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    Cerebral blood flow differences in cognitive disengagement syndrome and attention deficit hyperactivity disorder: Doppler ultrasonography findings
    (Pergamon-Elsevier Science Ltd, 2025) Karaman, Ahmet Kursat; Sarigedik, Enes; Eryilmaz, Osman Kamer; Kucukdag, Meltem; Naldemir, Ibrahim Feyyaz
    Objective: The present study aims to investigate potential differences in cerebral blood flow between children with Cognitive Disengagement Syndrome (CDS) and those with Attention Deficit Hyperactivity Disorder (ADHD) using Doppler ultrasound. Methods: In this single-center prospective study, we included 24 cases in the ADHD group with CDS symptoms, 29 cases in the ADHD group without CDS symptoms and, 26 children in the healthy controls. The children ranged in age from 6 to 15. Participants were evaluated by diagnostic interviews and standardized measures. Doppler ultrasound was performed to measure peak systolic velocity and blood flow volume (BFV) in the internal carotid (ICA) and vertebral arteries for each participant. Results: The right ICA and total ICA BFVs were significantly lower in the CDS group compared to the ADHD and control groups (p = 0.007 and p = 0.003, respectively). In addition, there was a weak negative correlation between right ICA BFV and CDS scores, suggesting a possible link between reduced cerebral blood flow and CDS symptom severity. Conclusion: This study provides a noteworthy starting point for research on the neurovascular basis of CDS. Our findings indicated significant differences in cerebral blood flow between CDS and ADHD, supporting the idea that CDS is a unique attentional disorder with distinct neurobiological characteristics from ADHD.
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    Evaluation of parenchymal collaterals in patients with meningioma using contrast-enhanced T1 MPRAGE sequence
    (Masson Editeur, 2025) Gozgec, Elif; Ogul, Hayri; Naldemir, Ibrahim Feyyaz; Sakci, Zakir; Kantarci, Mecit
    Background: Post-contrast T1-MPRAGE sequence has been used in routine tumor imaging at many centers for decades. Meningiomas may be accompanied by leptomeningeal as well as parenchymal collaterals. In this study, we aimed to demonstrate the collaterals that may accompany meningiomas on postcontrast T1-MPRAGE imaging and to investigate their relationship with location, size, histologic features, adjacent bone, and parenchymal changes. Methods: In this study, postcontrast T1-MPRAGE images of 326 meningiomas from 259 patients were independently analyzed by two observers. The presence of parenchymal collaterals and unilateral, contralateral or bilateral localization were determined. Meningiomas' diameters, locations, presence of dural sinus invasion, associated parenchymal changes and bony changes were determined. Histologic grades were determined if applicable. The data obtained were analyzed statistically. Results: Parenchymal collaterals were demonstrated in 25% of meningiomas (66/259). Of these, 65% were unilateral, 12% contralateral and 23% bilateral. There was a significant correlation between malignancy and the presence of collaterals in histologically diagnosed meningiomas (77%, p = 0.01). The presence of collaterals was also significantly higher in meningiomas with sinus invasion and bone destruction (p < 0.001). As tumor size increased, unilateral and bilateral collateral development increased (p < 0.001, p = 0.008, respectively), but it was not significant in contralateral cases. There was significant concordance between the observers in terms of the presence of collaterals (kappa: 0.773). Conclusions: Meningiomas may be accompanied by parenchymal collaterals. WHO grade 3 histologic type, sinus invasion, bone destruction and size increase are predictors of collateral development.
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    Evaluation of the Relationship Between Radial Artery Intima Media Thickness and Complications at the Intervention Site After Radial Angiography
    (Sage Publications Inc, 2024) Naldemir, Ibrahim Feyyaz; Karaman, Ahmet Kursat; Guclu, Derya; Ay, Esra Koc; Kayapinar, Osman; Kaya, Adnan; Sarigedik, Enes
    The present study investigated the relationship between pre-procedural radial intima-media thickness (rIMT) and radial artery thrombosis (RAO) in patients undergoing angiography using a transradial approach (TRA). Patients (n = 90) who underwent cerebral or peripheral arterial angiography using TRA were included in the study. Ultrasonographic evaluation was performed before and 12 h after the procedure. Preoperative rIMT measurement was performed at the distal radial artery. Presence of radial artery occlusion was evaluated by ultrasonography after radial catheterization and revealed occlusive thrombus in the radial artery in 13 patients. rIMT was found to be statistically significantly higher in patients with thrombus (P < .05). When it was evaluated whether there was a correlation between age and rIMT, a positive significant correlation was found (P < .01). Our study suggests that increase of rIMT may be a risk factor for RAO in the intervention area. Before the procedure, ultrasound (US) assessment of the radial artery may be useful in determining the risk of occlusion. Thus, RAO-related technical risk factors (procedure time, number of punctures, sheath thickness, etc.) can be managed more carefully in patients having radial angiography.
