Browsing by Author "HAKYEMEZ, BAHATTİN"
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Publication A rare cause of epilepsy: Ulegyria revisited in a series of 10 patients(Sage Publications, 2021-09-17) Demir, Aylin Bican; Eser, Pınar; Bekar, Ahmet; Hakyemez, Bahattin; Bora, İbrahim; BİCAN DEMİR, AYLİN; Eser, Pınar; BEKAR, AHMET; HAKYEMEZ, BAHATTİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı/Epilepsi Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6739-8605; 0000-0003-0132-9927; 0000-0002-3425-0740; ABX-9081-2022; AAI-2073-2021; V-7170-2017; AAI-2318-2021; ENI-7759-2022Introduction. Ulegyria results from perinatal hypoxic-ischemic brain injury in term infants. The specific mushroom-shaped configuration of ulegyria results from small atrophic circumvolutions at the bottom of a sulcus underlying an intact gyral apex. Clinically, ulegyria is generally associated with epilepsy. Here, we aimed to delineate the characteristics of patients with ulegyria and the epileptic seizures they experience. Material and methods. Medical records including radiology and pathology reports, video-electroencephalographic (EEG) analysis, operative notes, hospital progress and outpatient clinic notes were reviewed retrospectively in a total of 10 ulegyria patients. Results. Patients ages ranged between 24 and 58 years (mean, 32 +/- 9.8 years). Past medical history was confirmed for neonatal asphyxia in 2 (20%). Neurological examination was remarkable for spastic hemiparesis in 1 (10%) patient with perisylvian ulegyria and for visual field deficits in 2 patients (20%) with occipital ulegyria. Ulegyria most commonly involved the temporoparietal region (n = 5, 50%) followed by the perisylvian area (n = 2, 20%). Except the one with bilateral perisylvian ulegyria, all patients had unilateral lesions (n = 9, 90%). Hippocampal sclerosis accompanied ulegyria in 2 patients (20%). All patients experienced epileptic seizures. Mean age at seizure onset was 8.8 +/- 5.4 years (range, 2-20 years). Interictal scalp EEG and EEG-video monitoring records demonstrated temporoparietal and frontotemporal activities in 5 (50%) and 2 (20%) patients, respectively. The seizures were successfully controlled by antiepileptic medication in 8 patients (n = 8, 80%). The remaining 2 patients (%20) with concomitant hippocampal sclerosis required microsurgical resection of the seizure foci due to medically resistant seizures. Discussion. Ulegyria is easily recognized with its unique magnetic resonance imaging characteristics and clinical presentation in the majority of cases. It is highly associated with either medically resistant or medically controllable epileptic seizures. The treatment strategy depends on the age at onset and extends of the lesion that has a significant impact on the severity of the clinical picture.Publication A rare cause of posterior reversible leukoencephalopathy after kidney transplantation(Frontiers Media Sa, 2019-10-01) Ersoy, Alparslan; Ersoy, Yavuz; Kır, Elif; Kaya, Ahmet; Oruç, Ayşegül; Akgür, Suat; Ünsal, Oktay; Hakyemez, Bahattin; ERSOY, ALPARSLAN; Kır, Elif; KAYA, AHMET TUFAN; ORUÇ, AYŞEGÜL; AKGÜR, SUAT; Ünsal, Oktay; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-9094-9735; 0000-0002-0342-9692; AAH-5054-2021; AAI-2318-2021; AAH-4002-2021; CZH-4661-2022; JYF-5512-2024; EJA-1761-2022; JJY-8484-2023Publication Analysis of predictive and preventive factors for access complications associated with vascular closure devices in complicated endovascular procedures(Springer, 2021-06-21) Gönen, Korcan Aysun; Hakyemez, Bahattin; Erdogan, Cuneyt; HAKYEMEZ, BAHATTİN; Erdoğan, Cüneyt; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; COE-1124-2022Purpose The main goal is to evaluate the effectiveness of angioseal and starclose vascular closure devices (VCDs) in high-risk patients under intensive anticoagulation who require therapeutic angiographic procedures and to discuss which factors are important in complications associated with VCDs. Materials and methods Medical records of the patients who underwent therapeutic complex interventional vascular