Headache is a common symptom of stroke. Although it is common, many factors such as risk factors, characteristics and pathophysiology have not been adequately investigated. Its underlying mechanisms and properties may vary at different times. Headache may be a nonspecific, insignificant headache, or it may be a symptom of a life-threatening cause that requires urgent diagnosis and treatment. In this review; We reviewed the relationship between headache and stroke In different time periods such as before stroke, during stroke and after stroke

INTRODUCTION: One major issue related to carotid artery revascularization procedures is their potential for inducing disturbances in blood brain barrier (BBB) permeability. The evaluation for sulcal contrast enhancement (SCE) on post-contrast fluid-attenuated inversion recovery (FLAIR) sequences is a commonly used approach to determine BBB integrity. In this study, we assessed the interplay between SCE, and clinical, perfusion and BBB permeability features in a series of patients undergoing carotid artery stenting, and also evaluated the topographic distribution of this phenomenon.
METHODS: Clinical information (including demographic data, cardiovascular risk factors, degree of stenosis, indication and timing of the procedure), together with pre- and immediate post- (<24 hours) procedural magnetic resonance imaging (MRI) data was prospectively collected in a consecutive series of patients. SCE was graded on post-contrast FLAIR sequences, and its relationship with hemodynamic (CBV, CBF, MTT) and parenchymal permeability (K-trans) changes was analyzed. Regions of contrast extravasation were semi-automatically outlined and co-registered to a standard template in order to determine the topography of SCE.
RESULTS: SCE on post-contrast FLAIR sequences was observed in 11 out of 42 patients (26%) prior to stenting, a feature that was independently related to a recent history (<30 days) of ischemic stroke (p=0.008) and lower degree of stenosis (p=0.014) in multivariate analyses. De novo or increased SCE following the procedure was seen in 22 patients (52%); increased permeability was primarily observed in the ipsilateral cortical watershed territories. No clinical or imaging features was predictive of SCE in the post-stenting period. The positive predictive value of de novo high-grade SCE for predicting post-procedural focal neurological symptoms was low [27% (95% CI, 17%-41%)].
DISCUSSION AND CONCLUSION: Our findings highlight that BBB dysfunction in the blood-CSF interface is a frequently common observation in the peri-stenting setting. Its relationship with perfusion, and BBB permeability alterations within the brain parenchyma itself, and its utility for predicting hyperperfusion syndrome is poor.

INTRODUCTION: Since 2015, endovascular therapy(ET) has become the standard treatment for patients with large vessel occlusion (LVO) in acute ischemic stroke (AIS). Recent studies have demonstrated the efficacy and safety of ET in selected patients such as onset time beyond six hours or with large infarct. However, the development of intracerebral hemorrhage (ICH) after mechanical thrombectomy (MT) represents one of the most significant complications. There is a currently insufficient data set on the risk factors associated with ICH after MT and its clinical significance. The aim of this study was to determine the significance and risk factors of ICH after ET for AIS.
METHODS: A comprehensive review of patients who underwent MT at Fýrat University Faculty of Medicine Stroke Center between 2021 and 2023 was performed. This review retrospectively scanned the files of these patients. The following variables were analysed: Admission NIHSS scores, ASPECT score, collateral status and whether intravenous thrombolysis (IV tPA) was administered. The time from the onset of symptoms to angiography, duration of MT, technique, number of thrombectomies, thrombectomy recanalisation rate, comorbidities, classification of hemorrhages and 3rd month mRS (Modified Rankin Scale) were analyzed retrospectively.
RESULTS: The results of the study indicated that 80 patients (65.6%) did not experience any ICH, while 42 patients (34.4%) did experience ICH in the 24 hour control brain computer tomography (CT.) Of the patients, 18 (14.75%) developed hemorrhagic infarct (HI); 18 (14.75%) parenchymal hematoma (PH); 6 (4.9%) subarachnoid hemorrhage(SAH) and no patient developed symptomatic intracranial hemorrhage(sICH). In the analyses, time interval from symptom onset to artery puncture, hypertension (HT) and diabetes mellitus (DM) were found to be statistically significant risk predictors.
DISCUSSION AND CONCLUSION: In our investigation, 68% of patients with HI exhibited a modified Rankin Scale (mRS) value greater than or equal to 3 at the three-month follow-up.Indicating that HI may not be a benign imaging finding. In patients who underwent bridging therapy with IV tPA and previously used antiplatelet and/or anticoagulant agents did not predispose to ICH significantly. A longer duration from symptom onset to puncture, HT and DM was found to increase the occurrence of ICH. Hemorrhage following ET was associated with a poor clinical outcome.

INTRODUCTION: Internal intracranial carotid artery(iICA) calcifications are an important risk factor for stroke.The aim of this study is to determine which clinical factors are associated with the medial and intimal calcification patterns of the iICA in patients with ischemic stroke and to determine the effect of these calcification patterns on clinical outcome.
METHODS: Our study was planned as a retrospective observational study.Patients with acute ischemic stroke who were hospitalized in our clinic within the last one year (August 2021-July 2022)were included in the study. Initial computed tomography(CT) and of all patients were evaluated by an experienced radiologist.In our study, patients were divided into three groups according to a recently developed and validated scoring method(a method that evaluates the roundness, structure, and morphology of calcification using a specific weight to determine whether the calcification is predominantly intimal(<7 points) or medial(≥7 points).Those without iICA calcification were included in groupI, those with intimal calcification were included in groupII, and those with medial calcification were included in group III.
RESULTS: Of the114patients, 44.7%(n=51)were female and the mean age of the patients was 63.08±13.94 years. According to the calcification pattern, it was determined as group I: 15.8%(n = 18), group II: 37.7%(n = 43), group III: 46.5%(n = 53).When demographic and clinical variables of the three groups were evaluated, significant differences were found between groupI and groupIII in terms of age(p<0.001), hypertension(p<0.001), diabetes(p<0.001) and hyperlipidemia(p=0.015).In the neurologic evaluation ofthe patients, no significant difference was found between group I and group III with the initial NIHSS scores, but a significant difference was found between the NIHSscores evaluated at the 1st month.
DISCUSSION AND CONCLUSION: The location of iICA calcification in the arterial wall affects the clinical outcome of stroke patients.The iICA calcification prevalance increase with age and can be reduced by treating modifiable risk factors such as hypertension, hyperlipidemia and diabetes.

