Objective: Vasoneuronal coupling depends on integrity of neuronal function and vascular reactivity. We, therefore, assessed the blood flow velocity changes of bilateral posterior cerebral arleries by transcranial Doppler sonography in migraine patients to the visual stimulus during attack free period and control subjects.
Materials and methods: T\venty-five migraine patients and 25 control subjects were investigated. Transcranial Doppler sonography from the both posterior cerebral arteries \vere monitored during 10 cycles of 20 seconds eyes open observing and searching complex moving visual images, and 20 seconds eyes close to assess blood flov velocity changes on activated striate and extra striate visual cortical areas.
Results: Neither migraine patients nor control subjects had significant side to side differences considering the absolute blood flow velocities, relative deviation indexes and relative increase of blood flo,v velocities. Migraine patients showed lower reactivity to visual stimulus on both sides than control subjects. However, only relative deviation index (mean±SEM, %; 24.0±5.2 p=0.015) and relative increase of blood flow velocities (28.1±8.9 p=0.014) reached statistical difference on the right sides in the migraine patients with aura comparing to control subjects (38.0±2.2 and 47.8: 1: 3.1, relative Dl and relative increase of BFV respectively).
Conclusions: Dur results showed that, the migralne patients with aura had signiflcantly lower neuronal activity and/or vascular reactivity to higher-level visual stimuli than those of control subjects indicating that migraine patients with aura, but not without aura, have abnormal neuronal and vascular integrity even during headache-free period.

in the !ast 25 years, the most important therapeutic agent far the treatment of ischemic stroke and arteriosclerotic heart disease was aspirin (30-1200 mg/per day). Unfortunately, on follow-up only one fourth of the 40.000 patients with ischemic stroke had prophylactic benefit from the aspirin. Thereafter, ticlopidine has been developed asa new drug for the secondary prophylaxis of ischemic stroke, ischemic cardiac disease, and peripheric arterial disease. The most important side-effect of ticlopidine is on the hematologic system, because of that effect a new agent, clopidogrel, has been produced. The advantage of clopidogrel versus aspirin was shown in the CAPRIE, and we might expect new and hopeful future in the treatment of cerebral and cardiac ischemic disease.

lnternudear opthalmoplegia is characterised by ipsilateral adduction deficiency and contrlateral nystagmus asa result of medial longitýýdinal fasciculus lesion. it ýmýy develop due lo many causes. in th is study we present 10 cases (8 unilateral,2 bilaleral) of isolated involvemenl MLF due to ischemic lesions.

A case of progressive hemifacial atrophy, involving the right side of the face is presented. The patient had tonic clonic seizures. EEG showed slow wave paroxsisms and CT was normal. Ccrebral 99m Tc-1-Iexamethylpropylene amine oxime (HMPAO) SPECT revealed decreased cerebral perfusion on the contralateral parietal regions that suggests an underlying neurological disorder with \"ascular component. SPECT findings may give important clues to explain the etiology of this unknown disorder.

Cardiovasculary system diseases ha ve an important role in the etiology of ischemic cerebrovascular diseases. Total 208 patients (127 male, 81 female) who had been hospitalized at GAT A Neurology Deparlment were taken into the study. Of patients, 142 electrocardiograms (68.7 %), 133 carotis Doppler US (63.9 %), 113 Transthoracal echocardiography (TTE) and Transesophageal echocardiography (TEE) (54.3) were found pathologic. üne hundred sixty-eight palients (80.7 %) suffered hyperlension of these 168, 43 had left ventricular hypertrophy, 149 (71.6 %) had heart disease. 118 patients with heart disease (79.1 %) had hypertension. As a result, routine TTE, electrocardiogram, carotis Doppler US and if necessery TEE in ali patients with ischemic cerebrovascu!ar disease especially in the young ones and multifactorial approaches to the risk factors of ischemic cerebrovascular disease were thought to be effective in the prevention of ischemic cerebrovascular disease.

In our study, the TIA patients hospitalized in our service were followed dur:ing the tirsi week in order to investigate the risk factors fer stroke occurrence. in a series of 156 patients ( F/M: 63/93, median age 61±12 years) included in this study. 94 remained as TIA, whereas 62 of them had stroke during the first week. ln the TIA group having 94 patients F/M ratio was 42/52, the median age was 61.5±11 years, whereas F/M ralio was 21/41, the median age was 59.1±11 years in the stroke group having 62 patients. in the analysis of risk factors between TIA group and stroke group, cigarette smoking was detected asa ýnajor risk factor in stroke occurrence( p=0.02).

Carotid Ultrasonography has become widely available and is currently the principal noninvasive tool for evaluating carotid artery disease. In this study, we aimed to compare DUS results with DSA results in determining the degree of stenosis in symptomatic patienls presented with transient ischemic attack (TIA) or ischemic stroke. Fourty six patients with ischemic stroke or TIA of carotid distribution were identified for whom both OUS and DSA were available. Our results show that the reliability of carotid DUS in determining especially the severely stenosed and occluded vessels is quite high but not adequate enough to go to surgery without performing angiography.

Although pharmacotherapeutic studies of aphasia have been employed by variety of agents, results remain unsatisfactory. The purpose of this study is to determine the efficacy of lizuride, dopamine agonist, on nonfluent aphasia secondary to stroke. This study involved 50 patients (23 women-27 men, mean age ±SD: 54.1 ±10.99, a mean education :ý:SD: 6.2 ± 3.70) with nonfluent aphasia. Their aphasia severity rating was performed with a scale which are modified from Mayo clinic and the modified Bostan Diagnostic Aphasia Examination for Turkish citizen. Group l (40 patients) was given 0.6 mg/daily of lizuride per oral. Group Il (10 patients) was given no drugs considering as controls. All patients were followed up three months. Group I; It was found that verbal fluency and repetition improved in the first month, picture description and writing improved in 2nd month, copylng, answering to complex questions and confrontation improved in the 3 rd month significantly (p<0.05). Group II: It was found that verbal fluency improved in the 3rd month significantly (p<0.05). When the Group I and group II were compared to subtext of aphasia, improvement to verbal fluency was found more significantly high in the group I (p<0.005) Our results suggest that lizurid may be useful for improving subtexts of aphasia in nonfluent aphasic patients, espedally verbal fluency and repetition.

lýý this report. auýhors present their initýal experiencc with loca\ intraartcrial fibrinolytic thcrapy in acuýe cerebrovascular ocdusion. 9 patients have becn treaýed by loca! intraartcrial fibrinolysis. Following the placement of the microcathetcr into or adjacent to the thrombi, urokinase was infused. Thrombolysis was angiographically succcssful in 6 patienýs, showing completc rccanalization. üne patient died secondary to hemorrhage into the irýfarcted area. No or minimal neurologic defýcits were present in ali 6 patients with angiographically dcmoruýtrated rccanalization. Finaly, il is suggcstcd that local irýtraarterial fibrinolysis may be nn effective treatýnent in !he selected cases of acute cerebrovascular ocdusion, though, furýher detailcd studies are neccessry for finn condusions.