procedures were reviewed retrospectively. One hundred sixty-six patients were divided into two groups regarding VCDs used for access-site closure after the procedure: group 1, (angioseal); group 2, (starclose). Data including patients' demographics and comorbidity information, procedural characteristics, and complications were analyzed. Results The device deployment success rate was 100%. For the procedural characteristics, there was no significant difference between the groups except access site (P = 0.016) and sheath size > 6F (P = 0.0001). No major complications had occurred in none of the patients. Minor complications including hematoma, access-site pain, and access-site infection, except prolonged hemostasis did not differ significantly between groups. The patients' demographic and periprocedural factors were not significantly correlated with the development of complications. Conclusion Contrary to published reports, our study showed that demographic and periprocedural factors may not be responsible for the vascular access-site complications associated with VCDs.Publication Association of brain volume and cognition in the chronic and episodic migraine patients(Sage Publications, 2013-06-01) Zarifoğlu, Mehmet; Şener, D. K.; Karlı, Nejdet; Hakyemez, Bahattin; Taşkapılıoğlu, Özlem; Özbek, Sevda Erer; Bakar, Mustafa; ZARİFOĞLU, MEHMET; Şener, D. K.; KARLI, HAMDİ NECDET; HAKYEMEZ, BAHATTİN; Taşkapılıoğlu, Özlem; ERER ÖZBEK, ÇİĞDEM SEVDA; BAKAR, HACI MUSTAFA; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Bölümü; 0000-0003-4436-3797; AAI-2318-2021; AAK-6623-2020; EHN-5825-2022; IOZ-7564-2023; CXD-7623-2022; DLN-1836-2022; EKN-8251-2022Publication Cadasil in the differential diagnosis of multiple sclerosis: Five case reports(Wiley, 2015-06-01) Taşkapılıoğlu, O.; Görükmez, O.; Uzun, Pınar; Atasay, G.; Hakyemez, Bahattin; Yakut, T.; Bakar, Mustafa; Uzun, Pınar; Atasay, G.; HAKYEMEZ, BAHATTİN; Yakut, T.; BAKAR, HACI MUSTAFA; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Radioloji Bölümü; 0000-0002-9241-0896; AAI-2318-2021; GIK-0439-2022; EML-7784-2022; GIS-1493-2022; EKN-8251-2022Publication Castleman's disease: Unilateral cervical involvement and imaging findings a case report(Sage Publications Inc, 2007-06-01) Atahan, S.; Hakyemez, B.; Doğan, Nurullah; HAKYEMEZ, BAHATTİN; Topal, N. B.; BOLCA TOPAL, NAİLE; Parlak, M.; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0003-1455-6918; AAI-2327-2021; AAI-2318-2021; AAG-8521-2021Castleman's disease is an idiopathic lymphoproliferative disorder characterized by massive enlargement of lymph nodes. It may have a unifocal or multifocal presentation; the mediastinum is the most common site (70%). Patients with cervical disease usually have unifocal involvement (90%). The main problem posed by cervical Castleman's disease is that it should be considered in the differential diagnosis of cervical tumors. This report describes a patient who had unifocal Castleman's disease on the left side of the neck, and discusses the differential diagnosis with findings on magnetic resonance imaging, computed tomography and ultrasonography.Publication Causes of ischemic stroke in patients with atrial fibrillation(Türk Nöroloji Derneği, 2020-12-01) Dinc, Yasemin; Bakar, Mustafa; Hakyemez, Bahattin; Dinç, Yasemin; DİNÇ, YASEMİN; Bakar, Mustafa; BAKAR, HACI MUSTAFA; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAI-2318-2021; IUQ-6999-2023Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1% of the adult population. However, ischemic strokes in patients with AF can be triggered by alternative mechanisms, especially in high-risk patients with additional vascular risk factors. In some patients, atherothrombotic mechanisms may cause stroke, and AF may be incidental or a symptom of atherosclerotic disease. In this case, it may be difficult to distinguish cardioembolic stroke from stroke due to large artery atherosclerosis. The aim of this study was to determine the causes of non-cardioembolic ischemic stroke in patients with non-valvular AF and to determine the risk factors for craniocervical atherosclerotic