Papers by SEREFNUR OZTURK
BMJ Neurology Open, Jun 1, 2023
Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: a seconda... more Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: a secondary analysis of a large randomised controlled trial.
Exon Publications eBooks, Jun 22, 2021
The risk factors for stroke increase with age. During the pandemic, the novel coronavirus disease... more The risk factors for stroke increase with age. During the pandemic, the novel coronavirus disease (COVID-19) has become another risk factor for stroke. Although in its infancy, emerging data suggest that COVID-19 not only increases the risk of stroke, especially in the elderly, but also its severity. Thromboembolic events leading to a hypercoagulative state appear to be the leading mechanism. This chapter provides an overview of our current knowledge of COVID-19 being a risk factor for stroke. The epidemiology, risk factors, pathology, and mechanisms of COVID-19-mediated stroke are discussed from a neurological perspective.
Turkish Journal Of Neurology, Mar 1, 2018
One of the most important reasons why the use of the intravenous (IV) tissue plasminogen activato... more One of the most important reasons why the use of the intravenous (IV) tissue plasminogen activator (tPA), which is one of the key elements of acute ischemic stroke treatment, is not sufficiently widespread is the fact that many common questions have not been adequately answered. In this review, questions about systemic nonneurologic conditions, problems related with IV tPA treatment and complications of treatment, which were collected from our colleagues practicing in Turkey and which are more important in clinical practice, were answered on the basis of the current literature and clear recommendations are made.
Translational Stroke Research, Sep 9, 2020
Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify t... more Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if commenced between 48 h and 7 days after onset. Logistic regression was used to identify predictors and effects of neurological deterioration and the effect of tranexamic acid on neurological deterioration. Of 2325 patients, 735 (31.7%) had neurological deterioration: 590 (80.3%) occurred early and 145 (19.7%) late. Predictors of early neurological deterioration included recruitment from the UK, previous ICH, higher admission systolic blood pressure, higher NIHSS, shorter onset-to-CT time, larger baseline hematoma, intraventricular hemorrhage, subarachnoid extension and antiplatelet therapy. Older age, male sex, higher NIHSS, previous ICH and larger baseline hematoma predicted late neurological deterioration. Neurological deterioration was independently associated with a modified Rankin Scale of > 3 (aOR 4.98, 3.70-6.70; p < 0.001). Tranexamic acid reduced the risk of early (aOR 0.79, 0.63-0.99; p = 0.041) but not late neurological deterioration (aOR 0.76, 0.52-1.11; p = 0.15). Larger hematoma size, intraventricular and subarachnoid extension increased the risk of neurological deterioration. Neurological deterioration increased the risk of death and dependency at day 90. Tranexamic acid reduced the risk of early neurological deterioration and warrants further investigation in ICH.
JAMA Neurology, Oct 1, 2020
The concept of embolic stroke of undetermined source (ESUS) unifies a subgroup of cryptogenic str... more The concept of embolic stroke of undetermined source (ESUS) unifies a subgroup of cryptogenic strokes based on neuroimaging, a defined minimum set of diagnostic tests, and exclusion of certain causes. Despite an annual stroke recurrence rate of 5%, little is known about the etiology underlying recurrent stroke after ESUS. OBJECTIVE To identify the stroke subtype of recurrent ischemic strokes after ESUS, to explore the interaction with treatment assignment in each category, and to examine the consistency of cerebral location of qualifying ESUS and recurrent ischemic stroke. DESIGN, SETTING, AND PARTICIPANTS The NAVIGATE-ESUS trial was a randomized clinical trial conducted from December 23, 2014, to October 5, 2017. The trial compared the efficacy and safety of rivaroxaban and aspirin in patients with recent ESUS (n = 7213). Ischemic stroke was validated in 309 of the 7213 patients by adjudicators blinded to treatment assignment and classified by local investigators into the categories ESUS or non-ESUS (ie, cardioembolic, atherosclerotic, lacunar, other determined cause, or insufficient testing). Five patients with recurrent strokes that could not be defined as ischemic or hemorrhagic in absence of neuroimaging or autopsy were excluded. Data for this secondary post hoc analysis were analyzed