Dementia (dementia) Risk Assessment Program

The incidence of Alzheimer’s disease in society is increasing, while average life expectancy increases. The risk of catching this disease with the frequency of 10% at the age of 60 and 50% at the age of 80 makes each individual suffering from amnesia anxious. However, every forgetfulness condition does not lead to Alzheimer’s disease. Individuals who are only forgetful and maintain normal daily life are diagnosed with Minimal Cognitive Impairment (MCI) in other words Mild Cognitive Impairment (MCI). Said group catching Alzheimer’s disease in a higher percentage is a scientific fact. It is possible to investigate who carries higher risk factor. Research of high-risk patients will be held in this program, and rehabilitation and treatment for protection eill be arranged. Alzheimer’s disease is “unavoidable” but “can be postponed”.

Research Program

Routine history and Neurological examination, drawing out family tree if there is a family history

Laboratory Tests:

• Amyloid Beta 42 / Beta 40 ratio
• Determination of the APOE gene, determinations of the presenilin genes,
• Plasma lipid profile and thyroid function tests, B12 and folic acid levels
• Neuropsychological Tests: The cognitive test performance of individuals that has MCI diagnosis is lower. There are many tests used for diagnosis. The scores obtained from the test batteries, which lasts approximately 30 minutes, are important in determining the risk. Another important point is the scores obtained in these parameters showing a declining trend in 6 months follow-up examinations.The tests that we want to perform:
• Bender-Gesatalt
• Wais-Wechsler
• Memory for design
• Short cognitive examination scale
• Depression scales

An opinion regarding the risk of dementia will be presented to you after these tests are performed by evaluating all findings together.

In Individuals That Carry High Risk

• EEG (CORTICAL MAPPING)
• MRI (Amyloid imaging and volumetric examinations)
• PET imaing will be recommended.

Liv Hospital is committed to not sharing your test and evaluation results with 3rd parties without your consent in any way.

The risk of cerebrovascular disease increases in cases such as advanced age, hypertension, arteriosclerosis, ischemic heart disease, peripheral vascular disease, heart rhythm disorders, heart valve diseases, diseases increasing bleeding or obstruction trend, high cholesterol levels. Cerebrovascular diseases can manifest as bleeding or vascular occlusion in the brain. Those with this risk must have their regular follow-ups regarding related diseases performed; and not to disrupt their treatment, to minimize the risk factors, to pay attention to their diet, to make regular walks are recommended. Essentially, it can be summarized in this manner, preventive treatment is recommended; this approach can be made by related units as well as our unit. In patients experiencing pioneer symptoms of stroke, the causes should be revealed, tighter and more serious treatment and follow-up must be performed. The secondary protection measures are taken in those experiences stroke as well as trying to correct existing shortcomings and complaints.

Clot dissolver treatment applications in sudden occlusive stroke

Ischemic strokes constitute 80% of all strokes and can lead to the loss of related tissue, loss of different functions, paralysis or and death. tPA is used for the purpose of resolving such clots. The other stroke type is stroke with bleeding, so to say brain hemorrhage; tPA is not used in this type of stroke. Primarily bleeding is excluded with Brain CT or MRI imaging before administering tPA.

tPA is especially administered within 3 hours from the beginning of ischemic stroke attack and if there is no drawbacks to administration. The symptoms of stroke decrease or significantly improves in one of 3 patients if administered immediately. In a recent, large and controlled study, tPA administration through vein has been found useful in admissions within 3-4.5 hours

from the beginning of stroke; and ensured complete regression of symptoms in one of 14 patients.

Arterial tPA administration can be performed only in selected cases in the centers that are able to perform this fastly be in the presence of experienced practitioners for example, if a large vessel is occluded, neurological symptoms are severe, systemic administration (vein administration) carries drawbacks or admisson to emergency department is between 4.5-6 hours. Arterial tPA administration in such selected cases is included in the early stroke treatment guidelines due to being found beneficial.

Bleeding within the brain or anywhere in the body is the most important and most common risk of this treatment. bleeding may develop in 6 of 100 patients in the first 3 hours after tPA administration, and death or serious injury in the long term is observed in 1 of these. This risk is also similar in tPA administration within 3-4.5 hours.

tPA administration in some types of stroke can be performed if early admission is in question and the related center is equipped and experienced in this field after excluding various drawbacks.

Time & Place:

LIV Hospital – Council of Neurological Sciences is a multidisciplinary, scientific and social meeting where selected cases are discussed and Brain Check-up cases are evaluated. The meetings will commence on the 15th January, 2016 and will be held every friday between 14:00 – 16:00 at the B2 meeting room.

Content:

Interesting clinical and Neurological cases.
Non-diagnostic cases.
Cases to be decided upon (Treatment and examination strategies).
Multidisciplinary cases.
Incomplete cases.
Brain Check-up patients.

Departments:

LIV Hospital – Council of Neurological Sciences primarily aimes for the participation of; Neurology, Neuroradiology, Brain and Nerve Surgery, Endocrinology and Metabolism, Radiation Oncology, Medical Oncology, Radiology, Physiotherapy and Rehabilitation, Algology, Anesthesiology, Reanimation and ICU departments.

Notation & Recording

Every patient file discussed in the council will be recorded. The radiological examination which will be presented should be recorded in DICOM format on a CD, DVD or USB. RadiAnt software can be used fort his purpose.

Notice:

LIV Hospital– Council of Neurological Sciences announcements will be made via mailing system. Non staff participants will receive e-mails.