Background: The prognostic value of the neutrophil–lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline (p = 0.018) and 24 h (p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

Introduction: This study aims to delineate the prevalence, clinical characteristics, diagnostic findings, and treatment outcomes of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD) in a cohort over four years, providing a basis for improved diagnostic criteria and therapeutic strategies. Materials and Methods: In a retrospective cohort study at a tertiary care center, we analyzed medical records of 90 patients presenting with CNS demyelinating symptoms, focusing on those diagnosed with MOGAD based on the International MOGAD Panel criteria. Data on clinical presentation, serum Anti-MOG antibody testing, MRI, VEP scans, CSF analysis, and treatment outcomes were evaluated. Results: Among the cohort of 90 patients, 7 patients were identified with positive Anti-MOG antibodies, indicating a prevalence of 7.8%. Clinical manifestations varied widely, including optic neuritis, myelitis, and cerebral cortical encephalitis. Diagnostic findings highlighted the absence of oligoclonal bands in CSF analysis and diverse MRI lesions. Most patients responded well to immunosuppressive treatments, though relapses occurred in two cases. The study underscores the heterogeneity of MOGAD presentations and the importance of personalized treatment approaches. Conclusion: Our findings contribute to the growing understanding of MOGAD, emphasizing its distinct clinical and diagnostic features compared to other CNS demyelinating disorders. The study advocates for the integration of MOG antibody testing in clinical practice to enhance diagnostic accuracy and patient outcomes. Future research should aim at longitudinal and multicentric studies to validate our findings and further refine MOGAD management strategies.

Introduction: Carotid artery stenosis is the presence of 50% or more stenosis in the internal carotid artery (ICA) according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria and is one of the leading etiological factors of ischemic stroke. The severity of stenosis is associated with stroke risk. The prevalence of bilateral carotid artery stenosis (BCAS) varies. This study aims to evaluate the clinical outcomes and complications associated with carotid artery stenting in patients with BCAS or occlusion in a comprehensive stroke center.Methods: The data of patients who underwent carotid artery stenting (CAS) between January 2020 and September 2024 were scanned. The demographic data and comorbidities were noted from the patients’ files. Then, the patients were divided into two groups. The first group is “bilateral 50%–99% ICA stenosis” and the second group is “one side ICA occluded contralateral side ICA ≥50% stenosis”. Both groups were also listed as symptomatic and asymptomatic. Demographic and endovascular procedure data were analyzed.Results: A total of 82 patients were included in this study, 69 male (84.14%) and 13 female (15.85%). The mean age was 69.46 ± 7.24. Hypertension (HT) was the most common comorbid disease (69.51%). Sixty‐six patients (80.50%) were symptomatic and 16 (19.50%) were asymptomatic. TIA developed in one patient in the first group. Two minor (The National Institutes of Health Stroke Scale [NIHSS] 1–3) and two major strokes developed in the second group. Only three patients (two in the first group, one in the second group) underwent postdilatation balloon angioplasty.Conclusion: Endovascular treatment seems to be an acceptable strategy in comprehensive stroke centers where the possible complication risks can be well managed in this group of patients.

Wernicke encephalopathy (WE) is a serious acute neurological condition that is commonly associated with vitamin B1 (thiamine) deficiency due to alcohol abuse, albeit it can also occur in non-alcoholic settings. In cases of thiamine deficiency, a clinical diagnosis of WE is considered when two or more of the classic features—such as ophthalmoplegia, gait ataxia, and confusion—are present. A rare clinical manifestation of WE, including bilateral sixth cranial nerve palsy, ataxia, and pontine involvement on MRI, is described in this report. A 36-year-old male was admitted with complaints of diplopia for five days, along with a one-month history of hallucinations and insomnia. His medical history revealed chronic alcohol dependence, including recent consumption of homemade alcohol shortly before his complaints began. On neurological examination, bilateral restricted lateral gaze was observed. Axial T2-weighted MRI images of the brain showed a hyperintense lesion at the pontine midline. The patient was admitted with a preliminary diagnosis of WE and started on thiamine therapy at 500 mg/day for five days, followed by 200 mg/day and then 100 mg/day, each administered for an additional five days. During the early stages of WE, patients typically exhibit characteristic symptoms such as alterations in mental status, ophthalmoplegia, and ataxia. On T2-weighted MRI, Wernicke encephalopathy is indicated by hyperintense lesions in brain regions with high carbohydrate metabolism, particularly involving the ventral thalamus, hypothalamus, mammillary bodies, periaqueductal gray matter, and the floor of the fourth ventricle. This case has been presented to highlight a rare clinical presentation of Wernicke encephalopathy.

Giriş: Virchow-Robin boşlukları olarak bilinen perivasküler boşluklar, metabolik atıkları temizlemek için beyin omurilik sıvısı (BOS) ve interstiyel sıvının astrositik aquaporin 4 (AQP4) kanalları yoluyla değişimine izin vermektedir. Glimfatik sistemde bu perivasküler boşlukların mekanizmasında ortaya çıkan aksamalar, nörodejeneratif hastalıkların oluşum mekanizmalarından biri olarak gösterilmektedir. Bu yazımızda demansiyel süreç ile takip edilen, nörogörüntülemesinde genişlemiş Virchow-Robin boşlukları saptanan, nadir görülen bir olguyu sunmayı amaçladık. Olgu: Seksen yaşında kadın hastanın yaklaşık altı yıl önce başlayan ve giderek artan unutkanlık şikayetleri olduğu öğrenildi. Özgeçmişinde Alzheimer tipi demans ön tanısı olduğu öğrenildi. Nörolojik muayenesinde genel durum iyi, şuuru açık, koopereydi, kişi ve zaman dezoryanteydi. Toplam 30 puanlık mini mental test 13 puan saptandı. Kranial manyetik rezonan görüntüleme (MRG) de her iki serebral hamisferde yaygın perivasküler genişleme ve T2 hiperintensiteleri ve konveksite düzeyinde mikrohemoraji odakları izlendi. Dört yıl önce de çekilen kranial MRG da perivasküler genişlemeler izlendi. Serebral amiloid anjiopati ön tanısı ile interne edildi ve 1 mg/kg dan kortikoteroid tedavisi verildi. Kortikosteroid tedavisi ile semptomları gerilemeyen olgunun kranial MRG’si nöroradyoloji konseyinde Virchow-Robin boşluklarının genişlemeleri olarak değerlendirildi. Tartışma: Bu perivasküler boşlukların genişlemesi yüksek olasılıkla ileri yaş, hipertansiyon ve aterosklerotik karotis plakları gibi arteryel damarlardaki patolojiler ve nabızda izlenen dalgalanmalar ile açıklanmaya çalışılmıştır. Perivasküler boşluklardaki bu genişlemelerin daha çok bazal ganglionlar ve sentrum semiovalede görüldüğü bildirilmiş. Bizim olgumuzda ön planda amilod anjiopatide düşünülse de kortikosteroide tedavi yanıtı alınamamıştır. Nöroradyoloji konseyinde MRG lezyonlarının Virchow-Robin boşluklarının genişlemesi lehine değerlendirilmesi üzerine, bu perivasküler boşlukların genişlemelerinin demans riskinde artışa neden olabileceğini vurgulamak amacıyla sunuma değer görülmüştür.