from March to June 2019. INTERVENTIONS Patients were randomly assigned to receive rivaroxaban, 15 mg/d, or aspirin, 100 mg/d. MAIN OUTCOMES AND MEASURES Association of recurrent ESUS with stroke characteristics. RESULTS A total of 309 patients (205 men [66%]; mean [SD] age, 68 [10] years) had ischemic stroke identified during the median follow-up of 11 (interquartile range [IQR], 12) months (annualized rate, 4.6%). Diagnostic testing was insufficient for etiological classification in 39 patients (13%). Of 270 classifiable ischemic strokes, 156 (58%) were ESUS and 114 (42%) were non-ESUS (37 [32%] cardioembolic, 26 [23%] atherosclerotic, 35 [31%] lacunar, and 16 [14%] other determined cause). Atrial fibrillation was found in 27 patients (9%) with recurrent ischemic stroke and was associated with higher morbidity (median change in modified Rankin scale score 2 [IQR, 3] vs 0 (IQR, 1]) and mortality (15% vs 1%) than other causes. Risk of recurrence did not differ significantly by subtype between treatment groups. For both the qualifying and recurrent strokes, location of infarct was more often in the left (46% and 54%, respectively) than right hemisphere (40% and 37%, respectively) or brainstem or cerebellum (14% and 9%, respectively). CONCLUSIONS AND RELEVANCE In this secondary analysis of randomized clinical trial data, most recurrent strokes after ESUS were embolic and of undetermined source. Recurrences associated with atrial fibrillation were a minority but were more often disabling and fatal. More extensive investigation to identify the embolic source is important toward an effective antithrombotic strategy.
Turkish Journal Of Neurology, Dec 17, 2021
Parainfectious Neurological Syndromes Patients with COVID-19 encountered the most common neurolog... more Parainfectious Neurological Syndromes Patients with COVID-19 encountered the most common neurological disorders during the symptomatic viral period in the early disease period, which is all examined within the scope of "parainfectious syndromes," such as anosmia, ageusia, encephalopathy (metabolic and/or hypoxic), viral Coronavirus disease-2019 (COVID-19) can be associated with wide-range neurologic symptoms and complications. Parainfectious manifestations that are seen during the active infection period include stroke, olfactory and taste disturbance, encephalopathy, encephalitis, neuropathies, and myopathies. The main postinfectious complications are acute disseminated encephalomyelitis, transverse myelitis, Guillain-Barré syndrome, cognitive disorders, and sleep disorders. COVID-19 commonly causes neurological mid-to-long-term disability. The disease prognosis can be improved with sufficient knowledge, prompt recognition, and effective management of neurological complications.
European stroke journal, Jan 24, 2020
Introduction: Seizures are common after intracerebral haemorrhage. Tranexamic acid increases the ... more Introduction: Seizures are common after intracerebral haemorrhage. Tranexamic acid increases the risk of seizures in non-intracerebral haemorrhage population but its effect on post-intracerebral haemorrhage seizures is unknown. We explored the risk factors and outcomes of seizures after intracerebral haemorrhage and if tranexamic acid increased the risk of seizures in the Tranexamic acid for IntraCerebral Haemorrhage-2 trial. Patients and methods: Seizures were reported prospectively up to day 90. Cox regression analyses were used to determine the predictors of seizures within 90 days and early seizures (7 days). We explored the effect of early seizures on day 90 outcomes. Results: Of 2325 patients recruited, 193 (8.3%) had seizures including 163 (84.5%) early seizures and 30 (15.5%) late seizures (>7 days). Younger age (adjusted hazard ratio (aHR) 0.98 per year increase, 95% confidence interval (CI) 0.97-0.99; p ¼ 0.008), lobar haematoma (aHR 5.84, 95%CI 3.58-9.52; p < 0.001), higher National Institute of Health Stroke Scale (aHR 1.03, 95%CI 1.01-1.06; p ¼ 0.014) and previous stroke (aHR 1.66, 95%CI 1.11-2.47; p ¼ 0.013) were associated with early seizures. Tranexamic acid did not increase the risk of seizure within 90 days. Early seizures were associated with worse modified Rankin Scale (adjusted odds ratio (aOR) 1.79, 95%CI 1.12-2.86, p ¼ 0.015) and increased risk of death (aOR 3.26, 95%CI 1.98-5.39; p < 0.001) at day 90. Discussion and conclusion: Lobar haematoma was the strongest independent predictor of early seizures after intracerebral haemorrhage. Tranexamic acid did not increase the risk of post-intracerebral haemorrhage seizures in the first 90 days. Early seizures resulted in worse functional outcome and increased risk of death.
