The detection of high S100B levels in peripheral circulation after acute ischemic stroke and the correlations of S100B levels with infarct size (good) and disability (poor) imply that S100B protein may be used as a peripheral marker in acute ischemic stroke patients.
An understanding of the etiological mechanisms is important for therapeutic decisions and prognostic evaluation of patients with ischemic stroke. The object of this study was to evaluate the risk factors, etiological subtypes, and topography of lesion in patients with medullary infarctions (MIs). Besides, we also investigated early neurological deterioration, new vascular events, and functional outcome of all patients at 3-month follow-up. We analyzed our database consisting of patients who were diagnosed with acute MI and who were admitted within 24 hours of onset. Etiological classification of stroke was made on the basis of the Trial of Org 1972 in Acute Stroke Treatment criteria. All of the infarctions were grouped into anteromedial, anterolateral, lateral, and posterior arterial territories and also categorized into those involving the upper, middle, or lower medulla oblongata. Early neurological deterioration, major vascular events within the first 3 months of follow-up and modified Rankin Score at 3 months were reviewed. A total of 65 patients with medullary infarctions were reviewed. Involved arterial territories differed according to the etiological classification. Large artery atherosclerosis was the most common etiological subtype; however, small vessel disease was the most common subtype in medial MIs. The lesions involving the anteromedial territory were common in the upper medullary region, whereas the lesions involving the posterior and lateral territories were common in the lower medulla oblangata. Recurrent stroke was seen in the posterior and lateral territories; however, early progression and poor functional outcome were mostly seen in lesions involving the anteromedial territories.
PH was more prevalent in patients with contralateral high-degree carotid stenosis and patients without diabetes mellitus after CAS. PH did not cause any post-procedural complications or major vascular events at follow-up, but it resulted longer hospital stays. Further studies are needed to better define the pathophysiologic mechanisms underlying these hemodynamic alterations.
Özürlülüğün tanımı ve özürlülere sağlık kurulu raporlarının nasıl verilmesi gerektiği ile ilgili mevzuat, Bakanlar Kurulu'nun 16.12.2010 tarih ve 27787 sayılı resmi gazetede yayımlanan "Özürlülük ölçütü, sınıflandırması ve özürlülere verilecek sağlık kurulu raporları hakkında yönetmelik" ile düzenlenmiştir. Özürlü; doğuştan veya sonradan, bedensel, zihinsel, ruhsal, duygusal ve sosyal yeteneklerini çeşitli derecelerde kaybetmesi nedeniyle toplumsal yaşama uyum sağlama ve günlük gereksinimlerini karşılamada güçlükleri olan, korunma, bakım, rehabilitasyon, danışmanlık veya destek hizmetlerine ihtiyaç duyan birey olarak tanımlanır (1). Özürlülük sağlık kurulu üyeleri; iç hastalıkları, genel cerrahi, göz hastalıkları, kulak-burun-boğaz, nöroloji, psikiyatri, fizik tedavi ve rehabilitasyon uzmanlarından oluşur. Özürlü sağlık kurulu raporu; kişilerin özür ve sağlık durumunu, yararlanabileceği sosyal hakları ve çalıştırılamayacağı iş alanlarını belirten belgedir. Özürlü sağlık kurulu raporlarını düzenlemeye yetkili sağlık kurumları ve hakem hastaneleri Sağlık Bakanlığı tarafından belirlenir ve ilan edilir.
Background: Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. Objective: To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. Conclusions: The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice.
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