stenosis.Materials and Methods: This study identified risk factors for craniocervical atherosclerotic stenosis in patients followed up at the Uludag University Faculty of Medicine Department of Neurology with a diagnosis of ischemic stroke and non-valvular AF. In this study, 180 patients who were followed up with a diagnosis of non-valvular AF and acute ischemic stroke between January 1st, 2019 - March 1st 2020, in Uludag University Faculty of Medicine Department of Neurology, were retrospectively included.Results: In this study, the non-cardiac stroke rate was 20% in patients with non-valvular AF who had acute ischemic stroke. Ischemic stroke due to large vessel atherosclerosis was found in 14.4% of these patients, and 9.5% of all patients with AF were stented. When dermographic features, clinical features, and risk factors were analyzed for craniocervical atherosclerotic stenosis, a significant statistical result was obtained with male sex (p=0.020) and smoking (p<0.001).Conclusion: Stroke is a heterogeneous group of diseases caused by many complex mechanisms. Prevention of stroke recurrence is possible by starting effective treatment early. The presence of critical artery stenosis in a patient with acute ischemic stroke with AF causes stroke recurrence and this relapse cannot be prevented by anticoagulant treatment. Angiographic evidence also revealed ethnic and racial differences in patients with acute ischemic stroke. Therefore, more precise information can be obtained through prospective studies in our population.Publication Comparison of the effects of medical and surgical treatments in giant prolactinoma: A single-center experience(Springer, 2021-07-08) Hakyemez, Bahattin; Cander, Soner; CANDER, SONER; Oz Gul, Ozen; ÖZ GÜL, ÖZEN; Eylemer, Eda; Gunes, Elif; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Gullulu Boz, Elif; GÜLLÜLÜ BOZ, SAİDE ELİF; Yilmazlar, Selcuk; YILMAZLAR, SELÇUK; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAA-3274-2019Purpose Giant prolactinomas, which have extremely large sizes and high prolactin (PRL) values, are rarely seen. Although medical therapy is effective, surgical treatment is more frequently applied due to slightly lower response rates and compression symptoms. This study aimed to compare the medical and surgical treatment results in giant prolactinomas. Methods Thirty-nine patients who were followed up in our center for giant prolactinoma were included in the study, and the response rates of the patients were evaluated after the medical and surgical treatments. The treatment responses were compared in terms of tumor volume, PRL level, visual field, and pituitary function. Results The outcomes of the 66 treatment periods (medical n = 42; surgical n = 24) in 39 patients (mean age, 47.2 years; men, 89.7%) were evaluated. The most common presentations were hypogonadism and visual defects. The mean longest tumor diameter at diagnosis was 52.2 +/- 11.8 mm, and the median PRL levels were 5000 ng/mL. PRL level normalization was achieved in 69% with medical therapy, and a curative response was obtained in only two patients with surgery. Tumor volume reduction was 67% (no cure) in the medical and 75% (13% cure) in the surgical groups (p = 0.39). Improvement of visual field was 70.8% in the medical and 84.2% in the surgical group (p = 0.12). Conclusion In our study, it was observed that medical therapy was effective and safe in patients with giant prolactinomas. The use of surgical treatment should be limited to prolactinomas with compression or post-resistance to medical treatment in serious cases.Publication Demonstration of cephaloceles in patients with rhinorrhea: Single centre experience of intrathecal gadolinium enhanced MR cisternography(Briefland, 2020-01-01) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Yılmazlar, Selçuk; Hakyemez, Bahattin; BİLGİN, CEM; CANDAN, SELMAN; YILMAZLAR, SELÇUK; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; HHS-7433-2022; AAH-5070-2021; AAI-2318-2021; GVS-7682-2022Background: MR cisternography has the crucial role for diagnosis of cerebrospinal fluid (CSF) leakage in patients with rhinorrhea and otorrhea. Trauma is the major cause of rhinorrhea. Cephalocele is diagnosed in some rhinorrhea patients.Objectives: To evaluate the CSF leakage in patients with rhinorrhea and assess the frequency of cephalocele in the etiology of rhinorrhea.Patients and Methods: Intrathecal gadolinium enhanced MR cisternography and nonenhanced CT of paranasal sinus images of patients with suspected CSF rhinorrhea between October 2012 and September 2018 were evaluated retrospectively. Twenty-one patients with the diagnosis of contrast leakage causing rhinorrhea were included in the study. All patients had intrathecal gadolinium enhanced MR cisternography. Three dimensional (3D)-T1 weighted and 3D-fluid attenuated inversion recovery (FLAIR) head MRI was obtained after administration of 1 ml intrathecal gadoterate meglumine after half, 3, and 8 hours. Locations of contrast leakage and etiologies were analyzed.Results: Patient group consisted of 21 patients with persistent or intermittent rhinorrhea. CT imaging showed bone defect in all patients. Intrathecal gadolinium enhanced MR cisternography revealed CSF leakage (10 ethmoid, 10 sphenoid, and 1 frontal). Cephalocele was detected in 10 of 21 patients.Conclusion: MR cisternography with intrathecal gadolinium enhancement is an effective and safe imaging modality compared to other techniques used for diagnosis of CSF leakage. Accurate localization of CSF fistula and demonstration of herniating content from cranial bone defect is feasible with this technique.Publication Different cases, different manifestations of post-covid-19 retinal artery occlusion: A case series(Galenos Publ House, 2023-04-01) Yalçınbayır, Özgür; YALÇINBAYIR, ÖZGÜR; Gündüz, Gamze Uçan; UÇAN GÜNDÜZ, GAMZE; Coşkun, Funda; COŞKUN, NECMİYE FUNDA; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; DOĞANAY, SELİM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Oftalmloloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pulmoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-7311-5277; 0000-0002-5458-1686; 0000-0003-3604-8826; IYJ-9408-2023; AAD-1271-2019; AAH-6225-2021Coronavirus disease 2019 (COVID-19) is a procoagulant disease that increases the risk of clinically evident thrombotic complications. Herein we present 3 cases with different retinal artery occlusions that emerged soon after the diagnosis of COVID-19. The first patient had central retinal artery occlusion (CRAO) that resulted in visual loss in one eye. The second patient had inflammatory peripheral retinal artery occlusion, vasculitis, and uveitis which did not affect vision. The third patient presented with CRAO following the progression from orbital cellulitis to orbital apex syndrome. Interestingly, CRAO progressed to internal carotid artery occlusion in this case within days and resulted in monocular visual loss. Variations in the underlying pathophysiology and the characteristics of individual immune responses in patients with COVID-19 may be factors that determine differences in clinical manifestations. This article aims to describe different presentations of COVID-19-related retinal artery occlusions and discuss possible pathophysiological aspects.Publication Direct aspiration thrombectomy experience with the SOFIA 6F catheter in acute ischemic stroke(Springer, 2021-01-19) Bilgin, Cem; Durmuş, Yavuz; Haki, Cemile; Nas, Ömer Fatih; Hakyemez, Bahattin; NAS, ÖMER FATİH; HAKYEMEZ, BAHATTİN; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0002-3425-0740; AAG-8561-2021; AAI-2318-2021Introduction As the SOFIA (Soft torqueable catheter Optimized For Intracranial Access) 6F catheter has a large luminal diameter, it can be used as an aspiration catheter. Furthermore, it may function as an intermediate catheter when a stent retriever is required. Purpose We aimed to evaluate the usefulness of the SOFIA 6F catheter in mechanical thrombectomy with the direct aspiration first pass technique.Method Patients who had undergone mechanical thrombectomy (September 2017-January 2019) using the SOFIA 6F catheter in two centers were retrospectively