Stroke is among the leading diseases that cause death and disability worldwide. In stroke, different neurological deficits and functional decline occur depending on the area in the brain where blood flow is impaired. With functional decline, patients also experience physical, mental and social problems. During post-stroke rehabilitation, mostly motor and sensory deficiencies, speech disorders, and physical functioning are focused on. However, psychosocial problems that have a negative impact on the lives of stroke patients are also very important. The main psychosocial problems are post-stroke depression and anxiety, post-stroke cognitive impairment and post-stroke fatigue. Around 20% to 50% of people can be affected by at least one of these problems after a stroke. These problems create difficulties for both the patient and their relatives. However, psychosocial problems are inadequately addressed within current routine treatment services and there is little evidence that they are systematically addressed. Recently, guidelines have been published highlighting psychosocial problems, emphasizing the importance of early assessment and treatment of these problems. Research shows that additional efforts are needed to improve health care for people with stroke. In this context, there should be greater awareness of psychosocial problems and patients should be supported through active follow-up care.

INTRODUCTION: Ischemic stroke is the most common type of stroke in the world. Mechanical thrombectomy (MT) is an effective treatment that can prevent functional dependence in approximately half of patients with acute ischemic stroke with proximal vascular occlusion. However, the clinical course is heterogeneous in patients with ischemic stroke treated with MT. The success of revascularization, long-term clinical course and functional independence with MT depend on many factors.
In our study, we aimed to evaluate the effectiveness of MT in the treatment of acute ischemic stroke, the factors affecting successful revascularization and functional independence, and to investigate the factors that may contribute to early cerebral collateral formation.
METHODS: In the study, patients who received endovascular treatment for acute ischemic stroke at Fýrat University Hospital between May 2016 and May 2019 were retrospectively evaluated and recorded in terms of demographic characteristics, clinical status and radiological images. CT Angiographic (CT Anjio) collateral conditions of the patients taken before the MT procedure were evaluated based on the mTAN score. Chi-square statistical analysis was used to analyze the relationship between collateral score and favorable clinical outcome (mRankinS 0-2) and ravascularization success.
RESULTS: In 23 of 39 patients, successful (TICI 2b-3) recanalization was achieved after the procedure. TAN (2-3) good collaterals were present in 24 patients. Of the 23 patients who recanalized well, 82 percent (n: 19) had good TAN (2-3) collaterals. A significant relationship was found between patients with good collaterals evaluated according to the mTAN score and recanalization success.(p: 0.012<0.05).
DISCUSSION AND CONCLUSION: Patients with acute ischemic stroke who have good collaterals have successful recanalization and functional independence but more studies are needed in the future to reveal the factors that contribute to collateral formation, which has such an impact on the success of treatment in patients with ischemic stroke.

INTRODUCTION: Non-aneurysmal subarachnoid hemorrhage (SAH) accounts for 15% of cases of SAH and is characterized by milder symptoms. However, this group is a heterogeneous group with varying clinical course and outcomes itself. The aim of this study is to examine the radiological features, clinical observations and results of patients with non-aneurysmal perimesencephalic and non-perimesencephalic SAH.
METHODS: 31 patients were included in this retrospective study conducted in two centers.There was no reason to explain the hemorrhage at the time of admission. As a result of radiological imaging, they were divided into two groups: perimesencephalic and non-perimesencephalic SAH.The patients' admission symptoms (headache, dizziness, nausea and vomiting, aphasia, paresis), demographic data, etiological factors, complications (epileptic seizure, rebleeding, hyponatremia, hydrocephalus, shunt dependence, infarction related to delayed cerebral ischemia) and 3rd month modified Rankin Scores were analyzed.
RESULTS: The mean age was 48.5±8.4 years and the male-female gender ratio was equal (52% male).18 (58%) of the patients had non-perimesencephalic SAH. When demographic data were compared, the female gender ratio was higher in perimesencephalic hemorrhage (p=0.007).There were no notable differences observed when comparing etiological factors, complication rates, admission and discharge Glasgow coma scale, intensive care and neurology service stays, and 3rd month modified Rankin scores (p>0.05). Complications were observed in 2 patients with perimesencephalic SAH (vasospasm in 1 patient, epileptic seizure in the other), and in 4 patients with non-perimesencephalic SAH (rebleeding in 1 patient, delayed cerebral ischemia in 1 patient, hyponatremia in 1 patient, epileptic seizure in 1 patient). All patients achieved positive clinical and functional outcomes both at discharge and during the follow-ups (3rd month).
DISCUSSION AND CONCLUSION: Perimesencephalic SAH and non-aneurysmatic non-perimesencephalic SAH have similarities in their clinical characteristics, prognosis, and average duration of hospitalization. Compared to aneurysmatic SAH, they demonstrate reduced complication rates and a more favorable prognosis.

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for the presence of cerebral small-vessel disease, stroke and burden of cerebral atherosclerosis and it is frequently associated with comorbidities such as obesity, metabolic disorders, hypertension, coronary artery disease, circulatory insufficiency, and carotid atherosclerosis, all of which contribute to adverse effects on the cerebrovascular system. This study aimed to analyze the relationship between carotid atherosclerosis (CA) and obesity, vascular risk factors in patients with OSAS.
METHODS: In this retrospective study, we reviewed patients admitted to neurology and chest diseases outpatient clinic with sleep apnea syndrome and hospitalized during nightime for Polysomnography between September 2020-June 2023. Patients with moderate or severe OSAS who underwent bilateral carotid artery Doppler USG for any reason within six months were included in the study group. The control group included the patients meeting criteria who admitted to neurology outpatient clinic. Body Mass Index (BMI) of all patients was calculated as weight (kg) /height (m2). Patients with acute or chronic upper airway or lung infection, severe obstructive or restrictive lung diseases, acute-subacute stroke and myocardial infarction, heart or renal failure, patients with a history of major surgery within six months were also excluded.