European Journal of Neurology, May 10, 2022
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Genel tıp dergisi, Sep 20, 2021
Öz Dünya Sağlık Örgütü tarafından 11 Mart 2019'da pandemi olarak kabul edilen COVID-19 hastalığın... more Öz Dünya Sağlık Örgütü tarafından 11 Mart 2019'da pandemi olarak kabul edilen COVID-19 hastalığının pandeminin ilk döneminde öncelikle solunum yollarını etkileyen ve ciddi akut solunum yetmezliğine (SARS) neden olan bir viral enfeksiyon olduğu kabul edilmiştir. Zaman içinde vasküler sistemler başta olmak üzere diğer organ sistemlerini ve en önemlisi de diğer sistemlerle beraber nörolojik sistemleri ve hatta bazen sadece nörolojik sistemleri etkilediği ortaya konmuştur. Ciddi semptomu olmayan hastalarda bile koku alma kaybı sık olarak görülmekte olup bazı hastalarda ilk veya tek belirti olabilmektedir. Viral enfeksiyonun iyileşmesine rağmen koku alma fonksiyonunun aynı hızla kazanılamaması yaşam kalitesini etkileyen önemli bir nörolojik tutulumdur. Dünyada pandemi sürecinde vaka bildirimleri ve klinik verilerin analizleri ile hızlı bilgi akışı devam etmektedir. Bu yazıda literatür incelemesi ile dünyada bildirilen nörolojik tutulumlar ışığında kranial sinir tutulumları, serebrovasküler hastalıklar ve inme, ansefalit, epilepsi, Guillain Barré sendromu, psikiyatrik bozukluklar ile ilgili güncel bilgilerin paylaşılması amaçlanmıştır.
Turkish Journal Of Neurology, Jun 30, 2020
Re cei ved/Ge lifl Ta ri hi: 04.04.2020 Ac cep ted/Ka bul Ta ri hi: 10.04.2020 © Telif Hakkı 2020... more Re cei ved/Ge lifl Ta ri hi: 04.04.2020 Ac cep ted/Ka bul Ta ri hi: 10.04.2020 © Telif Hakkı 2020 Türk Nöroloji Derneği Türk Nöroloji Dergisi, Galenos Yayınevi tarafından basılmıştır. Neurological diseases are the most common and important health burden over the world. Coronavirus disease-19 (COVID-19) pandemic is a new and important burden for the neurological area. Information related to the neurological involvement of Severe Acute Respiratory syndrome-Coronavirus-2 infection has been increased during the last several months. Frequency and mechanisms of neurological involvement of the disease may be explained more efficiently by neurologists who are included within the multidisciplinary COVID-19 teams. Other very important point is possibility of failure of follow up and treatment of chronic neurological disorders which needed frequent and regular control and also quick action for the acute treatment. The regulations are extremely important for the neurologists to perform their responsibilities with considering all these requirements.
