The CHA2DS2-VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke.

OBJECTIVES: Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention. MATERIALS AND METHODS: A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated. RESULTS: CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p < .001). Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥3 as a predictor of unsuccessful intervention with 76,6% sensitivity and 83,3% specificity, positive predictive value 50%, negative predictive value 84,6% (area under the curve [AUC]: 0.827,95% CI: 0.739-0.895, p < .001). In the multivariate analysis; atrial fibrillation ([ß] = 4.201; [CI]: 1.251-14.103, p = .020), CHA2DS2-VASc score ([ß] = 0.053; [CI]: 0.004-0.750, p = .030) were found independent predictors for unsuccessful intervention treatment. CONCLUSIONS: In our study, we showed that the CHA2DS2-VASc score is associated with the success of endovascular intervention in patients with acute ischemic stroke who underwent percutaneous endovascular treatment.

Low vitamin B12 level and vitamin D level adversely affect on cochlear health in women.

The aim of this study is to examine the association between low serum vitamin B12 levels and low serum vitamin D levels and cochlear health in women. A prospective case-control study was carried out in the Department of Otolaryngology, Malatya Training and Research Hospital between 2017-2018. Thirty (30) patients with vitamin B12 deficiency (a mean age of 32.5 ± 1.7 years(y) women); 30 patients with vitamin D deficiency (a mean age of 32.3 ± 1.58 y women) and 30 controls (a mean age of 27.8 ± 1.48 y women) were recruited. The study participants have no evidence of symptomatic hearing loss. Transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) of the study participants were recorded. A comparative analysis of the parameters revealed that results at TEOAE 1,2,3,4 kHz (p = 0.013, p = 0.002, p = 0.001, p = 0.001, respectively) and at DPOAE 1, 2, 6 kHz (p < 0.001, p < 0.001, p = 0.002, respectively) were somewhat lower in patients with vitamin B12 deficient group when compared with the controls. Moreover, TEOAE 3,4 kHz (p = 0.005, p = 0.013 respectively) and DPOAE 1,2,6 kHz (p = 0.005, p = 0.01, p = 0.031, respectively) were lower in the vitamin D deficiency group compared with the controls. There was a significant association between both vitamin B12 deficiency and vitamin D deficiency and cochlear health. Patients with vitamin B12 and vitamin D deficiency should be evaluated for cochlear function.

Occipital neuralgia following thoracic herpes zoster: case report.

Paroxysmal shooting or stabbing pain in the dermatomes of the nervus occipitalis major or nervus occipitalis minor is defined as occipital neuralgia. The initial cause of the neuralgia appears to be from inflammation, damage or irritation of these nerves. In this article, we present a patient with occipital neuralgia followed by thoracic herpes lesion.