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    Behcet's disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study
    (OXFORD UNIV PRESS, 2019) Uluduz, Derya; Midi, Ipek; Duman, Taskin; Colakoglu, Sena; Tufekci, Ahmet; Bakar, Mustafa; Nazliel, Bijen; Tascilar, Nida; Goksan, Baki; Sungur, Mehmet Ali; Kozak, Hasan Huseyin; Demir, Serkan; Misirli, Cemile Handan; Kucukoglu, Hayriye; Cinar, Nilgun; Domac, Fusun Mayda; Ozturk, Serefnur; Yayla, Vildan; Karahan, Ali Yavuz; Afsar, Nazire; Goksu, Eylem Ozaydin; Mengulluoglu, Necdet; Aytac, Emrah; Yesilot, Nilufer; Ince, Birsen; Yalin, Ozgur Osman; Oruc, Serdar; Demirci, Seden; Senol, Mehmet Guney; Yilmaz, Arda; Gokce, Mustafa; Kusbeci, Ozge Yilmaz; Uzuner, Gulnur; Caglayan, Hale Zeynep Batur; Acikgoz, Mustafa; Zeydan, Burcu; Ozdag, Fatih; Baybas, Sevim; Ekmekci, Hakan; Cabalar, Murat; Yaman, Mehmet; Yurekli, Vedat Ali; Tekeli, Hakan; Genc, Hamit; Utku, Uygar; Tokuc, Firdevs Ezgi Ucan; Uzuner, Nevzat; Bektas, Hesna; Kablan, Yuksel; Goksel, Basak K.; Milanlioglu, Aysel; Orken, Dilek Necioglu; Aluclu, Ufuk
    Objective This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behcet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). Methods VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. Results BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). Conclusions BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score 2).
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    Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study
    (Hindawi, 2020) Uluduz, Derya; Sahin, Sevki; Duman, Taskin; Ozturk, Serefnur; Yayla, Vildan; Afsar, Nazire; Uzuner, Nevzat; Midi, Ipek; Cinar, Nilgun; Sungur, Mehmet Ali; Domac, Fusun Mayda; Ince, Birsen; Goksan, Baki; Misirli, Cemile Handan; Bakar, Mustafa; Kozak, Hasan Huseyin; Colakoglu, Sena; Karahan, Ali Yavuz; Goksu, Eylem Ozaydin; Ozdag, Fatih; Senol, Mehmet Guney; Yurekli, Vedat Ali; Aluclu, Ufuk; Demir, Serkan; Kucukoglu, Hayriye; Oruc, Serdar; Yesilot, Nilufer; Nazliel, Bijen; Tokuc, Firdevs Ezgi Ucan; Bektas, Hesna; Aytac, Emrah; Gokce, Mustafa; Caglayan, Hale Zeynep Batur; Tufekci, Ahmet; Uzuner, Gulnur; Orken, Dilek Necioglu; Yalin, Osman Ozgur; Utku, Uygar; Yılmaz, Arda; Genc, Hamit; Cabalar, Murat; Milanlioglu, Aysel; Ekmekci, Hakan; Zeydan, Burcu; Baybas, Sevim; Kablan, Yuksel; Goksel, Basak Karakurum; Acikgoz, Mustafa; Kurucu, Hatice; Demirci, Seden; Gunes, Taskin
    Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group.Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF.Results. The mean age of the RHRF (-) group (43.2 +/- 13 years) was significantly higher than of the RHRF (+) group (34 +/- 9years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 +/- 9years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%).Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.
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    The COVID-19 from Neurological Overview
    (TURKISH NEUROLOGICAL SOC, 2020) Acar, Türkan; Demirel, Esra Acıman; Afsar, Nazire; Akçalı, Aylin; Demir, Gülşen Akman; Alagöz, Aybala Neslihan; Mengi, Tuğçe Angin; Arsava, Ethem Murat; Ayta, Semih; Bebek, Nerses; Bilgiç, Başar; Boz, Cavit; Çakar, Arman; Çelebisoy, Nese; Çevik, Mehmet Uygur; Delen, Firuze; Tekçe, Hacer Durmuş; Ekmekçi, Hakan; Elmalı, Ayşe Deniz; Erdinç, Oğuz Osman; Erdoğan, Füsun Ferda; Eren, Fettah; Ergün, Ufuk; Parman, Yeşim Gülşen; Gümüş, Haluk; Algin, Demet İlhan; Karabudak, Rana; Karadaş, Ömer Yıldız; Koç, Emine Rabia; Adapınar, Demet Özbabalık; Özdemir, Atilla Özcan; Öztürk, Şerefnur; Kocaman, Ayşe Sağduyu; Şahin, Sevki; Topcuoğlu, Esen Saka; Sener, Özden; Tezer, F. Irsel; Togrol, Rıfat Erdem; Tokcaer, Ayşe Bora; Topcuoğlu, Mehmet Akif; Tuncer, Neşe; Ali Ulvi, Uluç; Yön, Mehmet İlker
    Objective. Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption. Methods. A total of 60 patients were randomized into two groups (N =30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded. Results. Intraoperative and postoperative opioid consumption at 0-8, 8-16, and 16-24 hours and rescue analgesic use were significantly lower in the ESPB group (P< 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P< 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P > 0.05 each). Conclusion. US-guided ESPB may provide better pain control than SAPB after VATS. Question. Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective. Findings. This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB. Meaning. Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.