analyzed. We used the thrombolysis in cerebral infarction (TICI) scale to evaluate the success of recanalization. National Institutes of Health Stroke Scale scores on admission and discharge were used together with the modified Rankin Scale (mRS) scores at 90 days.Results In 132 (89.1%) of the 148 cases, the thrombus was in the anterior system. The SOFIA 6F catheter reached the thrombus site in 130 (87.8%) cases. The rate of successful recanalization (TICI >= 2b) was 89.1%. The targeted clinical outcome (mRS score <= 2 at 90th days) was achieved in 49.3% of cases. Symptomatic intracranial hemorrhage occurred in 5.4%. The rate of emboli to new vascular territories was 5.4%. Mortality was 14.1%.Conclusion In the majority of our cases, the SOFIA 6F catheter provided effective and rapid recanalization with aspiration thrombectomy.Publication Dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging identifies glioblastoma immunohistochemical biomarkers via tumoral and peritumoral approach: A pilot study(Elsevier Science, 2019-04-09) Öztürk, Kerem; Soylu, Esra; Tolunay, Şahsine; Narter, Selin; Hakyemez, Bahattin; Özturk, Kerem; Soylu, Esra; TOLUNAY, ŞAHSİNE; NARTER, SELİN; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; AAI-2318-2021; E-1228-2018; AAI-1612-2021; DSW-1175-2022; FOL-7699-2022OBJECTIVE: We aimed to evaluate the usefulness of dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging (DCE-pMRI) to predict certain immunohistochemical (IHC) biomarkers of glioblastoma (GB) in this pilot study.METHODS: We retrospectively reviewed 36 patients (male/female, 25:11; mean age, 53 years; age range, 29-85 years) who had pretreatment DCE-pMRI with IHC analysis of their excised GBs. Regions of interest of the enhancing tumor (ER) and nonenhancing peritumoral region (NER) were used to calculate DCE-pMRI parameters of volume transfer constant, back flux constant, volume of the extravascular extracellular space, initial area under enhancement curve, and maximum slope. IHC biomarkers including Ki-67 labeling index, epidermal growth factor receptor (EGFR), oligodendrocyte transcription factor 2 (OLIG2), isocitrate dehydrogenase 1 (IDH1), and p53 mutation status were determined. The imaging metrics of GB with IHC markers were compared using the Kruskal-Wallis test and Spearman correlation analysis.RESULTS: Among 30 patients with available IDH1 status, 14 patients (46.6%) had IDH1 mutation. EGFR amplification was present in 24/36 (66.6%) patients. Mean Ki-67 labeling index was 29% (range, 1.5%-80%). p53 mutation was present in 20/36 GBs (55%), whereas OLIG2 expression was positive in 29/36 GBs (80.5%). Various DCE-pMRI parameters gathered from the ER and NER were significantly correlated with IDH1 mutation, EGFR amplification, and OLIG2 expression (P < 0.05). Ki-67 labeling index showed a strong positive correlation with initial area under enhancement curve (r = 0.619; P < 0.001).CONCLUSIONS: DCE-pMRI could determine surrogate IHC biomarkers in GB via tumoral and peritumoral approach, potential targets for individualized treatment protocols.Publication Effectiveness of percutaneous vertebroplasty in cases of vertebral metastases(Elsevier Masson, 2015-11-01) Nas, O. F.; İnecikli, M. F.; Kaçar, E.; Büyükkaya, R.; Özkaya, G.; Aydın, O.; Erdoğan, C.; Hakyemez, B.; NAS, ÖMER FATİH; ÖZKAYA, GÜVEN; Erdoğan, Cüneyt; HAKYEMEZ, BAHATTİN; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0002-3425-0740; AAG-8561-2021; COE-1124-2022; A-4421-2016; AAI-2318-2021Purpose and objectives: To assess the effectiveness of percutaneous vertebroplasty (PV) in patients with vertebral collapse due to metastases.Materials and methods: PV procedures performed on 95 vertebras in 52 patients with primary malignancy were retrospectively evaluated. Vertebral metastases, primary malignancies of the patients, pain before and after PV on a visual analogue scale (VAS), amount of polymethylmethacrylate (PMMA) cement applied to the vertebral body during PV, PMMA cement leakage and vertebral approaches were evaluated.Results: VAS scores of 43 patients (in total 79 vertebras) were