RESULTS: According to the inclusion and exclusion criteria, 47 patients with moderate or severe OSAS and 40 patients without OSAS were recruited. Male sex and patients with obesity (BMI>30 kg/m2) were more prevalent in the study group and the difference was statistically significant (P< 0,05). However, the incidence of CA was similar between all groups, there was no significant difference.
DISCUSSION AND CONCLUSION: Although obesity was more common in the OSAS group, the number of patients with CA or stenosis was similar in both groups. The findings suggest that well-known vascular risk factors and comorbidities may have a primary effect on atherogenesis, rather than a direct effect of OSAS.

INTRODUCTION: It is aimed to compare ultrasonographic intima media thickness (IMT) manual measurement and reading with automatic edge detection algorithms.
METHODS: Manually measured IMT (IMT-manual) and algorithm-measured IMT indices [IMT-maximum (IMT-max), IMT-mean (IMT-avg), IMT-minimum (IMT-min) and IMT-standard deviation (IMT-SD)] were compared in terms of repeatability and variability in recordings and measurements made by 2 different sonographers 3 days apart in 20 healthy controls. The ability of IMT indices to classify vascular risk factors was tested in 606 cases.
RESULTS: : Coefficient of Variation (CV) of IMT indices for "Repeatability" was in the range of 20-30% (acceptable level), except for IMT-SD. The concordance correlation coefficient (ρc) was below 0.9 (Suboptimal) for all IMT indices. Coefficient of Repeatability (CR) for each IMT parameter was over 100 microns. The CV for inter-operator aggrement was 19%-22% for IMT-max and IMT-min, while it was 22.6%-24.8% for IMT-manual. For all IMT methods, ρc was suboptimal (95% confidence intervals [CIs] ranged from 0.745 to 0.863). The mean CR was greater than 100 microns for each IMT index (199.9 for IMT-max, 132.2 for IMT mean, 168.7 for IMT-min, and 151.9 IMT-manual, in microns). The 95% CI lower limit of ROC-AUC of IMT indices was not above 0.6 for any risk factor category. All IMT indices generally tend to increase as the number of risk factors increases (Kendal tau, between 0.07-0.24).
DISCUSSION AND CONCLUSION: Manual IMT measurement techniques and automatic edge detection IMT algorithms have comparable repeatability, reproducibility, and potential for classifying vascular risk factors.

INTRODUCTION: The descriptive and cross-sectional study sought to examine the preparedness of caregivers giving care to 167 stroke patients in a state hospital in Zonguldak province in the west of Turkey for caregiving and the stress they perceive.
METHODS: The data was collected via the Personal Information Form, the Modified Barthel Index (MBI), the Preparedness for Caregiving Scale (PCS) and the Perceived Stress Scale (PSS).
RESULTS: The MBI score of the stroke patients was found to be 42.06±39.30, the PCS score of the caregivers was found to be 19.47±7.40 and the PSS score was found to be 26.07±9.14. The patient’s age and treatment time were statistically correlated with the mean PCS score in a negative direction (p<.05). The mean MBI score was statistically correlated with the mean PCS score in a positive direction; while the mean MBI score was statistically correlated with the mean PSS score in a negative direction (p<.05). The mean PCS score was significantly correlated with the mean PSS score in a negative direction (p<.05).
DISCUSSION AND CONCLUSION: The study determined that a number of variables such as the patient’s functional independency, age, place of hospitalization and caregiver’s affinity with patient, care experience and reasons for caregiving affect the preparedness of caregivers for caregiving and the stress they perceive. In order to increase the preparedness of caregivers for caregiving, it was recommended to give discharge training including other members of family concerning the course of disease, complications and management of care process.

Anastomoses between the carotid artery and vertebrobasilar system exist in the intrauterine period and are expected to close during embryogenesis. Rarely, it is observed that these arteries do not close in patients. There are 4 anastomoses described, these are: trigeminal, otic (acoustic), hypoglossal and proatlantal intersegmental arteries. Persistent arteries are often accompanied by hypoplasia of the posterior circulation or vertebral arteries. Since this condition causes changes in normal hemodynamic flow, aneurysms, ischemic cerebrovascular attacks, atherosclerosis, subarachnoid hemorrhage and arteriovenous malformations can be observed. In this case report, we present a patient diagnosed with acute ischemic cerebrovascular disease with persistent proatlantal intersegmentary artery on imaging.

Spontaneous recurrent extracranial internal carotid artery vasospasm is a rare event that causes ischemic stroke in young patients. Its pathophysiology has not yet been clearly elucidated. It is a dynamic process, recur and can be diagnosed by serial cerebrovascular imaging, otherwise it is confused with internal carotid artery dissection or stenosis. Although various treatments such as calcium channel blocker, antiaggregant, anticoagulant, steroid, endovascular interventional techniques have been tried in the cases reported in the literature, no clear treatment with proven benefits has been reported. In this article, we present a 25-year-old male patient who described episodes of hemiparesis, hemihypoesthesia, and speech impairment, diagnosed serial cerebrovascular imaging.

Cerebral amyloid angiopathy-related inflammation is a rare but increasingly recognized subtype of cerebral amyloid angiopathy with distinctive clinical and imaging findings. Proposed diagnostic criteria depending on clinical and magnetic resonance imaging characteristics have excellent diagnostic accuracy. Patients with cerebral amyloid angiopathy-related inflammation should be treated with corticosteroids and / or immunosuppressives. In this paper, we report two cases with typical characteristics of cerebral amyloid angiopathy-related inflammation.