Background:Patients with equinovarus deformity have an increased risk of fall and ankle ligament injury, because of inappropriate prepositioning of the ankle at the end of the swing phase, and inadequate leg and ankle stability during the stance phase. Accordingly, the aim of this study is to compare anterior talofibular ligament (ATFL) thickness of chronic stroke patients with that of healthy individuals using ultrasonography.Methods:This was a case-control study conducted in a university hospital between July 2015 and July 2016. We included 38 patients [study group; mean age, 59.0 ± 11.1 years; mean body mass index (BMI), 25.4 ±4.3 kg/m2] and a control group of age-, sex-, and BMI-matched healthy individuals. Demographic and clinical characteristics of the patients (i.e., age, weight, height, Brunnstrom motor recovery stage, Functional Ambulation Scale, Ashworth Scale, and duration of hemiplegia) were recorded during their visits. Furthermore, ultrasound image of the ATFL was obtained from each ankle. The thickness of the ATFL was measured at the midpoint of the ligament between the attachments on the lateral malleolus and the talus using ultrasonography.Results:In the study group, the mean thickness of the ATFLs of the affected side (2.75 ± 0.41 mm) was thicker than both the unaffected side (2.42 ± 0.30 mm) and the healthy controls (2.35 ± 0.19 mm; p = 0.007, p < 0.001, respectively). No differences were seen between the two sides of the control group.Conclusion:Chronic stroke patients have a thicker ATFL on both the affected and unaffected sides, compared with healthy individuals. This architectural feature of the ATFL may be a result of equinovarus deformity together with spastic muscles. For this reason, early treatment of deformed ligaments and spastic muscles is needed to prevent equinovarus deformity in patients with stroke.

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Diabetes insipidus (DI) is a rare disorder of water homeostasis and characterized by the persistent excretion of abnormally large of volumes of dilute urine. DI is a syndrome characterized by polyuria, polydipsia. DI can be divided into four forms, central DI, nephrogenic DI, gestational DI, and primary polydipsia. Central and nephrogenic DI may be acquired or inherited. Central diabetes insipidus (DI) is a rare endocrine disorder. Central DI results from a defect in arginine vasopressin (AVP) production, while nephrogenic DI results from a defect in AVP renal response. The most common treatment of Central DI is the administration of synthetic ADH, desmopressin. Dehydration may develop in these patients. Hypernatremia and rhabdomyolysis may also occur. As a result, acute kidney injury occurs in some cases. In this article, we tried to discuss a case of hypothalamo-pituitary insufficiency in a 47-year-old female patient who presented with acute kidney injury, in the light of the literature.

Cerebral venous thrombosis (CVT) is a rare condition involving various symptoms that is mainly seen in younger adults. The most commonly involved are the superior sagittal sinus, lateral sinus, and simoid sinus. About 1% of all ischemic strokes are considered CVT. It is seen 3-fold more in young women. The incidence was estimated to be approx. 1/1000000. Cerebral venous sinuses are superficial and deep spaces, and they have vital functions. There are many symptoms. The most common complaint is headache (89%). Studies reported many different clinical symptoms. Neurological signs including motor and sensorial losses, impaired consciousness, speech disorder, epileptic seizures, visual problems (hemianopia, nystagmus, diplopia, and papilledema), and cranial nerve signs may be seen. The diagnosis is made primarily by suspecting the clinical condition and radiological presentation of thrombosis. The most basic diagnostic method is cranial imaging. Anticoagulants are the main method of treatment. The prognosis has improved over the last years thanks to early diagnosis.