evaluated. Median VAS scores of patients declined from 8 (4-10) before PV to 3 (0-7) within one day after the procedure, to 2 (0-9) one week after the procedure and eventually to 2 (0-9) 3 months after the procedure (p < 0.001). PMMA amount applied to the vertebral body during PV varied between 1.5-9 mL (average +/- SD 4.91 +/- 1.61). There was no significant statistical correlation between PMMA amounts and VAS scores within one day after, 1 week after and 3 months after the PV procedure (p > 0.05).Conclusion: PV is a simple, effective, reliable, easy to perform and minimally invasive procedure in patients with painful vertebral metastases.Publication Endovascular treatment modalities for basilar artery fenestration aneurysms: Experience of two centers and literature review(Tübitak Bilimsel ve Teknolojik Araştırma Kurumu, 2021-01-01) Korkmaz, Mehmet; Çınar, Celal; Nas, Ömer Fatih; Hakyemez, Bahattin; Oran, İsmail; NAS, ÖMER FATİH; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0002-3425-0740; AAI-2318-2021; AAG-8561-2021Background/aim: The aim of this study is to present our experience on various endovascular treatment modalities of basilar fenestration aneurysms and reviewing our findings together with literature data. Materials and methods: A total of 26 basilar artery fenestration (BAF) aneurysms in 24 patients were endovascularly treated in two different neurointerventional radiology clinics. All patients had been evaluated with computed tomography (CT), CT angiography, and digital subtraction angiography before the procedure. Results: Aneurysms of all patients were successfully occluded (technical success rate 100%). Procedure-related complications were seen in two patients. Our comprehensive literature research revealed that studies related with the topic are composed mostly of case reports. In the literature, a total of 113 BAF aneurysms of 101 patients had been treated endovascularly in 46 studies between 1993 and 2019. Success rate of the treatment was reported as 97%, clinical success rate as 91%, and complication rate as 8.8%, while these rates are 100%, 92%, and 7.6% in our study, respectively. Conclusion: Although the number of cases is low in our study, to our knowledge, it is the widest series in the literature until today. Our results demonstrate that BAF aneurysms can be treated successfully and safely with different endovascular techniques, with more stent use in recent years.Publication Evaluation of clinical, radiological, and demographic characteristics of juxtacortical hemorrhages in cerebral venous thrombosis(Türk Nöroloji Derneği, 2021-12-01) Dinç, Yasemin; Özpar, Rıfat; Bakar, Mustafa; Hakyemez, Bahattin; DİNÇ, YASEMİN; ÖZPAR, RİFAT; BAKAR, HACI MUSTAFA; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0001-6649-9287; 0000-0002-3425-0740; IUQ-6999-2023; AAH-5062-2021; EKN-8251-2022; AAI-2318-2021Objective: Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease. Intracranial hemorrhage may occur in 40% of the patients with CVT. The morphology of the intracranial hemorrhages ranges from small juxtacortical hemorrhages (JH) to large parenchymal hematomas. Although it has been suggested that JH is a characteristic of CVT, studies examining the relationship between JH and CVT are limited. In this study, it was aimed to determine the clinical, radiological, and demographic characteristics of JH in patients with CVT.Materials and Methods: In this study, a total of 157 patients who were followed up with the diagnosis of CVT between 2015 and 2021 were included retrospectively. Patients were categorized as, those with and without JH. Variables associated with JH were determined by comparing the demographic, clinical, and radiological characteristics, CVT etiologies and clinical outcomes of the patients.Results: When the clinical, demographic, and radiological characteristics of the patients with and without JH were compared; female gender (p=0.037), clinical initial symptom (0.003), early superior sagittal sinus (SSS) thrombosis (p<0.001), venous collateral scale (VCS) (p<0.001), being in the postpartum period (p=0.006), development of intracranial herniation (p<0.001), and poor clinical outcome (p<0.001) were significantly related with JH. When the significant variables were evaluated with the binary logistic regression, the most significant and independent variables were found to be SSS thrombosis (p=0.043), cortical vein thrombosis (CoVT) (p=0.010), and seizures after CVT (p=0.004). By contrast, no relationships were found between the groups in terms of VCS in binary logistic regression.Conclusion: Diagnosis of CVT is possible with high clinical suspicion and correct interpretation of radiological imaging. JH could be detected with non-contrast cranial computed tomography, which is the first imaging modality, and may cause the clinician to suspect from SSS thrombosis and CoVT. More precise results could be obtained with the prospective multicenter studies.Publication Evaluation of recurrent vertebral hydatid cyst with computed tomography myelography in a case with spinal instrumentation(Elsevier Science, 2015-11-01) Sanal, Bekir; Nas, Ömer Fatih; Büyükkaya, Ramazan; Hacıkurt, Kadir; Hakyemez, Bahattin; NAS, ÖMER FATİH; Hacıkurt, Kadir; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAG-8561-2021; AAI-2318-2021; EWW-9360-2022Publication Evaluation of risk factors associated with stroke recurrence in patients with minor ischemic stroke(Türk Nöroloji Derneği, 2022-03-01) Dinç, Yasemin; Akarsu, Emel Oğuz; Hakyemez, Bahattin; Bakar, Mustafa; DİNÇ, YASEMİN; OĞUZ AKARSU, EMEL; HAKYEMEZ, BAHATTİN; Bakar, Mustafa; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0002-3425-0740; IUQ-6999-2023; IZQ-0662-2023; IWC-9957-2023; AAI-2318-2021; EKN-8251-2022Objective: Recurrent ischemic stroke (RIS) is a major threat CO patients with IS. The risk of RIS in patients with minor IS (MIS) is 10-13% in the first 3 months. Despite the advanced examination and treatment of the patients, RIS is still common. It is important to know which risk factors cause RIS in order to rake some precautions. The aim of this study is to determine the risky group by determining the demographic, clinical and radiological features associated with RIS in patients with MIS.Materials and Methods: We included 310 patients diagnosed as having acute IS (AIS) by Bursa Uludag University Faculty of Medicine Department of Neurology between 01.01.2019 and 01.01.2020, retrospectively.Results: When clinical, radiological and dermogrophic features were analyzed between patients with and without RIS, there were statistically significant differences between groups in terms of the presence of coronary artery disease (CAD), atherosclerotic vascular disease, anterior circulation stroke, craniocervical atherosclerotic stenosis, atherosclerotic stenosis in the anterior circulation, atherosclerotic stenosis of the symptomatic internal carotid artery (ICA), atherosclerotic stenosis in the asymptomatic ICA and performing carotid artery scenting. When significant variables were analyzed by using binary logistic regression in patients with MIS, it was found that the most significant variables were CAD and asymptomatic ICA stenosis.Conclusion: In our study, the risk factors associated with RIS in patients with MIS were the presence of CAD and asymptomatic ICA stenosis. Atherosclerosis is a systemic disease and therefore craniocervical atherosclerotic stenosis may be multiple. Angiographic evidence has also revealed ethnic and racial differences in patients with AIS. For this reason, more precise information can be obtained with prospective studies to be conducted in our own population.Publication Flow diverter stents in the treatment of recanalized intracranial aneurysms(Sage Publications, 2021-01-02) Akgül, Erol; Onan, Hasan Bilen; İşlek, İrem; Tonge, Mehmet; Durmuş, Yavuz; Barbüroğlu, Mehmet; Azizova, Aynur; Erol, Cengiz; Hakyemez, Bahattin; Sencer, Serra; Aydın, Kubilay; Arat, Anıl; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740 ; AAI-2318-2021BackgroundWe assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly.Materials & MethodsPatients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients' demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded.ResultsEighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3-6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero.ConclusionThe drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.Publication Hemodynamic examination of brain aneurysm based on computational fluid dynamics (CFD) simulations(IEEE, 2015-01-01) Süslü, Barış; Olcay, Ali Bahadır; Hakyemez, Bahattin; IEEE; HAKYEMEZ, BAHATTİN; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Bölümü; 0000-0002-3425-0740; AAI-2318-2021Aneurysms that bulge on intracranial carotid arteries can be detected by using medical imaging technologies. Aneurysm, which is detected in this scope of study, is isolated from the rest of the arteries and vessel cloud with the help of Computer Aided Design (CAD) programme. Obtained geometry is transferred into Computational Fluid Dynamics (CFD) with applicable extension. Drop in pressure, velocity values (x, y, z plane) and wall shear stress (WWS) is recorded through the aneurysm and arteries which aneurysm initialize on. At the same time, this study gave us an opportunity to analyze parameters that affect aneurysm and its' around via visual way. We observed homogenous WWS distribution and consistent velocity values in our simulation outputs. In addition, change in pressure through the aneurysm was recorded. As a result, patient specific investigation of hemodynamics parameters in-vivo is a quite challenging problem so that image-based CFD is powerful and convenient tool to acquire mentioned parameters for the diagnosis and treatment procedure.Publication Identifying the risk factors of early neurological deterioration after thrombolysis in patients with acute ischemic stroke(Galenos Yayıncılık, 2022-09-01) Dinç, Yasemin; Özpar, Rıfat; Hakyemez, Bahattin; Bakar, Hacı Mustafa; DİNÇ, YASEMİN; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6649-9287; 0000-0003-0342-5939; 0000-0002-3425-0740; 0000-0001-5229-0001; IUQ-6999-2023; AAH-5062-2021; AAI-2318-2021; EKN-8251-2022Objective: The efficacy of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) therapy in the treatment of acute ischemic stroke (AIS) has been demonstrated in many studies and IV rt-PA therapy has been increasingly used all over the world. Early neurological deterioration (END) in AIS is common and potentially associated with a poor clinical outcome. The prevalence of END in AIS ranges from 13% to 37% in studies. The aim of this study is to determine the prevalence and risk factors of END in patients with AIS receiving IV rt-PA therapy. Materials and Methods: One hundred fifty seven patients who were given IV rt-PA treatment by Bursa Uludag University Faculty of Medicine, Department of Neurology between 01.01.2020 and 01.01.2021 were retrospectively included in this study. It was planned to determine the risk group by comparing patients with END with those without. Results: Age (p=0.023), serum glucose level (p=0.045), The National Institutes of Health Stroke score at discharge (p<0.01), Alberta Stroke Program Early CT (ASPECT) score (p<0.01) when clinical, radiological and demographic data associated with END were evaluated and, statistically significant correlation was found with the presence of major vessel occlusion (p=0.012), ischemic stroke due to cardioembolism (p=0.002), clinical outcome (p<0.001) and symptomatic intracerebral hemorrhage (p<0.001). When the significant variables associated with END were evaluated with binary logistic regression, the most significant variables were found to be age (p=0.006) and ASPECT score (p<0.001). Conclusion: The causes of END are multifactorial. The most associated risk factors were found to be advanced age and low ASPECT score. It was understood that the most common cause of END was the inability to perform mechanical thrombectomy for major vessel occlusion. Contrary to popular belief, the most common cause of END in patients with AIS who received IV rt-PA treatment was not considered to be symptomatic intracranial hemorrhage but to inadequate recanalization or late recanalization.