Publications by authors named "Dogan Dinç Oge"

3 Publications

  • Page 1 of 1

Intracerebral hemorrhage volume estimation: Is modification of the ABC/2 formula necessary according to the hematoma shape?

Clin Neurol Neurosurg 2021 Jun 24;207:106779. Epub 2021 Jun 24.

HacettepeUniversity Hospitals, Neurology Department, Neurocritical Care and Stroke Units, Ankara, Turkey. Electronic address:

Objective: We studied the proposal to modify the ABC/2 formula to ABC/3 for irregular-shaped intracerebral hematoma (ICH) volume estimation.

Patients And Methods: The volume of 133 ICHs were estimated with Kwak's (simplified C; all slices with hemorrhage are considered equal), Kothari's (weighted C) and coronal (reformatted C; measuring C directly on coronal reformatted images) ABC/2 methods, and compared with computer-assisted planimetric measurements. The accuracy, precision and correlation of three ABC/2 methods and their ABC/3 modifications were determined in smooth (Barras' group 1 or 2) and irregular (Barras' group 3-5) shaped ICHs.

Results: As the hematoma size increases, the shape becomes irregular. In all hematomas, both smooth (n = 81) and irregular (n = 52) shaped, Kothari's ABC/2 formula provided the closest result to the planimetric measurement, with an underestimation of 1.77 mL, and 10.2% difference on average. Kothari's ABC/2 disclosed the best correlation (Lin's coefficient=0.9622) regardless of ICH shape. When simplified-ABC/2 method was modified as ABC/3, volume estimation accuracy increased (Correlation coefficient increased from 0.838 to 0.915) for irregular hematomas; however, despite this improvement the accuracy remained below the Kothari's ABC/2 (not ABC/3) method. Neither reformatted coronal ABC/2 nor its ABC/3 modification provided any advantage over ABC/x formulas with slice counting.

Conclusion: Kothari's ABC/2 method is a valid method for estimation of ICH volume for both regular and irregular shaped hematomas. Simplified (Kwak's) ABC/2 or coronal ABC/2, or their /3 counterparts do not provide additional advantage.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
June 2021

Stroke Mechanism in COVID-19 Infection: A Prospective Case-Control Study.

J Stroke Cerebrovasc Dis 2021 Aug 1;30(8):105919. Epub 2021 Jun 1.

Department of Neurology, Hacettepe University Hospitals Turkey.

Background: The characteristics and pathophysiological mechanisms involved in acute ischemic stroke in patients with COVID-19 infection have not been fully clarified. We prospectively studied the phenotypic and etiological features of acute stroke occurring in COVID-19 infection.

Patients & Methods: Within nine months starting from April-2020, the presence of COVID-19 infection was determined by thoracic CT and SARS-CoV-2 PCR in all acute stroke cases managed in a single tertiary center. Consecutive and prospective data on vascular risk factors/comorbidities, in-hospital quality metrics, discharge outcomes, etiological subclassification and blood markers of thrombosis / inflammation were compared in 44 COVID-19 positive cases (37 acute ischemic stroke, 5 TIA, 2 intracerebral hematoma) and 509 COVID-19 negative patients (355 ischemic, 105 TIA, 44 hematoma and 5 stroke mimic).

Results: COVID-19 positive patients had more severe strokes, delayed hospital admission, longer hospital stay, higher mortality rates, but had similar vascular risk factors/comorbidities frequency, thrombolysis/thrombectomy utilization rates, metrics, and stroke etiological subtype. They had significantly higher CRP, fibrinogen, ferritin, leukocyte count and lower lymphocyte count. No difference was detected in aPTT, INR, D-dimer, platelet, hemoglobin, homocysteine levels and ANA, anti-dsDNA antibody and ENA panel positivity rates. Anti-phospholipid antibodies have been studied in 70% of COVID-19 positive and all cryptogenic patients, but were never found positive. Tests for coagulation factor levels and hereditary thrombophilia did not show major thrombophilia in any of the stroke patients with COVID-19.

Conclusion: We documented that there is no significant difference in etiological spectrum in acute stroke patients with COVID-19 infection. In addition, cryptogenic stroke and antiphospholipid antibody positivity rates did not increase.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
August 2021

The dynamics of hematoma surface regularity and hematoma expansion in acute intracerebral hemorrhage.

J Clin Neurosci 2020 Apr 20;74:160-163. Epub 2020 Feb 20.

Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. Electronic address:

The clarification of factors that contribute to hematoma expansion in the setting of intracerebral hemorrhage (ICH) and the relevant physical dynamics are implemental for development of management strategies. Herein, we assessed the interplay between hematoma expansion and surface regularity of intracerebral bleeds. To do so, hematoma contours were outlined on admission and follow-up computed tomography (CT) studies using semi-automated thresholding algorithms in 133 ICH patients. Hematoma volume, surface area and surface regularity [SR=6√πvolumesurfacearea, ranging from 0 (very irregular surface) to 1 (perfectly regular surface suggestive of 3D spherical structure)] were determined by 3D Slicer software ( Hematoma growth was defined as ≥33% relative growth, or ≥ 6 mL absolute growth. Our results are as follows: The median (IQR) hematoma volume was 14.2 (6.0-34.9) mL on admission CT obtained 2.4 (1.5-4.4) hours after symptom onset; the mean ± SD SR value was calculated as 0.62 ± 0.14. Patients who underwent imaging at earlier time points were more likely to have higher SR (r = 0.18; p = 0.035). The median hematoma volume at follow-up, 35 (21-47) hours after the initial scan, was 19.7 (6.9-44.4) mL. The regularity index decreased significantly at this time point to 0.58 ± 0.13 (p < 0.001) and corresponding increase of surface irregularity was independent of change in hematoma volume. Baseline hematoma volume, INR, and time to initial imaging were significant predictors of hematoma expansion. In conclusion, our findings suggest that hematomas evolve into more irregular 3D shapes during follow-up. These observations are consistent with the 'domino' hypothesis put forward for ICH expansion.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
April 2020