RESUMEN
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.
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Isquemia Encefálica , Ataque Isquémico Transitorio , Accidente Cerebrovascular , Adulto , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/epidemiología , Isquemia Encefálica/etiología , Femenino , Humanos , Isquemia , Persona de Mediana Edad , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiologíaRESUMEN
AIM OF STUDY: The NLR is a simple and inexpensive parameter that is useful as a marker of subclinical inflammation. The purpose of this study was to investigate the clinical characteristics of patients diagnosed with acute cerebral ischemia at the time of initial evaluation in the emergency department. PATIENTS AND METHODS: The study was designed as a multicentre cross-sectional study of acute ischemic stroke patients. Neurological evaluations were assessed using the NIHSS and mRS. Evaluations included the results of patients' laboratory tests performed at the time of presentation to the emergency department. RESULTS: Seven hundred and thirty-five ischemic stroke patients were included in the study. Stroke cases assessed by the mRS as mild or severe showed significant differences with respect to age, leukocyte counts, neutrophil counts, NLR, LDL cholesterol values, and serum glucose values (P = .001). When analysed using NIHSS, lymphocyte levels were significantly higher in very severe stroke cases compared with mild, moderate, and severe cases. NLR was also significantly higher in very severe stroke cases and severe stroke cases as compared with the mild and moderate stroke groups. Neurological evaluations assessed using the mRS showed a mild positive correlation with neutrophil and leukocyte count and a weak correlation with the NLR. CONCLUSION: The NLR exhibited a significant correlation with the results of the mRS and NIHSS. The NLR measured in the very early period was also significantly associated with clinical condition. These results suggest that high NLR values may be a marker of stroke' severity.What's known Stroke is an important disease that has a significant impact on mortality and morbidity and is closely related to the aging world population. In recent years, highly innovative approaches have been developed in the treatment of stroke. Although a long distance has been covered in the early diagnosis of stroke, the ability to predict the severity of the disease with many parameters is still up to date. What's new At the time of admission, in the absence of infection, parameters such as leukocytelymphocyte count and NLR may be telling about stroke severity. Demonstrating the utility of these simple, practical, inexpensive and naninvasive parameters to predict stroke severity can contribute to the scoring to be established at the time of initial diagnosis.
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Isquemia Encefálica/diagnóstico , Estudios Transversales , Humanos , Linfocitos , Neutrófilos , Valor Predictivo de las Pruebas , Accidente Cerebrovascular/diagnósticoRESUMEN
BACKGROUND AND AIM: Orthostatic tremor is a high frequency tremor predominantly on calf muscles during standing. Brainstem is the most probable generator in the pathogenesis since it comprises bilaterally projecting centers regulating stance or tone. We aimed to investigate the functional role of brainstem through the evaluation of acoustic startle response in primary orthostatic tremor patients. PATIENTS AND METHOD: We included 7 (2 males) consecutive patients and 13 (5 males) healthy volunteers. Diagnosis was confirmed by polymyographic surface electromyography. All subjects underwent acoustic startle response and blink reflex investigations. RESULTS: Presence rate (71.4% vs. 100%, p=0.042) and response rate (27.5% vs. 40.5%, p=0.047) of total acoustic startle response were lower in patient group. Similarly, probability over orbicularis oculi was lower among patients (p=0.003). However, blink reflex was observed in all patients and healthy volunteers and latencies of startle and blink reflexes were similar between groups. CONCLUSIONS: In our patient group, normal response rate and latencies of R1 and R2 show structural integrity of at least blink reflex circuit at brainstem. On the other hand, suppressed response rates probably reflect decreased excitability of auditory startle reflex pathway.
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Mareo/psicología , Reflejo de Sobresalto , Temblor/psicología , Estimulación Acústica , Anciano , Parpadeo , Tronco Encefálico/fisiopatología , Estudios de Casos y Controles , Mareo/fisiopatología , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Temblor/fisiopatologíaRESUMEN
Chronic exposure to manganese (Mn) fume during welding may lead to mainly extrapyramidal syndrome that is resistant to treatment. We present a 32-year-old patient who developed severe postural instability, Parkinsonism, dystonia, and pyramidal signs in the 10th year of welding. The neurological condition of the patient worsened markedly in the following 3 years, resulting in severe disability rendering him to be assisted in all his daily activities and he did not benefit from any dopaminergic agent. T1 sequences of the MRI of the brain showed pallidal hyperintensity symmetrically. Welders in our country often protect their eyes but ignore to use tools that protect them from inhalation of the fume. Since chronic Mn toxicity may cause serious disability and irreversible neurological disturbances, we strongly believe that it is necessary to inform welders and their employers about this potential hazard.