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Yayın Assessment of Patients with Intracerebral Hemorrhage or Hemorrhagic Transformation in the VENOST Study(Karger, 2021) Duman, Taşkın; Yayla, Vildan; Uluduz, Derya; Göksu, Eylem Özaydin; Yurekli, Vedat Ali; Genc, Hamit; Utku, UygarIntroduction: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. Materials and Methods: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. Results: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was >= 3 in 23.1% of the patients in the CH group. Discussion and Conclusion: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.Yayın Atopic disorders are more common in childhood migraine and correlated headache phenotype(WILEY-BLACKWELL, 2014) Ozge, Aynur; Oksuz, Nevra; Ayta, Semih; Uluduz, Derya; Yildirim, Veli; Toros, Fevziye; Tasdelen, BaharBackgroundThe supportive clinical and pathophysiological data about the correlation between migraine and atopic disorders are far from a coincidence. In order to determine and investigate the correlates of atopic disorders in a specific dataset, we performed this retrospective cross-sectional clinical-based study. MethodsThe dataset was composed from three tertiary center web-based databases (). Headache diagnosis and differential diagnosis were made according to the International Classification of Headache Disorders, 2nd version and the Diagnostic Statistical Manual of Mental Disorders, 5th edition. Migraine with aura, migraine without aura, chronic migraine and episodic and chronic tension type headache (TTH) patients were included. All other causes of headache disorders, including comorbid headache disorders like migraine plus TTH or possible causes of headache, were excluded. ResultsThe study included 438 patients with migraine and 357 patients with TTH, whose age and sex distribution were identical. After descriptive statistics accordingly, 80 migraine (18.2%) and 23 TTH (6.4%) patients were found to have specific atopic disorders (P < 0.001). Atopic disorders are more commonly reported in patients with migraine with aura (21.6%) than those with migraine without aura and TTH (P < 0.001). The most common atopic disorders were seasonal rhinitis, conjunctivitis and asthma. There was also a close correlation between TTH with atopic disorders and psychiatric comorbid disorders of the patients. ConclusionsAlthough the International Classification of Headache Disorders, 2nd version, does not specify, atopic disorders should be suspected in all migraine patients and their relatives, not only for accurate diagnosis but also for planning prophylactic medications, such as -blockers.Yayın Auditory Evoked Blink Reflex in Peripheral Facial Paresis(LIPPINCOTT WILLIAMS & WILKINS, 2015) Ayta, Semih; Sohtaoglu, Melis; Uluduz, Derya; Uygunoglu, Ugur; Tutuncu, Melih; Akalin, Mehmet Ali; Kiziltan, Meral E.Purpose:The auditory blink reflex (ABR) is a teleceptive reflex consisting of an early brief muscle contraction of the orbicularis oculi in response to sound stimuli. Constriction of the orbicularis oculi in response to auditory stimulation is accepted as a part of the startle reaction. The blink reflex and ABR might share a final common pathway, consisting of facial nerve nuclei and the facial nerve and may have common premotor neurons.Methods:In this study, the authors evaluated the value of the ABR in patients with peripheral facial palsy (PFP), cross-checking the results with commonly used blink reflex changes.Results:In total, 83 subjects with PFP and 34 age-matched healthy volunteers were included. Auditory blink reflex was elicited in all control subjects and in 36 PFP cases on the paralytic sides (43.3%), whereas it was asymmetric in 30.1% of the patients. Auditory blink reflex positivity was significantly lower in PFP cases with increasing severity. Blink reflex results were largely correlated with ABR positivity.Conclusions:Auditory blink reflex is a useful readily elicited and sensitive test in PFP cases, providing parallel results to blink reflex and being affected by disease severity.Yayın 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, UfukObjective 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).Yayın Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the VENOST Study(Elsevier, 2019) Duman, Taşkın; Demirci, Seden; Uluduz, Derya; Kozak, Hasan Hüseyin; Demir, Serkan; Misirli, Cemile Handan; Kucukoğlu, HayriyeAim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.Yayın 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, TaskinBackground. 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.Yayın 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, BijenPurpose: 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.Yayın Gender differences in older adults with chronic migraine in Turkey(WILEY, 2015) Ozge, Aynur; Uluduz, Derya; Selekler, Macit; Ozturk, Musa; Baykan, Betul; Cinar, Nilgun; Domac, Fusun M.; Zarifoglu, Mehmet; Inan, Levent E.; Akyol, Ali; Bolay, Hayrunnisa; Uzuner, Gulnur T.; Erdemoglu, Ali K.; Oksuz, Nevra; Temel, Gulhan O.Aim: Chronic migraine is a growing and disabling subtype of migraine with different risk factors and clinical features, even in older adults. We sought to define and differentiate clinical features of chronic migraine in older adults. We also aimed to compare major clinical features of chronic migraine in older adults with those in younger people of both sexes. Methods: We used electronic dataset (Turkish Headache Database) from 13 tertiary headache centers in Turkey. Electronic dataset included detailed headache-defining features according to ICHD-II criteria based on face-to-face interviews and examination by a headache specialist. Using statistical methods, clinical variables of chronic migraine in older adults were compared with those of younger adults. We included 915 patients with chronic migraine (mean age 43.80 +/- 13.95 years); 83.3% were females. In total, 301 patients (32.9%) with chronic migraine aged >50 years were compared with 614 patients aged <50 years. Results: There was no significant change in men with increasing age. However, duration of headache history, severity of attacks, previous histories of motion sickness and positive family history of headaches were significantly different in women with increasing age. Further sex-related differences have been shown in parameters such as attack duration, quality and associated nausea. Conclusion: Chronic migraine is an infrequent type of migraine and shows age-related changes in some phenotypic characteristics, such as severity of attacks, especially in women aged older than 50 years. Furthermore, positive family history of headaches and history of motion sickness increase the likelihood of developing chronic migraine in older women, indicating involvement of some gender-related, but as-yet unknown, genetic factors.Yayın Headache as the sole presenting symptom of cerebral venous sinuses thrombosis: Subgroup analysis of data from the VENOST study(Kare Publ, 2021) Duman, Taşkın; Çınar, Nilgün; Uluduz, Derya; Domac, Füsun Mayda; Özturk, Serefnur; Yayla, Vildan; Karahan, Ali YavuzObjectives: 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.Yayın 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, NevzatBackground: 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.
