Aim: Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is defined as the serum atherogenicity index. High TG/HDL-C ratio is related with vascular diseases, insulin resistance and metabolic syndrome. The TG/HDL-C ratio in cerebrovascular diseases, especially in silent cerebral lesions hasn't been well studied. The aim of this study was to evaluate the frequency of silent cerebral ischemia (SCI) and leukoaraiosis (LA), and its relationship with TG/HDL-C ratio in patients admitted with the first ischemic stroke attack. Material and Methods: We retrospectively evaluated 200 patients who admitted to Bulent Ecevit University Faculty of Medicine, Department of Neurology with the diagnosis of acute first ischemic stroke. Silent cerebral lesions were defined as LA and SCI with magnetic resonance imaging. TG/HDL-C ratio was calculated by dividing TG levels by HDL-C levels. Results: Silent cerebral lesions were detected 124 (83.2%) of 149 patients. LA severity was evaluated according to Fazekas score, 22 (14.8%) of patients were grade 0, 49 (32.9%) of them were grade 1, and 78 (52.3%) of them were advanced periventricular white matter hyperintensity (adv-PWMH) group. TG/HDL-C ratio in SCI group was higher than the group without SCI, but it wasn't statistically significant (p=0.091). A significant increase was observed in the TG/HDL-C ratio, as LA severity increased. TG/HDL-C ratio was significantly higher in adv-PWMH group (p=0.050). Conclusion:High serum atherogenicity index is associated with atherosclerosis and vascular endothelial dysfunction. With this simple, inexpensive and effective test method, high-risk group of LA and SCI could be identified.

Background/Aim: Chronic migraine (CM) is defined as headache occurring on 15 or more days per month for more than three months, which, on at least 8 days per month, has the features of a migraine headache. Greater occipital nerve (GON) blocks with local anesthetics and steroids are used in CM. GON block is widely used effectively in CM treatment. The aim of this study was to assess the effectiveness of GON blocks in CM. Methods: This retrospective cohort study was conducted in Bulent Ecevit University Faculty of Medicine, Department of Neurology. Data of 43 CM patients who had GON block were collected. CM was diagnosed using International Classification of Headache Disorders (ICHD-3). GON blocks were repeated every week in the first month and monthly thereafter for the following 6 months. The injections were performed radially at 2 cm lateral and 2 cm inferior to the protuberantia occipitalis externa with a needle and 2 mL of 0.25% bupivacaine bilaterally. Headache attack frequency (days), headache duration (hours) and severity of pain (Visual Analog Scale (VAS)) were compared between before and after GON block in the first month. Results: Headache attack frequency decreased from 12.8 (8.4) (pretreatment) to 3.8 (3.5), and headache severity (VAS), from 8.5 (1.2) to 4.5 (1.8) (P<0.001 for both) within one month. No serious adverse effects were observed. Conclusion:This study showed significant decreases in headache parameters in CM. GON block is widely used effectively in CM treatment, and there is a need to standardize the application technique, dose, and frequency.