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    Cerebral venous sinus thrombosis: an analyses of 47 patients.
    (2012) Uzar E.; Ekici F.; Acar A.; Yucel Y.; Bakir S.; Tekbas G.; Oncel O.
    Cerebral venous sinus thrombosis (CVST) is an extremely rare disease and its early treatment is important for decreasing the morbidity and mortality. In present study, it was investigated to clinical and etiological factors, localization features, treatment, and prognosis of patients with CVST. The study group included CVST cases who were followed up between January 2008 and June 2010. Demographical, clinical, radiological, etiological and prognostic characteristics of 47 patients with CVST were retrospectively investigated. Presentation complaints of the patients were as follows in order: acute and/or sub-acute headache (80.8%), impaired consciousness (25.5%), ear complaints (21.3%), paresis (19.1%) and epileptic seizures (14.9%). Chronic daily headache without any signs of neurological deficit was found in 10.6% of cases. Neurologic examinations of 40.4% of the CSVT patients were found to be normal. The most frequently found etiological factors were as follows: MTHFR gene mutation (25.5%), local infections due to chronic otitis complications (21.3%), puerperium (17%), pregnancy (12.8%), lupus anticoagulant positivity (12.8%). The sigmoid sinus was found to be involved in 35 patients (74.5%), the transverse sinus in 29 (61.7%) and superior sagittal sinus in 21 (44.7%). Impaired consciousness (p = 0.046), hemorrhagic infarct (p = 0.017), acute onset (p = 0.026), and presence of hemiparesis (p = 0.019) were found to be associated with increased mortality. New onset sub-acute or chronic headache may be the only neurologic complaint of CVST patients. Early diagnosis and anticoagulant treatment may decrease mortality and/or morbidity rates related with CVST in these patients.
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    Demographic and etiologic data and risk factors of young stroke patient
    (Duzce University Medical School, 2012) Acar A.; Uzar E.; Çevik M.U.; Yücel Y.; Cansever S.; Arikanoğlu A.; Ekici F.
    Purpose:Was to evaluate the etiopathogenesis and vascular risk factors in young patients with ischemic stroke. Methods: Fifty-three young patients (age between 17-45 years) with ischemic stroke were analysed retrospectively. The cases were classified according to TOAST classification. In medical history, smoking, alcohol taking, oral contraceptive, abortion history, pregnancy, hypertension, diabetes mellitus, and atherosclerosis has been evaluated. Results: Of the 53 patients, 23 (43.4%) were males and 30 (56.6%) were females. The risk factors described for the etiology of stroke was found to large vessel disease 17 (32.1%), cardioemboli 12 (22.6%), small vessel disease 11 (20.8%), other factors 11 (20.8%) and undetermined factors 3 (5.7%). Conclusions: We believe that may reduce the incidence of stroke in the young patients by determined risk factors and taking the necessary measures, hereby may prevent mortality and disability in the patients who have risk for stroke. © 2012 Düzce Medical Journal.
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    Evaluation of erythropoietin effects on cerebral ischemia in rats
    (Maghira and Maas Publications, 2007) Aluclu M.U.; Acar A.; Guzel A.; Bahceci S.; Yaldiz M.
    Objective: Majority of severe disabilities in adults are caused by stroke. The aim of our study is to learn the effects of erythropoietin (EPO), on infarct size in cerebral ischemia and to determine neurological behavioral scores and histopathological evaluation. Material & methods: In this study 30 adult Sprague-Dawney rats were used. Cerebral ischemia was constituted by intraluminal filament method with a 4-0-nylon suture. Reperfusion was started after two hours of middle cerebral artery occlusion. The rats were randomly divided into two groups as follow: control and EPO groups. Saline 0.9% (0.6 m5 ml/kg) and EPO (5 000 U/kg) was administered intraperitoneally in the groups. Three coronal slices in two millimeters thickness were obtained from cerebrum, cerebellum and brain stem, and were stained with a 2% solution of triphenyltetrazolium chloride. Transparent sheets were placed over each section and the areas of the brain and infarct were measured. The neurological scores were determined at 24th, 48th and 72nd hours after reperfusion. Results: Percent of ischemic area (%) in cerebrum, cerebellum and brain stem level in EPO groups were less than those of control group (p<0.0001). In addition, we determined that EPO group was better than controls of neurologic score and histopatologically after cerebral ischemia. Conclusions: We concluded that EPO may decrease ischemic area in experimental cerebral ischemia in rats and it seems that EPO may be beneficial. © 2007 Neuroendocrinology Letters.
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    Protective effect of caffeic acid phenethyl ester in rat cerebral ischemia/reperfusion damage
    (Turkish Neurosurgical Society, 2011) Uzar E.; Acar A.; Firat U.; Evliyaoğlu O.; Alp H.; Tüfek A.; Yavuz C.
    Objective: Because oxidative stress is related to cerebral ischemia/reperfusion (I/R) injury, modulation of oxygen free radical production may represent a new approach to the management of cerebral I/R. Caffeic acid phenethyl ester (CAPE) has been determined to have neuroprotective, antioxidant, anti-inflammatory, and anti-apoptotic activities. The aim of this study was to investigate whether CAPE has a protective effect on cerebral I/R damage, and to determine the possible effects of CAPE on total antioxidant/oxidant status. Methods: A total of 30 rats were randomly divided into three groups as control group, I/R group, and I/R + CAPE. Total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) levels and histopathological cellular structures were evaluated in cerebral tissues obtained after the experiment procedure in all groups. Results: In the brain tissue, TOS and OSI levels were found to be significantly increased in the I/R group compared to the controls (p= 0.023, p= 0.001, respectively). Significantly decreased TAS levels were found in the I/R group compared to the controls (p= 0.001). CAPE treatment prevented the increase in TOS and OSI that is produced by cerebral I/R (p= 0.041, p= 0.001, respectively). TAS was found to be increased in the CAPE + I/R group compared with the I/R group (p= 0.002). In the I/R group, the brain sections showed findings of cerebral I/R damage including inflammation, vascular congestion and necrosis (for both variables, p= 0.001). These histopathological cerebral damage findings were found to be significantly reduced in the CAPE + I/R group compared to the I/R group (for both parameters, p< 0.05). Conclusion: In this study, it was found that oxidative stress had an important role in the pathogenesis of cerebral I/R damage, and histopathological and biochemical evaluations showed significantly decreased I/R damage following CAPE treatment in rats.