INTRODUCTION: Public awareness of the modifiable risk factors in the etiology of stroke, the symptoms of stroke and what to do in a short time when stroke develops is one of the most important primary prevention measures to reduce negative consequences of the disease. One of the best ways to increase public awareness of stroke and explain its life-saving properties to the public is through public education. In this study, we aimed to measure the effectiveness of public education given to the healthy community in terms of stroke and the relatives of patients who had stroke in the acute or chronic period.
METHODS: The cross-sectional study was first divided into two main groups as training and control groups and the training group was analyzed as pretest-posttest group and the control group was divided into relatives of acute stroke patients and relatives of chronic stroke patients. The data of the training group were collected by the pre-test-post-test method applied to the participants within the "Stroke Awareness Meeting". In the first week following the meeting, the same questionnaire was applied to the relatives of the patients who applied to the stroke center and to the relatives of the patients who came for follow-up in the stroke outpatient clinic.
RESULTS: After the training, the participants' knowledge about what to do when stroke symptoms develop and their knowledge about the health institution where a person who has had a stroke will be taken first increased significantly. In the group of relatives of both patient groups, knowledge about the health institution where a person with a stroke would be taken first, knowledge about the ability of a person with a stroke to return to normal life and knowledge about the frequency of using blood thinners were significantly higher than the pre-training group. In the post-training group, the rates increased and the differences closed, and even the rate of knowledge in many parameters exceeded that of the patient relatives groups.
DISCUSSION AND CONCLUSION: Stroke is one of the most important public health problems because it is preventable, its harms can be reduced and it has negative health outcomes. Stroke is a very important and preventable health problem in our country with its aging population and the role of educational interventions in prevention and early intervention is important.

INTRODUCTION: Intima-media thickness [IMT] of the carotid artery determined by ultrasonography is used as a surrogate marker for vascular risk prediction and control. IMT thickness shows asymmetry between the carotid arteries on both sides, but the reason for this is not fully explained. This study targeted the relationship between hand- and eye-dominance and IMT asymmetry.
METHODS: : In 610 cases [56.2% female, mean age 64.5±9.9 years], the common carotid artery [CCA] IMT mean, maximum, minimum and standard deviation were measured on the right and left sides with automatic contour determination technology. CCA systolic and diastolic diameters were measured from M-mode traces. Hand dominance was determined by Chapman and Chapman, eye dominance was determined by standard punched paper test. Differences and relationships between parameters were examined in multiple regression models.
RESULTS: IMT-mean and IMT-maximum values were approximately 25 µm thinner on the left side compared to the right, and CCA systolic and diastolic diameters were 0.22 mm smaller (p<0.001). This relationship persisted after adjusting for age, DM, smoking, coronary artery disease, and female gender. No statistically significant relationship was found between hand and eye dominance and IMT indices in multiple regression analysis models.
DISCUSSION AND CONCLUSION: IMT asymmetry is a condition resulting from anatomy; eye or hand dominance has no apparent effect on it.

Takayasu arteritis (TA) is a form of large vessel vasculitis characterized by granulomatous inflammation of the vessel wall. It tends to be more prevalent at a younger age and among females. Stroke is a common complication of TA, occurring in 10-20% of cases. However, it is exceedingly rare for stroke to be the initial clinical manifestation. Here, we present three cases of stroke associated with TA. In the first case, a 16-year-old female patient presented with acute stroke symptoms and received thrombolytic treatment. Despite no prior medical history of disease, the patient was diagnosed with Takayasu through subsequent examination and imaging after the stroke. In the second case, a 45-year-old female patient, previously diagnosed with TA, presented with ischemic stroke. Vascular imaging revealed large vessel occlusion believed to be secondary to vasculitis. In the last case, an elderly female patient with TA and additional comorbid diseases experienced a stroke presentation. It is crucial to recognize that stroke can indeed be the initial clinical presentation of Takayasu arteritis. Therefore, clinicians must remain vigilant and consider the risk of stroke in the follow-up of TA patients, as it significantly impacts the disease's course and prognosis.

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a monogenic, hereditary cerebral small vessel disease characterized by leukoencephalopathy and lacunar infarctions. The clinical manifestations are lacunar stroke, stepwise and / or progressive neurological deterioration, vascular dementia, spondylosis and premature alopecia. Intracerebral hemorrhage has been reported in only a few patients to date. We report a patient with CARASIL and fatal cerebellar hemorrhage and discuss the safety and efficacy of antiplatelets in patients with hereditary cerebral small vessel disease.

Caroticocavernous fistula can present with proptosis, ocular humming, chemosis, visual disturbances, orbital pain and cranial nerve deficits. It is caused by an abnormal shunt between the carotid artery and the cavernous sinus. A 33-year-old woman presented with new onset of diplopia. Right eye outward gaze limitation was detected on examination and right caroticovernous fistula was observed on imaging and successfully treated endovascularly. Caroticocavernous fistula should be considered in the differential diagnosis because of her symptoms and examination findings. This case is presented because of the characteristic imaging findings.