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    Radial Artery Thrombosis and Associated Risk Factors in Patients Undergoing Radial Coronary Angiography
    (Touch Medical Media Ltd, 2024) Koc, A. Y. Esra; Naldemir, Ibrahim Feyyaz; Ozde, Cem; Akture, Gulsah; Aytekin, Seda; Kayapinar, Osman; Karaca, Gurkan
    Background: Radial access is considered the preferred method for coronary angiography (CAG) and percutaneous coronary intervention. Radial artery thrombosis (RAT) stands out as the primary complication associated with trans- radial access. Our objective was to explore the occurrence of RAT and its associated risk factors. Method: A study encompassing 150 patients who underwent coronary interventions via radial access was conducted. Colour Doppler ultrasonography was used to assess proximal and distal radial flow rates 4-6 hours post- procedure. Patients diagnosed with RAT constituted the study group, while those without RAT were designated as controls. Results: Among the 150 patients, 20 (13.3%) developed RAT, with partial occlusions observed in 2.7% and total occlusions in 10.7%. Univariate analysis identified potential correlations between RAT and variables such as female gender, hypertension (HT), history of coronary artery disease, use of anti- thrombocyte medications, duration of compression, indication for CAG, haematocrit levels, neutrophil count, creatinine levels and estimated glomerular filtration rate. However, only HT showed a statistically significant association. Multivariate analysis confirmed HT, anti- thrombocyte drug use, duration of compression, haematocrit levels and creatinine levels as independent predictors of RAT. Conclusion: HT, anti- thrombocyte drug use, duration of compression, haematocrit levels and creatinine levels are identified as independent predictors of RAT. Standard pulse examination may not adequately detect RAT.
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    Using Smartphone to Evaluate Cranial Computed Tomography Videos: An Inter-Observer Study
    (Duzce Univ, Fac Medicine, 2022) Naldemir, Ibrahim Feyyaz; Karaman, Ahmet Kursat; Altinsoy, Hasan Baki; Bogan, Mustafa; Karadag, Mehmet
    Objective: Many clinicians receive Cranial Computed Tomography (CCT) images or videos by their smartphone. The aim of this study was to evaluate the reliability of the CCT videos that are shared through smartphone in the diagnosis. Methods: The CCT videos that were sent via WhatsApp were examined in 9 sections: soft tissue, bone structure, parenchyma, ventricle, vascular structures, middle ear, orbits, sinuses and the extra axial space. Results: The CCT videos were analyzed in 9 sections; there was a perfect agreement among specialists in one of these sections, good agreement in 6 and poor agreement in 2. When compared with the gold standard, it was shown that 5 out of 9 sections could be an alternative to the gold standard. Conclusions: It may be thought that evaluation of the CCT videos can be obtained with messenger applications such as WhatsApp, which is a cheap, fast and common application. But this study shows that diagnostic images and videos shared through the smartphone by a messenger application can not be an alternative to standard evaluations.
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    Visual assessment of cerebrospinal fluid flow dynamics using 3D T2-weighted SPACE sequence-based classification system
    (Sage Publications Ltd, 2024) Naldemir, Ibrahim Feyyaz; Karaman, Ahmet Kursat; Ogul, Hayri; Onbas, Omer
    Background: Flow-related signal void artifacts can be visualized on the T2-weighted (T2W) three-dimensional sampling perfection with application-optimized contrast (3D-SPACE) sequence. Flow void artifacts in the cerebral aqueduct and the fourth ventricle can provide information about cerebrospinal fluid (CSF) flow dynamics. Purpose: In this study, we aimed to test the performance of the T2W 3D-SPACE sequence in assessing the CSF flow in the aqueduct and/or fourth ventricle. Material and Methods: A total of 137 patients (age range = 3-89 years) who underwent CSF flow study were included. The amount of signal loss on T2W 3D-SPACE due to flow in the aqueduct and fourth ventricle was assessed and graded using a 4-point scale of 0 (absence of flow void) to 3 (signal void filling the aqueduct and entire fourth ventricle). A correlation was then sought between the quantitative values obtained by phase-contrast magnetic resonance imaging (PC-MRI) and the amount of signal void in the 3D-SPACE sequence. Results: At the aqueduct level, there was a statistically significant difference in the forward flow velocity and the flow volume among different grades (all P < 0.001). In the grade 3 group, CSF peak systolic flow velocity and mean flow volume were found to be significantly higher than in the other grades (P < 0.001). The mean aqueduct area in the grade 0 group was found to be significantly different from that in the other classes (P < 0.001). Conclusion: The amount of signal loss in the fourth ventricle observed on T2W 3D-SPACE is correlated with the peak systolic velocity and flow volume measured quantitatively in PC-MRI.