There are various approaches applied in the therapies of aphasia, an acquired language disorder that develops due to a stroke or cerebrovascular accident (CVA). Within the framework of The International Classification of Functioning, Disability and Health (ICF), these approaches are classified as ‘impairment-based’ and ‘activity/participation-based’ approaches. The primary aim of this study, designed with a descriptive research model, is to provide a resource for speech and language pathologists working with individuals with aphasia by presenting research findings on the effectiveness of impairment-based approaches applied in aphasia therapies at national and international levels. In this regard, studies of impairment-based approaches to aphasia therapy conducted in the literature were included. The results of the studies were summarised and information was provided on the therapies' duration, frequency, and intensity, the type of aphasia for which they are suitable, the effectiveness of the therapies, and the gains achieved. The findings of the studies revealed that the impairment-based approaches discussed in this study were effective on individuals with both fluent and nonfluent aphasia with different severity levels. Each approach was found to produce gains in different language skills, such as increasing verbal output, naming, auditory comprehension, repetition, reading, and writing, depending on the area of focus

INTRODUCTION: This study aimed to evaluate the diagnostic and therapeutic challenges of posterior circulation stroke in the emergency department, identify clinical presentation patterns, laboratory findings, and factors associated with clinical outcomes.
METHODS: This single-center, retrospective observational study was conducted in collaboration with the Emergency Department and Department of Neurology at Eskiþehir Osmangazi University Hospital between 2019 and 2023. A total of 606 patients diagnosed with posterior circulation stroke were included. Clinical, laboratory, imaging, treatment data, time-to-hospital arrival, reperfusion therapies, and outcomes were analyzed.
RESULTS: The most common presenting symptoms were vertigo (38.6%), nausea/vomiting (35.5%), speech disturbance (32.2%), and altered mental status (28.9%). Only 13% of the patients received intravenous (IV) thrombolysis, and 7.8% underwent endovascular therapy. In the majority of 480 patients (77%) who could not receive treatment, late presentation (>4.5 hours) was detected. Advanced age, elevated glucose, creatinine, and BUN levels, as well as lower hemoglobin values, were found to be more frequent in the poor outcome group.
DISCUSSION AND CONCLUSION: Posterior circulation strokes pose significant challenges in emergency care due to their non-specific symptoms and delayed recognition. Enhancing clinical awareness, improving triage protocols, and refining diagnostic algorithms may facilitate early identification, timely treatment, and better outcomes for this underrecognized stroke subtype.

INTRODUCTION: Recurrent ischemic stroke is defined as a new event in a different vascular territory at least 24 hours after onset, or in the same territory at least 21 days later. These events challenge secondary prevention and are complicated by changes in etiologic subtypes over time. We aimed to analyze subtype evolution in recurrent ischemic stroke and its relationship with recurrence interval.
METHODS: This retrospective study included 94 patients with recurrent ischemic stroke. Clinical and radiological data were reviewed. Initial and recurrent subtypes were compared, and patients were categorized by lesion localization and recurrence interval. Associations were tested using chi-square methods, with McNemar’s test applied for paired comparisons of initial and recurrent TOAST subtypes.
RESULTS: Subtype reclassification occurred in 43 patients (45.7%). The most frequent change was from cryptogenic to cardioembolic or possible cardioembolic stroke (29.8%). McNemar’s test showed significant asymmetry, with 28 cryptogenic-to-cardioembolic reclassifications and none in the opposite direction (P<.001). Among initially cryptogenic patients, 63% recurred within the first year, mostly reclassified as cardioembolic. In the cardioembolic group, subtype consistency was 100%. Recurrence tended to occur earlier in this group, but without statistical significance (P =.629)
DISCUSSION AND CONCLUSION: Cryptogenic-to-cardioembolic reclassification was the most common pattern, indicating that many cryptogenic cases may conceal underlying cardioembolic mechanisms. These findings emphasize the need for long-term cardiac monitoring and periodic reassessment of etiology in recurrent ischemic stroke.

INTRODUCTION: To investigate the prognostic value of the C-reactive protein to high-density lipoprotein cholesterol (CRP/HDL-C) ratio, a composite marker reflecting both inflammation and lipid metabolism, in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).
METHODS: In this retrospective study, 206 consecutive AIS patients with large vessel occlusion who underwent MT between February 2023 and June 2025 were analyzed. Data including demographic, clinical, imaging, procedural, and laboratory parameters were obtained from medical records. Functional outcome was assessed at 90 days using the modified Rankin Scale (mRS), with mRS >2 defined as poor outcome. Univariate comparisons were made, and independent predictors were identified through multivariate logistic regression analysis.
RESULTS: The study population comprised 104 (50.5%) patients with good outcome (mRS ≤2) and 102 (49.5%) with poor outcome (mRS >2). The poor outcome group had significantly higher age, baseline NIHSS scores, longer puncture-to-recanalization times, lower ASPECTS, lower rates of successful recanalization (TICI 3), and required a higher number of passes. Laboratory analysis revealed that the poor outcome group had significantly elevated CRP levels (P=.02) and CRP/HDL-C ratios (P=.001). Multivariate analysis identified low ASPECTS (OR=0.26, 95% CI 0.09–0.72, P=.01) and high CRP/HDL-C ratio (OR=2.05, 95% CI 1.11–3.77, P=.02) as independent predictors of poor outcome.
DISCUSSION AND CONCLUSION: The CRP/HDL-C ratio is an independent predictor of 90-day functional outcome in AIS patients following MT. This simple and readily available biomarker may serve as a useful tool for risk stratification and clinical management.