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    Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study
    (W B SAUNDERS CO LTD, 2020) Uluduz, Derya; Midi, Ipek; Duman, Taskin; Yayla, Vildan; Karahan, Ali Yavuz; Afsar, Nazire; Goksu, Eylem Ozaydin; Mengulluoglu, Necdet; Aytac, Emrah; Sungur, Mehmet Al; Yesilot, Nilufer; Ince, Birsen; Yalin, Osman Ozgur; Oruc, Serdar; Senol, Mehmet Guney; Yilmaz, Arda; Gokce, Mustafa; Demirci, Seden; Kusbeci, Ozge Yilmaz; Uzuner, Gulnur; Caglayan, Hale Zeynep Batur; Acikgoz, Mustafa; Kurucu, Hatice; Ozdag, Fatih; Baybas, Sevim; Ekmekci, Hakan; Cabala, Murat; Yaman, Mehmet; Yurekli, Vedat Ali; Tekeli, Hakan; Genc, Hamit; Utku, Uygar; Sahin, Sevki; Tokuc, Firdevs Ezgi Ucan; Uzuner, Nevzat; Bektas, Hesna; Kablan, Yuksel; Goksel, Basak Karakurum; Milanlioglu, Aysel; Orken, Dilek Necioglu; Aluclu, Ufuk; Colakoglu, Sena; Tufekci, Ahmet; Bakar, Mustafa; Nazliel, Bijen
    Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
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    A Multicenter Study of 1144 Patients with Cerebral Venous Thrombosis: The VENOST Study
    (ELSEVIER SCIENCE BV, 2017) Duman, Taskin; Uluduz, Derya; Midi, Ipek; Bektas, Hesna; Kablan, Yuksel; Goksel, Basak K.; Milanlioglu, Aysel; Orken, Dilek Necioglu; Aluclu, Ufuk; Colakoglu, Sena; Tufekci, Ahmet; Bakar, Mustafa; Nazliel, Bijen; Tascilar, Nida; Goksan, Baki; Kozak, Hasan Huseyin; Demir, Serkan; Misirli, Cemile Handan; Kucukoglu, Hayriye; Cinar, Nilgun; Domac, Fusun Mayda; Ozturk, Serefnur; Yayla, Vildan; Karahan, Ali Yavuz; Afsar, Nazire; Goksu, Eylem Ozaydin; Mengulluoglu, Necdet; Aytac, Emrah; Yesilot, Nilufer; Ince, Birsen; Yalin, Ozgur Osman; Oruc, Serdar; Demirci, Seden; Senol, Mehmet Guney; Yilmaz, Arda; Gokce, Mustafa; Kuspeci, Ozge Yilmaz; Uzuner, Gulnur; Caglayan, Hale Zeynep Batur; Acikgoz, Mustafa; Zeydan, Burcu; Ozdag, Fatih; Baybas, Sevim; Ekmekci, Hakan; Cabalar, Murat; Yaman, Mehmet; Yurekli, Vedat Ali; Tekeli, Hakan; Genc, Hamit; Utku, Uygar; Tokuc, Firdevs Ezgi Ucan; Uzuner, Nevzat
    Background: Based on a number of small observational studies, cerebral venous sinus thrombosis has diverse clinical and imaging features, risk factors, and variable outcome. In a large, multicenter cerebral venous thrombosis (VENOST) study, we sought to more precisely characterize the clinical characteristics of Caucasian patients. Methods: All data for the VENOST study were collected between the years 2000 and 2015 from the clinical follow-up files. Clinical and radiological characteristics, risk factors, and outcomes were compared in terms of age and sex distribution. Results: Among 1144 patients 68% were women, and in older age group (>50 years) male patients were more prevalent (16.6% versus 27.8%). The most frequent symptoms were headache (89.4%) and visual field defects (28.9%) in men, and headache (86.1%) and epileptic seizures (26.8%) in women. Gynecological factors comprised the largest group in women, in particular puerperium (18.3%). Prothrombotic conditions (26.4%), mainly methylenetetrahydrofolate reductase mutation (6.3%) and Factor V Leiden mutation (5.1%), were the most common etiologies in both genders. 8.1% of patients had infection-associated and 5.2% had malignancy-related etiology that was significantly higher in men and older age group. Parenchymal involvement constitutively hemorrhagic infarcts, malignancy, and older age was associated with higher Rankin score. Epileptic seizures had no effect on prognosis. Conclusions: Clinical and radiological findings were consistent with previous larger studies but predisposing factors were different with a higher incidence of puerperium. Oral contraceptive use was not a prevalent risk factor in our cohort. Malignancy, older age, and hemorrhagic infarcts had worse outcome. (c) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.