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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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    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.
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    What Happens in the Other Eye? Blink Reflex Alterations in Contralateral Side After Facial Palsy
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Sahin, Sevki; Yaman, Mehmet; Mungan, Semra Ozturk; Kiziltan, Meral Erdemir
    Alterations in blink reflex excitability may occur in the contralateral side (CLS) and in the symptomatic side after peripheral facial palsy (PFP). In this study, the alterations of blink reflex in CLS were evaluated in cases with PFP who showed "three different types" of recovery. For this purpose, the R2 response area and recovery curve of the blink reflex were evaluated. The study included 51 patients suffering from PFP and 20 age- and sex-matched healthy controls. Cases with PFP were divided into three groups: patients with PFP with partially cured and accompanied by synkinesis (postfacial syndrome), patients with PFP with residual weakness, and patients who suffered from recurrent PFP. All three groups' R2 values of CLS were compared with the values of controls and patients who had synkinesis. The CLS of all three groups' R2 area values were found to be significantly higher when compared with controls. These values were found to be highest in patients who suffered from recurrent PFP. Hyperexcitability occurs in CLS after PFP and this is highest in patients who suffer from recurrent PFP. It suggested that the contralateral reorganization caused by peripheral nerve damage correlates with the severity of the lesion and the recurrence of axon damage enhances the excitability of the reflex cycle, which affects the contralateral facial nucleus.