Neurology Asia
Background & Objectives: Symptomatic carotid artery stenosis (SCAS) is one of the most important ... more Background & Objectives: Symptomatic carotid artery stenosis (SCAS) is one of the most important causes of ischemic stroke. We aimed to investigate the relationship between hematological and inflammatory parameters in patients with SCAS and controls. Method: Patients who underwent digital subtraction angiography for SCAS were evaluated retrospectively. Patients with carotid stenosis greater than 50% who had a stroke in the last six months were included in the study. Clinical and sociodemographic characteristics, stent characteristics, filter use, balloon dilatation status, arch type, presence of contralateral occlusion, and complication status were recorded. Hemogram was evaluated using fluorescence flow cytometry. Data were analyzed among patients with SCAS, ischemic stroke patients without stenosis and healthy control group. Results: SCAS was higher in patients with advanced age, male, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, and a history of strok...
Neurology Asia, Mar 1, 2023
Background & Objectives: This study aimed to compare PD patients with and without COVID-19 and to... more Background & Objectives: This study aimed to compare PD patients with and without COVID-19 and to evaluate the associated factors about prognosis. Methods: The data of 37 hospitalized PD patients associated with COVID-19 pneumonia were evaluated. It was compared with the data of 40 PD patients who did not have COVID-19 in the same period. Clinical findings, prognosis, mortality and other related factors were compared in PD patients with and without COVID-19. Results: Hypertension was higher comorbid disease in PD patients with COVID-19 (p = 0.005). The duration of PD was longer in patients without COVID-19 disease (6.02 ± 2.80 vs 5.08 ± 4.59) (p = 0.028). In PD patients with COVID-19, the most common symptoms were myalgia-arthralgia (73.0%) and fatigue (48.6%). Intensive care was required in 17 (45.9%) patients, and invasive mechanical ventilation (IMV) was required in 9 (24.3%) patients. The in-hospital mortality rate was 29.7% (n = 11). Mortality and IMV requirement were higher in patients whose initial symptom was diarrhea (p = 0.004, p = 0.008, respectively). No correlation was detected between PD stage, treatment options and prognosis (p < 0.05). Conclusion: Mortality rate and IMV requirement are higher in PD patients with COVID-19 pneumonia, particularly in patients with initial symptoms of diarrhea. These patients should be followed more carefully in terms of probable poor prognosis.
COVID-19 Pandemic, Mental Health and Neuroscience - New Scenarios for Understanding and Treatment [Working Title]
COVID-19 disease was defined as a disease of primary respiratory system. However, symptoms associ... more COVID-19 disease was defined as a disease of primary respiratory system. However, symptoms associated with central nervous system were detected in approximately 2/3 of the hospitalized patients. The rate of ischemic cerebrovascular diseases is higher in central nervous system. In addition, hemorrhagic cerebrovascular diseases, encephalitis and/or encephalopathy are the other diseases. Complex pathogenesis was demonstrated in the central nervous system diseases associated with SARS-CoV-2. It was reported that SARS-CoV-2 virus could directly invade the central nervous system, especially via the olfactory nerves or the haematological pathway. As a result, endothelial cells, pericytes and/or neurons can be infected (direct pathway). Another mechanism is central nervous system deficit resulting from peripheral immune reactivation (indirect pathway). All these etiopathogenetic results support that COVID-19 disease is associated with cognitive dysfunction. Cerebral hypoperfusion associated...