INTRODUCTION: Stroke is one of the most prevalent neurological disorders and remains a leading cause of mortality and long-term disability. This study aimed to evaluate the self-reported prevalence of stroke in the population, the clinical characteristics of individuals with a history of stroke, as well as their access to healthcare services and functional status, using data from the Turkish Health Survey (THS) conducted by the Turkish Statistical Institute (TSI).
METHODS: Data from individuals aged 15 years and older were extracted from the THS conducted in 2014, 2016, 2019, and 2022. Information on stroke prevalence, stroke-related risk factors, post-stroke functional outcomes, and healthcare utilization was compared across survey years, age groups (15–50, 51–65, 66–80, and ≥81 years), and between sexes.
RESULTS: A total of 76,197 participants were included, with a mean age of 43.1 (±17.6) years; 53% were female. Across the four survey years, the self-reported prevalence of stroke in the population ranged between 0.8% and 1%. The median age of individuals reporting stroke was 63 years (interquartile range, 48– 73). Notably, 28% of stroke cases occurred before age 50, and 57% before age 65. Comorbidities such as diabetes (37%), hypertension (65%), kidney disease (26%), and depression (29%) were significantly more common among women (P=.009, P<.001, P=.004, and P=.02, respectively). Half of the individuals younger than 50 years reported not using prescribed medications in the preceding two weeks.
DISCUSSION AND CONCLUSION: Over time, no substantial decline has been observed in the prevalence of stroke. The persistently high prevalence of modifiable risk factors in the community is striking. Further epidemiological studies are warranted in this field, and the development of new and inclusive strategies for both primary and secondary stroke prevention is urgently needed.

INTRODUCTION: Moyamoya disease is a rare disorder with an unknown etiology, characterized by progressive vascular disorder of the supraclinoid intracranial arteries. While it can be found worldwide, Moyamoya disease has the highest prevalence in East Asia. RNF231 gene is frequently found in these patients however, the penetrance is low. The annual incidence of this disease is between 0.1 and 1.5 per 100000 people. In this study, our Moyamoya cases are discussed in comparison with findings from the current literature.
METHODS: Eight patients with Moyamoya vessels identified by digital subtraction angiography at the Interventional Neurology Angiography Unit of Samsun University Training and Research Hospital were retrospectively evaluated between January 2017 and January 2025.
RESULTS: Upon angiographic evaluation, Moyamoya disease diagnosis was made in 7 patients (3 male and 4 female) throughout the eight-year span. Furthermore, 1 patient with anti-phospholipid antibody disease was diagnosed with Moyamoya syndrome. The age range of these patients was between 32 and 60. 2 patients were asymptomatic. Among the patients, 3 had a history of hemorrhagic stroke only (One patient was observed with recurrence). Ischemic stroke was observed in 2 patients both with recurrence. 1 patient presented with a history of both ischemic and hemorrhagic stroke. 1 case had involvement of the posterior circulation and indirect bypass surgery was performed on two patients.
DISCUSSION AND CONCLUSION: Patients with stenosis and/or occlussion of unilateral or bilateral supraclinoid intracranial arteries should be evaluated for Moyamoya disease or syndrome by digital substraction angiography.

Stent infections are exceedingly unlikely, particularly in the internal carotid artery (ICA). The treatment for these patients is still under debate, with a high mortality rate. In this article, we report a 47-year-old male patient who underwent stent implantation in the right ICA and presented with infection and pseudoaneurysm at the stent site 15 days later. The patient was managed with antibiotics and dual antiplatelet therapy. Early antibiotic treatment can control stent infection in cases where the pseudoaneurysm does not continue to grow.

Hyperperfusion syndrome (HPS) is a rare complication of revascularization procedures performed for chronic stenosis of internal carotis artery, manifesting with a spectrum of clinical findings ranging from mild symptoms such as headache to severe neurological deficits. Here in, we present a case of HPS following carotid artery stenting. A 75-year-old male presented with significant symptomatic internal carotid artery (ICA) stenosis. Despite strict blood pressure control and maintenance of normotension following carotid artery stenting, delayed arterial filling was observed in the distal branches of the middle cerebral artery due to hyperperfusion. HPS can present a devastating course after carotid artery stenting. If not properly managed, it may lead to severe cerebral edema, intracerebral or subarachnoid hemorrhage, and death.