Services are provided on a 24-hour basis in the Neurology Clinic, Neurology Service, Intensive Care and Emergency Service. All cerebrovascular diseases examinations and treatments are performed in our clinic. Our clinic is among the few centers that can perform clot dissolving (thrombolytic therapy) and interventional endovascular treatments in early cerebral vascular occlusions.
Areas of diagnosis and treatment
Cerebral vascular occlusion is a life-threatening brain disease caused by the blockage of one or more of the vessels leading to the brain. Fibrinolytic therapy (also known as thrombolytic therapy, t-PA) is a form of treatment applied to patients who have had cerebrovascular occlusion to dissolve the clot that forms in the vein and blocks the vein. Restoring the flow in the brain vessels by melting the clot with fibrinolytic therapy provides significant benefits to the patient in the early and late periods. Especially in life-threatening cerebrovascular occlusion, the application of this treatment within the first 4.5 hours after the onset of symptoms reduces disability in patients with paralysis. Opening the vessel with fibrinolytic therapy varies according to how early the patient applies, the characteristics of the patient and the size of the obstruction, but it reduces the disability due to stroke.
Ankara City Hospital Interventional Neurology Team serves in our Stroke Center. In cases of cerebrovascular occlusions, patients who are admitted to our hospital in the early period (up to 24 hours) are evaluated, and attempts are made to remove clots with angiography in appropriate patients. Clot clearance is performed with aspiration and / or recoverable stents in the vessel. By intervening in cervical vascular occlusions, the risk of paralysis (by stenting method) of patients is reduced. Patients with bubbles (aneurysm) and vascular ball (brain arteriovenous malformation-AVM) are treated by our 24/7 stroke team. The Interventional Neurology team, where current technologies are applied in the best way and serving with high-level medical devices in terms of technical equipment, has approximately 12 years of experience. All of the current treatments applied in the world are carried out in our hospital. Patients with stroke are followed up in the Stroke Outpatient Clinic. The appointment to the Stroke Polyclinic is given by the secretaries in the general neurology outpatient clinics. For patients who want to make an appointment from outside, internal phone number: 300210-300221
Epilepsy disease is defined as “epilepsy” among the people. It is a picture that occurs as a result of the sudden and excessive electrical activity of neurons in the brain. In attacks that start suddenly, sometimes individuals feel that these attacks may begin, and sometimes they can occur unexpectedly. In the periods between attacks, individuals are generally completely healthy. Different types of seizures can be seen. There may be seizures in which there is no contraction such as abstinence, freezing, feeling of fear, as well as sudden loss of consciousness, falling to the ground, continuous spasm of the arms and legs, foaming from the mouth, incontinence, locking in the teeth and bruising. As it can occur as a result of many diseases of the brain or in the presence of a genetic predisposition, the cause cannot be clearly defined in many patients. Epilepsy seizures should be observed very well by the relatives of the patient, because these observations are very important in informing the physician and during the diagnosis stages. Even today, thanks to the possibilities offered by technology, it will be very valuable data for the relatives of the patients to document their condition during the attack with phone video recordings and to present them to the relevant physician during the examination application. Epilepsy is diagnosed and treated by neurologists. Good results can be obtained with regular follow-up and treatment.
Multiple Sclerosis (MS)
Multiple sclerosis (MS) is a disease that progresses with the formation of multiple plaques in the brain and spinal cord as a result of a disorder in the person’s immune system. The symptoms of the disease emerge when the cells responsible for defending the body perceive the myelin sheath around the nerve cells as a foreign substance and try to destroy it in an unknown way. It is seen with a prevalence of 50-300 in every 100 thousand people. about 2.5 million in the world, it is estimated that about 50.000- 60.000 MS patients in Turkey. It is mostly a disease of young age and it is seen 3 times more in women than in men. These patients are usually diagnosed between the ages of 20 and 40. However, it is accepted that the onset of the disease occurs before the symptoms start. The diagnosis of the disease is rarely made under the age of 12 and above the age of 55. In MS, which can take any place of the brain and spinal cord, the symptoms of that region occur in any region. These symptoms last for a few days to a few weeks. Complaints such as blurred vision, double vision, numbness or weakness in one arm, ipsilateral arm and leg, or both legs, instability in walking, tremors in one or both hands, speech disorder, urinary incontinence or inability to do so are disorders that occur in MS. The diagnosis of the disease is made by magnetic resonance imaging in addition to history and detailed neurological examination. Supportive diagnostic tests such as VEP, SEP, Lumbar puncture can also be performed. MS treatment can be grouped in three main groups as treatment for attacks, treatments to stop the progression of the disease and treatment of symptoms. Many treatment options to stop the progression of the disease can be applied in our hospital.