Turkish Journal Of Neurology, 2017
Amaç: Hastane enfeksiyonları (HE) özellikle yoğun bakım üniteleri (YBÜ) gibi yüksek riskli alanla... more Amaç: Hastane enfeksiyonları (HE) özellikle yoğun bakım üniteleri (YBÜ) gibi yüksek riskli alanlarda yatan hasta gruplarında ciddi tehdit oluşturmaktadır. Bu alanlardaki enfeksiyon etkenlerinin tanınması ve bu enfeksiyonların tedavisi hem primer hastalığın prognozu hem de hastanede kalış süresi üzerinde etkilidir. Bu çalışmada nöroloji YBÜ'de (NYBÜ) aktif enfeksiyon surveyans değerlendirmesi yapmayı planladık. Gereç ve Yöntem: NYBÜ'de on iki aylık sürede 291 hasta çalışmaya dahil edilmiştir. Fakültemiz enfeksiyon kontrol komitesi tarafından tutulan kayıtlar "Hastalık Kontrol ve Önleme Merkezi" (Centers for Disease Control and Prevention) tanı kriterlerine göre incelenmiş ve HE tanısı konulmuştur. İzole edilen mikroorganizmalar ve sistemik tutulumları incelenmiştir. Bulgular: NYBÜ'deki enfeksiyonlar tüm HE'lerin %6,39'unu oluşturmaktadır. Bunlar; deri ve yumuşak doku enfeksiyonları (%3,13), kan dolaşımı enfeksiyonları (%9,38), mekanik ventilatörden bağımsız pnömoniler (%9,38), ventilatör ile ilişkili pnömoniler (%6,25) ve üriner sistem enfeksiyonlarıdır (ÜSE) (%71,88). Bu ünitede on iki ayda on dört farklı mikroorganizma tespit edilmiştir. Sonuç: YBÜ'de en sık tespit edilen enfeksiyon ÜSE olduğundan üriner kateter takılması ve bakımında daha dikkatli olunması gerekmektedir. Ayrıca HE'lerin tanınması ve neden olan mikroorganizmaların antibiyotik duyarlılıklarının belirlenmesi hem ampirik tedaviyi belirlemede, hem de mortalite ve morbiditeyi azaltmada oldukça önemlidir. Anahtar Kelimeler: Hastane enfeksiyonları, nöroloji yoğun bakım ünitesi, surveyans Objective: Nosocomial infections (NI) are serious threats for patients, especially those treated in intensive care units (ICU), which have high risk. Therefore, determining the infectious agents in this area and treating the infections are crucial for both the prognosis of primary disease and the time of stay in hospital. In this study, we aimed to perform an active infection surveillance in the neurological ICU (NICU). Materials and Methods: Two hundred ninety-one patients who stayed in NICU over a twelve-month period were included in the study. Data obtained by infection control committee of our faculty according to "Centres for Disease Control and Prevention" diagnostic criteria were used for the diagnosis of NI. Isolated microorganisms and their systemic involvement were examined. Results: The infections in NICU constituted 6.39% of all NI in the hospital. These were skin and soft tissue infections (3.13%), bloodstream infections (9.38%), pneumonia not associated with mechanical ventilator (9.38%), pneumonia associated with mechanical ventilator (6.25%), and urinary tract infections (UTI) (71.88%). Fourteen different microorganisms were determined in the unit over the twelve months.
Van Medical Journal, 2019
Epilepsi hastalığı, dünyada yaklaşık elli milyon insanı etkilemektedir. Bu hastalık hasta ve yakı... more Epilepsi hastalığı, dünyada yaklaşık elli milyon insanı etkilemektedir. Bu hastalık hasta ve yakınlarında mesleki, sosyal ve evlilik ile ilgili kaygılara yol açmaktadır. Ayrıca uyku bozuklukları epilepsi hastalıklarında normalden daha sık görülmektedir. Hastalık ilişkili kaygı ve uyku bozukluğu hastalığın prognozunu olumsuz yönde etkileyebilmektedir. Bu nedenle kaygı ve uyku durumunun değerlendirilmesi önemlidir. Gereç ve Yöntem: Çalışmaya 2016-2017 yıllarında nöroloji polikliniğine başvuran, 18-85 yaş arası primer epilepsi hastaları alınmıştır. Hastaların demografik ve klinik özellikleri değerlendirilmiştir. 