
Affiliation(s)
- Refik Kunt
- Department of Neurology, School of Medicine, İzmir Demokrasi University, İzmir, Turkey
| | - Bilge Piri Çınar
- Department of Neurology, School of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Burcu Yüksel
- Neurology Clinic, Antalya Training and Research Hospital, Antalya, Turkey
| | | | - İdris Sayılır
- Neurology Clinic, Samsun Training and Research Hospital, Samsun, Turkey
| | | | | | | | - Baykal Yıldız
- Neurology Clinic, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Didem Öz
- Neurology Clinic, Dokuz Eylül University, İzmir, Turkey
| | - Ahmet Onur Keskin
- Neurology Clinic, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Osman Korucu
- Neurology Clinic, Keçiören Training and Research Hospital, Ankara, Turkey
| | | | - Volkan Solmaz
- Department of Neurology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Meliha Akpınar
- Department of Neurology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Fatma Zehra Altunç
- Neurology Clinic, Antalya Training and Research Hospital, Antalya, Turkey
| | - Zeynep Elmas
- Neurology Clinic, Medicalpark İzmir Hospital, İzmir, Turkey
| | - Çağatay Büyükuysal
- Department of Statistics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Mustafa Ekici
- Emergency Medicine Clinic, Atatürk State Hospital, Aydın, Turkey
| | - Güven Güvendi
- Department of Physiology, School of Medicine, İzmir Demokrasi University, İzmir, Turkey
| |
Collapse
|
8
|
Özakbaş S, Çinar BP, Öz D, Kösehasanoğullari G, Kurşun BB, Kahraman T. Monthly Pulse Methylprednisolone Therapy is Effective in Preventing Permanent Disease Progression in Secondary Progressive Multiple Sclerosis. ACTA ACUST UNITED AC 2018; 56:115-118. [PMID: 31223243 DOI: 10.5152/npa.2017.19339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 01/28/2017] [Indexed: 11/22/2022]
Abstract
Introduction Secondary progressive multiple sclerosis (SPMS) is the phase in which disability continues to worsen with or without accompanying attacks. Monthly methylprednisolone pulse therapy can be used in the secondary progressive phase. The purpose of the present study was to evaluate the effects of methylprednisolone pulse therapy on the basis of clinical and MRI parameters in patients with SPMS. Methods This was a multi-center, examiner-blinded, prospective study. Patients with SPMS with EDSS scores of 3 or more, using one or none of azathioprine, interferon or glatiramer acetate, were evaluated. Patients were given IVMP (1 dose of 1 g IV) once a month for 24 months. EDSS scores, MRI findings, quality of life, and adverse events were evaluated. Results Ninety-seven SPMS patients were included in the study. Significant decreases in new/enlarging, Gd-enhanced, and spinal lesions were observed from baseline to year 2. EDSS scores remained stable at the end of the second year. Monthly high-dose IVMP resulted in a significant decrease in attacks. Conclusion This study is important in terms of emphasizing that this therapeutic option should not be overlooked, since monthly pulse therapy can halt or even reverse progression, regarded as a natural course in SPMS, albeit to a small extent.
Collapse
Affiliation(s)
- Serkan Özakbaş
- Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Bilge Piri Çinar
- Samsun Research and Training Hospital, Neurology Clinic, Samsun, Turkey
| | - Didem Öz
- Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Behice Bircan Kurşun
- Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, İzmir Katip Çelebi University Faculty of Health Sciences, İzmir, Turkey
| |
Collapse
|
9
|
Gülcü A, Gezer NS, Men S, Öz D, Yaka E, Öztürk V. Management of free-floating thrombus within the arcus aorta and supra-aortic arteries. Clin Neurol Neurosurg 2014; 125:198-206. [PMID: 25173962 DOI: 10.1016/j.clineuro.2014.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/18/2014] [Accepted: 08/07/2014] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Clinical management strategy and the best treatment option of free floating thrombus (FFT), detected in patients with acute ischemic cerebrovascular diseases is still uncertain due to the rarity of these conditions. Recent studies emphasize that FFT within cerebral vessels may not be a surgical emergency since complete dissolution without any further neurologic progression occurred in 86% of patients treated medically. The aim of this study was to investigate the effect of medical treatment on the fate of thrombus and the clinical status in acute cerebrovascular event patients with detected FFT in the artery feeding the compromised brain territory at the time of diagnosis. MATERIALS AND METHODS We have retrospectively reviewed the initial and follow up computed tomography angiography, diffusion-weighted magnetic resonance imaging examinations of 37 acute ischemic stroke patients with detected FFT and treated medically. The patients were evaluated for any change of the FFT, residual stenosis after the FFT shrunk or disappeared and neurologic outcome. RESULTS FFT was located in cervical carotid artery, intracranial artery and arcus aorta in 23, 6 and 5 of the patients respectively. Dissection accompanied the FFT in 3 patients. Recanalization was maintained in 34 patients however, three of them suffered from new infarctions. A total occlusion was detected in three patients. Two of them had new infarcts while one was stable during clinical follow-up period. CONCLUSION The results of our retrospective study have shown that FFT in the proximal aorta and supra-aortic arteries tend to resolve with anticoagulant and/or antiplatelet treatment without causing recurrent adverse events in most of the cases. Furthermore, resolution of the clot seems to provide a safer ground for a recanalization procedure like stenting or endarterectomy if needed.
Collapse
Affiliation(s)
- Aytaç Gülcü
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Naciye Sinem Gezer
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Süleyman Men
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Didem Öz
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Erdem Yaka
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Vesile Öztürk
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| |
Collapse
|