Parkinson’s Disease and Other Movement Disorders
Parkinson’s Disease is a movement disorder disorder characterized by loss of brain cells and manifested by slowing movements and tremors as a result of dopamine deficiency. Although it is typically a disease of middle and old age, it can also be seen in younger ages. It is necessary to closely monitor the expected effects and possible side effects of the treatment, to review the doses with regular doctor visits, to adjust the dose if necessary, and to take measures against side effects in a timely manner. In our Movement Disorders Polyclinic, drug treatment of Parkinson’s patients is organized. Other diseases that cause parkinsonism are evaluated. Apart from Parkinson’s disease, patients with movement disorders with involuntary movements, tremor, dystonia (involuntary contraction), chorea (movements in a dancing style), ataxia (gait disorders) are also evaluated in our Movement Disorders Polyclinic.
Huntington’s Disease is a genetically transmitted disease that typically begins at the age of 30-50, affecting movement, behavior, and recall, in which nerve cells in the brain are destroyed over time. Patients mostly apply with involuntary movements. If there is an abnormal gene in either mother or father, the probability of the child being sick is 50%. It is thought that there are more Huntington’s patients in our country than expected. In our polyclinic, patients and their relatives are followed up, gene tests are performed after genetic counseling, and our patients are approached in a multidisciplinary manner with our psychiatrists.
Deep Brain Stimulation (Brain Battery Application)
As Parkinson’s disease progresses, oral medications may be insufficient, they may need to be taken more frequently or in higher doses, which may lead to increased side effects. If, despite all the adjustments, the slow periods of the patient reach more than 4-5 hours a day and involuntary movements reduce the quality of life, our patients are followed up in our Advanced Parkinson Polyclinic. These patients are candidates for device-assisted therapies. In our hospital, deep brain stimulation (brain pacemaker) is applied to patients who are suitable for surgery with neurosurgeons. Levodopa carbidopa intestinal gel (duodopa) can be applied to patients who are not suitable for surgery by opening an apomorphine pump or peg-j. Battery adjustment is made in our advanced Parkinson Polyclinic, and patients who have been applied apomorphine or duodopa pump are regularly followed up.
Neuromuscular disease means muscle-nerve disease. Diagnosis, treatment and follow-up of major nervous system involvement, which is called Myasthenia Gravis (MG) and other diseases involving the muscle-nerve junction, muscle diseases with genetic or later emergence, genetic or polyneuropathy that may occur due to various reasons later. Neuromuscular disease polyclinic It is performed in.
In the electrophysiology laboratory, electroencephalography (EEG) and electroneuromyography (ENMG) shots are performed by experienced faculty members.
It is a neurological examination based on the examination of electrical potentials of nerves and muscles and consists of nerve conduction studies and needle EMG. The nerves are stimulated with a low voltage electrical stimulus, and the activity of the muscles during both resting and voluntary muscle is examined with a sterile needle. Repetitive (sequential) nerve stimulation and Single fiber EMG (SFEMG) are other examinations that make it possible to evaluate the function of the nerve-muscle junction. In our laboratory, the anterior horn cells of the spinal cord (motor neuron diseases), nerve roots (lumbar and neck hernias), neural networks (congenital or ENMG examinations for traumatic injuries), nerves (facial paralysis, nerve compression and injuries, carpal tunnel syndrome and other entrapment neuropathies, polyneuropathy), nerve-muscle junction (myasthenia gravis) or muscle fiber involvement (myopathy). Evoked Potential (BAEP, SEP, VEP) examinations, which are defined as the electrical response of the nervous system, are also performed in our laboratory.
The method of recording the change of electrical potentials that occur slightly differently while stimulated by the activation methods with continuous rhythmic electrical potentials that occur spontaneously during the activities of the brain is called EEG. EEG provides information about the functional state of the brain rather than its structural functions. The main purpose of the EEG is to evaluate the electrical currents emanating from the brain cells. EEG allows you to see which brain region is emitting what type of distorted electricity. EEG can be used as a diagnostic method in the diagnosis of any disease that disrupts the electrical activity of the brain. It is an indispensable examination method in the diagnosis of epilepsy and determination of its types. Only electrical waves of the brain are recorded during the EEG. No electricity is given to the body. There is no radiation effect. It is a painless and harmless examination method. EEG can be performed in people of all ages.
Botulinum Toxin Injection
Botulinum toxin is used as a muscle relaxant drug in diseases such as dystonia that contract muscles involuntarily and uncontrolled. Although the duration of action of botulinum toxin varies from person to person, it can take 3-6 months depending on the person’s muscle use. As the number of applications increases, applications can generally be opened. Botulismus toxin treatment is individual. The application points and dose are adjusted according to the gender and the contraction force of the musc