16 sorudan oluşan epilepsi bilgi ölçeği, 20 sorudan oluşan epilepsi kaygı ölçeği ve Pittsburgh uyku kalitesi anketi uygulanmıştır. Veriler SPSS Windows 16 sürümü ile değerlendirilmiştir. Bulgular: 49 (%48) kadın ve 53 (%52) erkek hasta katıldı. Yaş ortalamaları 31,86±11,04 idi. 12,11±12 yıldır epilepsi hastalıkları vardı. Ortalama 1,82±1,02 farklı epilepsi ilacı kullanmaktaydılar. Son 1 ayda ortalama 2,06±1,04 nöbet öyküleri vardı. Epilepsi bilgi ölçeği 10,56±3,24; kaygı ölçeği 61,28±6,82 ve uyku kalitesi de 8,22±3,27 olarak sonuçlandı. Hastalık ilişkili kaygılar ve uyku kalitesi arasında ise ilişki yoktu (r: 0,12; p: 0,23). Hastalık hakkında sahip olunan bilgiler ile kaygılar arasında zayıf bir ilişki saptandı (r: 0,35; p: 0,09). Nöbet sıklığı ile uyku bozukluğu arasında ise daha kuvvetli bir ilişki vardı (r: 0,47; p: 0,04). Sonuç: Hastalar, epilepsi hastalığı hakkında orta düzey bilgiye ama yüksek düzey kaygıya sahipti. Hastalarda çoğunlukla uyku bozukluğu vardı. Bu nedenle, hastaların takip ve tedavileri sırasında hastalık ilişkili kaygılarına ve uyku bozukluklarına da yer verilmesi önemlidir.
Turkish Journal Of Neurology, 2020
346 Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Aydın Talip Yıldoğan, Selçuk Ünivers... more 346 Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Aydın Talip Yıldoğan, Selçuk Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Konya, Türkiye Tel.: +90 507 103 31 95 E-posta: [email protected] ORCID: orcid.org/0000-0002-9482-6203 Ge lifl Ta ri hi/Re cei ved: 05.12.2019 Ka bul Ta ri hi/Ac cep ted: 31.03.2020 ©Telif Hakkı 2020 Türk Nöroloji Derneği Türk Nöroloji Dergisi, Galenos Yayınevi tarafından basılmıştır. Akut iskemik inmede intravenöz doku plazminojen aktivatörü (tPA) sekelsiz sağkalım oranını artırmaktadır. Artan tPA kullanımı ile bu tedavinin komplikasyonları ve yönetimi daha önemli hale gelmiştir. Seksen yaşında erkek hasta 3 saat önce ani başlayan konuşma bozukluğu ve sağ kolda güç kaybı nedeniyle başvurdu. Manyetik rezonans görüntülemede sol insular kortekse uyan lokalizasyonda akut iskemi saptandı. İnfüzyonun 30. dakikasında dilde ve dudakta şişkinlik, konuşurken zorlanma ve seste kabalaşma gözlendi. Hafif solunum sıkıntısı saptandı. Orolingual a...
European Journal of Neurology, 2021
Ağrı - The Journal of The Turkish Society of Algology, 2020
Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may somet... more Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]). Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared. Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group. Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.
Van Medical Journal, 2018
Turkish Journal Of Neurology, 2018
Subarachnoid hemorrhage (SAH) is a clinical condition with acute-onset, sudden, and severe headac... more Subarachnoid hemorrhage (SAH) is a clinical condition with acute-onset, sudden, and severe headache. In addition to headache, severe nausea, vomiting, dizziness, confusion, agitation, focal neurologic deficits, and hypertension can be detected. Findings of meningeal irritation may accompany to these clinical features, 6-24 hours after the hemorrhage. Digital subtraction angiography (DSA) is used for surgical or endovascular treatment planning in order to identify vascular abnormalities, in addition to other imaging studies. After DSA, the frequency of all neurologic complications is between 0.2% and 4.5%. Headache may occur after DSA in an average 50% of patients. This rate is especially higher in female patients. Headache types are usually classified as migraine, tension or postoperative atypical headaches The incidence of severe headache after DSA is low. Vascular wall rupture should be considered first in severe headache after the procedure. It should also be kept in mind that after all other secondary causes are excluded; SAH-like headaches after DSA can be detected.
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Papers by SEREFNUR OZTURK