There is increasing evidence that inflammation is involved in the mechanisms of acute ischemic stroke. The utility of neutrophil-to-lymphocyte ratio (NLR) has recently been reported to help in the prognostication of stroke. The utility of NLR in the diagnosis of stroke remains uncertain. In this retrospective study, patients with acute ischemic stroke who presented within the first 24 hours of symptom onset to our clinic from September to December 2019 were studied, involving 93 patients with stroke and 60 control. The mean age in the stroke group was 71.7 ± 12.2 years whereas it was 72.6 ± 5.7 in the control group (p=0.405). The female/male ratio was 47/46 in the stroke group and it was 26/34 in the control group (p=0.411). The NLR level was higher in patients with ischemic stroke as compared to control (p=0.029) whereas hemoglobin levels were lower in the patient group (p= 0.025). The ROC curve analysis revealed that a NLR cutoff point of 2.34 had 61.3 % sensitivity and 60% specificity in detecting patients with ischemic stroke. The regression analyses also revealed that the NLR and hemoglobin levels were predictors for stroke. In conclusion, NLR and hemoglobin may potentially be paraclinical markers in differential diagnosis of stroke.

OBJECTIVE: The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. METHODS: Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. RESULTS: The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (p<0.05). Catalase and superoxide dismutase levels of the kefir group were significantly higher than ischemia group (p<0.05). In histopathological samples, the kefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (p<0.05). In immunohistochemical staining, hipoxia-inducible factor-1alpha and caspase 3 immunopositive neurons were significantly decreased in kefir group compared with ischemia group (p<0.05). The neurological deficit scores of kefir group were significantly higher than ischemia group at 24 h (p<0.05). CONCLUSION: Our study revealed that kefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future.
Animals ; Aorta ; Caspase 3 ; Catalase ; Cultured Milk Products* ; Diet ; Humans ; Ischemia ; Malondialdehyde ; Neurons ; Neuroprotective Agents* ; Oxidative Stress ; Pathology ; Rats* ; Reperfusion Injury ; Spinal Cord Ischemia ; Spinal Cord* ; Superoxide Dismutase

Dural injury during spinal surgery can subsequently give rise to a remote cerebellar hemorrhage (RCH). Although the incidence of such injury is low, the resulting hemorrhage can be life threatening. The mechanism underlying the formation of the hemorrhage is not known, but it is mostly thought to develop after venous infarction. Cerebellar mutism (CM) is a frequent complication of posterior fossa operations in children, but it is rarely seen in adults. The development of CM after an RCH has not been described. We describe the case of a 65-year old female who lost cerebrospinal fluid after inadvertent opening of the dura during surgery. Computerized tomography performed when the patient became unable to speak revealed a bilateral cerebellar hemorrhage.
Adult ; Cerebellum ; Cerebrospinal Fluid ; Child ; Female ; Hemorrhage* ; Humans ; Incidence ; Infarction ; Mutism* ; Spine

Purpose: This study aimed to evaluate the radiation-induced adverse effects on ocular structures in head and neck cancer patients and investigate the radiation dose-volume effects on the cornea, lacrimal gland, retina, optic nerve and chiasm. Materials and Methods: A total of 38 eyes of 19 patients were included in this prospective, cohort study. All patients underwent complete ophthalmological examination in addition to contrast sensitivity, visual field and visual evoked potentials (VEP) tests. Ophthalmological examinations and psychophysical tests were performed in 6th, 12th, 18th, 24th months and in the last visit. The relationship between the ophthalmologic findings, and the radiation doses below and above the cut-off values was evaluated. Results: Contrast sensitivity decrease and visual field deterioration were observed in 42% of the patients in the last visit (median 26 months) whereas a prolonged latency and decreased amplitude of P100 wave in VEP was observed in 58% and 33% of the eyes, respectively at 24th month. Totally 16 patients (84.2%) developed dry eye disease and eight of them received radiotherapy below tolerance doses and had mild to moderate dry eye findings. Radiation-induced retinopathy was observed in three of the eyes in eight patients who received radiation above tolerance dose. Conclusion Head and neck cancers treated with radiotherapy, resulted in various ophthalmic complications. All patients who are treating with radiotherapy should be evaluated by an ophthalmologist in terms of anterior and posterior segment damage, even if the radiation dose is below the tolerance limit.

OBJECTIVES: This study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration. METHODS: A retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented. RESULTS: The study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasons CONCLUSION: The temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.
Endoscopy ; Female ; Humans ; Male ; Nasal Cavity ; Neoplasm Metastasis ; Orbit Evisceration ; Orbit* ; Recurrence ; Retrospective Studies ; Skin ; Surgical Flaps ; Tissue Donors